neoplasms of the oral cavity

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1、NeoplasmsoftheOralCavityAnatomyOralcavity:skin-vermilionjunctionofthelips.junctionofthehardandsoftpalate(above).thelineofthecircumvallatepapillae(below).lips,buccalmucosa,upperandloweralveolarridges,retromolartrigone,anteriortwo-thirdsoftongue,mouthfloor,hardpalate.AnatomyCheek:mucos

2、a,pharyngobuccalfascia,buccinatorfatpad,buccinatormuscle,subcutaneoustissue,skin.V2,V3.facialnervebuccinatormuscle.lymphaticsdrainparotidcompartment,levelII.AnatomyHardpalate:primarypalate(palatineprocessofthemaxilla).horizontalplateofpalatinebone.incisiveforaminanasalcavity.ptery

3、gopalatinefossaskullbase.posteriorhardpalatelevelIIorretropharyngeallymphnodes.primarypalatelevelIB.AnatomyAlveolarridge:buccalsuperior&inferioralveolarridgeslevelIA,IB.lingualaspectslevelII,lateralretropharyngealnodes.AnatomyRetromolartrigone:base:posteriormandibularalveolus(la

4、stmolar).apex:maxillarytuberosity.lateral:coronoidprocess.medial:anteriortonsillarpillar.ascendingramusofmandible(mandibularperiosteum).referredotalgia:V3,lesserpalatinenerve,glossopharyngealnerve.LevelII.AnatomyTongue:sulcusterminalis.anterior2/3:oralcavity.posterior1/3:oropharynx.h

5、yoglossus,styloglossus,genioglossus.V3(externalear,EAC,tympanicmembrane)otalgia.tipIA.lateral2/3IB,II.medialIII.tip&midlinebilateral.AnatomyFloorofthemouth:mandibularalveolus--oraltongue.anteriortonsillarpillar.Wharton’sductorifices(lingualfrenulum).sublingualglands(mylohyoidmus

6、cle,mandible,hyoglossus).lingualartery.V3.lymphaticdrain:superficial(bilateral),deep(ipsilateral).posterioripsilaterallevelII.Epidemiology&Etiology95%squamouscellcarcinoma.Timeofdiagnosis:95%>40y/o(60y/o).Incidence&mortalityratesdeclineslowly.5-yearsurvivalrateimprovedslightly(53.5%

7、58.7%).Tobacco(dose-dependent),alcohol.Continuedsmoking(curedoffirstprimaryca):40%recurrenceorsecondca.20yearstobacco-free≒nonsmoker.Epidemiology&EtiologyHPV.Type16:15-25%H&Nca.HPV-positivetumor:Youngerpatientswithlimitedornotobacco&alcohol.Poordifferentiation.Moreadvancedstage.Bett

8、eroverallsur