Includes most common tumors of oral cavity including scc,bcc, melanoma, ameloblastoma, odontoma, fibromas, pindborg tumors etc.
Presented by Dr. Binaya Subedi
Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. So here are slides containing information about salivary gland tumours with images.
Includes most common tumors of oral cavity including scc,bcc, melanoma, ameloblastoma, odontoma, fibromas, pindborg tumors etc.
Presented by Dr. Binaya Subedi
Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. So here are slides containing information about salivary gland tumours with images.
This PPT is mainly oriented towards Bailey & Love - Topic on Skin & Sub-cutaneous tissue. Few common diseases has been added. Very useful to Final yr. MBBS Students
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
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
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.
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
8. Salivary gland neoplasm
1. Major salivary gland
a. Parotid gland
b. Submandibular gland
c. Sublingual gland
2. Minor salivary gland
600 – 1,000 minor salivary gland distributed throughout
the mucosa of the upper aerodigestive tract (more
common in the soft and hard palate).
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9. 80% of salivary gland tumor occur in the parotid.
10 – 15% in the minor salivary gland.
5 – 10% in the submandibular gland.
80% of the parotid tumor are benign.
The most common is pleomorphic adenoma.
50% of the submandibular gland tumor are benign.
30% of the minor salivary gland are benign.
sumeryadav2004@gmail.com
10. Malignant disease of the parotid
Pathogenesis:
1. Reserve cell theory
(currently the favored
theory) of salivary gland
neoplasia states that salivary
neoplasms arise from
reserved (stem cells) of the
salivary duct system e.g.
adenoid cystic carcinoma
and acinic cell carcinoma
arising from intercalated
duct reserve cell. The
mucoepidermoid carcinoma,
squamous cell carcinoma,
and salivary duct carcinoma
arise from excretory reserve
cell.
Salivary gland unitsumeryadav2004@gmail.com
11. 2. Multicellular theory of
salivary gland neoplasia
states that salivary
neoplasm arise from
already differentiated
cells along the salivary
gland unit. For example,
squamous cell carcinoma
arises from the excretory
duct epithelium and
acinic cell carcinoma
arise from the acinar
cells.
Salivary gland unit
sumeryadav2004@gmail.com
12. What are the most common benign
tumor of the parotid?
1. Pleomorphic adenoma (benign mixed tumor).
2. Warthin’s tumor (papillary cyst adenoma
lypmhomatosum).
3. Monomorphic adenoma
a. Basal cell adenoma
b. Canalicular adenomas
c. Oncocytoma
d. Myoepitheliomas
4. Granular cell tumor
5. Hemangioma
sumeryadav2004@gmail.com
13. What are the most common malignant neoplasm of
the parotid gland?
1. Mucoepidermoid carcinoma – 40%
It can high, intermediate, and low-grade base on the
clinical behavior and the tumor differentiation which is
related to the percentage of mucinous to epidermoid cell.
2. Adenoid cystic carcinoma – 10%
Adenoid cystic carcinoma are unique among the salivary
gland tumors because of their indolent and protracted
clinical course.
Characterized by perineural spread including skip lesions.
The disease thus specific survival continuous to declined
for more than 20 years after initial treatment.sumeryadav2004@gmail.com
14. 3. Acinic cell carcinoma – 10 – 15 % of
It is considered a low-grade tumor.
4. Malignant mixed tumor - 7%
It is considered a high-grade malignancy.
5. Polymorphous low grade adenocarcinoma – 10%
It is a low-grade variant of adenocarcinoma.
6. Adeno carcinoma – 10%
It is a high-grade with poor prognosis.
7. Squamous cell carcinoma – 4%
It is high-grade, more common in elderly patients, and
can confused with high-grade mucoepidermoid
carcinoma. sumeryadav2004@gmail.com
15. The malignant parotid tumor can be classified
into:
1. High-grade: aggressive behavior, local invasion, and
lymph node metastasis.
- high grade mucoepidermoid carcinoma
- adenoid cystic carcinoma
- carcinoma ex phelomorphic adenoma
- adenocarcinoma
- aquamous cell carcinoma
- undifferentiated carcinoma
sumeryadav2004@gmail.com
17. Evaluation of patients with a parotid mass
1. History
Important points in the history:
- Parotid mass (duration, rate of the growth,
presence of pain)
- Facial paralysis
- Cervical lymphadenopathies
- Eyes and joints symptoms
- History of exposure to radiation
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18. 2. Examination
- Size of the mass
- Skin fixation
- Cervical adenopathies
- Facial nerve functions
- Raised ear lobule and retromandibular groove
obliteration
3. Investigation
C.T. and MRI are both effective modalities for imaging
the size, the local, and the regional extension of the
primary tumor and the neck metastasis.
