Correction of whistle deformity secondary to cleft lip repair by V-Y plasty: a simple and effective technique.

Several techniques are available for the surgical repair of the cleft lip, however, avoiding secondary deformities and achieving consistent results remains a challenge. The whistle deformity is a secondary lip deformity characterised by inadequate fullness of the central upper lip with abnormal exposure of the central incisors when the lips are at rest, giving a whistling appearance. The causes include scarring of the vermilion and failure to restore the mucosal or muscular continuity. Various surgical options are available ranging from simple procedures like V-Y plasty and Z-plasty to complex procedures like complete lip redo, locoregional flaps, fillers and grafts. V-Y plasty is a simple, effective procedure for lip lengthening that can be performed under local anaesthesia as an outpatient procedure. It is less technique sensitive and also allows for some degree of muscle repair. We present a case of whistle deformity satisfactorily corrected with V-Y plasty.

Assessment of Alar Flare and Efficacy of Alar Cinch Suture in the Management of Alar Flare Following Le Fort 1 Superior Repositioning: A Comparative Study.

OBJECTIVES: To prospectively analyze the amount of alar flare, factors contributing to alar flare and efficacy of cinch suture as an adjunctive procedure for alar flare reduction. STUDY DESIGN: Thirty adult patients with vertical maxillary excess, who underwent Le Fort 1 impaction, were divided into 2 groups of 15 each. Alar cinch was performed as an adjunct procedure in group 2 patients and results were compared to group 1 which was the control group. Measurements were made on the patients and on 1:1 standardized photographs. RESULTS: Group 2 showed a near pre-operative alar position compared to group 1. The alar flare resulting from every millimeter of impaction was significantly less in group 2 compared to group 1. CONCLUSION: Alar cinch suture restores the normal alar width by preventing the lateral drift of the naso-labial muscle and thereby reducing the postoperative nasal flare significantly.

Salivary gland tumors: a diagnostic dilemma!

Salivary gland tumors generate considerable interest because of their heterogeneous and variable histology, grade of malignancy, and clinical behavior. Fine needle aspiration cytology (FNAC) is considered the first diagnostic modality for salivary neoplasms due to its ready availability and ease of performance. However it cannot always be relied upon in isolation, and should be used in conjunction with other investigations like incisional biopsy. We present two cases, which highlight the drawbacks of relying on FNAC alone, which resulted in misdiagnosis of adenoid cystic carcinoma as pleomorphic adenoma.

Maxillo-Mandibular Cemento-ossifying Fibroma: A Rare Case Report.

Cemento-ossifying fibroma (COF) is a benign fibro osseous lesion of the jaws which has been described as a demarcated or rarely encapsulated neoplasm consisting of fibrous tissue and varying amounts of mineralized material resembling bone and/or cementum (Dinkar et al. in IJDA 2(4):45-47, 2010). Majority of lesions occur in the mandible and only few cases of COFs of the maxillary sinus and bilateral COFs of the mandible have been reported in literature (Dinkar et al. in IJDA 2(4):45-47, 2010; Tamiolakis et al. in Acta Stomatol Croat 39(3):319-321, 2005; Hamner et al. in Oral Surg Oral Med Oral Pathol 26(4):579-587, 1968; Gunaseelan et al. in Oral Med Oral Pathol Oral Radiol Endod 104:e21-e25, 2007). These lesions have a very low recurrence rate (Ertug et al. in Quintessence Int 35(10):808-810, 2004) and are generally treated by enucleation. In this paper we present a rare case of COF occurring in both the maxilla and mandible of the same patient. Only one such case (Takeda and Fujioka in Int J Oral Maxillofac Surg 16(3):368-371, 1987) has been reported in literature so far.

Radiographic assessment of influence of cleft width and canine position on alveolar bone graft success: a retro-prospective study.

PURPOSE: To evaluate the effect of cleft width and the pre-surgical position of the permanent cuspid, on the success of secondary alveolar bone grafts, using preoperative and post-operative radiographs. METHODOLOGY: A total of 20 cases treated with secondary alveolar bone grafting for alveolar clefts were included in the study. Pre-surgical maxillary occlusal radiograph was used to determine the cleft width. Canine position was assessed by marking 6 points on a pre-surgical intra oral periapical radiograph. Alveolar bone contour and the success of bone grafts were determined using 11 points marked on post-operative periapical radiographs taken after a minimum follow-up of 6 months. RESULTS: Linear regression analysis of pre-operative cleft width and pre-operative position of the permanent cuspid were carried out on the bone graft success which was determined using post-surgical periapical radiographs. P < 0.05 was set. The results obtained had weak correlations and were statistically not significant. CONCLUSION: We concluded that the success of the alveolar bone graft has minimal or no relation to the pre-operative width of the cleft or the position of the permanent cuspid at the time of grafting.