Veidlapa Nr. M-3 (8)

Study Course Description

Oncostomatology

Main Study Course Information

Course Code

RMS_047

Branch of Science

Clinical medicine; Surgery

ECTS

19.00

Target Audience

Dentistry; Medicine

LQF

Level 8

Study Course Implementer

Course Supervisor

Ģirts Šalms

Residency Speciality

Speciality

Maxillofacial Surgeon

Supervisor of Medical Speciality

Ģirts Šalms

Contacts

About Study Course

Objective

A trained specialist who is able in the patients with oncological diseases of the mouth, face and jaws to establish diagnosis, to choose the most suitable treatment method, perform clinical and surgical treatment, and coordinate cooperation with other specialists in addition to treatment.

Learning Outcomes

Knowledge

1.Knows: etiopathogenesis and classification of tumors of the mouth, face and neck, surgical and clinical treatment methods, additional examination and treatment methods.

Skills

1.Can: - explain the possible etiopathogenesis of tumors; - perform clinical diagnosis of tumors of the mouth, face and jaws; - establish a diagnosis according to the TNM classification; - perform differential diagnosis and plan additional investigations; - interpret examination data and plan treatment tactics; - describe the basic principles of treatment; - compare different treatment tactics and results; - justify the choice of treatment tactics; - prepare patients before surgery; - inform patients about surgical manipulations, possible complications and prevention options; - draw up medical documentation; - independently perform small-scale oncological operations; - perform postoperative care and inform patients about rehabilitation options. - to analyze treatment outcomes, survival and quality of life.

Competences

1.Patients with oncological diseases of the mouth, face and jaws will be able to: establish a diagnosis, choose the most appropriate treatment method, perform clinical and surgical treatment, and coordinate cooperation with other specialists in addition to treatment.

Assessment

Individual work

Title	% from total grade	Grade
1. Individual work	-	-
Clinical work in P. Stradiņš hospital and RECUH Oncology Centre of Latvia. Acquaintance with mandatory and topical literature. Attending seminars. Presentation on clinical cases.

Examination

Title	% from total grade	Grade
1. Examination	-	-
Clinical work in P. Stradiņš hospital and RECUH Oncology Center of Lavia (70%). Acquaintance with mandatory and topical literature (10%). Attendance at seminars (10%). Presentation on clinical cases (10%).

Study Course Theme Plan

FULL-TIME

Part 1

Seminar

Modality	Location
On site	Auditorium

Topics

Historical development of head and neck oncology treatment. Epidemiology, etiology, pathology. Molecular biology. Precancerous conditions. Prognosis. Diagnosis and examinations. Signs, symptoms, radiological findings. Cytology and biopsy. Treatment of head and neck tumors. Anesthesia. Care. Types of feeding. Speech and language therapy. Tooth replacement. Psychosocial aspects. Assessment of the quality of life of oncology patients. Palliative care.

Seminar

Modality	Location
On site	Auditorium

Topics

Treatment of malignant tumors of the mouth and throat. Anatomy. Conventional tumor removal. Additional procedures. Treatment of mandibular tumors. Treatment of tumors of the upper jaw. Treatment of tongue base tumors. Laser surgery. Thermal surgery. Photodynamic therapy. Provision of airways. Complications. Prognosis. Historical perspectives on the treatment of neck tumors. Approaches and types of neck dissection. Sentinel node biopsy. Treatment of neck tumors in cases of positive and negative l

Seminar

Modality	Location
On site	Auditorium

Topics

Treatment of tumors of the nose and paranasal sinuses. Anatomy, epidemiology, pathology, typical symptoms, examinations. Tumor stages. Surgical approaches. Prognosis. Skull base tumors. Anatomy, epidemiology, pathology, typical symptoms, examinations. Tumor stages. Surgical approaches. Prognosis.

Seminar

Modality	Location
On site	Auditorium

Topics

Tumors of the parapharyngeal space. Anatomy, epidemiology, pathology, typical symptoms, examinations. Tumor stages. Surgical approaches. Forecast. Rare head and neck tumors: soft and hard tissue sarcomas, odontogenic tumors, lymphoproliferative tumors, orbital tumors - melanoma and tumors of the lacrimal apparatus. Metastases.

Seminar

Modality	Location
On site	Auditorium

Topics

Head and neck tumors in children. Historical perspectives. Radiotherapy. Principles of treatment. Primary therapy, additional therapy. Principles of radiotherapy, chemotherapy, combined therapy planning. Side effects. Radiotherapy to control recurrences. Chemotherapy for head and neck tumors. Side effects. Chemotherapy for relapse control. Choice of treatment methods from a cost perspective. Complications. Palliative care.

Seminar

Modality	Location
On site	Auditorium

Topics

Restoration of teeth after ablative operations of the oral cavity. Principles of treatment. Types of prosthetic rehabilitation. Implant-borne prostheses. Obturators. Craniofacial rehabilitation. Application of tissue expanders in the head and neck area. Device types. Reconstruction algorithms. Epiprostheses. Viral therapy. Gene therapy. Robotic surgery.

Seminar

Modality	Location
On site	Auditorium

Topics

Local and random pattern flaps. Buccal pad of fat, nasolabial, tongue flaps. Pedicled flaps: submental island, temporoparietal, temporalis, deltopectoral, pectoralis major, latissimus dorsi, sternocleidomastoid, trapezius. Anatomy. Indications and contraindications. Surgical techniques. Possible complications.

