Here in ALVURA, we deal with all types of head and neck lesions
1. oral cavity lesions
1. oral submucosal fibrosis
It a premalignant condition due to chewing of betel nut, pan masala, gutka. It causes thickening and fibrosis of oral mucosa. Causes restriction of mouth opening. Long term can lead to squamous cell carcinoma of the oral cavity.
- betelnut. arecanut, gutka, pan masala
- spicy food, chillies
- nutritional deficiency , vitamin b deficiency
- alcohol in addition to tobacco.
we at ALVURA provide a range of non surgical and surgical treatment
Not to consume areca nut & other chronic irritant such as hot and spicy food.
Advice green leafy vegetables. Administration of Vit. A, B complex & high protein diet.
Administration of Antoxid OD for 6 – 8 weeks.
Administration of Lycored OD for 6-8 weeks
Physiotherapy: - It increase mouth opening.
- Steroids: submucosal intralesional injections given. The recommended dose is 75 to 100 mg twice a week for 4 to 6 weeks.
- Placental extracts: Sub mucosal administration of aqueous extract of healthy human PE (Placentrex) has shown marked improvement of the condition. recommended dose of placental extract is 2ml twice weekly for 4 to 6 weeks.
- Hyaluronidase: The use of topical hyaluronidase shows significant improvement than steroids alone. The recommended dose is 1500 i.u twice weekly for 4 to 6 weeks. IFN-gamma: administration of intralesional injection of IFN-gamma showed marked improvement of symptoms.
Surgical treatment is indicated in patients with severe conditions. These include
- Simple excision of the fibrous bands: Excision can result in contracture of the tissue and exacerbation of the condition.
- Split-thickness skin grafting following bilateral temporalis myotomy or coronoidectomy. Trismus associated with OSF may be due to changes in the temporalis tendon secondary to OSF; therefore, skin grafts may relieve.
2. Nasolabial flaps and lingual pedicle flaps
Surgery performed only in patients with OSF in whom the tongue is not involved
2. oral cavity lesions
canker sores. They are painful, temporary sores that may occur anywhere in the mouth
- Stress or trauma in the mouth, such as biting the tongue
- Certain foods (especially acidic foods, such as tomatoes and pineapples)
- Family history
- Changes in hormone levels
- Deficiencies of iron, vitamin B12, or folic acid
- Bacterial infections, such as stomach ulcers caused by the bacterium, Helicobacter pylori
- Certain inflammatory bowel disorders, such as Crohn’s disease or ulcerative colitis
- Infection with the AIDS virus
- Behcet’s disease
Aphthous ulcers have various sizes. They typically occur on the inner surface of the cheeks and lips, on the tongue, and the soft palate. Usually they are an open, shallow grayish sore with a slightly raised, yellowish-white border, surrounded by a red border.
Some people get aphthous ulcers two or three times per year. Others develop lesions continually one after another. Usually the most painful phase is the first 3-4 days, and then the sores begin to heal.
- Minor ulcers (the most common form)
- Less than one centimeter in diameter
- Usually last 7-14 days
- Heal without scarring
- Major ulcers
- Greater than one centimeter in diameter
- Last several weeks or even months
- Heal with scarring
It is especially important to examine mouth sores that do not heal within two weeks. They may be a sign of cancer.
Aphthous ulcers usually resolve on their own within 1-2 weeks. Treatments for aphthous ulcers are not usually necessary. However, treatment options for especially painful or persistent aphthous ulcers may include the following
- oral pain relieving gels
- oral antibiotic rinses
- a short course of steroid
Leukoplakia is a disease that develops in the mouth, and it's most commonly found in seniors. Researchers are still trying to pinpoint its direct cause, but current suspicions are that tobacco use is to blame. The disease manifests itself as white patches found throughout the mouth. In fact, no part of the mouth is safe! These patches may form on the tongue, gums, roof, and cheeks.
Dental issues, like dental work or ill-fitting dentures, excessive alcohol use, too much sun exposure, or use of tobacco products - especially chewing tobacco
Raised white rough patch, burning sensation. Can coexist with submucosal fibrosis
Mostly disappear with tobacco cessation. The one which do not disappear need excision and pathological evaluation. They have very low risk of carcinogenesis.
due to high risk of carcinogenesis they need to be evaluated and excision.
head and neck cancers
these are tumors arising in the head and neck region. They can be benign or malignant( spreading or non spreading)
There are 5 main types of head and neck cancer, each named according to the part of the body where they develop.
Laryngeal and hypopharyngeal cancer. : mostly are squamous cell carcinoma.
These 2 factors greatly increase the risk of developing laryngeal and hypopharyngeal cancer:
- Tobacco. Use of tobacco, including cigarettes, cigars, pipes, chewing tobacco, marijuana, and snuff, is the single largest risk factor for head and neck cancer. Eighty-five percent (85%) of head and neck cancer is linked to tobacco use. Secondhand smoke may also increase a person’s risk.
- Alcohol. Frequent and heavy consumption of alcohol increases the risk of both laryngeal and hypopharyngeal cancer. Using tobacco and alcohol together increases this risk even more.
- Gender. Men are 4 to 5 times more likely than women to develop laryngeal and hypopharyngeal cancer.
- Age. People over 55 are at higher risk, although younger people may also develop these types of cancer..
- Occupational inhalants. Exposure to asbestos, wood dust, paint fumes, and certain chemicals may increase a person’s risk of developing laryngeal and hypopharyngeal cancer.
- Poor nutrition. A diet low in vitamins A and E can raise a person’s risk of laryngeal and hypopharyngeal cancer. Foods that are rich in these vitamins may help prevent the disease, including eating fresh fruits and vegetables, although more research is needed.
- Plummer-Vinson syndrome. This rare condition involves iron deficiency and causes difficulty swallowing. The presence of this disease increases the risk of hypopharyngeal cancer.
- Poor oral hygiene.
- Gastroesophageal reflux disease (GERD).
- Hoarseness or other voice changes that do not go away within 2 weeks. This is often an early symptom.
- An enlarged lymph node or lump in the neck
- Airway obstruction, difficulty breathing, and noisy breathing
- Persistent sore throat or a feeling that something is caught in the throat
- Difficulty swallowing that does not go away
- Ear pain
- Chronic bad breath
- Unexplained weight loss
- proper physical examination of the oral cavity
- direct laryngoscopy and proper visualization of larynx
- biopsy from the suspicious lesion
Hoarsness more then three weeks should always be evaluated . it could be sign of laryngeal cancer.
There are 3 main treatment options for laryngeal and hypopharyngeal cancer: radiation therapy, surgery, and chemotherapy.
Early stages respond very well to surgery or radiotherapy
later stages require multiple modules
Nasal cavity and paranasal sinus cancer.
Oral and oropharyngeal cancer.