The primary goal of palatoplasty is to achieve a tension-free palatal closure ensuring no postoperative complications. Many surgeons fracture the pterygoid hamulus to minimize tension during palatoplasty. However, this maneuver gained criticism by some authors on the grounds that it may lead to Eustachian Tube dysfunction. Our study intended to figure out the relationship of hamulus fracture with the postoperative state of middle ear in cleft palate children. Fifty consecutive cleft palate patients with an age range of 10 months to 5 years were recruited. All the patients were assigned to either hamulotomy or nonhamulotomy group preoperatively. The patients were subjected to otoscopic examination and auditory function evaluation by brainstem evoked response audiometry (BERA) preoperatively and 1 month and 6 months postoperatively. Otoscopy revealed that the difference in the improvement of middle ear status in both groups was statistically insignificant. Moreover, there was no significant difference in the BERA outcomes of the fracture and nonfracture populations. Complication rate in both groups was also statistically not significant. It can be concluded that hamulotomy does not have any effect on the hearing ability in cleft palate population, so hamulotomy can be performed for tension-free closure during palatoplasty.
Metastases in the oral cavity are rare and comprise approximately 1% of all oral malignancies. They usually involve the jaws but may also be found in the soft tissues and salivary glands. The most common metastatic malignancies in women are from primary cancers in the breasts. A case report of a 50-year-old female is presented here who underwent bilateral mastectomies two years back and now has presented with metastasis to mandible along with history of pulmonary metastasis, lymphedema of single arm and vesiculobullous lesion at surgical site. Diagnosis of metastasis was confirmed by histopathology giving picture of invasive ductal carcinoma. This case illustrates the importance of suspecting a metastatic lesion in the jaw. As these lesions are associated with a poor prognosis, early detection is of utmost importance.
The succedaneous permanent teeth develop in close proximity to primary teeth. They can get accidentally luxated or avulsed during the extraction of primary teeth. The purpose of this paper was to describe a case of a 14-year-old boy with an “iatrogenic avulsion” of an immature mandibular second premolar during the extraction of a primary mandibular second molar. The case was managed successfully with replantation technique within 30 minutes of extra oral period and followed up for 5 years. The replanted tooth remained clinically asymptomatic, showed continued root development and eruption and remained vital. This paper had also discussed about the modifications in extraction technique to avoid the iatrogenic avulsion of permanent tooth bud during extraction of primary teeth.
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