Management Of Malignant Salivary Gland Tumors Take note of the peculiarities
Management Of Malignant Salivary Gland Tumors Take note of the peculiarities
This slide is about secondary lymphoid organs. Majorly focusing on lymphnode, spleen and splenic circulation, tonsils, mucosal associated lymphoid tissue, appendix and their medical applications.
MBBS 2nd Year Pathology - Neoplasia : IntroductionNida Us Sahr
Chapter 7 (Neoplasia) from Robbins and Cotran Pathologic Basis of Disease (9th Edition) for MBBS 2nd Year.
After going through this presentation, it will be easy to understand Neoplasia from Robbins.
Esophagoscopy continues to be a reliable diagnostic and therapeutic tool with a wide variety of applications, including biopsy, dilatation of strictures, repair of Zenker's diverticulum, placement of stents, and retrieval of foreign bodies.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
4. Introduction
• Salivary gland tumours (SGTs) are part and
parcel of Head & Neck tumours.
• Different from other Head & Neck tumours in
several respects.
i. some seen no where else in the body.
ii.SCC,commonest Head & Neck tumours
extremely rare in salivary glands.
5. Introduction
Can occur at any site where salivary tissue is
found
Accurate pathologic diagnosis is key to the
management of these lesions
degree of aggressiveness depends on their
histological profiles
6. Epidemiology
Global annual incidence for all salivary gland
tumours
varies from 0.4-13.5 cases per 100,000
population
represent about 3% of all tumours.
2.5 per million in Norway; 7.5 in Sweden; 15 in
Caucasians living in the USA.
7. Epidemiology
Developing nations experience similar
incidence.
Approximately 80% of salivary gland tumours
are located in the parotid gland
10% in submandibular gland, and remainder
distributed among sublingual & minor salivary
glands(Snow,1979).
8. Epidemiology
In Nigeria, reports indicate more malignant than
benign SGTs.
Our study found the benign to malignant ratio was
1:2.3
With predominant involvement of major glands.
9. Epidemiology
Adoga A.S et-al in a 30-month (October 2005 – March
2008) retrospective review of Head and Heck
histopathologically confirmed cancer specimens;
found-
Thirty-two (41 %)cases confirmed histologically as
malignant Head and Neck tumours out of a total of
seventy-eight histologic specimens
Twenty three (23) males and 9 females(M:F= 2.6:1).
Mucoepidermoid carcinoma (6.3%)
10. Epidemiology
In the USA, salivary gland malignancies accounted for
6% of Head and Neck cancers,
and 0.3% of all malignancies
There is also some geographic variation in the
frequency of tumour types
12. Incidence of benign and malignant salivary neoplasms
according to the site of origin - Memorial Sloan-
Kettering
13. Epidemiology
There is no obvious gender variation, however there’s a
female preponderance in most tumour types.
average ages of patients with benign and malignant
tumours are 46 and 47 years, respectively, and
the peak incidence of most of the specific types is in the
sixth and seventh decades
Could also occur in children
16. Parotid Gland
An largely encapsulated gland located
lateral to the masseter muscle anteriorly and extends
posteriorly over the sternocleidomastoid muscle behind
the angle of the mandible
Laterally – dermis
Medially - lateral parapharyngeal space
Artificially divided into a superficial lobe and a deep
lobe by the branches of the seventh cranial nerve
17. Boundaries
Superior: External acoustic meatus, condyle of
mandible and zygomatic arch
Anterior: posterior border of the ramus of the
mandible and the muscles attached to it
Posterior: Mastoid process, sternocleidomastoid
muscle
Inferior: Posterior belly of digastric muscle
Medial: Styloid process
18. Parotid Gland
Almost purely serous, with an average weight of 25
grams
Its parenchyma is divided into lobules by fibrous septa
Has abundant intralobular and extralobular adipose
tissue (increases in relative volume with age)
Sebaceous glands are commonly seen,
either individually or in small groups
Has two layers of draining lymph nodes (range 1 to 20)
superficial layer lies beneath the capsule, and
deeper layer lies within the parotid parenchyma
19. Parotid Gland
Stensen duct:
courses anteriorly over the masseter muscle
pierces the buccinator muscle
enter through the buccal mucosa, usually opposite the
second maxillary molar
20. Submandibular Gland
Mixed; serous and mucous
Although the serous element predominates
(~90%).
In mixed acini the serous cells form caps, or
demilunes, on the periphery of the mucous cells.
Its intercalated ducts are shorter while the striated
ducts more conspicuous than those of the parotid
gland
21. Submandibular Gland
The second largest salivary glands, each weighing
approximately 10–15 grams
Divided into superficial and deep lobes by the
posterior edge of the mylohyoid muscle and
occupies the submandibular triangle
Wharton duct
courses anteriorly above the mylohyoid muscle
ends in the anterior floor of the mouth
22. Sublingual Gland
Mixed but predominantly mucous in type.
