By Charles Staley (Editor), John E. Skandalakis (Editor), Sean Moore William C. Wood (Editor)
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Additional resources for Anatomic Basis of Tumor Surgery, 2nd Edition
17 A bolster of Xeroform gauze is placed over the graft and sutured with 3–0 silk tieover sutures. This places pressure on the graft to increase the chances of graft take. The bolster should be left in place for 5 days and then removed. Healing of the defect by secondary intention is possible, but attempts should be made to cover the exposed mandible with advancement of mucosa. Full-thickness defects that communicate with the neck may require ﬂap closure with a platysma ﬂap, sternocleidomastoid ﬂap, or free tissue transfer.
The remainder of the oropharynx consists of the posterior pharyngeal wall and the lateral pharyngeal wall posterior to the posterior tonsillar pillar. Pharyngeal Relationship to Deep Neck Spaces The oropharynx has important relationships to surrounding potential deep neck spaces, including the retrovisceral spaces and the parapharyngeal space (lateral pharyngeal space). Although not part of the pharynx, these spaces may be involved with disease that originates in the pharynx or encroaches on the pharynx.
The base of tongue musculature is innervated by the hypoglossal nerve. The arterial supply of the base of tongue is through the lingual arteries. The base of tongue has a rich submucosal lymphatic drainage system primarily to the jugulodigastric lymph nodes. Lymphatic drainage to both sides of the neck is common. This necessitates addressing both the ipsilateral and contralateral neck when treating tumors of the base of tongue because of the likelihood of bilateral metastases, even with small tumors.
Anatomic Basis of Tumor Surgery, 2nd Edition by Charles Staley (Editor), John E. Skandalakis (Editor), Sean Moore William C. Wood (Editor)