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Background: Peripheral neurectomy(PN)is a minimally invasive procedure, for the management of trigeminal neuralgi (TN)consisting of surgical avulsion of terminal branches of the trigeminal nerve. Aim: To assess the efficacy of PN in the treatment of refractory TN and their recurrences in a follow up of 18 months. Materials and Methodology: Retro-prospective and prospective study was conducted on randomly selected 30 TN patients irrespective of age, gender and socio-economic status. The branch of trigeminal nerve involved was identified according to the site of pain. Then the PN procedure was performed under local or general aesthesia. The follow up of each patient was done for next 18 months. Results: Mean age of the TN patients 53.17 ± 13.84 years, with 66.7% of patients were within 60 years of age. Male to female ratio was 1:1.5. All patients showed unilateral TN. Mostly 26.7% trigger point was located in lower lip followed by 13.3% in upper lip. After 3,6 and 9 months follow-up, none of the TN patients treated with PN had pain and none had any effect on general activity. However, from 12 months till 18 months' follow up, 2 (6.7%) patients reported of pain. Conclusion: PNs are viable treatment alternative for TN, although peripheral neurectomy has chances of reoccurrence but still offer better quality of life in patients for many years without relaps.
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Introduction: Patients with OSCC in India (oral squamous cell carcinoma) presents at a later stage with approximately 28% presenting at stage III and 64% at stage IV disease. In this retrospective study we have reviewed the treatment modalities rendered and outcomes associated for the management of locally advanced oral squamous cell carcinoma in our Institute. We evaluated the survival data and the factors effecting survival. Methods: Kaplan Meir method was used to evaluate OS and DFS rate and log rank test was used to compare the survival amongst groups. Cox regression analysis (univariate and multivariate) was used to evaluate the hazard ratio to find out the possible factors influencing risk of death and disease. Results: The median OS and DFS in our study were 32 and 24 months respectively. On a subset analysis of only T4b patients who underwent either upfront surgery or induction chemotherapy followed by surgery there was no significant difference in OS and DFS. All patients with TURD had partial response after induction chemotherapy and were subjected to surgical resection followed by adjuvant therapy. Conclusion: Extracapsular spread, bone involvement, skin infiltration, treatments, surgical margins and Lymph node size are the prime predictors of survival.Upfront surgery remains the standard of care for resectable LAOSCC. Induction chemotherapy might improve the resectability in technically unresectable OSCC. There is no difference in survival between concurrent chemoradiation, sequential chemoradiation and radical radiotherapy in the management of unresectable disease. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04168-4.