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Objective: To determine the frequency of occult cervical metastasis in oral squamous cell carcinoma patients. Methods: This cross sectional study was conducted in the department of maxillofacial surgery, Mayo Hospital, Lahore from July 31st, 2015 to January 31st, 2016 on 100 patients of oral Squamous Cell Carcinoma (SCC) having clinically and radiologically negative nodes. Prophylactic functional neck dissection was done in each patient and was sent to the pathology lab for evaluation of any occult metastasis. Results: Overall frequency of occult cervical metastasis was found to be 27%. In 41(41 %) specimens of SCC of tongue, 13(31.7%) had occult metastasis. In Alveolar mucosa occult metastasis was found in 4(20 %) out of 20(20 %) patients. In SCC of buccal mucosa occult metastasis was found in 10(29.4%) out of 34(34 %) patients. In SCC of lip no occult metastasis was detected. Conclusion: Within the boundaries of the present study, it is concluded that occult cervical metastasis was most frequent in cases of SCC tongue, whereas no occult cervical metastasis detected in SCC of lip. Key Words: Squamous cell carcinoma, cervical lymph nodes, prophylactic neck dissection, occult cervical metastasis. Continuous...

Aim: To estimate indications and frequency of plate removal in patient treated for maxillofacial fractures. Method; In this retrospective study, records were reviewed from March 2015 to March 2018, over a period of 3 years. 139 Maxillofacial trauma patients treated with Open reduction and Internal Fixation with 202 plate, Result; In 139 patients, 202 plates were implanted for bone fractures. In total, 128(92%) were male and 11(8%) were female, 32(23.02%) had revisited with complaint and subsequently 47(23.26%) plates were removed. Mandible was commonest location where majority of the plates32(68.08%) were removed. Most common reason for plates removal was infection 20(42%). Minimum time for plate in situ was 3 months. Conclusion; the reason for plate removal is multifactorial. Establishing measures to minimize plate related complication and avoid patients from further invasive procedures. Keywords: Facial Bone Fracture, Osteosynthesis Plate, Plate Removal Trauma.

Objectives: Surgical treatment of patients with multiple mandibular fractures involving condylar segments may be a difficult proposition for a maxillofacial surgeon. These fractures can be double or triple fractures of the lower mandible and can also be associated with other fractures of the face. While many authors have suggested that the conventional approach to reducing and stabilizing a mandibular symphysis / para-symphysis fracture is appropriate before addressing a fractured condyle, there is another school of thought that suggests that the condylar segment should be reduced and repaired first. This article aims to review the results of operations where the reduction and fixation of a fractured condyle is performed prior to other associated mandible fractures, and to explore the effectiveness of various surgical methods including preauricular and retromandibular proposed in this case. Place and Duration: In the Oral and Maxillofacial surgery department of Faryal Dental College, Lahore for two-years duration from Jan 2018 to Jan 2020. Material and methods: The study included 60 surgically treated patients with multiple mandible fractures (double / triple), including the condyle component. For treatment of the fractured condylar segments, the preauricular and retromandibular (anterior parotid-transmasseteric) approach was used. Results: Condyle fracture was the first segment to be managed during sequencing of surgical treatment, regardless of the method used. First, good reduction and stabilization have been achieved with limited complications in treating a condyle fracture. Conclusion: While it is the surgeon's prerogative to sort multiple mandible fractures, addressing the condylar segment first provides the operator with a viable alternative to the conventional technique. Key words: condylar fractures, multiple mandibular fractures, preauricular approach, retromandibular approach

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