The mucous acini form elongated tubules with
peripheral serous demilunes
They’re paired and located in the submucosa,
superficial to the mylohyoid muscle.
Each gland is bounded:
laterally – inner cortex of the mandible and
medially by the styloglossus muscle; the paired glands
meet in the midline.
23. Sublingual Gland
Has multiple small or "minor" sublingual ducts,
referred to as the ducts of Rivinus, which open
directly into the oral cavity.
Some of these ducts unite to form the major ducts of
Bartholin.
These major ducts can also join the submandibular ducts.
The lingual nerve
descends laterally to the anterior end of the sublingual gland
runs along its inferior border
anteriorly, the lingual nerve and submandibular duct run
parallel until the lingual nerve ascends into the tongue
24.
25. Minor salivary glands
Most numerous at the junction of the hard and
soft palate, lips and buccal mucosa and most part
of aerodigestive tract
In the lateral aspects of the tongue, lips and
buccal mucosa are
seromucous
In the ventral tongue, palate, glossopharyngeal
area and retromolar pad
predominantly mucous.
26. Minor salivary glands
Those related to the circumvallate papillae
(von Ebner’s glands)
are serous
Are not encapsulated,
Those in the tongue and lip
can be deeply located in the musculature
27. Functional Unit
Consist of
the secretory acinus
related intercalated, striated and
excretory ducts,
myoepithelial cells
Acini may be
serous, mucous or mixed
Myoepithelial, or basket cells,
are contractile
located between the basement
membrane and the basal plasma
membrane of the acinar cells
also surround the intercalated ducts
28. Drainage pathway
both serous and mucous
cells are arranged into acini
drained by a series of
ducts—an intercalated duct
drains into a striated duct,
which
empties into an excretory
duct
32. Physiology
Production of Saliva
The production of saliva is an active process occurring
in 2 phases:
1)Primary secretion occurs in the acinar cells. This
results in a product similar in composition and
osmolality to plasma.
2)Ductal secretion results in a hypotonic salivary fluid.
It also results in decreased sodium and increased
potassium in the end product.
33. Physiology
Saliva is 99.5% water and otherwise proteins and
electrolytes.
Humans secrete about a liter of saliva per day.
Ca2+ concentration is twice as high in the
submandibular gland.
Gustatory and olfactory stimulation induce
predominantly parotid secretion.
Submandibular gland secretion has a higher mucin
content and a higher basal flow rate and is the
predominant unstimulated saliva.
34. Etiology
Not clearly understood but the following risk factors
have been implicated
- exposure to ionizing radiation
- smoking
- genetics; loss of alleles of chromosomes in 12q, 8q
and 17q
- ki-67 and p53
35. Etiology
Environment and Diet- deficiency of vitamin A,
industrial agents like nickel, cadmium, hair dyes,
silica, preservatives, wood dust
Infection- mumps, EBV and chronic sialadenitis
36. Theories
Bicellular reserve cell theory:
the origin of the various types of salivary neoplasms can be
traced to the basal cells “stem cell” of either the excretory
or the intercalated duct.
either of these two cells can act as a reserve cell with the
potential for differentiation into a variety of epithelial cells
Multicellular theory:
each type of neoplasm is thought to originate from a
distinctive cell type within the salivary gland unit
supported by the observation that all differentiated salivary
cell types retain the ability to undergo mitosis and
regenerate
41. Mucoepidermoid carcinoma
It is the most common malignant tumour of the
parotid gland
Common between 3rd and 8th decades of life( peak in
5th decade)
More common in female than male
Commoner in Caucasians
42. Mucoepidermoid carcinoma
Slow growing tumour but attaining large size
It could be high grade, intermediate grade or low grade
High grade is mainly epidermoid, rapidly enlarging,
with or without pain.
Regional and distant metastasis is common
43. Mucoepidermoid carcinoma
Low grade contains mucous cells mainly with regional
node spread
Gross pathology- well circumscribed to partially
encapsulated or unencapsulated, solid tumour with
cystic spaces
44.
45. Adenoid cystic carcinoma
Rare in parotid gland but overall second most common
malignancy
It is also called cylindromatous carcinoma
Equal male: female
Common in 5th decade
46. Adenoid cystic carcinoma
It is slow growing but highly malignant
It has high affinity for perineural spread
Clinical features may include; pain, paraesthesias,
facial weakness or paralysis
Spread to lungs, bones and liver
Histology- cribriform pattern, Swiss cheese
appearance
47.
