Читать книгу Essential Cases in Head and Neck Oncology - Группа авторов - Страница 22

A 68‐year‐old white male presents with a chief complaint of a painful sore around his right lateral maxillary teeth. He states he initially thought it was related to a dental infection, but after having a tooth pulled, the area has continued to enlarge.

Question: What are the other important points in history taking?

Answer:

 Presence of other adjacent loose teeth.

 Facial numbness.

 Difficulty in opening the mouth.

 Dysphagia, odynophagia.

 Voice changes.

 Presence of neck mass.

For maxillary lesions, it is always important to determine the extent of the disease. Signs such as loose teeth, difficulty in opening the mouth (trismus), and facial numbness (perineural invasion) could provide critical clinical clues to the extent of disease and aggressive behavior.

Question: What additional aspects of the history and risk factors should be investigated?

Answer:

 Tobacco or alcohol use.

 Any history of head and neck cancers.

 Past medical history for significant diseases: peripheral vascular disease, diabetes, autoimmune diseases, chronic kidney disease, coagulation disorders, to name a few.

This patient has a history of 10 pack‐year smoking but quit 25 years ago. He drinks alcohol socially with no history of excessive drinking. There is no history of significant diseases or malignancy.