C.T. saliography – it replaced now by high-resolution
contrasted C.T. and MRI.
sumeryadav2004@gmail.com
19. 4. FNAB
- The accuracy is around 90% depend on the
techniques of aspirate and the
cytopathologist.
5. Superficial parotidectomy is considered as a
diagnostic and therapeutic for most benign
tumors.
sumeryadav2004@gmail.com
20. Treatment
Surgery -Parotid
90%confined to superficial lobe - superficial parotidectomy
If adjacent to deep lobe - total parotidectomy
If invades adjacent soft tissue – radical parotidectomy
Never perform piecemeal excision in an attempt to preserve
facial nerve
Nerve grafting can be performed and RT can start3-4 wk
post op without adverse affects
syndrome – (gustatory sweating) due to redirection of
parasympathetic and sympathetic nerve fibers to the
dermal sweat glands sumeryadav2004@gmail.com
21. Indications of malignancy
Facial nerve involvement
Indurations / ulceration of skin , mucous membrane
Change in consistency
Fixity to muscles/ mandible
Lymph node metastasis
Rapid tumor growth
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25. Pleomorphic Adenoma
Mixed tumor
Consists of cartilage besides epithelial cells
Cartilage not of mesodermal origin
Derived from mucin secreted by epithelial cells
sumeryadav2004@gmail.com
39. The post-operative complications:
1. Skin flap necrosis
2. Hematoma
3. Salivary fistula and sialoseles – it presents as an
opening in the suture line below the lobule of the
ear.
4. Facial nerve paralysis – which could be:
a. Temporarily: 5 – 10% of the patients.
b. Permanent: less than 2% of the cases.
5. Numbness of the ear due to injury of great auricular
nerve. sumeryadav2004@gmail.com
40. 6. Xerostomia not common in the superficial
parotidectomy (30% of salivary producing tissue).
5. Frey’s syndrome (Gustatory sweating syndrome)
Incidence in 50% of the patients.
Etiology: post-operative growth of the interrupted
preganglionic parasympathetic nerve branches to
the parotid into the more superficial sweat glands.
The diagnosis is usually made from the history but
can be confirmed by the starch-iodine test.
sumeryadav2004@gmail.com
41. What is starch-iodine test?
Paint the affected skin with iodine, dust the
skin with the starch, feed the patient. The
appearance of bluish discoloration of the
overlying skin due to reaction of starch
and iodine in the presence of moisture
(sweat.
sumeryadav2004@gmail.com
42. How do you treat Frey’s syndrome?
Although frey’s syndrome is usually a minor problem, it
may require treatment which include:
1. Parasymphatholytic creams such as glycopyrrolate
lotion may also be applied to the skin or scopolamine
cream 3%.
2. Apply anti-perspirant to avoid sweating.
3. Jacobsen’s neurectomy via tympanotomy approach.
4. Elevating skin flap and placing tissue such as fascia,
dermis, or creating SCM muscle flap and if there is a
big defect you can use regional flap as a PMMF.
sumeryadav2004@gmail.com
43. Facial nerve paralysis
In parotid malignancy
a. Patient with clinically pre-op facial
nerve paralysis. What to do?
Intra-operative resection of the involved
part of the facial nerve and primary
grafting using greater auricular nerve or
sural nerve.
Post-operative radiotherapy (high-grade)
sumeryadav2004@gmail.com
44. b. Patient with a normal facial function
but intra-operative involvement of the
facial nerve. What to do?
Careful dissection of the tumor of the
facial nerve without sacrifying the facial
nerve and followed-up with radiotherapy
treatment.
sumeryadav2004@gmail.com
45. During an operation on the
parotid, where do you find
the facial nerve?
sumeryadav2004@gmail.com
46. 1. Tragal cartilage
(pointer) – always
point to the facial
nerve.
The facial nerve is
1 cm. inferior and
1 cm. medial to
the pointer.
sumeryadav2004@gmail.com
47. 2. Tympanomastoid
fissure – FN is 4
mm inferior to
the tympano
mastoid fissure as
it exit from the
stylo mastoid
foramen.
sumeryadav2004@gmail.com
48. 3. Posterior belly of
digastric muscle. The
facial nerve is superior
to the upper border of
the belly of the digastric
muscle.
sumeryadav2004@gmail.com
49. 4. Retrograde inferior
approach to the
facial nerve.
