Common factors delaying the diagnosis of oral cancer

Oral cancer is a serious health issue that has a universal occurrence. Cancer is the top cause of death in economically developed countries and the second most lethal entity in developing countries. Oral cancer has a five-year survival rate of 50% or less. This rate is much improved when lesions are diagnosed at an early stage of the disease [i.e. small and localized]. Detecting oral cancer at an early stage is believed to be the most effective means to reduce morbidity and duration of treatment. The objective of the study was to determine the frequency of common factors delaying the diagnosis of oral squamous cell carcinoma. A Descriptive, cross sectional study was carried out in Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar over a period of six months. Using structured proforma, data from 108 patients with delay in the diagnosis of oral squamous cell carcinoma were collected through history taking, clinical examination and histopathological confirmation. Delay in the diagnosis of squamous cell carcinoma was predominantly found in male patients with a male to female ratio of 3.15: 1. The mean age of the patient was 59.59. Most of the patients reporting with delay in the diagnosis were in the 6th decade of life [30.5%] followed by 5th decade [24.99%]. The most commonly involved site was mandibular left gingivolabial sulcus [22.2%]. Most of the patients with delay in diagnosis reported in stage IV [75%]. Patient delay was seen in 26.85% of the patients, with a professional delay of 14.81% of the patients. Both types of delay i.e patient and professional delay was seen in 58.33% of the patients. Amongst 108 patients a total delay in days of more than 200 days was seen in 39.82%, 25.92% of the patients had delay of more than 50 days. Delay in the diagnosis of squamous cell carcinoma was found more in males than females. Delay was most commonly seen in the 6th decade of life with most of the patients reporting in stage 4. Patient delay was 26.85%, professional delay in diagnosis was 14.81%. Both types of delay was seen in 58.33% of the patients and 39.82% of the patients reported with total delay of more than 200 days

Odontogenic fascial space infections in pregnancy - a study

Odontogenic infections are the most prevalent disease worldwide. These infections presenting initially as, localized periapical and periodontal abscess then perforate the cortical bone and spread causing facial cellulitis. Odontogenic infections spread along tissue planes involving initially primary and then secondary facial spaces depending upon the tooth involved and muscle attachments. Infections are common in pregnancy due to hormonal changes and altered immunological activity aggravating response to plaque accumulation and caries resulting in serious life threatening condition, like ludwigs angina. The present study carried out on 28 pregnant patients with severe odontogenic infections reporting to oral and maxillofacial unit of Khyber College of Dentistry, Peshawar, Khyber Pakhthunkhawa province of Pakistan. The age range was from 17 to 40 years and mean age of 24.78 SD +/- 5.043. Odontogenic infections were most common in the last trimester [50%] followed by late second trimester [28.5%]. The most common tooth involved is mandibular wisdom tooth [53.5%] and submandibular space [28%] being the most frequently involved. Patients presented with trismus, facial swelling and dysphagia on examination. Most patients were treated with incision and drainage under local or general anaesthesia depending upon the fitness of the patient and extraction of the offending tooth and intravenous antibiotic coverage

Post traumatic sialocele: a case report and literature review

Sialocele is an acquired lesion due to extravasation of saliva into the subcutaneous tissues due to trauma or surgery in the glandular region. Sialocele typically develops 8 to 14 days. Ultrasound of neck can be helpful in diagnosis of facial swelling. A case of 25 year old male patient with progressive facial swelling in the sub mental region with history of fire arm injury, which was diagnosed as sialocele is being reported. Sialography can be helpful in the diagnosis, but can increase further pressure in sailocele. In this case, diagnosis was made on history, clinical examination, aspiration of contents and ultrasound. The objective of the study is to present a case of post traumatic sialocele developing after fire arm injury. A detailed description of the condition and its management along with literature review is presented

Management of a maxillofacial trauma patient on warfarin

Maxillofacial trauma patients with prosthetic heart valves are a challenge to treat due to the risk of bacterial endocarditis. These patients are on anticoagulant therapy therefore, they are at a risk of bleeding and thrombosis. A case of 55 year old known epileptic male patient, with mitral valve replacement surgery performed in 1988, who presented to oral and maxillofacial surgery department, Khyber College of Dentistry, with fracture mandible due to fall is reported. The patient was on warfarin with an INR raised to 9.5 and a prothrombin time of 100 seconds. Routine investigations for general anaesthesia were performed and were in the normal range. Open reduction of the fractured mandible was planned under general anaesthesia, and the patient was switched from warfarin to low molecular weight heparin and INR and PT were lowered to 1.9 and 23 seconds respectively a day before surgery. Uneventful surgery was performed and complete recovery was achieved within 3 days

Clinical presentation and management of naso-labial cysts case series

Nasolabial cysts are rare non-odontogenic cysts of soft tissues of the nasolabial fold. They are

Kikuchis-Fujimoto disease

Kikuchi-Fujimoto disease or Sub-acute necrotizing lymphadenitis is a benign self-limiting condition. A case in a 24-year-old young female who presented with swelling in the right submandibular region and pain is reported. The erythrocyte sedimentation rate was elevated to 50 mm/h. Other serological tests for rubella, hepatitis B, hepatitis C, HIV, and toxoplasmosis, as well as tests for tuberculosis were performed which were negative. The excisional biopsy of the lesion showed necrotizing lymphadenitis consistent with Kikuchi-Fujimoto disease. No further treatment was given, and a full recovery was achieved within one month. Tuberculous lymphadenitis and lymphoproliferative disease were considered in differential diagnosis