Diseases of oral cav, nasoph and oroph

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Diseases of oral cav, nasoph and oroph

  1. 2. Diseases of the Oral Cavity, Oropharynx, and Nasopharynx Josefino G. Hernandez, MD Associate Professor and Vice Chairman, Dept of ORL, UP-PGH Associate Professor, Fatima College of Medicine Chairman, Dept of ENT, Asian Hospital and Medical Center Chairman, Philippine Academy of Rhinology
  2. 3. Oral Cavity
  3. 4. Floor of the Mouth
  4. 5. <ul><li>2. Pharynx </li></ul><ul><li>a. Nasopharynx: the free border of the soft palate divides the nasopharynx from the oropharynx </li></ul><ul><li>b. Oropharynx: a horizontal line at the level of the epiglottis separates the oropharynx from the hypopharynx </li></ul><ul><li>c. Hypopharynx </li></ul>
  5. 6. <ul><li> The posterior pharyngeal wall is continuous in all 3 divisions and consists of the fascia, muscle and mucosa overlying the base of the skull and the first 6 cervical vertebra. </li></ul>
  6. 8. Developmental Anomalies of the Face, Jaws and Mouth <ul><li>Oral Tori </li></ul><ul><li>1. Torus palatinus </li></ul><ul><li> nodular or lobular bony growth in the midline of the hard palate. </li></ul><ul><li> manifest beginning puberty, 25% of females and 15% of males. </li></ul>
  7. 9. Torus Palatinus
  8. 10. <ul><li>2. Torus mandibularis </li></ul><ul><li> single or multiple, unilateral or bilateral bony growths on the lingual aspect of the mandible in the region of the premolars. </li></ul><ul><li> become evident at puberty or later. </li></ul><ul><li> develops in 10% of the population. </li></ul>
  9. 11. Torus Mandibularis
  10. 12. <ul><li>Micrognathia </li></ul><ul><li>Diminution in size of jaw. May be congenital or acquired. Due to a failure at the growth center in the condyle. Mandibular micrognathia is usually an isolated polygenic trait but has been noted in association with craniofacial dysostosis, in acrocephalosyndactyly and in trisomy 21 (mongolism). </li></ul><ul><li>Prognathism </li></ul><ul><li>Enlargement or anterior placement of the lower jaw may be absolute or relative and is a multifactorial hereditary trait. </li></ul>
  11. 13. Macroglossia <ul><li> Most congenital cases are due to lymphangioma or hemangiolymphangioma. Cystic hygroma </li></ul><ul><li>may also be present. </li></ul>
  12. 14. Macroglossia
  13. 15. Hemangioma
  14. 16. Cavernous Lymphangioma
  15. 17. Median Rhomboid Glossitis <ul><li>It has been considered to be caused by embryonal failure of the tuberculum impar to submerge, that is, to be covered by the lateral lingual tubercles. It is characterized by a smooth to nodular, elevated or depressed area void of papillae,located just anterior to the circumvalate papillae. </li></ul>
  16. 18. Median Rhomboid Glossitis
  17. 19. Ankyloglossia <ul><li>Secondary to a congenitally short lingual frenulum. Frenulum could be clipped in infancy or Z-plasty could be performed to lengthen frenulum and produce more tongue mobility. </li></ul>
  18. 20. Ankyloglossia
  19. 21. Lingual Thyroid <ul><li>Embryonal failure of the thyroid gland to descend from the foramen cecum to the anterior neck. </li></ul>
  20. 22. Lingual Thyroid
  21. 23. Cleft Lip and Cleft Palate <ul><li>Combination of cleft lip and cleft palate comprises about 50% of the cases </li></ul><ul><li>Isolated cleft lip and cleft palate accounts for 25% each </li></ul><ul><li>Isolated cleft lip is bilateral in 20% </li></ul><ul><li>If unilateral, cleft is more common on the left side(70%) </li></ul>
