ABSTRACT
Introduction: Restricted mouth opening is a long-termsequelae of head neck cancer treatment. This is a majorconcern as it leads to multiple problems in maintenanceof oral hygiene, speech, chewing, swallowing, prostheticrehabilitation, and follow-up intra-oral examination. Inthis study, our aim was to assess maximum mouth opening(MMO) amongst postoperative oral cancer patients withor without conventional radiotherapy over a period ofone year.Material and methods: A prospective longitudinal study wasdone in oral cancer patients, within three years, to compareeffect of post-operative radiotherapy (PORT) on MMO overa follow-up period of one year with control of post-operativecases without radiation. Level of significance was set at alphalevel 0.05.Results: Among 18 patients of PORT and 19 patients ofcontrol group, repeated measure ANOVA were significantfor the following parameters: within subject effect in eachgroup; between subject effect and interaction effect of monthand radiation. Multiple pairwise comparison showed MMOat 3rd, 6th, 9th and 12th month were significantly different inPORT group, in comparison to preoperative MMO. In thecontrol group however, only postoperative MMO at 1st monthwas significantly different. After one-year, mean MMO, inPORT and control was 32.56±4.29mm and 46.37±4.65mm,respectively and total trismus in radiotherapy group was66.67% and that of control group was nil.Conclusion: Conventional radiotherapy in oral cancer patientscan lead to high rate of trismus as a late effect. Strict exerciseprotocol along with close monitoring is recommended to havebeneficial effect to the patients.
ABSTRACT
Of all the deformities in leprosy, 80% require minor surgery and the rest major surgery. Upper and lower limbs and face are mainly affected by deformities. Either the median or ulnar nerve and rarely the radial nerve are involved in isolation or in combination. Tendon transfer is the only option available in cases of deformities like simian hand, ulnar claw hand, wrist drop and failure to the metacarpals. The only motor function to be restored in median nerve palsy is opponensplasty. For radial nerve palsy standard FCU transfer, FDS transfer and FCR transfer are the reconstructive methods. For ulnar nerve palsy, an intrinsic minus hand function is restored by the motors PL, ECRL, FDS, EIP or EDM extended by four tail fascia lata graft onto lateral or ulnar bands of fingers. When ulnar nerve is part of much more extensive paralysis, reducing the availability of suitable motors, static mathods of conection of claw hand are done.