ABSTRACT
Introduction: Difficulties to find the ideal donor site with perfect matching tissues have always made the reconstruction of facial complex defect a tough problem for surgeons. The main aim of reconstruction is to restore facial contour (esthetics) and function (mastication, deglutition, and speech). Aim: The aim of the study was to analyze the versatility of forehead flap in maxillofacial/nasal and intraoral defects. Materials and Methods: This retrospective study was conducted to analyze the versatility of forehead flap in maxillofacial/nasal and intraoral defects. A total of 25 consecutive patients, of either sex, who required soft tissue reconstruction of the maxillofacial region, including oral cavity and nasal defects due to tumor ablative surgery. Follow-up was done for up to 4 months – 1 year and on every follow-up visit, patients were questioned about the degree of satisfaction, with mouth opening, swallowing, and donor site esthetics. Cosmetic deformity judged subjectively. Results: Of 25 patients, 17 patients were males, 12 patients were above 60 years. Maximum number of site of tumor involvement was noted in cheek 9 patients (36%) and in lower lip 5 patients (20%). About 44% patient had stage 2 tumors and 28% had stage 3 tumors. About 18 patient had adjuvant radiation, 1 patients had chemo RT, and 6 patients had no adjuvant treatment. About 16% of patients had a complication of altered forehead sensation. Conclusion: Forehead flap is a reliable technique for the reconstruction of maxillofacial region defects. It is easy to rise and can provide coverage for wide defects as far as the para mandibular and submandibular regions. Moreover, it does not require patient repositioning.
ABSTRACT
Introduction: Major head and neck surgery involve dissections close to crucial structures such as nerves and vessels. For this reason, it is very important to use safe instruments for dissection and hemostasis. In a wide variety of surgical procedures, advanced vessel sealing devices are replacing traditional techniques for vessel ligation. Aim: Our study aimed to compare the bipolar vessel sealing system versus suture ligation in selective neck dissection in patients with oral cancer. Methods: This prospective comparative study was conducted to compare the outcome of the bipolar vessel sealing system versus suture ligation in selective neck dissection in patients with oral cancer. Out of 40 patients enrolled in the study, 20 patients were in Group A (bipolar vessel sealing system) and 20 patients in Group B (Suture ligation). The outcome measures recorded were blood loss, operating time, duration of hospital stay, pre-operative blood transfusion, Fromme’s surgical field scale, post-operative pain, and drainage volume. Treatment protocol and follow-up protocol were followed and the results were statistically analyzed and discussed. Results: Out of 40 patients, 20 patients had bipolar vessel sealing system and 20 patients had suture ligation. In bipolar vessel sealing system of 20 patients, 12 patients were male and 8 patients were female, mean value of blood loss is 26.84 ± 22.34 ml, operating time is 48.56 ± 5.48 min, duration of hospital stay is 12.92 ± 1.28 days, mean value of post-operative pain in day 0 is 3.5 ± 1, day 1 is 3.1 ± 1, day 2 is 1.8 ± 0.5, and day 3 is 1.1 ± 0.5, and drainage volume (ml) in 24 h is 72.48 ± 28.46, 48 h is 24.57 ± 18.29, and 72 h is 7.24 ± 6.7. In suture ligation of 20 patients, 15 patients were male and 5 patients were female, mean value of blood loss is 39.28 ± 16.44 ml, operating time is 54.22 ± 4.14 min, duration of hospital stay is 13.87 ± 1.42 days, mean value of post-operative pain in day 0 is 4.01 ± 0.9, day 1 is 3.8 ± 1.1, day 2 is 2.4 ± 0.6, and day 3 is 1.6 ± 0.8, and drainage volume (ml) in 24 h is 98.28 ± 36.87, 48 h is 41.28 ± 21.24, and 72 h is 18.29 ± 9.45. Conclusion: Bipolar vessel sealing system is more efficacious in terms of reducing blood loss, operating time, and better surgical field than conventional suture ligation. Thus, bipolar vessel sealing system is more advantageous compared to the traditional techniques, from both a clinical and economic point of view.
ABSTRACT
Dipeptidyl peptidase (DPP)-IV inhibitors are a new approach to the treatment of type 2 diabetes. DPP-IV is a member of a family of serine peptidases that includes quiescent cell proline dipeptidase (QPP), DPP8, and DPP9. DPP-IV is a key regulator of incretin hormones, but the functions of other family members are unknown. To determine the importance of selective DPP-IV inhibition for the treatment of diabetes, we conducted molecular docking studies on clinical inhibitors of DPP-IV.