Diagnosis of mid-cheek mass has always been a diagnostic dilemma for clinicians. The incidence of the accessory parotid gland (APG) has been well documented in the literature. However, a diverse spectrum of pathologies can arise from this accessory parotid tissue. Basal cell adenoma is a rare benign tumor that predominantly affects the parotid gland. Its occurrence in the accessory parotid gland has been documented in 9 cases till date. Surgical approaches for the management of such APG lesions have been in debate. This report documents a case of Basal Cell Adenoma arising in accessory parotid tissue in a 55-year-old woman who was treated by transoral excision. This paper also reviews previously documented cases of all APG lesions and attempts to elucidate the rationale for selecting an appropriate surgical approach.
Background
Lignocaine with adrenaline is routinely used as a local anesthetic for dental procedures. Adrenaline was added to increase the duration of anesthesia. However, epinephrine containing a local anesthetic solution is not recommended in conditions such as advanced cardiovascular diseases and hyperthyroidism. Recently, ropivacaine has gained popularity as a long-acting anesthetic with superior outcomes. The goal of this study was to assess and compare the effectiveness of 0.75% ropivacaine alone and 2% lignocaine with adrenaline (1:80,000) in the removal of bilateral maxillary wisdom teeth using the posterior superior alveolar nerve block technique.
Methods
This was a single-blind, randomized, split-mouth, prospective study assessing 15 systemically sound outpatients who needed bilateral removal of maxillary third molars. We randomly allocated the sides and sequences of ropivacaine and lignocaine with adrenaline administration. We evaluated the efficacy of both anesthetics with regard to the onset of anesthesia, intensity of pain, variation in heart rate, and blood pressure.
Results
The onset of anesthesia was faster with lignocaine (138 s) than with ropivacaine (168 s), with insignificant differences (p = 0.001). There was no need for additional local anesthetics in the ropivacaine group, while in the lignocaine with adrenaline group, 2 (13.3%) patients required additional anesthesia. Adequate intraoperative anesthesia was provided by ropivacaine and lignocaine solutions. No significant difference was observed in the perioperative variation in blood pressure and heart rate.
Conclusion
Ropivacaine (0.75%) is a safe and an adrenaline-free local anesthetic option for posterior superior alveolar nerve block, which provides adequate intraoperative anesthesia and a stable hemodynamic profile for the removal of the maxillary third molar.
Aim:
This study aims to compare the level of serum beta-2 microglobulin (β2-M) in normal healthy individuals and patient with squamous cell carcinoma (SCC).
Methodology:
This study has been conducted in patients attending the Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Deralakatte, Mangalore. Sample comprises of 25 cases of clinically and histologically diagnosed oral cancer and 25 normal healthy individuals as control group. The serum was analyzed for β2-M by enzyme-linked immunosorbent assay.
Results:
It was observed that there was a significant increase in serum β2-M levels in oral SCC patients as compared to controls. Circulating levels in serum β2-M were also elevated significantly among different clinical stages with progressive rise from stage I to stage IV of the disease.
Conclusion:
The evaluation of these markers would be useful in assessing malignant change, increasing accuracy of clinical diagnosis and also in assessing the spread and invasiveness of the cancer of the oral cavity.
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