Surgical Treatment of Pathology

Question 0

How should a swelling be investigated?

Answer 0

1) Location
- anatomical striuctures involved?
- ascertain tissues of origin
2) Duration
- how long and has it changed over time?
3) Shape
- Sharply defined or diffuse?
4) COnsistency
- fluctuant/ soft/ firm/ bony hard
5) Associated pathology
3)

Question 1

How should pain be investigated?

Answer 1

1) Location - ask patient to point to it
2) Type - sharp, dull, continuous, throbbing etc…
3) Duration - how long has the patient had the pain?
4) Onset
5) Exarcebations?
6) Severity

Question 2

how should an ulcer be investigated?

Answer 2

1) Location - anatomical surface, strutcures involved
2) Duration
3) Size - diameter and depth
4) Shape
5) Edge of ulcer
- undermined/ punched out/ rolled/ raised, rolled and everted (characteristic of malignancy)
6) Floor of ulcer
7) Base of ulcer
8) Associated pathology
9) Similar ulcers elsewhere?

Question 3

How should a biossy be chosen?

Answer 3

If lesion small, can perform total excision
If larage lesion, incisional biopsy.
Thin deep sections preferable to superfical large sections and should contain some normal tissue.

Question 4

What are the surgical options to treat a patholgy?

Answer 4

1) OBserve - may be harmless and not a pathology
2) Reduce the size of the pathology
- for developmental or inflammatory lesions
3) Complete excision of abnormmal area
4) Resection - cut through normal tissue to remove pathology
SCC - 1cm
Ameloblastoma - 2cm
MMalignant melanoma - 3cm