management of facial skin cancers

emphasis on the surgical approaches that offer safe andreliable outcome to management of condylar fractures.

References

Ellis EE, Dean J: Rigid fixation of mandibular condyle fractures. OralSurg Oral Med Oral Pathol 76:6, 1993

Le BT: A minimally invasive approach for open treatment of man-dibular condyle fractures. J Oral Maxillofac Surg 59:94, 2001 (suppl)

Sorel B: Open versus closed reduction of mandible fractures. OralMaxillofac Surg Clin North Am 10:541, 1998

S106Management of Salivary Gland DisordersBrian L. Schmidt, DDS, MD, PhD, San Francisco, CAR. Bryan Bell, DDS, MD, Portland, OR

The practicing oral and maxillofacial surgeon rou-tinely sees and is referred patients with salivary glanddisorders ranging from infections to neoplasms. Manage-ment of salivary gland disorders tests all of the oral andmaxillofacial surgeon’s clinical, diagnostic, and surgicalskills. The goal of this course is to review contemporarytechniques for diagnosing and managing salivary glanddisorders.

Salivary gland neoplasms vary widely in their presen-tation and clinical behavior. A clear understanding oftumor behavior, imaging, and presurgical planning arefundamental for successful management of salivary glandneoplasms. The histologic types, incidence, and manage-ment of minor and major salivary gland neoplasms, bothbenign and malignant, will be reviewed in this course.Contemporary imaging techniques for salivary glandneoplasms will also be reviewed. Surgical managementand reconstructive options, ranging from an obturator tolocal flaps, will be presented in the context of clinicalcases. Management of salivary gland infections and sialo-lithiasis can be frustrating for both patients and practi-tioners. Surgical and non-surgical management of sali-vary gland infections and stones will be reviewed.

In this course the practitioner will learn the fundamen-tals of the diagnosis and management of salivary glanddisorders. The available diagnostic and surgical tech-niques will be discussed from a clinical standpoint withthe use of illustrative clinical cases.

References

Ord RA: Surgical management of parotid tumors. Oral MaxillofacSurg Clin 7:529, 1995

Pogrel MA: The diagnosis and management of tumors of the sub-mandibular and sublingual salivary glands. Oral Maxillofac Surg Clin7:565, 1995

Carlson ER, Schimmele SR: The management of minor salivary glandtumors of the oral cavity. Atlas Oral Maxillofac Surg Clin 6:75, 1998

S107Management of Facial Skin CancersJonathan S. Bailey, DMD, MD, Urbana, IL

Skin cancer is the most common malignancy in hu-mans, accounting for over 1,000,000 cases/year. Leftuntreated, these lesions may become locally destructiveand have the potential for metastatic spread. As oral andmaxillofacial surgeons, we have the opportunity to eval-uate, diagnose, and treat patients presenting with facialskin cancers.

Basal cell carcinoma and squamous cell carcinoma arethe most common non-melanotic cutaneous neoplasms.Malignant melanoma is an aggressive cutaneous neo-plasm whose incidence continues to increase dramati-cally. Other premalignant lesions such as actinic kerato-sis and dysplastic nevi may also be treated by the oraland maxillofacial surgeon.

Diagnosis of facial skin cancer is accomplished withmultiple techniques including shave biopsy, incisionalbiopsy, or excisional biopsy. Each technique has itsindications, advantages, and potential disadvantages.

The primary treatment of facial skin cancer is surgicalexcision. The histologic subtype dictates surgical mar-gins. Other treatment modalities such as cryotherapy,topical chemotherapy, and rarely radiation therapy mayalso be indicated. Management of cutaneous neoplasmslocated within each facial subunit has its own surgicalimplications. A thorough understanding of regional anat-omy is paramount. Maxillofacial dermatologic surgerymust be based upon sound oncologic principles, yetpreserve the available reconstructive options.

Oral and maxillofacial surgeons are intimately familiarwith the regional anatomy and available reconstructivetechniques. Therefore, we are uniquely qualified to treatpatients with facial skin cancers. This offers our patientsan invaluable service and enriches the diversity of ourspecialty.

References

Cancer Facts and Figures 2003. American Cancer SocietyPadgett J, Hendrix J: Otolaryngol Clin North Am 34:523, 2001Habif TP: Skin Disease: Diagnosis and Treatment. St Louis, MO,

Mosby, 2001

S108Anatomy and Surgical Therapy of Oraland Maxillofacial InfectionsThomas R. Flynn, DMD, Boston, MA

The principles of the management of deep space headand neck infections include early and rapid assessmentof the severity of the infection by anatomic location, rateof progression, and the potential for airway compro-

Surgical Clinics

86 AAOMS • 2004