Introduction: An unsightly scar following cleft repair can undo the good work of even an experienced surgeon. A functioning orbicularis oris muscle beneath the lip scar maintains a zone of dynamic tension resulting in a stretched scar. Botulinum toxin type A (BTA) can be used to create a temporary paralysis of the orbicularis muscle during the healing phase. This may lead to better scar formation after a cleft lip repair. Method: The present prospective randomized control trial enrolled 28 infants with unilateral cleft lip undergoing primary lip repair. They were randomized to receive injection of either BTA (botox group) or normal saline (control group) intraoperatively into adjacent orbicularis oris muscle immediately after completion of cleft lip repair. Blinded experts reassessed the scar after 6 months. Objective assessment was undertaken employing Visual Analogue Scale (VAS), Vancouver Scar Scale (VSS), and photographic scar width measurements. Results: Twenty-two subjects were able to complete a follow-up duration of 6 months. Children in the BTA (Botox Group) had a statistically significantly better VAS score and lesser scar width compared to the control group. However, the difference in the VSS score between both groups was not statistically significant. On comparing patients with cleft lip alone with cleft lip and palate, no statistically significant difference was found in VAS, VSS, and scar width. There were no complications associated with the use of botulinum toxin A. Conclusions: Botulinum toxin type A injection is a safe and effective addition to improve scar appearance following cleft lip repair. There was improvement in appearance of the scar in terms of width, but no improvement was seen in the scar pigmentation. The scar outcome is independent of cleft lip classification.
This study is to Analyze Association of Level 3 Lymph Node Metastasis with various contributing factors was conducted at SMS, Medical College & Hospital, Jaipur.
Lump was most common symptom of presentation with pain and nipple discharge distant second and third. Nipple areola complex and skin involvement was less.
Mean duration of symptom before diagnosis was 3.61 months and in those with level III positivity it was 4 months. It was higher than western studies but similar to other studies in India and developing countries, reflecting delay in seeking medical opinion.
Keywords: Level 3, Lymph Node & Metastasis.
These days, the world is afflicted with various types of non-communicable diseases, which are also known as modern epidemics. Cancer is one among them. Head and neck cancer (HNC) is the sixth most common malignancy reported worldwide and one with high mortality ratios among all malignancies. The Indian subcontinent accounts for one-third of the world's burden
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