Nasolabial and extended nasolabial flaps for reconstruction in oral submucous fibrosis

OBJECTIVES: The objective of the study was to evaluate the results of nasolabial/extended nasolabial flaps as a modality for treatment of oral submucous fibrosis. MATERIALS AND METHODS: Eleven patients of Stage III or IVa maximum interincisal opening were selected to be operated. Nasolabial/extended nasolabial flaps were done for both the sides. All of the flaps were done in a single stage and were inferiorly based. A similar flap harvest/surgical technique was utilized for all the cases. RESULTS: The preoperative mouth opening ranged from 5 to 16 mm, with a mean of 10.09 mm. At 6 months the mouth opening ranged from 29 to 39 mm. Some of the complications encountered were poor scar, wisdom tooth traumatising the flap, decreased mouth opening due to non compliance and too much bulk. All of theses were managed satisfactorily. CONCLUSION: The nasolabial flap is a very reliable flap to restore the function of oral cavity. Important adjuvant measures are habit cessation, lifestyle changes, and aggressive physiotherapy.

Surgical correction of grade III hypertelorism

Orbital hypertelorism is an increased distance between the bony orbits and can be caused by frontonasal malformations, craniofacial clefts, frontoethmoidal encephaloceles, glial tumors or dermoid cysts of the root of the nose, and various syndromic or chromosomal disorders. We report a series of 7 cases of hypertelorism that were treated in our hospital. The underlying causes in our series were craniofacial clefts 0 to 14 (4 cases), craniofacial clefts 1 to 12 (1 case), and frontonasal encephalocele (2 cases), all congenital. Surgical techniques used to correct the deformity were box osteotomy and medial wall osteotomy with or without calvarial and rib grafts. A few of our cases were reoperations with specific challenges.

maxillofacial trauma management trends at Armed Forces Institute of Dentistry, Rawalpindi

The aim of this study was to evaluate and analyze current trends in the management of trauma in patients presenting to oral and maxillofacial surgery department of Armed Forces Institute of Dentistry. Rawalpindi from Jan 2008 to Dec 2010. In this retrospective study, data of 613 patients with maxillofacial fractures treated at oral and maxillofacial surgery department, Armed Forces Institute of Dentistry was reviewed and analyzed. The main parameters recorded were gender, pattern of facial bones fracture and treatment modality of fracture. Out of these 613 patients, 564 [92%] were males and 49 [8%] were females with a male to female ratio of 11.5:1. The mandible was the most common bone to be fractured, with 307 fractures [50.1%], followed by 116 fractures [18.9%] of zygomatic bone, 83 fractures [13.5%] of maxillary bone, 64 patients [10.5%] had panfacial trauma, 26 [4.3%] were having nasal fracture while Naso-orbito-ethmoid fractures [NOE] were seen in 15 [2.4%] cases. The management of the injured face has undergone major changes, outcomes are considerably better than 30 years ago as more comprehensive assessment and management is now possible

Aetiology and pattern of dentoalveolar injuries in patients at armed forces institute of dentistry, Rawalpindi

To determine the aetiology and pattern of dentoalveolar injuries in patients presenting to oral surgery department of Armed Forces Institute of Dentistry, Rawalpindi. Cross sectional study. Oral Surgery department, Armed Forces Institute of Dentistry, Rawalpindi. September 2008 to August 2009. One hundred and thirty eight consecutive patients presenting to oral surgery department with dentoalveolar injuries irrespective of the age and gender were included in the study. Edentulous patients, patients with only soft tissue injury and patients with other maxillofacial injuries but no dentoalveolar injury were excluded. The included patients were asked about the cause of injury and the pattern of injury was noted clinically. This information was collected on specially designed proformas. All injuries were classified according to Andersean's classification. Out of these 138 patients, 111 [80.4%] were males with a male to female ratio of 4.1:1. The age ranged from 2-65 years with a mean age of 21.22 years. RTA was the most common cause of injury and was seen in 58 [42%] patients. Followed by fall noted in 52 [37.7%] patients. Other causes observed were contact sports in 7 [5.1%], violence in 4 [2.9%] and work place accident in 7 [5.1%] patients. Regarding pattern, the most common type of injury was avulsion and subluxation followed by crown fractures, luxation, root fractures and tooth displacements in various directions. Males especially the young lot was more affected by dentoalveolar trauma. RTA and fall remain the main causes of these injuries in our population. Avulsion, subluxation and luxation were the most common patterns of trauma observed. Maxillary incisors were the most commonly affected teeth in these traumatic episodes