Hence, we recommend routine single tooth extractions in patients on long-term antiplatelet medication, without interruption or alteration of their medication. Such patients do not have an increased risk of prolonged or excessive postoperative bleeding.
A 65-year-old male was presented with complaint of swelling on left side of the neck for last two months. On examination, there was a left Level II lymph node of size 2x3 cm. The lymph node was hard in consistency and had a restricted mobility. The patient was a previously treated case of carcinoma of right lower alveolus and was treated with segmental mandibulectomy, right side selective neck dissection and pectoralis major myocutaneous flap reconstruction in the year 2000. The patient also had received adjuvant radiotherapy in the same year and he was under regular follow up since then.The Fine Needle Aspiration Cytology from the lymph node showed metastatic squamous cell carcinoma. An ultrasound of the neck showed 2x3 cm lymph node with necrosis and calcification and was abutting internal jugular vein. An upper aerodigestive tract endoscopy and chest imaging revealed no separate lesion.A modified radical neck dissection was done for clearing Level I, II, III, IV and V and left internal jugular vein. Intraoperatively, we found that thyrolingual trunk was arising from medial aspect of left CCA, 10 mm below the carotid bifurcation. The STA was going downwards and the lingual artery was going upwards [Table/ Fig-1]. The postoperative period was uneventful and the patient is under regular follow up.
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