Epidermoid cysts, dermoid cysts and teratoid cysts are cystic malformations lined with squamous epithelium. They present as soft nodular lesions with a sessile base. Their prevalence is 7% in head and neck patients and 1.6% within the oral cavity. The authors present a case series of 21 patients with dermoid and epidermoid cysts who underwent surgical removal. One year of follow-up was carried out without evidence of recurrence. The removal of these cysts is of great concern as it can cause serious social stigma, aesthetic and functional impairment, dysphagia and dysphonia. Key words:Epidermoid cyst, dermoid cyst, cystic malformations ABSTRACTArticle history:
Despite many advances in internal fixation, angle fracture remains among the most difficult and unpredictable fracture to treat compared with those of other areas of the mandible. Large number of studies on mandibular angle fracture treatment attests to the fact that no single approach has been shown to be ideal, and that treatment of mandibular angle fractures remains conceptually controversial, with a bothersome complication rate. During the past decade, significant attention has been placed on variety of plate fixations for mandibular angle fractures.1-14 Fixation using miniplates has been shown to simplify surgery and reduce surgical morbidity, but failed to surpass the predictability of rigid fixation. 15-18Although there have been several studies on linear and curvilinear plates for mandibular fracture fixation, only a few reports on the use of low profile three-dimensional (3D) strut or mesh plates are reported in the literature. 1,6 In fact, majority of studies on 3D strut plates are in vitro biomechanical studies. The geometry of 3D strut plate conceptually allows for an increased number of screws, stability in 3D, and resistance against torque forces while maintaining a low profile and malleability. The 2.0-mm titanium 3D curved angle strut plate allows for almost no movement at the superior and inferior borders with manual torsional and bending forces, as opposed to when a single linear plate is applied to the superior border area. When only one linear plate is placed at the superior border, torsional and bending forces usually cause movement along the axis of the plate with buccal-lingual splaying and gap formation at the inferior border, respectively. Because the Keywords ► angle fracture ► mandibular angle ► rigid fixation ► 3D plates ► curved strut plate AbstractThe aim of the study was to evaluate the efficacy and complication rate with use of 2.0-mm titanium three-dimensional (3D) curved angle strut plate for mandibular angle fractures. Twenty cases requiring internal fixation of the mandibular angle by 2.0-mm titanium 3D curved angle strut plates were evaluated. Postoperative clinical and radiological analyses were done on 1st, 2nd, 4th, and 6th weeks, which included wound healing, transmitted movements, difficulty in function and occlusion, and neurosensory changes, if any. Reasonable level of success in terms of immediate jaw function was noted in all cases. Transient inferior alveolar nerve dysfunction was observed in three cases, which recovered gradually in 2 months, and surgical site infection was observed in two cases, which resolved with appropriate course of antibiotics and wound care. Fixation of mandibular angle fractures with a 2.0-mm titanium 3D curved angle strut plate is predictable, expeditious, and has less complication rate.
To improve visualization of suspicious lesions of the oral mucosa and to assess the accuracy of Velscope in assessing cellular changes occurring in oral premalignancy for early diagnosis. Materials and methods: In this prospective, randomized in-vivo clinical study a total of 250 patients who gave history of chewing tobacco were screened. The selection of the site of biopsy was taken based on the area of loss of fluorescence identified by the Velscope within the lesion. Routine blood investigations were done. A biopsy was performed to confirm the findings of clinical examination. The data was collected and analysed. Results: Among 200 patients only 110 underwent incisional biopsy. Of these only 89 patients showed neoplastic changes. Of the control biopsies, none of them showed any dysplastic changes. Out of 106 who exhibited speckling under autofluorescence, only 89 showed dysplastic changes whereas only 17 showed no dysplastic changes. Out of these 17 specimens, the histopathological diagnosis of 5 was coated tongue, 3 were pigmented lesions, 3 were geographic tongue and 2 were mucositis. Of the remaining 4, the histopathological diagnosis of 1 was oral submucous fibrosis, 1 was lichen planus and 2 were frictional keratosis. Conclusion: False positive findings are possible in presence of highly inflamed tissues, and it is possible that use of Velscope alone may result in failure to detect regions of dysplasia, but it has its use definitely to improve clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Use of the scope has allowed practitioners to identify the best region for biopsy. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. However, poor specificity is a major limitation for using it as a screening tool.
Introduction Mucormycosis emerged as a wildfire in post-covid-19 infected patients. Most frequently involved sites of mucormycosis are rhino-orbital, rhino-sinusal and rhino-orbito-cerebral. The hallmark sign of mucormycosis is tissue necrosis, which is often a late sign. The fatality rate of mucormycosis is 46% globally. Despite early aggressive combined surgical and medical therapy, the prognosis of mucormycosis is poor. Methods We searched the electronic database of PubMed, web of science, Embase, Scopus and Google Scholar from Jan 2020 until December 2021 using keywords. We retrieved all the granular details of original research articles, case reports/series of patients with rhino-orbito-cerebral mucormycosis (ROCM), and COVID-19 reported worldwide. Subsequently, we analyzed the patient characteristics, associated comorbidities, location of mucormycosis, treatment given and its outcome in people with COVID-19. (Prospero registration-CRD42021256830, June 4, 2021).Results Overall, 544 rhino-orbito-cerebral mucormycosis patients were included in our review with a history of Covid-19 infection. Out of which 410 patients had diabetes mellitus which has proven to be major contributing immunocompromised disease. Other diseases like hypertension, chronic kidney diseases, hypothyroidism, etc., were also attributed as an immunocompromised disease causing increased number of covid associated mucormycosis cases. We found out that total number of patients alive after taking only antifungal drug treatment were 25 in number, whereas total number of patients alive when antifungal drugs were combined with surgical intervention were 428 which was significantly higher. Conclusion Our systematic review concluded that surgical debridement should be performed whenever feasible in parallel to antifungal treatment in order to reduce the mortality rate of COVID-19 associated rhino-orbito-cerebral mucormycosis patients. KeywordsRhino-orbito-cerebral mucormycosis • Covid associated rhino-orbito-cerebral mucormycosis • Covid associated mucormycosis • Mortality • Treatment * Sneha Setiya
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