48. Acinic cell tumour
Mainly occurs in the parotid glands
It is a low grade malignant tumour
It constitute 3% of all salivary gland tumours and 90%
occur in the parotid gland
Can involve facial nerve or neck nodes
Metastasis to lungs or vertebrae
Five year survival is 85%
50. Adenocarcinoma
Rare
5thto 8thdecades
F > M
Parotid and minor salivary glands
Presentation:–Enlarging mass–25% with pain or facial
weakness
53. Malignant mixed tumour
It has the worst prognosis
Types :
- carcinoma expleomorphic adenoma; it is the
commonest, most aggressive
- primary malignant mixed tumour
- metastasizing mixed tumour
- extensive infiltration and tissue destruction are
common.
55. Squamous cell carcinoma
Rare in the parotid
High grade tumour
Common in 6th – 7th decade
It is rapidly growing tumour associated with pain,
facial nerve palsy, skin fixity and ulceration
It has poor prognosis
5-year survival: 24% 10-year survival: 18%
Treatment is by radical parotidectomy + radiotherapy
56. Lymphoma
May develop in intraparotid lymph nodes.
On fine needle aspiration cytology, parotid
lymphomas are frequently confused with Warthin’s
In many cases, open or core biopsy is necessary to
arrive at the correct diagnosis.
59. Specific
Fine needle aspiration cytology
Ultrasonography
Computed Tomography
Magnetic Resonance Imaging
Frozen Section
60. TNM staging (Union for International
Cancer Control 2017)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor 2 cm or less in greatest dimension without gross
extraparenchymal extension
T2 Tumor more than 2 cm but not more than 4 cm in greatest
dimension without gross extraparenchymal extension
T3 Tumor more than 4 cm and/or tumor having gross
extraparenchymal extension
T4a Tumor invades skin, mandible, ear canal, and/or facial nerve
T4b Tumor invades skull base and/or pterygoid plates and/or encases
carotid artery
61. Regional lymph nodes
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest
dimension
N2a Metastasis in a single ipsilateral lymph node, more than 3 cm but
not more than 6 cm in greatest dimension
N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6
cm in greatest dimension
N2c Metastasis in bilateral or contralateral lymph nodes, none more
than 6 cm in greatest dimension
N3 Metastasis in a lymph node more than 6 cm in greatest dimension
63. Treatment
A)Surgery :
- total conservative parotidectomy( T1, T2 and T3)
- radical parotidectomy(t4); both superficial and deep
lobes, facial nerve, soft tissues with skin, mandibular
ramus and masseter muscle
- facial nerve reconstruction; greater auricular nerve/
sural nerve
64. Treatment
B) Radiotherapy:
- three to six weeks after surgery
- delayed for six weeks if nerve grafting done
- dose- 50- 70 gy( 1.5 – 2 gy in 5 days in 8 weeks)
C) Chemotherapy:
-5 fluorouracil
- cisplatin
- doxorubicin
- epirubicin
66. Prognosis
Variables such as histological subtype, grade, stage,
age, gender, pain, skin invasion and facial nerve
dysfunction, resection margins and comorbidity have
been identified as stastically significant prognostic
factors
67. Conclusion
Parotid gland tumours are the commonest(80%) of all
salivary gland tumours
They exhibit a diverse range of histological type and
clinical behaviour
Investigations are essential to help tailor appropriate
treatment and should include fine needle aspiration
cytology reported by an expert pathologist
68. Majority of these tumours will be treated by surgery,
the extent of which should be tailored to the size,
clinical and histological type of tumour
Facial nerve conservation should be considered if not
affected
Adjuvant radiotherapy should be considered in
malignant cases with adverse clinical or histological
features
Adequate follow up visits is essential for these patients
70. References
Eisele DW, Johns ME. Salivary Gland Neoplasms.Head
and Neck Surgery-Otolaryngology, Second Edition, ed.
Byron J. Bailey. Lippincott-Raven Publishers,
Philadelphia, PA 1998: 1485-1486.
Kontis TC, Johns Me. Anatomy and Physiology of the
Salivary Glands. Head and Neck Surgery-
Otolaryngology, Second Edition, ed. Byron J. Bailey.
Lippincott-Raven Publishers, Philadelphia, PA. 1998:
531-539.
Wilson J (ed). Effective Head and Neck Cancer
Management. Second Consensus. British Association
of Otolaryngologists, Head and Neck Surgeons, 2000.
71. Samuel A Adoga, E.N John, Simon J Yilkot, Onyekwere
Nwaorgu. The pattern of head and neck malignant
tumours in Jos; March 2010 DOI:
10.4314/hmrj.v8i1.52871
Brian J.G. Bingham, Maurice R. Hawthorne. “Synopsis
of Operative ENT Surgery.” (1992): 104-21.
Khalid, Imtiaz, Zakir, Beena. “Handbook of ENT
Surgery.” (2010): 167-85.
N.J Roland, R.D.R McRae, A.W McCombe. “Key topics
in Otolaryngology.” Second edition, 2006:159-161.