Cancer of the Face and Mouth

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THE problems of diagnosis and treatment of malignancies of the face and mouth differ from those encountered in the management of neoplasms elsewhere in the body. Early diagnosis is the rule rather than the exception, since face and mouth lesions are usually noticed by the patient early in their course, and readily found by the examining physician. Therapy is complicated by the facial features and functioning organs whose involvement and removal may produce major cosmetic and functional deformity. Despite these differences, the application of sound surgical principles is the basis of treatment; the initial lesion must be eradicated as early in the course of the disease as possible, with removal of regional sites of metastasis when indicated. The only limitation to radical therapy is the production of cosmetic or functional deformity incompatible with a reasonably satisfactory existence.

Two modes of treatment are available: irradiation and surgery. These should not be considered antagonistic since the size, location and radiosensitivity of a given lesion may demand the use of one or the other, or both, to offer the best possibility of cure. For example, irradiation in the form of interstitial radon or radium gives excellent results when used for most intraoral lesions which, in general, are highly radiosensitive. Surgical removal of the same lesions may be difficult and often less satisfactory. In the management of metastatic cancer in the neck, however, the value of irradiation remains unestablished, and surgery is the treatment of choice. Many lesions, particularly of the face, may be. . .



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