TUMOR in the maxillofacial and cervical regions
The monograph presented to the reader's attention examines the most frequently observed tumors in the maxillofacial and cervical regions, primary multiple /synchronous, metachronous, synchronous-metachronous/, oro-facial manifestations in visceral malignancies, paraneoplastic syndromes with oro-facial symptoms and metastatic tumors in the oro-facial and cervical regions. The large range of nosological entities, which covers the indicated pathology and the specificity in the development of these oncological diseases in the oro-facial area, gave the author the reason at the beginning of the monograph in a separate chapter to examine with such a focus the topographical and surgical / clinical / anatomy of maxillofacial and cervical areas.
The complexity of the clinical anatomy in the oro-facial and neck areas / rich innervation, blood supply, lymph circulation / proximity to the central nervous system, presence of organs performing vitally important functions / vision, hearing, breathing, nutrition, smell, taste, etc. ./ are prerequisites for the development of various problematic situations and complications in the surgical treatment of patients with tumors in this area. This is the main argument to analyze emergency and urgent conditions in these patients and their behavior in a separate chapter. Modern concepts regarding the etiology, pathogenesis, as well as the classification of tumors developing in the oro-facial and cervical regions are presented in a synthesized form. The issues related to the symptoms, methods of diagnosis, surgical and conservative (radiation, chemotherapy) treatment of tumor diseases in the oro-facial region are examined and critically understood in accordance with the concepts in the literature, reflecting the modern achievements in this scientific and applied field. The writing of the monograph is the result of my 35 years of clinical experience and observations related to the surgical treatment of patients with tumors in the maxillofacial and neck areas. Extensive clinical material was analyzed.
The statistical data reflected in the monograph are the result of observation and analysis of 28,979 patients treated by employees of the Department of Oral and Maxillofacial Surgery at the University of Medicine - Sofia for a period of 22 years: in the hospital of the department on the territory of the Faculty of Dentistry -Sofia, who until 2000 was a structural unit in it and in the clinic for "Maxillofacial Surgery and Oto-Rhino-Laryngology of UMBAL - "St. Anna - Sofia, which I have headed since its creation in 2005 / I work at this position and at the moment, and I have been the head of the Department of OLCH since 1999 - now my third term as such/. Of the 22,979 patients treated in inpatient conditions for the specified period with various diseases in the maxillofacial and neck areas, 6,369 – /21,79%/ have tumors. Among them, 6,522 tumors were diagnosed (the higher number of tumors is due to the diagnosis of synchronously and/or metachronously developing primary multiple ones). The material in the individual chapters is presented clearly and specifically in terms of frequency, localization, diagnosis, treatment and prognosis of tumors in the maxillofacial and cervical regions.
Controversial issues, mostly related to treatment, are not discussed, but those treatment methods that have been tested in practice and have proven their effectiveness are analyzed. The logic in the construction and analysis of the material makes it possible to quickly find the necessary information. Fragments of the monograph in the form of scientific articles have been published in various Bulgarian and foreign journals, which is reflected in the description of the used literature, as well as in: – my dissertation work for the Ph.D. "Surgical Treatment of Malignant Skin Tumors of the Face and Neck, 2002; - "Clinical surgery, 2005, under ed. of Art. cor. Prof. D. Damyanov; – “Maxillofacial and Oral Surgery, 2006, edited by me; - "Surgical diseases, 2007, sub. row of Prof. N. Yaramov; - "Maxillofacial surgery, 2009, volume IV, of which I am the responsible editor in volume XIV "Manual of surgery with editor-in-chief art. cor. Prof. D. Damyanov. I do not claim that the monograph covers comprehensively and completely exhausts the issues discussed in it.
Its main task is to analyze the main clinical aspects of this difficult field - oncological diseases in the maxillofacial and neck areas, in order to help, in a practical aspect, the practitioners of this specialty to correctly navigate the numerous problems arising in the diagnosis and treatment of tumors in this area. In the last decade, with the introduction of clinical pathways, specialists from borderline and other specialties (ENT, dermatologists, plastic surgeons, general surgeons) have been working in the domain of this specialty, but not in all cases the results are encouraging regarding the healing of patients.
I will be satisfied if this book turns out to be useful and timely especially in the practical /surgical treatment of such patients/ and scientific activities. This is the idea behind its writing and the shared experience in an applied-scientific direction. Any critical comments will be gratefully received!
Professor Radomir Ugrinov, M.Sc.