Seminar

Modality	Location
On site	Auditorium

Topics

Basic principles of microvascular surgery. Evaluation of patients before choosing a microsurgical flaps. Basic criteria for successful microsurgical reconstruction. Free flaps: radial forearm, suprafascial, subfascial, osseocutaneous, radial forearm composite flap, anterior lateral thigh (ALT), rectus abdominis, lateral arm, composite fibula, deep circumflex iliac arteries (DCIA). Anatomy. Surgical techniques. Instruments and equipment. Indications and contraindications. Complications.

Seminar

Modality	Location
On site	Auditorium

Topics

Scapula systemof flaps – to include tip of scapula and TDAP, jejunal, gastro-omental, and gracilis flaps. Anatomy. Surgical techniques. Instruments and equipment. Indications and contraindications. Complications. Types of monitoring. Surgery for facial paralysis. Etiology. Diagnostics. Principles of surgical treatment. Static surgery procedures. Dynamic surgery for facial nerve reanimation.

Seminar

Modality	Location
On site	Auditorium

Topics

Maxillary obturators, types, manufacturing stages. Cheek bone implants. Nasal prosthesis. Nasal bone implants. The importance of the soft tissue surrounding implants. Orbital prosthesis. Orbital implants. Ear prosthesis. Auricular implants. Free skin grafts: full and split thickness, dermal alloplast. Bone grafts for implant surgery.

Seminar

Modality	Location
On site	Auditorium

Topics

Mandibular reconstruction. Types of mandibular defects, preferred sources of reconstruction for each defect. Maxillary reconstruction. Types of maxillary defects. Reconstruction methods: prosthesis vs. autologous reconstruction. Laryngeal reconstruction. Types of defects. Complications. Lateral skull base reconstruction. Types of defects. Application of flaps in reconstructions. Types of reconstructions for children.

Seminar

Modality	Location
On site	Auditorium

Topics

Salivary gland disease, other swellings of the face and neck. Diseases of the parotid, submandibular, sublingual, and minor salivary glands. Surgical anatomy of the salivary glands. Embryology and physiology. Histopathology. Topographical anatomy of facial nerve. Salivary atresia, aplasia. Salivary gland examination. MRI, PET/CT, US: characterization, basic principles, comparison. Puncture for cytological analysis and biopsy. Sialography.

Seminar

Modality	Location
On site	Auditorium

Topics

Neoplasia of the salivary glands. TNM classification. Staging and grading of tumours. Benign tumors of the salivary, parotid, sublingual, submandibular glands. Pleomorphic adenoma. Malignant tumors of salivary, parotid, sublingual, submandibular, minor salivary glands. Lymphomas. Tumors of the lymphoreticular system. Lipomas. Metastatic tumors in the salivary glands. Parotid salivary gland surgical techniques. Conservative surgical approaches.

Seminar

Modality	Location
On site	Auditorium

Topics

Extra-capsular dissection, indications, principles for facial nerve retention. Conventional surgical approach. Surgical techniques of parotidectomy. Surgical approaches to a deep lobe parotidectomy. Monitoring of the facial nerve function during the parotid surgery. Anesthesia during salivary gland operations. Facial nerve paresis, paralysis. Classification. Other complications: sialocele, neuroma, Frey's syndrome, dissemination of tumor cells during surgery. Recurrences. Metastatic neck disease

Seminar

Modality	Location
On site	Auditorium

Topics

Acute and chronic sialadenitis. Salivary stone disease. Diagnostics. Treatment. Minimally invasive surgery, sialoendoscopy. Intracorporeal lithotripsy. Systemic diseases of the salivary glands. Sjögren's syndrome. Bacterial and fungal infections. Viral infections. Cysts. Salivary gland injuries, facial nerve damage, fistulas. Salivary gland tumors in children. Embryonic cysts of the neck region: dermoid, branchial cleft, thyroglossal duct, cystic hygroma. Malignant blood disseases of the salivar

Total ECTS (Creditpoints):

19.00

Number of Residency Seminars:

Length (weeks):

Final Examination:

Residency exam (Theory and practice)

Bibliography

Required Reading

Jatin Shah's Head and Neck Surgery and Oncology. 5th Edition. By Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh, et al. 15 May, 2019.

Local Flaps in Head and Neck Reconstruction. 2nd Edition. by Ian Jackson. June 30, 2007. Thieme.

Oral, Head and Neck Oncology and Reconstructive Surgery. 1st Edition. 24 Aug 2017. By R. Bryan Bell, Peter A. Andersen, and Rui Fernandes.

Textbook of Oral Cancer: Prevention, Diagnosis and Management (Textbooks in Contemporary Dentistry). 1st Edition. 2020 Edition. by Saman Warnakulasuriya (Editor), John S. Greenspan (Editor).

Pathology and Genetics of Head and neck Tumors. Edited by L. Barnes, J.W. Eveson, P. Reichart, D.Sidransky. Lyon, 2005.

Atlas of Head and Neck Surgery’ – Otolaryngology. By B.J.Bailey, K.H.Calhoun, et al. January 1, 1996. Section I Head and neck, Section III Plastic and reconstructive surgery.

Open access atlas of otolaryngology, head & neck operative surgery.

Contemporary Oral Oncology Diagnosis and Management. Editors: Moni Abraham Kuriakose. ISBN: 978-3-319-14917-2 (Online)

Additional Reading

Periodiskā zinātniskā literatūra onkostomatoloģijā.