Aim: To estimate the frequency of cervical lymph node extracapsular spread in oral squamous cell carcinoma patients. Methodology: This prospective study was conducted in the Department of Oral and Maxillofacial Surgery, The University of Lahore from 1st December 2021 to 30th November 2022 and 50 diagnosed cases of oral squamous cell carcinoma were enrolled. Computed tomography scan was conducted for the diagnosis in addition to the histopathology of the samples. The CT scan images were used for identification of lymph node size, shape, and central necrosis. The frequency of the extracapsular extension of lymph nodes with the central necrosis was correlated with histopathology. Results: The mean age of the patients was 60.5± 11.1 years with 60% of the cases were males and 40% of the cases were females. 36% of those patients were having a history of smoking, 22% were having a history of taking pan, 14% supari & chalia, 8% alcoholics and 6% consuming gutka. The primary tumor site identified through clinical and diagnostic imaging was anterior 2/3rd of tongue in 38% followed by posterior 1/3rd of tongue in 20%, buccal mucosa 14%, mandible and lip each as 10%, maxilla 4%, floor of mouth and retromolar trigone region each as 2%. It was observed that T3 and T4 cases had more ECS than T1 and T2 with a percentage of 20% and 30% respectively. Practical implication: Knowledge of frequency and burden of this disease in Pakistan will assist in generating more efficient management and treatment protocols with early detection strategies of oral squamous cell carcinoma through association analysis and biomarker role of cervical lymph node extracapsular spread. Conclusion: Extracapsular spread is observed more in patients having advanced stage tumor or having advanced grade of oral squamous cell carcinoma. Key words: Extracapsular spread, Oral squamous cell carcinoma, Recurrence, Histopathological examination
Aim: To evaluate the difference and functional outcome between open reduction and internal fixation (ORIF) and intermaxillary fixation (IMF) in mandibular fractures. Study Design: Retrospective study. Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Faryal Dental College, Sheikhupura, Lahore from 1st February 2019 to 31st January 2021. Methodology: One hundred and fifty seven patients treated for fractures of mandible and reviewed their prognosis based on use of intermaxillary fixation after reduction of fracture. The patients were divided into two groups; Manual reduction group without the intermaxillary fixation and the intermaxillary fixation group. Results: Good results have been obtained in most patients after mandible fracture reduction. However, complications occurred in 19 (27.5%) patients in group 2 after surgery. 6 patients had an infection, 4 patients had a wound dehiscence, and 4 patients had osteomyelitis. No loosening of the mounting bolts and/or crack of the mounting plates was observed. Correct occlusion was achieved using posterior arch wires and elastic rings in 2 malocclusion patients. Occlusion failed in two patients in Group 1 due to osteomyelitis, and the second operation was performed under general anaesthesia. The mean complication severity scores for Group 1 and Group 2 were 1.37 and 1.38, respectively, with no significant difference. Conclusion: Among the patients treated with manual reduction, 2 patients had malocclusion and 1 patient required a new surgery. Such a simple mandible fracture can give good results even with manual reduction without intermaxillary fixation. For a simple mandible fracture, only manual reduction without intermaxillary fixation or intermaxillary fixation was recommended for a short time. Key words: Complication, Fracture, Internal fixation, Mandible
Background: Head and neck carcinoma is the malignant lesions which develops on lips, oral cavity, nasal mucosa, paranasal sinuses, inside or outside the throat or parotid glands. Magnetic resonance imaging can be a good alternative to invasive procedures for detection of metastatic disease in cases of head and neck tumors. Objective: To evaluate diagnostic accuracy of magnetic resonance imaging in detecting metastasis in neck nodes of oral squamous cell carcinoma with reference to postoperative neck histopathology. Study Design: Cross sectional study Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Mayo Hospital Lahore from 1st January 2014 to 30th June 2014. Methodology: Eighty seven patients with biopsy proven squamous cell carcinoma of orofacial origin were enrolled who had single malignant tumor at the time of diagnosis. Results: The mean age of the patients was 50.44±12.44 years. There were 58 (66.67%) males and 29 (33.33%) females. In terms of sensitivity, specificity, and diagnostic accuracy, magnetic resonance imaging was 94.12%, 61.11%, and 80.46% respectively taking histopathology as gold standard. Conclusion: For the detection of cervical nodal metastases in oral squamous cell carcinoma, MRI is a useful and trustworthy method with a high sensitivity and specificity, especially when compared to postoperative neck histopathology. Keywords: Histopathology, Carcinoma, Magnetic resonance imaging (MRI),Metastasis
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