ObjectivesThe objective of the study was to evaluate the results of nasolabial/extended nasolabial flaps as a modality for treatment of oral submucous fibrosis.Materials and MethodsEleven patients of Stage III or IVa maximum interincisal opening were selected to be operated. Nasolabial/extended nasolabial flaps were done for both the sides. All of the flaps were done in a single stage and were inferiorly based. A similar flap harvest/surgical technique was utilized for all the cases.ResultsThe preoperative mouth opening ranged from 5 to 16 mm, with a mean of 10.09 mm. At 6 months the mouth opening ranged from 29 to 39 mm. Some of the complications encountered were poor scar, wisdom tooth traumatising the flap, decreased mouth opening due to non compliance and too much bulk. All of theses were managed satisfactorily.ConclusionThe nasolabial flap is a very reliable flap to restore the function of oral cavity. Important adjuvant measures are habit cessation, lifestyle changes, and aggressive physiotherapy.

Sphenoidal Dysplasia is the absence of complete or a part of sphenoid bone, most commonly the greater wing of sphenoid. It can occur as an isolated deformity or in Neurofibromatosis-1 (NF1). Features of NF1 include café au lait spots, inguinal or axillary freckling, neurofibromas, optic gliomas, scoliosis and tibial deformity. Our study is retrospective case series of 3 cases of Sphenoid wing dysplasia. There was 1 case of isolated bone defect, 1 case of NF-1 and 1 case of operated Craniofacial Fibrous Dysplasia involving the sphenoid wing. There were 2 primary operated cases while 1 was operated secondarily. There was resolution of pulsatile exophthalmos in patient with sphenoid and temporal bone defect. Patient with facial deformity NF1 was debulked to the satisfaction of the patient, the patient however declined surgery to correct the sphenoid bone deformity. The 3rd patient was a re-do surgery patient in which the previous implant material was removed and the CSF rhinorrhoea, the patient did not consent to the correction of vertical orbital dystopia. Sphenoid wing dysplasia is a complex deformity requiring multi-speciality care and treatment planning. With meticulous planning and surgery, good results can be achieved as shown in our case series.

Introduction: In maxillofacial trauma the preferred intubation method for general anesthesia is nasotracheal intubation in most of the trauma centers. We conducted a retrospective study to review the utility of this method of intubation in maxillofacial trauma patients. We aimed to review the intra-operative and postoperative concerns and complications for nasotracheal intubation and effectiveness of this method of intubation in maxillofacial trauma patient. Methodology: This study included 56 patients of maxillofacial trauma, who were treated in our centre of Oral and Maxillofacial Surgery at Islamic International Dental Hospital, Islamabad in the period of two years, 1st January 2016 to 31st December 2017. Results: The study showed that nasal intubation is relatively more effective in isolated mandibular trauma patients. But there are difficulties regarding intubation in maxillary fractures and pan-facial trauma patients. Conclusion: Although nasotracheal method of intubation is difficult to attain in some cases, but still it is an effective method of intubation for majority of the maxillofacial trauma cases with very low rate of complications. Received: 30 Sep 2018Reviewed: 16 Nov 2018Accepted: 17 Nov 2018 Citation: Khan K, Bibi J, Qayyum MU. Intubation concerns in maxillofacial trauma patients Anaesth Pain & Intensive Care 2018;22 Suppl 1:S109-S112

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Orbital hypertelorism is an increased distance between the bony orbits and can be caused by frontonasal malformations, craniofacial clefts, frontoethmoidal encephaloceles, glial tumors or dermoid cysts of the root of the nose, and various syndromic or chromosomal disorders. We report a series of 7 cases of hypertelorism that were treated in our hospital. The underlying causes in our series were craniofacial clefts 0 to 14 (4 cases), craniofacial clefts 1 to 12 (1 case), and frontonasal encephalocele (2 cases), all congenital. Surgical techniques used to correct the deformity were box osteotomy and medial wall osteotomy with or without calvarial and rib grafts. A few of our cases were reoperations with specific challenges.