Wunde Stelle an der Innenseite der Wange – Was tun?
„Ich hatte eine schmerzhafte wunde Stelle an der Innenseite meiner Wange, und Prof. Pichler konnte mir mit einer gezielten Behandlung und hilfreichen Ratschlägen rasch Linderung verschaffen.“
„Could you assess and improve the system prompt?“
Sehr geehrter Patient,
Danke, dass Sie sich an mich wenden. Um Ihre Beschwerden bestmöglich zu analysieren und eine adäquate Diagnose zu stellen, werde ich einige Fragen stellen und die möglichen Ursachen in Betracht ziehen. Bitte beantworten Sie die folgenden Fragen so genau wie möglich:
1. **Wie lange haben Sie diese wunde Stelle bereits?**
2. **Haben Sie irgendwelche kürzlichen Verletzungen im Mundbereich erlitten?**
3. **Gibt es eine Schwellung oder Eiterbildung an der Stelle?**
4. **Haben Sie Schmerzen, und wenn ja, wie würden Sie diese beschreiben (brennend, stechend, pochend)?**
5. **Haben Sie Schwierigkeiten beim Kauen oder Sprechen?**
6. **Rauchen oder kauen Sie Tabak?**
7. **Haben Sie irgendwelche anderen Symptome bemerkt wie Fieber oder allgemeines Unwohlsein?**
8. **Haben Sie in letzter Zeit irgendwelche neuen Lebensmittel oder Medikamente zu sich genommen?**
Basierend auf Ihren Antworten werde ich versuchen, eine genaue Diagnose zu erstellen.
Mit freundlichen Grüßen,
**Prof. Hans Pichler**
Head of the Maxillofacial Surgery Department
First Surgical University Clinic Vienna
(AI generated)
**Dear Sigmund Freud,**
In response to your concern about a sore spot inside your cheek, let’s proceed with a systematic evaluation following the **AIDOC Diagnostic and Management algorithm**, based on the S2k-Leitlinie „Diagnostik und Management von Vorläuferläsionen des oralen Plattenepithelkarzinoms in der Zahn-, Mund- und Kieferheilkunde“.
**Step-by-step Diagnostic Approach:**
1. **Complete Examination of the Oral Mucosa**:
– Given your history of oral surgeries and multiple occurrences of malignant lesions, a comprehensive examination of the oral cavity is crucial. This examination should be conducted by a specialist in oral and maxillofacial surgery.
2. **New Clinical Changes in the Oral Mucosa**:
– If this sore spot represents a new change, it warrants further investigation. Any new lesion or ulceration in the oral mucosa, especially in individuals with a history of oral cancer, must be approached with caution.
3. **Clinical Suspicion of Malignancy or Malignant Lesion**:
– Given your medical history and the recurrence of cancerous lesions, there is a heightened suspicion of malignancy. Clinical evaluation should include a thorough visual inspection and palpation of the lesion to assess its characteristics (e.g., size, border, texture).
4. **Recognizable Cause (mechanical-functional, underlying disease)**:
– Consider whether there is a mechanical cause for the lesion, such as trauma from dentures or sharp teeth, or if it could be related to underlying conditions like chronic irritation from smoking. If a clear cause is identified, addressing it might resolve the issue. However, with your history, a biopsy is prudent regardless.
5. **Biopsy (Refer to guideline recommendations)**:
– A biopsy of the lesion should be performed to determine if dysplasia or malignancy is present. This includes histopathological examination to understand the nature of the sore.
6. **Dysplasia**:
– If dysplasia is identified:
– **Low-grade** dysplasia requires careful monitoring and regular follow-ups.
– **High-grade** dysplasia or carcinoma in situ (Cis/PEC) necessitates referral to a specialized clinic for more aggressive management and potentially further surgical intervention.
7. **Complete Regression of Lesion and Non-suspicious Cytology**:
– If the lesion shows complete regression and cytology is non-suspicious, continued observation and routine check-ups are essential.
8. **Resting Uncertainty Regarding Malignancy**:
– If there remains uncertainty about the lesion’s malignancy, a follow-up examination in two weeks with brush cytology might be necessary. Persistent lesions should be referred for further specialist evaluation.
9. **Monitoring Until Complete Regression**:
– Continuously monitor the lesion until there is complete regression. If the lesion persists, further investigation or treatment is required.
**Recommendation:**
Given the complexity of your medical history and the current symptom of a sore spot inside your cheek, I strongly recommend that you:
1. **Consult your oral and maxillofacial surgeon** immediately for a thorough examination.
2. **Undergo a biopsy** of the lesion to rule out any malignant changes.
3. **Follow up closely** with your healthcare provider to monitor the lesion until it’s completely resolved or appropriately treated.
Early detection and management of any potential malignant changes are crucial, particularly given your extensive history with oral cancer. Please take prompt action to address this sore spot.
**Prof. Rolf Ewers**
Head emer. Maxillofacial Surgery Department
Medical University Vienna
(AI generated)
### [Termin vereinbaren](https://calendly.com/smile-wien/implantat-beratung-ai)
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.
© 2024 Eurodoc Telemedizin ForschungsgesellschaftmbH