  22. 24. Bifid Uvula
  23. 25. Treatment <ul><li>Cleft lip: </li></ul><ul><li>Cheiloplasty: Rule of 10 </li></ul><ul><li> Millard’s technique </li></ul><ul><li>Cleft Palate: </li></ul><ul><li>Palatoplasty: Before child learns to speak Von Langenbeck technique (bilateral relaxing incision) </li></ul><ul><li> V to Y technique </li></ul>
  24. 26. Cysts of the Jaws and Oral Floor <ul><li>Odontogenic cysts </li></ul><ul><li>Nonodontogenic cysts and fissural cysts </li></ul>
  25. 27. Odontogenic Cysts
  26. 28. Radicular Cyst Classification
  27. 29. Radicular Cyst with Oro-Cutaneous Fistula
  28. 30. Dentigerous Cyst, Maxilla
  29. 31. Dentigerous Cyst X-ray
  30. 35. Nonodontogenic Cysts <ul><li>Fissural cysts </li></ul><ul><li>Nasoalveolar cyst </li></ul><ul><li>Nasopalatine cyst </li></ul><ul><li>Globulomaxillary cyst </li></ul>
  31. 36. Nasoalveolar cyst (Klestadt’s cyst) <ul><li>Arises from the epithelial rests located at the junction of the globular, lateral nasal and maxillary processes. </li></ul>
  32. 37. Nasoalveolar Cyst
  33. 38. Nasoalveolar Cyst
  34. 39. Nasopalatine Cyst X-ray Coronal View Axial View Lateral
  35. 40. Nasopalatine Cyst
  36. 42. Dermoid Cyst, Upper Lip
  37. 43. Lip Mucocele
  38. 44. Ranula
  39. 45. Disorders of the Oral Mucosa
  40. 46. Black Hairy Tongue Elongation of the filiform papillae with overgrowth of pigment producing bacteria or fungi
  41. 47. Atrophic Glossitis (Smooth Tongue)
  42. 48. Scrotal Tongue
  43. 49. Stomatitis
  44. 50. Leukoplakia
  45. 51. Erythroplakia
  46. 52. Oral Candidiasis
  47. 53. Oral Candidiasis (Thrush)
  48. 54. Oral Tumors
  49. 55. Ameloblastoma, Mentum
  50. 56. Ameloblastoma, Mandible
  51. 57. Incision lines Tumor Defect
  52. 58. Clavicular Grafting Closure w/drains
  53. 59. SPECIMEN
  54. 60. Post-op 1 month 3 months 3 years
  55. 61. Cementifying Fibroma
  56. 62. Incision Lines Tumor Defect w/cheek flap
  57. 63. THIN SPLIT-THICKNESS SKIN GRAFT IS HARVESTED TO LINE THE INNER CHEEK FLAP
  58. 64. SPECIMEN CLOSURE
  59. 65. Palatal Defect 1 Week Post-op
  60. 66. Granuloma Pyogenicum
  61. 67. Fibromyxoma
  62. 68. Squamous cell Ca, Buccal Mucosa Ulcerative Type Leukoplakia Around the Ulcer
  63. 69. Squamous cell Ca, Tongue Exophytic Type
  64. 70. Palatal Carcinoma
  65. 71. Nasopharynx
  66. 73. Enlarged Adenoids
  67. 74. Juvenile Nasopharyngeal Angiofibroma Axial View Coronal View
  68. 76. Juvenile Nasopharyngeal Angiofibroma SPECIMEN
  69. 77. Oropharynx
  70. 79. Acute & Chronic Tonsillitis ACUTE CHRONIC
  71. 80. Peritonsillar Abscess
  72. 81. Unilateral Tonsillar Enlargement
  73. 82. Indications for Tonsillectomy <ul><li>Absolute </li></ul><ul><li>Hypertrophy resulting in cor pulmonale </li></ul><ul><li>Hypertrophy resulting in sleep apnea </li></ul><ul><li>Hypertrophy resulting in dysphagia with associated weight loss </li></ul><ul><li>Consideration of malignancy </li></ul><ul><li>Recurrent peritonsillar abscess or abscess extending into adjacent tissue spaces </li></ul>
  74. 83. <ul><li>Relative indication </li></ul><ul><li>Documented recurrent bouts of tonsillitis </li></ul><ul><li>Tonsil and adenoid hypertrophy associated with orofacial or dental abnormalities that narrow the upper airway </li></ul><ul><li>Rheumatic fever history with heart damage associated with chronic recurrent tonsillitis </li></ul>
  75. 84. Thank You

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