Background: Ludwig's angina is an infection of the submandibular cavity in the form of cellulitis that is rapidly progressive and potentially life-threatening. Neutrophils and lymphocytes play an important role in this infection process. Neutrophil-lymphocyte Ratio (NLR) is a simple biomarker to evaluate systemic inflammation. We aimed to determine the association between NLR and various prognostic parameters in patients with Ludwig's Angina. Methods: A retrospective cohort study was conducted using medical records of Ludwig's Angina patients treated at Dr. Soetomo General Hospital, Surabaya, Indonesia, between January 2018 – December 2021. The NLR cut-off value was calculated using the receiver operating characteristics (ROC) curve. The association between NLR with severity, length of stay (LoS), and mortality were analyzed using SPSS version 23 for Windows. Results: We recruited a total of 96 patients. NLR values are divided categorically into low NLR and high NLR using a cut-off value of 16.86. There were 49 patients (51%) with low NLR and 47 (49%) with high NLR. There was a significant relationship between NLR with severity, LoS, and mortality in Ludwig’s angina patients (p=0.032, p=0.002, and p=0.026, respectively). According to a survival study, the high NLR group's survival rate was significantly lower than the low NLR group's (p=0.009). Conclusion: There was a significant relationship between NLR severity grading, survival, and the length of stay in patients with Ludwig's Angina.

Introduction:  Maxillofacial fractures were caused most by traffic accidents. This study aims to know about concomitant trauma in maxillofacial fractures.Method: Observational descriptive study to evaluate maxillofacial fracture patients in Head and Neck Division of Surgery Department, Dr Sutomo Hospital between 2015 – 2016.Result: Distribution of maxillofacial fracture patients in 2015 - 2016 based on sex, data on male patients was 77.52%. In 2015 male compared to female 70.5%, increased in 2016 male compared to female 83.82%. The side of fracture found midface fracture 48%, lower face 30.2% and combination mid and lower face 21.7%. Data on maxillofacial trauma with concomitant trauma were 46.5%. Concomitant injury in 2015 was 36.06% and in 2016 as many as 55.88% where there was an increase in cases of concomitant trauma. In 2015 there were 63.63% of the accompanying brain injuries, while in 2016 there were 42.1% brain injuries, where the trauma outside the brain injury also increased.Conclusion: Incidence of concomitant injuries in maxillofacial fractures is 46,5 %, and head injury found 50 % in concomitant injuries. The cause of traffic accidents were motorcycles.Â

Introduction: The Boey score is the most commonly used scoring system for risk stratification because of its simplicity and high predictive value for mortality and morbidity in cases of gastric perforation. This score is widely used in daily practice because it only assesses 3 assessment components; namely the onset of perforation, shock at first admission, and comorbid disease; which is easy to do and has a fairly good accuracy. In Boey score 2, the mortality rate is still high, so research on the factors that most influence mortality at Boey Score 2 needs to be done.Methods: This study uses secondary data from medical records of patients who meet criteria of inclusion and exclusion. This study is a comparative test using a cohort analytic observational study design (longitudinal retrospective), comparing the components of the Boey score which is the most influential in predicting the mortality rate in gastric perforated patients. Boey score 1 and Boey score 2 at RSUD Dr. Soetomo SurabayaResults: Total subject of the study was 65 people, consisting of 43 men (66.2%) and 22 women (33.8%). The Boey score was 16 people (24.6%) with a Boey score of 1 and 49 people (75.4%) with a Boey score 2.From the Boey score component, 49 people (75.4%) were obtained with the onset of perforation> 24 hours, 31 people (47.7%) with preoperative shock, and 34 people (52.3%) with comorbidities. Comorbidity in study subjects included hypertension in 17 people (26.2%), diabetes mellitus in 4 people (6.2%), heart disease in 4 people (6.2%), lung disease in 5 people (7.7%), and kidney disease in 7 people. people (10.8%)Conclusion: Shock is the most dominant Boey Score predictability factor that affects the mortality rate in gastric perforation patients with Boey score 1 and Boey score 2.

Background: Ameloblastomas are rare odontogenic neoplasms of the mandible and maxilla. They have high recurrence rates if improperly treated. Due to their aggressive nature and high recurrence rate, treatment remains a matter of debate. Complete excision of the lesion with the least morbidity would be the therapeutic challenge.Case Report: A 67 years old woman complained of swelling on her left jaw four years ago, the jaw was small swelling initially, and then it has grown to the size of a tennis ball. She had a history of similar swelling on the same site 12 years back for which she was operated on (enucleation). On physical examination, there is a mass in the left mandibular bone above the surgical wound, hard, painless and motionless, with a size of 18 cm x 11 cm x 11 cm. Plain x-ray examination showed multiple cystic lesions in the left mandible. In this case, segmental mandibular resection was performed, followed by reconstruction using a K-wire.Discussion: Many treatment options range from conservative treatment of curettage, enucleation to radical surgical approaches of wide margin excision. Radical treatment approaches have the advantage of lowering the recurrence rates but at the same time pose extremely difficult challenges of reconstruction of the surgical defects.Conclusion: Ameloblastoma has high recurrence rate if it is not treated properly. At least 1 cm of healthy bone should be removed during surgical procedure beyond panoramic radiograph visible margins. In our patient, though radical surgery eliminated a large possibility of recurrence.

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