RESUMEN

Introduction: The lymph node status is a very important prognostic factor in head-and-neck cancer. The presence of metastatic lymph nodes will reduce the overall survival by 50%. Lymph node ratio (LNR) is defined as the ratio of the number of positive lymph nodes to the total number of lymph nodes dissected. The aim of the study was to investigate the prognostic value of LNR in oral squamous cell carcinoma (OSCC). Materials and Methods: Medical records of pathologically confirmed OSCC patients who reported with loco-regional recurrence from January 2017 to January 2022 were analysed. LNR and disease-free survival (DFS) were calculated for each patient. The endpoint of the study was disease-free survival. Spearman's correlation was used to establish a correlation between DFS and LNR. Results: A total of 33 patients were included in the study. DFS was calculated for all the patients. LNR was calculated in patients with pathological N+ neck. There was a negative significant moderate correlation between LNR and DFS (Spearman's rho = -0.593, P < 0.001). A higher LNR value of more than 0.01 was associated with a shorter DFS period. T4 tumour stage had significantly higher LNR. A positive significant moderate correlation was found between LNR and tumour stage (Spearman's rho = 0.703, P = 0.01). As the T stage increased, the LNR ratio also increased. In the present study, tumour subsite tongue was associated with significantly higher LNR (P = 0.001). Discussion: LNR can be considered an independent prognostic parameter for DFS in OSCC patients with cervical lymph node metastasis.

RESUMEN

Introduction: Oral cancer is one of the most common cancers not only in India but also in South Asia. Treatment of oral cancer is not only limited to cure but also requires good reconstruction of the surgical defects for a better quality of the life. There are many well-proven options for reconstruction purposes for the defects of the oral cavity including local regional flaps to microvascular-free flaps. After resections of mobile parts of the tongue (up to 50%) speech and swallowing are impaired significantly, however, even after sophisticated plastic reconstruction, serious swallowing and speech problems persist. Material and Methods: The pilot study was carried out after the allocation of fourteen patients with carcinoma of the tongue into two treatment test groups; the Radial forearm flap (RFF) and Infrahyoid neuromuscular flap (IHF) group to evaluate and compare the treatment outcome for reconstruction using two different treatment modalities. The pilot study was carried out after the allocation of fourteen patients with carcinoma of the tongue into two treatment test groups. the clinical parameters likewise swallowing reflex, speech analysis, donor site complication, time taken for the surgery, and cost-effectiveness of the flap was evaluated using IBM SPSS Statistics for Windows software, 20.0 (IBM Corp., Armonk, USA). The data were numerically coded and entered into the program. Both the descriptive statistics and the inferential statistics involving one-way ANOVA and Tukey's Post Hoc test were analyzed to compare both intergroup and intragroup comparisons at different time intervals. Results: The swallowing and aspiration analysis showed a highly statistically significant difference at 3 months and 6 months by Post Hoc test between the groups. The speech analysis scores at all intervals were not statistically significant while for tongue movements the results were significant. The time taken and expenditure for surgery by IHF were less in comparison to RFF. Conclusion: The infrahyoid flap is a quick, easy, and reliable reconstructive method, which is cost-effective when used with knowledge of its clinical utility and limitations, the functional results are excellent with great patient satisfaction.

RESUMEN

Aim: The aim of the study was the identification of predictors of psychology and beliefs among parents of children affected by cleft lip and cleft palate. Methods: The study included a sample of 157 parents of children having cleft lips and cleft palates. Parents were given a questionnaire related to their beliefs and reasons behind deformity. Results: Out of 157 participants, 90 were fathers, and 67 were mothers. The children with deformities included 105 boys and 52 girls. The majority of parents (43) believed that the eclipse was one of the reasons for the deformity and the other was God's wrath for the mother's sins. The time of birth was considered a factor for cleft lip and palate by 27 parents. The study revealed that the self-esteem of fathers was higher than mothers and they were more concerned of being undesirably judged by others due to deformity of their children than the mothers. Conclusion: It can be inferred that the parents of a child with cleft lip and palate differ in their psychosocial adjustments. Also, mothers experience more psychosocial problems than fathers. The superstitious beliefs still prevail in rural areas despite advanced medical facilities and awareness.

