An unusual case of neural palatal swelling.

Neural tumors in the oral cavity occur both in the soft tissues and in the jaw bones. They occur as painless, smooth surface swelling in the soft tissues of the mouth, exhibiting a slow rate of growth and mild expansion of the cortical plates. Here, we report a rare case of a cellular variant of schwannoma in a young Indian female patient who presented with an asymptomatic nodule in the mid-palatine raphe region of the hard palate, mimicking a fibroma, thus creating a dilemma in the diagnosis.

Elective Tracheostomy in Head and Neck Surgery: Our Experience.

INTRODUCTION: Tracheostomy is commonly used to secure the airway during the immediate postoperative period in maxillofacial oncological operations. We conducted a study to review the utility of elective tracheostomy in head and neck surgery. AIM: To review the incidence of intraoperative, perioperative and postoperative complications and its management in elective tracheostomy and to analyse its utility in head and neck surgery. MATERIALS AND METHODS: The study included review of 50 patients, who were treated for head and neck cancers in the Department of Oral And Maxillofacial Surgery of our centre between January 2011 to December 2014. RESULTS: The study showed a male predilection with mean tracheostomy time of 25 minutes and operative time of 11 hours. The patients had an ICU stay of two days and elective ventilation of one day with mild tracheal secretion seen postoperatively. No other complications were noted intraoperatively or postoperatively. CONCLUSION: Elective tracheostomy even though an invasive tool when used properly in selected patients, can be safe and beneficial to the patients.

Oral eumycetoma of infancy: a rare presentation and a brief review.

Mycetoma is a chronic granulomatous infection of skin and subcutaneous tissue, which may involve bone. The disease is caused by true fungi (eumycetoma) or filamentous bacteria (actinomycetoma). Both types of organism are important soil saprophytes, and therefore infection is normally acquired by traumatic inoculation of the skin by contaminated material. Clinically, mycetomas are characterized by tumefaction, draining sinuses and discharging grains. The grains are aggregates of fungal hyphae or bacterial filaments, and grain size, colour and consistency provide the initial clue to the causative organism. To our knowledge, this probably is the first case report of oral eumycetoma of infancy. Review of literature shows only ten cases of eumycetoma involving the head and neck, including the present case. Histological examinations of the biopsies were the cornerstone in the diagnosis of mycetoma. The distinction between eumycetoma and actinomycetoma is essential for treatment. Direct microscopic examination of the grain and histopathological examination, using histochemical staining will distinguish between the two. Treatment consists of long courses of antifungals and antibacterials agents, often combined with surgery.