Use of 90° Hopkin's Telescopic Examination as an OPD Tool to Clinically Evaluate and Record Oral Cavity Lesions: Our Experience in Early Detection, Especially in Patients with Limited Mouth Opening.
BACKGROUND
Restricted mouth opening due to premalignant lesions like oral sub-mucous fibrosis, malignancies of oral cavity and postoperative status is very common in Indian patients. It is very difficult to evaluate, document and biopsy the lesions due to inability to access, vast area and diversity of premalignant lesions and subject variations. 90° Hopkin's slender out-patient examination telescope was found useful tool in this.


OBJECTIVE
The aim of the study was to evaluate the use of magnified view and reach of a slender telescope to document and examine the oral cavity for any premalignant and malignant lesions, especially for patients with restricted mouth opening and to study its impact on management.


METHODS
A 90(0) Hopkin's telescope was used to evaluate and document oral cavity examination in the Out Patients Department (OPD). The data of first 2000 patients was analysed.


RESULTS
Difficult to reach areas, where mouth opening was severely restricted was the significant subset. A total of 1394 patients approached OPD for primary diagnosis at our tertiary cancer care centre. Six hundred and six patients were the ones in follow up after treatment in form of Surgery, Chemotherapy or Radiotherapy, or combination. Five twenty three patients (of 1394) with mouth opening ≤ 20mm formed the study group. Telescope guided biopsies were also taken in 50 patients from 56 sites. Serial recordings were compared objectively in premalignant, treatment evaluation and close watch groups. An increase of 5.6% in rate of diagnosis of malignancy was made possible with the help of telescopic examination in patients with mouth opening ≤ 20mm.


CONCLUSIONS
A 90(0) Hopkin's telescopic examination is a useful tool to evaluate and record oral cavity lesions, especially in patients with restricted mouth openings. It is a useful tool for screening high risk group, giving definite advantage of objective evaluation and recording of the lesion. It can also be used to objectively evaluate response of neo-adjuvant chemotherapy and as a teaching tool for the fellows.
Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India .
Dushyant
D
Mandlik
Fellow, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India .
Karan
K
Gupta
Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India .
Daxesh
D
Patel
Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India .
Purvi
P
Patel
Senior Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India .
Rajendra
R
Toprani
Senior Consultant and Director, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India .
Kaustubh
K
Patel
Oral cancer; Oral sub mucous fibrosis; Prevention