Oral cavity and oropharynx

Abstract

Malignant tumors of the oral cavity and oropharynx are predominantly (greater than 90-95%) squamous cell carcinomas. Less common tumors include minor salivary gland tumors (especially on the hard palate), verrucous carcinomas, lymphomas, melanomas, and sarcomas. The most common risk factors are tobacco, smoked and smokeless, and alcohol abuse. Less common factors include poorly fitting dentures, poor dentition with irregular surfaces, and poor oral hygiene. Nonsmokers can also be diagnosed with oral cavity and oropharynx cancer. Among nonsmokers, human papillomavirus (HPV) has recently been associated with malignancies of the oropharynx, and may portend better outcomes when compared to those without HPV infection. Malignancies of the oral cavity and oropharynx account for approximately 4% of all newly diagnosed nonskin malignancies, with a 2:1 male predominance. Approximately 34,000 new cases are diagnosed each year. Two-thirds of these are in the oral cavity and one-third in the oropharynx. Oral cancer accounts for an estimated 7,550 deaths yearly (Cancer Facts and Figures, 2007). While oral cavity and oropharynx cancer accounts for only a small number of all new cancers, the functional problems created by these tumors and their treatment are significant. Oral cavity and pharyngeal dysfunction affects speech, oral competence, the first and second (oral and pharyngeal) phases of swallowing, and in some instances, the ability to adequately protect the airway. Even small tumors may result in significant weight loss due to pain, dysphagia, and odynophagia, resulting in malnutrition. Dysarthria affects interpersonal communication and frequently results in withdrawal from public situations. © 2010 Springer-Verlag Berlin Heidelberg.