Oral Biopsies – Operative Warnings

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  • #12210
    sushantpatel_doc
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    Registered On: 30/11/2009
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    Pain. As it is a surgical procedure, there will be soreness
    after the biopsy. This can last for several days.

    Painkillers such as ibuprofen, paracetamol, Solpadeine or
    or Nurofen Plus are very effective. Obviously, the
    analgesic you use is dependent on your medical history &
    the pain you are experiencing.

    Swelling. There will be swelling afterwards. This can last
    several days.

    Use of an ice-pack or a bag of frozen peas pressed
    against the cheek adjacent to the biopsy site, will help to
    decrease the swelling.

    Avoidance in the first few hours post-op, of alcohol,
    exercise or hot foods / drinks will decrease the degree of
    swelling that will develop.

    Occasionally, there is bleeding into the cheek or the floor
    of the mouth (dependent on where the biopsy took place)
    – there may well be limitations to mouth opening or tongue
    use respectively. This also improves with time.

    Stitches. The biopsy will often be closed with stitches.
    These are dissolvable and ‘fall out’ within 10 – 14 days.

    Limited Mouth Opening (Trismus). Often the chewing
    muscles and the jaw joints are sore after the procedure
    so that mouth opening can be limited for the next few
    days.

    Scarring / Lumpiness at the Biopsy Site. Any cut to soft
    tissues produces a scar. Initially, after a biopsy, a scar
    will be produced. This softens and disappears (i.e.
    improves) with time.

    Regardless, it can feel quite obvious and lumpy
    (especially if the biopsy has been in the lips or cheeks.

    The scarring can also dependent on the size and size of
    the biopsy and the individuals’ tendency to scarring.

    Initial Tautness / Tenderness at the Biopsy Site. The
    biopsy margins are brought together with stitches hence
    there is some tension at the operation site. This tails off
    as the swelling goes down.

    Localised Area of Numbness at the Biopsy Site. This
    especially effects the lips and tongue (tip). Biopsies can
    damage the local nerves resulting in areas of numbness.
    These can take a number of months before normal feeling
    returns.

    Recurrence. Dependent on what is biopsied, there is a
    chance that the lesion can recur. They recur either due to
    the nature of the lump / patch or due to the recurrence of
    conditions that caused the lump / patch to develop.

    For instance, during pregnancy many odd lumps and
    bumps develop on the gums. If they are removed /
    biopsied, they recur. They are often left until after the end
    of pregnancy as most of the lesions disappear or
    dramatically regress.

    Polyps on the cheeks or lips can recur as the patient may
    bite on these areas again producing the polyps anew.

    Inconclusive Results & the Need for Re-Biopsy. The
    biopsy results can come back as inconclusive.

    If this is the case, then it is possible that the lesion may
    need to be biopsied again.

    If all the lump / bump has been removed, it is very unlikely
    that these come back as inconclusive (and also there is no
    possibility of re-biopsying the site).

    Further Treatment Dependent on Results. Depending on
    what the biopsy results are, will determine whether further
    treatment is required.

    If the lump turns out to be just a polyp or granuloma, then
    nothing further needs to be done.

    If the patch turns out to be symptomatic lichen planus
    then steroids can be prescribed and the patch can be
    reviewed in initially by the hospital and then by the GDP /
    GMP. If the lump turns out to be more serious, then
    further investigations and treatments may be necessitated.

    #17385
    drmittal
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    Registered On: 06/11/2011
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    Anatomical-Specific Warnings:

    Tongue – limitation mobility / function of tongue (due to
    swelling, tenderness etc); marked swelling.

    Gums – gum recession, hot-cold sensitivity due to
    exposed dentine as the gum recedes; need for use of
    Coe-Pak (surgical dressing / cement) dressing.

    Cheeks – numbness / tingling at the biopsy site
    (especially if biopsy of lip); problems with salivary gland
    ducts (adjacent to the upper 1st molars) being
    traumatised, tied off (by stitches) or cut through.

    Floor of Mouth – altered sensation; problems with salivary
    gland ducts being traumatised, tied off (by stitches) or cut
    through.

    Roof of Mouth – bleeding from biopsy site due to difficulty
    in apposing the wound sides; roof of mouth-floor of nose
    communications (especially if the soft palate is being
    operated on); need for use of Coe-Pak.

    #17386
    Anonymous

    What is a Biopsy?

    A biopsy is often recommended following a
    consultation on the clinic.

    It is a simple procedure that provides tissue for the
    histopathologists to discover the presence, cause or
    extent of a disease.

    The procedure is carried out under local anæsthetic, that is,
    you will be awake and have an injection to numb up the
    tissue in question. You will have stitches at the biopsy site
    that dissolve over the next 10 – 14 days. You can expect
    some discomfort and possibly swelling afterwards. These
    will settle over the next few days.

    The whole process should take less than 30 minutes.

    There are two types of biopsy:

    Excisional Biopsy.

    Where the biopsy aims to remove an area completely. This
    is usually only appropriate for small lumps or swellings.

    Incisional Biopsy.

    Occasionally, only a small piece of an abnormal area is
    removed to confirm a diagnosis.

    A local anaesthetic injection is used to numb the area which
    takes a couple of minutes to work. After this injection, the
    procedure should be painless. The biopsy usually leaves a
    small hole that often requires stitching. In the majority of
    cases the stitches used are dissolvable and take around
    two weeks to disappear.

    All together, this procedure usually takes around 15 – 20
    minutes from start to finish.

    Before Your Appointment

    No special precautions have to be taken before your
    biopsy. Make sure you take your medications as normal.

    Please eat and drink as normal prior to your appointment
    and DO NOT miss meals.

    After Your Appointment

    Following the procedure, the doctor will instruct you on how
    to keep yourself comfortable over the next few days.

    The biopsied area will be sore and any discomfort can be
    controlled by pain-killers such as paracetamol or ibuprofen.

    You will be able to eat and drink as normal immediately
    after the biopsy but avoid anything too hot for the first 24
    hours. Try not to either spit out or rinse out the mouth and
    do not do any physical exertion for the next 24 hours as
    this can make the swelling worse or dislodge the blood clot
    at the site of operation encouraging more bleeding.

    Use either a hot salty mouthwash or an antiseptic
    mouthwash such as Corsodyl, for the next few days,
    starting 24 hours after the procedure. This should lessen
    the chance of infection at the biopsy site and hasten the
    biopsy site’s healing.

    Results

    If the lump or bump that is being biopsied looks to be a
    well-recognised or common lump or bump, we won’t
    necessarily review you on clinic but will send the biopsy
    results to you.

    In other cases, you will normally be given a review
    appointment for the biopsy results to be discussed
    approximately 3 – 4 weeks after the biopsy.

    #17387
    Anonymous
    #17388
    Anonymous

    more information..

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