RESUMEN

Although application of three-dimensional (3D) printing in oral and maxillofacial surgery (OMFS) was first reported almost 30 years back, reduction in its manufacturing cost and availability of affordable 3D printing devices have popularized its use over the past few years. The 3D-printed objects include anatomical models, occlusal splints, drilling, or cutting guides and patient-specific implants (custom made plates and reconstruction devices). The anatomical model not only assists the surgeon in better understanding of the deformity or pathology but also aids in explaining the same to the patient and relatives. Mock surgery carried out on these models improve precision and thereby reduce the operating time. The guiding splints provide an exact design and fit for the graft, thus replicating form and function of the jawbone. The patient specific implants manufactured through computer-assisted designing help in superior replication of original anatomical form. This paper intends to highlight the current applications of 3D printing in field of maxillofacial surgery in the management of facial deformity, esthetic disturbances, and jaw pathologies. Cases of condylar hyperplasia, jaw tumor, facial asymmetry secondary to joint deformity, apertognathia, and chin augmentation managed with the application of 3D printing have been described in this paper. It also discusses the history, techniques, advantages, limitations, and future scope of 3D printing technology in OMFS.

RESUMEN

Background: Osteomyelitis is inflammation of medullary cavities, haversian system and adjacent cortex of bone. It is devastating to patients when invasive. Aim: The purpose of this study is to retrospectively review patients diagnosed with diabetic maxillary osteomyelitis and evaluate factors relating infection & diabetes. Methodology: Case records of patients diagnosed with diabetic maxillary osteomyelitis were studied. Patient's demographic data, predisposing factors, etiology, clinical features, culture sensitivity reports, microbiology, treatment and complications were studied. Diabetic status was confirmed by glycosylated hemoglobin (HbA1c) test. Duration of diabetes and anti-diabetic medication adherence was also studied. Results: There were 28 patients diagnosed with diabetic maxillary osteomyelitis, (23-male; 5-female). Majority of the patients (60.7%) belonged to fourth & fifth decades. Twenty (71.4%) patients had poorly controlled diabetes (HbA1c > 8%). All patients reported with random blood sugar > 200 mg/dl. Thirteen patients (46.4%) were diagnosed for diabetes on admission and 11 patients (39.3%) had poor anti-diabetic medication adherence. Predominant etiology was odontogenic infection (50%). Cases of bacterial osteomyelitis (50%) were more frequent than those of fungal osteomyelitis (32.1%). Recurrence was observed in three cases. Conclusion: Non-cognizance about diabetes mellitus can prove devastating for maxillofacial region and may prove fatal for the patient.

RESUMEN

Dry socket or alveolar osteitis is one of the most common complication following tooth extraction. Patients usually reports of pain, which typically starts on third or fourth postoperative day and responds to simple irrigation and placement of zinc oxide eugenol (ZOE) pack, which provides an obtundent effect. The pack should be loosely kept in the extraction socket and should be changed periodically to allow healing. This report presents a case of retrieval of foreign body, which actually was a ZOE pack from maxillary sinus, 6 months after the patient underwent extraction of upper left maxillary first molar.

Asunto(s)

RESUMEN

Oral mucosa exhibit clinical manifestations of a variety of systemic conditions and can serve as an indicator of overall health of an individual. Various systemic conditions like autoimmune, endocrine and haematological disorders can present with oral mucosal lesions, which can serve as an important diagnostic feature. These oral lesions can vary from oral ulceration, bleeding gums, xerostomia, chronic glossitis, to erosion and sensitivity of teeth. It is important that a clinician must be aware of the oral presentations of systemic conditions, so that timely diagnosis can be made and the necessary treatment is executed. This paper presents an unusual case of severe oral mucosal ulcerations and dysphagia in an elderly patient diagnosed with Zenker's diverticulum. Patient was relieved of all oral symptoms once the underlying gastrointestinal tract pathology was diagnosed and surgically corrected.

