Critical Cases
32 years old male suffering from left buccal mucosa carcinoma .wide excision with left pectoralis major myocutaneous flape with left radical neck dissection done.
63 years old female suffering from left upper FB sulcus carcinoma involving left buccal mucosa.The tumour was involving inferior wall of maxilla and extending in to maxillary sinus.patient had 3 cycles of neoadjuvant chemotherapy .left radical neck dissection
with left subtotal maxillectomy with left temporalis flape done.
68 years old male suffering from left post auricular metastatic mass.patient was operated for left tongue carcinoma before 8 months.bilateral neck dissection was done.now patient had this post auricular mass.wide excision with STG done.
32 YEARS OLD MALE SUFFERING FROM ADVANCE LEFT BUCCAL MUCOSA GROWTH INVADING LEFT MANDIBLE AND REACHING UP TO UPER GB SULCUS BUT MAXILLA IS SPARED.PATIENT HAS PAST HISTORY OF AORTIC VALVE REPLACEMENT IN 2014.IN 2016 PATIENT HAS TOPPED AL ANTICOAGULANTS.ECHOCARDIOGRAPHY
SHOWS AORTIS VALVE WASSTIFFED.WITH PERIOPERATIVE LOW MOLECULAR WEIGHT HEPARIN SURGERY WAS DONE.LEFT HEMIMANDIBULECTOMY WITH LEFT CHEEK GROWTH EXCISION WITH LEFT SIDE BILOBE PECTORALIS MAJOR FLAPE DONE.
33 YEARS OLD FEMALE SUFFERING FROM LEFT BUCCAL MUCOSA CARCINOMA INVOLVING UPPER AND LOWER B SULCUS.THE TUMOUR WAS REACHING UPTO DERMAL LEVEL OF SKIN.LEFT RADICAL NECK DISSECTION WITH LEFT HEMIMANDIBULECTOMY WITH LEFT LOWER PARTIAL MAXILLECTOMY WITH LEFT
PECTORALIS MAJOR FLAPE DONE.
45 YEARS OLD FEMALE SUFERING FROM LEFT LATERAL MARGIN ANTERIOR 2/3 PART OF TONGUE.GROWTH WAS REACHING NEARER TO FLOOR MOUTH BUT NOT INVADING FLOOR MOUTH.LEFT RADICAL NECK DISSECTION WITH LEFT HEMIGLOSSECTOMY WITH PRIMARY CLOSURE DONE.
47 YEARS OLD FEMALE SUFFERING FROM LEFT LOWER GB SULCUS CARCINOMA INVOLVING FLOOR MOUTH AND LEFT BUCCAL MUCOSA.THE CERVICAL NODES AT LEVEL 1 ARE VERY BADLY ADHERENT TO JUGULAR VEIN AND LEFT INTERNAL CAROTID ARTERY.LEFT INTERNAL JUGULAR VEIN WAS TOED AND
REMOVED WITH MASS.LEFT RADICAL NECK DISSECTION WITH LEFT HEMIMANDIBULECTOMY WITH LEFT PECTORALIS MAOR FLAPE DONE.
45 years old male suffering from advanced left buccal mucosa carcinoma involving external cheek skin and mandible.left radical neck dissection with left hemimandibulectomy with left buccal mucosa with left cheek skin excision done.defect was closed with
bilobe pectoralis flape
70 years old male suffering from upper lip carcinoma.wide excision with rotation flape done.
60 years old female suffering from right breast mass since 3 months.FNAC at three different laboratory shows adenocarcinoma.mammography shows right breast mass 3cm x 3cm in size.X Ray chest and sonography liver are normal. Right modified radical mastectomy
done.
53 years old male suffering from left buccal mucosa carcinoma involving left retromolar trigone .CT scan shows no significant neck nodes.left radical neck dissection with left segmental mandibulectomy with wide excision of left buccal mucosa with left
PM flape done.
42 years old female suffering from advanced right and left anterior 2/3 tongue growth involving posterior 1/3 on right side.left posterior 1/3 tongue carcinoma was spared.Anterior 2/3 of tongue was totally excised with right segmental mandibulectomy with
right pectoralis major flape done.
13 years old girl suffering from pus discharging sinus in midline of neck in sub mental area since 5 years.CT neck shows sinus connected with thyroglossal track .sistrunk operation was done.
51 years old male suffering from left buccal mucosa carcinoma.lesion is involving left lower GB sulcus.Level 1 nodes shows lymphadenopathy.X ray chest and USG liver are normal.Left radical neck dissection with left buccal mucosa growth excision with left
hemi mandibulectomy with left pectoralis major flape done.
40 years old male suffering from left buccal mucosa carcinoma .the lesion is nearer to lower gb sulcus and also nearer to upper gb sulcus.ct scan shows level 1 lymphadenopathy.All other investigations are normal.left radical neck dissection with left
marginal mandibulectomy with left upper alveolectomy with left pectoralis major myocutaneous flape done.
