Most neoplasm of the floor of the mouth are squamous cell carcinoma. They originate from anterior midline floor of the mouth and penetrate into the sublingual gland. Invasion of the mandible is a late manifestation. Lymphatic spread is the
submaxillary
and subdigastric nodes and advanced lesions of them produce severe pain.
The initial step in managing patients with cancer pain is the oncology therapy in the form of radiotherapy, surgery, or chemotherapy, alone or combined. When oncologic therapy is ineffective, the pain must be treated by systemic analgesic,
psychologic,
neurostimulating, regional analgesic, and meuroablative techniques.
We successfully treated with gasserian ganglion block on the left side and mandibular nerveblock on the right side with pure alcohol in the patient having severe submandibular, lower lip and tongue pain.
|