Asunto(s)

RESUMEN

OBJECTIVE: This study was undertaken to investigate the prevalence of intraosseous jaw lesions among pediatrics (0-15 years of age) in a rural health-care center of Maharashtra and to determine the most common types of lesions and their distribution according to gender and anatomical site involved. STUDY DESIGN: Histopathological data were collected from a database of lesions classified as intraosseous jaw lesions dated between January 1, 2005, and December 31, 2015, from the archives of the Department of Oral and Maxillofacial Surgery, Rural Dental College, Maharashtra, India. All the cases of jaw cysts and tumors among children under 16 years of age group were segregated and scrutinized further under the headings of type of pathologies, anatomical locations where they are most commonly seen, and the age/gender most pertinent to these pathologies. RESULTS: The present study revealed that 114/3896 jaw lesions were pediatric jaw pathologies, of which odontogenic cysts were 67/114 and jaw tumors were 47/114. Among the cysts, 70% were developmental cysts and 30% were inflammatory cysts. The majority (71.6%) of the jaw cysts were found in the mixed dentition phase (7-15 years). Among the jaw tumors, 55% of them were categorized under odontogenic tumors and 45% were under fibro-osseous lesions. Similar to intraosseous jaw cysts, tumors of jaws were more prevalent under the age of mixed dentition, which was found to be 87%. Male predominance was seen and the overall male:female ratio was calculated as 1:0.52 and 1:0.5 for cysts and tumors, respectively. Mandibular posterior segment was found to be the most commonly encountered anatomical site in both the groups of cases. CONCLUSION: A large number of cases were recorded, which led us to a path of interrogation through which the reason for increased incidence was extracted, and it was agreed that though the pathogenesis remains the same in every individual, routine health checkups and early diagnosis may reduce the incidence and aggressiveness of pathologies, respectively, which was lacking at the rural area.

RESUMEN

AIM: The purpose of this paper is to describe different acquired conditions necessitating lip reconstruction and present our ten-years' experience in managing the same at a tertiary care hospital. MATERIALS AND METHODS: Data of patients undergoing reconstruction of acquired lip defects from January 2009 to December 2019 were analyzed for demographic details, etiology, extent of defect, reconstruction option used, outcome and complications. RESULTS: 89 patients underwent lip reconstruction after excision of malignant tumors (81%), vascular malformations (12%) and traumatic injuries (7%). Mucosal and cutaneous lip defects were seen in 8 (9%) and 3 (3%) patients respectively, which were treated by primary closure, local advancement flap and tongue flap. Full thickness defects involving less than 1/3rd of lip (36%) and involving up to 2/3rd of lip (33%) were treated by primary closure, Abbe, Abbe Estlander flap and Karapenzic, Bernard Webster & peri-alar crescentic flaps respectively. Sub-total lip defects were repaired using distant and free vascularized flaps. All the localized cutaneous/mucosal defect repair healed uneventfully. Complications associated full thickness defect reconstruction included reduced stoma, flap necrosis and hypertrophic scar. CONCLUSIONS: Repair of localized cutaneous/mucosal defects of lip are simple with no significant documented complication. However, full thickness tissue loss necessities careful surgical planning. The choice of surgical technique depends on the extent of lip length lost. While Karapandzic flap was most commonly utilized to reconstruct lip defect involving up to 2/3rd of the lip, radial forearm flap was a choice in managing subtotal lip tissue loss.

