Background and Objectives The purpose of this prospective study was to evaluate the incidence and various risk factors influencing the sensory deficit in case of lingual nerve injury (LNI) in individuals whose impacted mandibular third molars are surgically removed under local anesthesia. Materials and Methods The study was based on the data collected prospectively from a random group of 100 patients who underwent surgical removal of bony impacted lower third molar in a dental hospital. Details of the patient, reason for extraction, type of impaction, method of surgery and signs and symptoms of nerve injury are recorded. Neurosensory testing was done to evaluate the LNI at 1 week, 1 months, 3 months and 6 months interval.Comparison was carried out using Chi square test. For all tests a P \ 0.05 was considered significant. Results The incidence of LNI was 4 % and of temporary in nature which recovered well within 6 months postoperatively. The age of the patient above 26 years, lingual flap retraction, depth of impaction (red line C10 mm) and duration of surgery above 30 min were the significant factors for causing LNI. Conclusions The age of the patient, depth of impaction, lingual flap retraction and longer duration of surgery are significant risk factors for LNI during mandibular third molar surgery. Greater care should be taken to avoid the morbidity and patients should be informed well ahead about the probable complications.

Odontogenic Keratocyst (OKC) is a developmental non-inflammatory odontogenic cyst which is proposed to be arising from cell rests of dental lamina. Among the jaw cysts OKCs account for third most common following radicular and dentigerous cyst. Most of the studies have stated that posterior part of the mandible is the most common site, but there are inconsistencies regarding the prominent location of OKCs in the maxilla. Very few studies and cases are reported with OKCs crossing maxillary midline. If do occur they are in older individuals. According to WHO reclassification, this cyst is considered as Keratocystic Odontogenic Tumour (KCOT) because of its neoplastic nature. This article describes a rare site of occurrence of this lesion especially in young patient.

Palatal fistulas are the common complications seen after cleft palate repair. Small fistula may be asymptomatic, the large ones produce various symptoms including regurgitation of fluids into nasal cavity and interference with normal speech. Although small fistulas can be successfully treated with local flaps such as palatal or buccal mucosal flaps, large fistulas pose difficulty. Because of rich blood supply, tongue is a suitable and convenient source of large flap. The anterior based dorsal tongue flap is a safe and effective method for closure of relatively large recurrent palatal fistula with out any functional impairment of donor site. This article describes one such case treated by single layer closure using anteriorly based tongue flap with excellent outcome.Keywords Palatal fistula · Cleft palate · Local flaps · Rich blood supply of tongue · Anterioly based dorsal tongue flap

Introduction: Chronic rhinosinusitis is a common health problem.However few studies comparing pre and post-FESS microorganisms and efficacy of FESS are present.The present study aims to analyze the alteration in sinonasal microbiome in patients of chronic rhinosinusitis with and without nasal polyposis after functional endoscopic sinus surgery. Patients and Methods: The prospective observational study was conducted in the Department of Otorhinolaryngology and Head Neck Surgery, SRMS IMS from November 2017 to April 2019 after the approval by the Research/Ethics Committee. All patients clinically diagnosed as Chronic Rhinosinusitis (CRS) with and without Nasal Polyposis posted for Functional Endoscopic Sinus Surgery (FESS) formed the study group.Culture analysis of specimen from middle meatus region was done twice first, prior to FESS and second 6 weeks post-FESS.The changes in the microbiome were then analysed. Results: In 31.4% patients methicillin resistant staphylococcus aureus was cultured prior to FESS. Other organisms cultured were Staphylococcus aureus, Pseudomonas, Aspergillus, E.coli, Rhizopus and E.Faecalis. Post-FESS cultures were obtained at 6 weeks. Staphylococcus aureus was cultured in 77% cases. No fungal microbes or MRSA were cultured post operatively. In 11.4 % cultures no microorganisms were detected. No statistical correlation was observed between the diagnosis and organisms cultured. Conclusion:The preoperative culture of MRSA and its absence in post-FESS cultures points to role in the pathogenesis of CRS. Fungal organisms Aspergillus and Rhizopus were cultured pre-operatively which were present in combination with bacteria supporting the co-infection theory. Effective role of FESS as surgical management is also consolidated.

<p class="abstract">Osteosarcoma is an uncommon primary malignant tumor of bone. Craniofacial osteosarcomas constitute only about 6.5–7% of all osteosarcomas. The most common histopathologic type is chondroblastic type in head and neck group and osteoblastic in extremity group. We present a case report of 21 year old male patient with chondroblastic osteosarcoma with two episodes of recurrence. The tumour was dealt with left hemimandibulectomy followed by radiochemotherapy. After first recurrence he underwent right hemimandibulectomy. During second recurrence excision of growth followed by radiochemotherapy was done. Thus an aggressive multi-modality approach was adopted for treatment. Osteosarcoma is an uncommon primary malignant tumor of bone. Craniofacial Osteosarcomas are considered a separate category in view of their low histologic grade, less frequent metastases and better prognosis. The most common presentation is local swelling with or without pain. Aggressive surgical approach with post-surgical radiochemotherapy can be an effective tool.</p>

Introduction- Trauma from external causes poses one of the greatest challenges for public health services in different parts of the world. Maxillofacial fractures are the most common outcome of trauma. Several factors which are contributing to these can be managed well after careful examination of the clinical profile of the patients. Aim - This study was done to find the clinical profile of maxilla facial fractures in a tertiary care hospital in Uttar Pradesh. Materials and methods -A retrospective study was conducted in Department of Otolaryngology and Head and Neck Surgery, SRMS IMS from May 2016 - October 2018. Medical records of 53 patients in and around west Uttar Pradesh with maxillofacial injuries admitted in our hospital were studied. Results –Males in age group in 20-40 yr were mostly involved in RTA which was most common cause of fmaxillofacial injuries. Fracture mandible was the most commonly fractured bone. Conclusion - There has to be strict regulations installed by the government to ensure compliance of rules regarding use of seat belts while driving and use of helmet while riding two-wheeler. Better compliance of traffic rules is an important factor in reducing the incidents of this trauma. KEYWORDS -Maxillofacial trauma, RTA , Fracture mandible