The lower branch of
the facial nerve
invariably can be
found immediately
external to the
posterior facial
vein as it exits the
lower pole of the
parotid gland.
sumeryadav2004@gmail.com
50. 5. Retrograde anterior
approach.
The parotid duct is
constant imposition
as it goes
horizontally across
the border of
masseter muscle.
It’s always
accompanied by a
branch of buccal or
zygomatic branch
within 1 cm. of the
duct.
Angle of
mandible
Parotid
duct
sumeryadav2004@gmail.com
51. Does the grading make
difference in management
of the parotid malignancy?
sumeryadav2004@gmail.com
52. Stage T N M
I T1 N0 M0
II T2 N0 M0
III T3 N0 M0
T1-3 N1 M0
IVA T1-3 N2 M0
T4a N0-2 M0
IVB T4b Any N M0
Any T N3 M0
IVC Any T Any N M1
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor < 2 cm, no extraparenchymal extension
T2 Tumor > 2 cm, < 4 cm, no extraparenchymal
extension
T3 Tumor > 4 cm or extraparenchymal extension
(or both)
T4aTumor invades skin, mandible, ear canal, facial
nerve, or any of these structures
NX Regional lymph nodes cannot be assessed
N0 No cervical nodes metastasis
N1 Single ipsilateral lymph node < 3 cm
N2a Single ipsilateral lymph node < 3 cm and <
6 cm
N2b Multiple ipsilateral lymph node
metastases, each < 6 cm
N2c Bilateral or contralateral lymph node
metastases, each < 6 cm
N3 Single or multiple lymph node metastases
< 6 cm
MX Distant metastases cannot be assessed
M0 No distant metastases
M1 Distant metastases present
Modified, with permission, from Greene FL,
Page DL, Fleming ID et al
(eds.):American Joint Committee on
Cancer: AJCC Cancer Staging Manual, 6th
ed. New York, Berlin, Heidelberg:
Springer-Verlag, 2002.
sumeryadav2004@gmail.com
53. Group 1: T1 and T2NO low-grade malignancy
Treatment is excision of the tumor with cuff of a
normal tissue.
Facial nerve is preserved.
Regional lymph node evaluated at the time of
surgery.
No post-op radio therapy unless the resection
margin is not clear.
sumeryadav2004@gmail.com
54. Group 2: T1 and T2NO high-grade malignancy
Treatment is total parotidectomy with excision of digastric
and submandibular nodes.
Facial nerve involvement:
a. patient with facial paralysis pre-operatively.
Resection of the facial nerve with primary grafting.
b. patient with normal facial function pre-op.
Resect the tumor of the facial and post-operative
wide field radiation.
sumeryadav2004@gmail.com
55. Group 3: T3NO or any N+ high-grade or
recurrent cancer.
Treatment is total parotidectomy
Modified radical neck dissection
Post-operative wide field radiotherapy
Facial nerve as in group 2
sumeryadav2004@gmail.com
56. Group 4: include all T4 tumor
Treatment is radical parotidectomy with modified
radical neck dissection and resection of
masseter muscle, part of the mandible or
mastoid or ear canal as required.
Resection of the facial nerve with the tumor and
primary grafting.
Followed by wide field post-operative
radiotheray. sumeryadav2004@gmail.com
57. Points to remember in parotid surgery:
1. Pre-op evaluation: general condition of the patient,
CBC, LFT and RFT, X RAYS , VIRAL
MARKERS, ECG
2. Consenting patients for possible facial weakness.
3. Operating in bloodless field by:
a. hypotensive technique
b. elevation of the head of the bed
c. delicate tissue handling
d. proper hemostasis
sumeryadav2004@gmail.com
58. 4. Using facial nerve monitoring during
operation and at the end of operation.
5. Exposure of the eye and the operative side of
the face.
6. Lazy S incision.
7. Landmark for the facial nerve.
8. Fasciovenus pane of patey.- facial nerve and
retromandibular vein forms it b/w superficial
and deep lobe.
sumeryadav2004@gmail.com
59. Indications of post-operative
radiotherapy
1. High-grade tumor
2. Gross or microscopic residual disease
3. Tumor involving or close to the facial nerve
4. Recurrent disease
5. Documented lymph node metastasis
6. Extraparotid extension
7. Deep lobe cancers
8. All T3 and T4 cancers
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