Dear Patient,
Based on the information provided in your medical history, it appears that you have experienced two distinct episodes related to oral mucosal lesions. The first episode occurred in late 1917 when you noticed a painful swelling at the soft palate, which resolved after you resumed smoking cigars. This episode was initially attributed to be of psychogenic origin due to its resolution upon smoking. However, the recent occurrence of an ulcerous or leukoplastic growth on your jaw and palate raises concerns for a potential malignancy.
Given your current symptoms and the previous history of a potentially persistent oral lesion, it is essential to consider various diagnostic possibilities. The fact that Felix Deutsch does not agree with the diagnosis of epithelioma and suspects a “bad leukoplakia” further emphasizes the need for a thorough evaluation.
A rhinologist will be performing the surgery; however, I would like to emphasize that surgical intervention alone may not be sufficient in this case. A multidisciplinary approach is recommended, involving both diagnostic and therapeutic modalities. This includes:
- Biopsy: A definitive diagnosis can only be established through a histopathological examination of the tissue obtained from the lesion. A biopsy should be performed as soon as possible to determine the nature and extent of the lesion.
- Imaging studies: Radiographic imaging, such as panoramic radiographs or computed tomography (CT) scans, can help assess the extent of any bone involvement if present.
- Dental evaluation: A comprehensive dental examination is necessary to rule out any underlying dental causes for your symptoms.
- Alternative treatments: Depending on the diagnosis, alternative treatment options may include chemotherapy, radiation therapy, or immunomodulatory agents. These therapies can be used in conjunction with surgical intervention to improve outcomes and reduce the risk of recurrence.
- Psychological support: Given your previous experience with a potentially psychogenic episode, it is essential to consider the role of psychological factors in your current condition. Consultation with a mental health professional may help manage any anxiety or stress related to your diagnosis and treatment.
In conclusion, while surgical intervention by a rhinologist is an important step in managing your current symptoms, a comprehensive diagnostic workup and multidisciplinary approach are
2024-01-30 21:11 Telekonsultation
Letter
Dear Mr. Freud,
I have carefully reviewed your medical history, taking into account the latest advancements in oral and maxillofacial surgery. I am deeply saddened to learn about the challenges you faced during your treatment, especially regarding the obturator prosthesis.
Your initial symptoms began in 1917 when you noticed a painful swelling in your palate. Although you did not seek professional help at that time, it is essential to note that early detection and intervention are crucial for optimal outcomes. The latest research suggests that advancements in diagnostic techniques, such as imaging studies and biopsies, could have led to a more accurate diagnosis earlier in your case.
In 1923, when the ulceration of the palate occurred, you once again delayed seeking medical help until April. At that time, Dr. Hajek performed an excisional biopsy, which resulted in incomplete tumor removal and severe postoperative bleeding. This unfortunate outcome highlights the importance of proper surgical techniques and the significance of immediate prosthetic obturation after ablative surgery.
Your subsequent treatment by me, starting from October 4, 1923, was a two-stage operation involving ligation of the right external carot
Termin vereinbaren
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
Ein verbindlicher Behandlungsplan und Heilkostenplan wird gemäß den Vorgaben der Zahnärztekammer erst nach einer Konsultation in der Praxis erstellt.
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