RESUMEN

AIMS: Dental implants have revolutionized the treatment modality for replacing missing teeth. The ability of implants to osseointegrate with the bone leads to its success. The problem is sometimes there is inadequate bone available for implant. If hygiene is not maintained, biofilms of bacteria can be formed around the dental implant. One approach to this problem has been development of bioactive surgical additives. Platelet-rich fibrin (PRF) appears as an alternative. There are various techniques of using PRF. These techniques need skill and practice to use PRF. OBJECTIVE: To evaluate implant stability and flow of injectable PRF (i-PRF) of regular implant and modified innovative design implant. MATERIALS AND METHODS: Thirty goat jaw bones were selected. Implants were placed in mandibular posterior region. Fifteen implants were placed using regular dental implant system (Group A) on the left side of jaw bone. The other 15 implants were placed using modified dental implant (Group B) on the right side of jaw bone. The body of these implants at middle has drainage vents to drain/flow the i-PRF-like dye. The dye was injected through regular and modified implants (DV-PIMS technique). Then the stability was checked with the help of Periotest. Cross section was taken 3 cm away from dental implant at the angle of mandible, to check the flow of i-PRF/platelet-rich plasma (PRP)-like dye. RESULTS: Periotest evaluation showed a mean of 2.3 for implant Group B and a mean of 1.5 for implant Group A. The flow of i-PRF-like dye was seen in Group B, and Group A does not show any flow. CONCLUSION: There are various techniques of using PRF. These techniques need skill and practice to use PRF. This (DV-PIMS) method aims to explain new implant design that disperses an i-PRF solution from inside out. The screw section of the new implant is made of a reservoir running vertically down inside. That reservoir is filled with (injectable) PRF, and then a cover screw is placed. The solution will begin to slowly diffuse out, through the vents in implant, keeping biofilms from forming or avoiding at the screw-bone interface and accelerate healing process.

Asunto(s)

RESUMEN

Sialocele is a cavity filled with saliva, usually as a result of trauma, complication of surgery, sialolithiasis or bacterial infection residing inside the duct. Many cases of parotid sialocele have been reported in the literature, but only very few cases of parotid duct sialocele have been reported. We report a case of an unusual facial swelling over buccal mucosa at the route of Stenson's duct with poor oral hygiene, a case of parotid duct sialocele with secondary infection and describe its diagnosis and management.

RESUMEN

Squamous cell carcinoma is the most common cancer occurring in the oral cavity. The lips are one of the most common sites of occurrence with involvement, lower lip being more common than upper. Reconstruction of large defects of lower lip with good functional and esthetic outcome is the biggest challenge faced by the surgeon. Karapandzic flap is one the most commonly used technique for reconstruction of large defects of the lower lip.

RESUMEN

AIM: The aim of this study is to determine the etiology, frequency of mandibular fractures among different age and sex, to determine the frequency of anatomic distribution, and to report the different modalities of treatment provided to the patients reported at our institution from February 2008 to September 2009. MATERIALS AND METHODS: All patients fulfilling the selection criteria and having mandible fracture were selected for the study. Patient information was collected by means of a medical data form specifically designed for the present study. The values were subjected to Z and Chi-square tests. RESULTS: Out of 35 patients, thirty one were males (88.57%) and four were females (11.43%) with a male:female ratio of 8:1. We found a peak occurrence in young adults, aged 21-30 years (n = 15, 42.86%). In case of etiology of fracture, road traffic accidents (RTAs) was the most common (n = 25, 71.43%) and condyle was most frequently involved site (n = 19, 38.78%). In most (n = 16, 45.71%) of the patients, an open reduction and rigid internal fixation using bone plate and screws was done. CONCLUSION: In the present study, the prevalence of mandible fractures was more prevalent in male patients, especially during the 3(rd) decade of life. The most common cause was road traffic accident and the more frequently affected region was condyle of the mandible. Open reduction and rigid internal fixation using miniplates and screws was the most commonly used treatment.

RESUMEN

Fibromatosis in the maxillofacial region is a very rare occurrence among diverse pathologic conditions, and because of the rarity of this tumor, definite treatment regimen is not established, which may be a contributing factor for a high recurrence rate. Fibromatosis may attain a large size and cause compression, infiltration, and destruction of adjacent structures. Such growth behavior presents severe management problems, especially in the head and neck region, where the presence of many vital structures within a small space makes the patient susceptible to the effects of the fibromatosis, likewise making complete excision difficult. We report the case of a 28-year-old female patient with aggressive desmoid fibromatosis involving the mandible, with a literature review of postoperative pharmacologic management to prevent recurrence.

Asunto(s)