33 years old male suffering from advance right lateral margin anterior 2/3 and middle 1/3 tongue growth involving floor mouth.ct scan shows 3.5n 8 3.0 cm growth approaching to midine but not crossing midline.Right radical neck dissection with right segmental
mandibulectomy with wide extended right hemiglossectomy with right pectoralis major myocutaneous flape done.
FEMALE AGED 62 YEARS OLD SUFFERING FROM LEFT LATERAL ANTERIOR 2/3 AND MIDDLE 1/3 TONGUE GROWTH INVOLVING MIDLINE.CT SCAN SHOWS GROWTH IS NOT INVOLVING FLOOR MOUTH.NO SIGNIFICANT LYMPHADENOPATHY.LEFT RADICAL NECK DISSECTION WITH LEFT WIDE EXCISION OF TONGUE
GROWTH WITH PRIMARY CLOSURE DONE.
48 YEARS OLD MALE SUFFERING FROM RIGHT LOWER GB SULCUS CARCINOMA.GROWTH WAS INVOLVING LOWER MANDIBLE FROM SECOND PREMOLAR TO RAMUS OF MANDIBLE.RIGHT RADICAL NESK DISSECTION WITH RIGHT HEMIMANDIBULECTOMY WITH RIGHT PECTORALIS MAJOR MYOCUTANEOUS FLAPE DONE.RECOSTRUCTION
IMAGE IS THERE.
56 years old female suffering from midline sub mental ulcerative growth.patient was operated twice for left buccal mucosa carcinoma before 8 years.Wide excision of midline sub mental mass with re onset of left forehead flape done.
44 YEARS OLD MALE SUFFERING FROM RIGHT RETROMOLAR TRIGONE CARCINOMA WITH EXTENSION OF GROWTH TO RIGHT CHEEK SURFACE.CT SCAN SHOWS MULTIPLE ENLARGED NODES ON RIGHT SIDE OF NECK.RIGHT INTERNAL JUGULAR VEIN IS INVOLVED IN MASS.RIGHT RADICAL NECK DISSECTION
WITH WIDE EXCISION OF RIGHT CHEEK SKIN GROWTH WITH RIGHT DISTAL MANDIBULECTOMY WITH RIGHT BILOBE PECTORALIS MAJOR MYOCUTANEOS FLAPE DONE.
42 YERAS OLD MALE SUFFERING FROM LEFT RETROMOLAR TRIGONE GROWTH WITH RESTRICTED MOUTH OPENING.CT SCAN SHOWS GROWTH IN RETROMOLAR TRIGONE INVOLVING LOWER GB SULCUS AND APPROCHING TO UPPER GB SULCUS.CT SCAN SHOWS LEVEL 1 AND 2 NECK LYMPHADENOPATHY.ALL OTHER
INVESTIGATIONS ARE NOEMAL.LEFT RADICAL NECK DISSECTION WITH LEFT DISTAL MANDIBULECTOMY WITH LEFT UPPER ALVEOLECTOMY WITH RECONSTRUCTION OF DEFECT WITH LEFT PM FLAPE.
40 years old female suffering from right lateral margin anterior 2/3 tongue growth.HPE shows well differentiated squamous cell carcinoma.Ct scan shows well defined growth with non specific lymph adenopathy.Right radical neck dissection with wide excision
of tongue growth done
73 YEARS OLD MALE SUFFERING FROM LEFT FRONTO PARIETAL AREA SCALP CARCINOMATOUS GROWTH SINCE 6 MONTHS.HISTOPATHOLOGY SHOWS IT IS WELL DIFFRENTIATED SQUAMOUS CELL CARCINOMA.PET CT SHOWS BOTH LUNGS VERY BTINY NODULES WITH SUV OF 4.6,BILATERAL TNTRAPAROTID
ARAE SHOWS INTRAPAROTID NODES WITH SUV OF 11.6.CLINICALLY PATIENT HAS NO SYMPTOMS.WIDE EXCISION OF SCALP GROWTH WITH STG AND LEFT SOHND DONE
59 years old male suffering from right pyriform fossa carcinoma involving right AE fold and right vocal cord .Growth was involving right lateral pharyngeal wall .right neck nodes are metastatic .Laryngectomy with Pharyngectomy with right neck nodes clearance
with left PM flape for pharyngoplasty done.
37 YEARS OLD MALE SUFFERING FROM ADVANCED LEFT BUCCAL MUCOSA CARCINOMA EXTENDING TO OUTER CHEEK SKIN.PATIENT WAS GIVEN TWO CYCLES OF NEOADJUVANT CHEMO THERAPY.NO RESPONSE WITH CHEMOTHERAPY.CT SCAN SHOWS DISESE INVOLVING UPPER AND LOWER GB SULCUS.LEFT
RADICAL NECK DISSECTION WITH LEFT DISTAL MANDIBULECTOMY WITH LEFT LOWER PARTIAL MAXILLECTOMY WITH BILOBE PECTORALIS MAJOR FLAPE KEPT.
