Pedicled flaps play an important role in cancer treatment centers, particularly in developing and emerging countries. Although different flaps can be used for facial reconstruction but Pectoralis major myocutaneous flap is still considered the workhorse for maxillofacial reconstruction because of simple procedure and high success rate, while other flaps of facial region ranging from pedicled to free flaps require greater surgical skills along with unpredictable results.The aim of this study is to find outcomes of Pectoralis major myocutaneous flap in reconstruction of middle and lower facial regions. Main outcome measures are vitality of the Pectoralis major myocutaneous flap, donor site morbidity and recipient and donor site complications.This study was carried out on 36 patients in BSMMU and Health & Hope Hospital in Dhaka from 1st April 2005 to 30th June 2011 who require soft tissue reconstruction of defects of middle and lower facial regions. The age and sex of the patients and size of defect were analyzed. Vitality of Pectoralis major myocutaneous flap, donor site morbidity and donor and recipient site complications were studied. In this study, male female ratio was 13:5; mean age 50 the success rate of was 100%. All of the flaps were vital but 13.8% of the flaps had partial loss of flap.Pectoralis major myocutaneous flap is a versatile flap as it can not only provide skin and mucosal cover simultaneously, but also provide adequate muscle bulk for through and through defects. It doesn't cause any hindrance in mandibular movements. DOI: http://dx.doi.org/10.3329/akmmcj.v3i2.11690 AKMMC J 2012: 3(2): 23-29
Background: Oral and maxillofacial surgical procedures present a unique set of problems for both the anaesthesists and the surgeons. Simultaneous access to the oral or nasal cavities and dental occlusion is required for the surgical treatment of some craniofacial deformities. Generally, airway is maintained by orotracheal or nasotracheal intubation and some instances by tracheostomy however, nasotracheal intubation is contraindicated in skull base or midface fracture. Tracheostomy has inherent complications ranging from surgical emphysema to disfiguration where as orotracheal route prevents free access to oral cavity. In these circumstances, submento-tracheal intubation may provide a better option to overcome these problems. Objective: The aim of this study was to evaluate outcome of conversion of orotracheal route to submentotracheal route for surgical correction of maxillofacial trauma & deformity and time required to change from oral to submental route, accidental extubation, postoperative complications, and the healing of intraoral and submental scars were evaluated. Patients and Methods: Method: A total of 23 patients were selected from maxillofacial department of BSMMU and other institutions from December 2007 to March 2011 to use this technique. After standard orotracheal intubation, a 2 cm incision was made lateral to the midline in the submentum and a blunt dissection opposite to the skin incision on the lingual aspect of the mandible provides access to the floor of the mouth, the orotracheal tube is disconnected and pulled through the floor of the mouth then to the submental incision, the tube is then sutured to the skin. Surgery was completed without interference from flexometallic endotracheal tube. Following surgery the sequence is reversed and the patients extubated in the conventional manner. Results The technique was used in 13 patients with multiple facial fractures & 10 patients with facial deformity. The mean age of the group was 30 (20-50) years .The submental orotracheal intubation was completed successfully in all patients. No accidental extubations or tube injuries occurred. The mean time required for intubation was 6 minutes. All patients were extubated in the operating theatre. The intraoral and submental accesses healed with minimal scarring in all patients .There were no incidence of intra- or postoperative complications related to submental intubation. Conclusions Submental intubation is a simple, safe, and predictable approach without significant morbidity that facilated safe airway and enhances meticulous surgical procedure of fractured skull base and midface. JBSA 2012; 25(1): 21-27
The aim of the stuey is to evaluate the association of periodontal condition of patients with Ischemic Heart disease at a university hospital in Bangladesh. This study was done at Bangabandhu Sheikh Mujib Medical University. Two group of patients was selected. Case group of 25 patients with history ischemic heart disease was selected at OPD of cardiology department another control group 25 patient was selected at dental OPD of BSMMU. Data were analyzed by SPSS, Version 10. In this study, The mean age (±SD) of patients was 50.4±8.49 years in the case group and 49.6±10.9 years in the control group. 50 patients consisting of 26 males (52%) and 24 females (48%) were examined. Study showed that probing depth, plaque index, gingival index, bleeding index, gingival recession and clinical attachment level is more in patient with ischemic heart diseases. This study showed higher incidence and more severe periodontal diseases in patients with ischemic heart diseases. DOI: http://dx.doi.org/10.3329/uhj.v7i2.10842 University Heart. Journal Vol. 7, No. 2, July 2011
Trigeminal neuralgia (TN) is a rare form of neuropathic facial pain characterized by severe paroxysmal pain in the face. The treatment of trigeminal neuropathic pain disorder is a major therapeutic challenge. Medical therapy often fails either due to poor responses to drugs or to unacceptable side effects and for those cases local anesthesia should be considered. Twenty patients (nine men and eleven women) who were diagnosed with TN previously and were not responsive to further medical treatment were selected for treatment. For this study, the affected nerve was blocked with 1.5 ml of 0.5% bupivacaine HCl. Patients visual analogue scores (VAS) were recorded on preoperative day and on post operative at day 3, 7days, 15 days. There was a significant difference between mean preoperative and postoperative VAS value. Preoperative value was 83.10± 6.06, at postoperative 3 days was 39.60 ± 7.86, at postoperative 7 days was 16.25 ± 6.46 and at postoperative 15 days was 3.30 ± 3.19. So it can be concluded that administration of 1.5 ml of 0.5% bupivacaine HCl nerve block at regular interval can be used as treatment for patients who are affected by the side effects from high-dose antiepileptic drugs. http://dx.doi.org/10.3329/bjpp.v26i1-2.19965 Bangladesh J Physiol Pharmacol 2010; 26(1&2) : 30-33
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