Lumbar Intramedullary Epidermoid Following Repair of Sacral Myelomeningocele and Tethered Cord: A Case Report With a Review of the Relevant Literature and Operative Nuances.

Epidermoid cysts of the spine are rare tumors. While the majority of them occur spontaneously, in very few cases, they can occur following previous surgery for spinal dysraphism. Such tumors tend to occur at the site of previous surgery. The occurrence of an epidermoid cyst at a level higher than the previous surgical site is a rare entity. We present a rare case of a lumbar intramedullary and extramedullary epidermoid occurring at a level higher than the previous surgical site, along with a discussion of the causes of such an occurrence and operative nuances regarding the management of an intramedullary epidermoid in a pediatric patient.

Evolution of surgical techniques in the management of vertebral body tumours and the current status.

Primary vertebral body tumours constitute only about 5% of skeletal tumours. Their morbidity is high due to instability and neurological deficits related to the spine. The complex anatomy further highlights the expertise needed in their management. A multidisciplinary management has heralded tremendous improvements in the treatment of primary vertebral body tumours. From incomplete resection with a high recurrence of these tumours in the early 20th century, to the present day complete en-bloc excision of the tumours, guided by the well-established staging and classification systems, have been the significant changes brought about in the long course of treatment of these complex tumours. The overall results are better with radical excision in combination with adjuvant therapies. Complex and previously unimaginable surgical techniques are accomplished easily with a multi-disciplinary approach and with newer spinal instrumentation. Understanding of the evolution of surgical techniques and the prevalent classifications are essential in the surgical management of vertebral body tumours.

Assessment of bleeding during minor oral surgical procedures and extraction in patients on anticoagulant therapy.

INTRODUCTION: The risk of postoperative hemorrhage from oral surgical procedures has been a concern in the treatment of patients who are receiving long-term anticoagulation therapy. A study undertaken in our institution to address questions about the amount and severity of bleeding associated with minor outpatient oral surgery procedures by assessing bleeding in patients who did not alter their anticoagulant regimen. SUBJECTS AND METHODS: Eighty-three patients receiving long-term anticoagulant therapy visited Department of Oral and Maxillofacial Surgery from May 2010 to October 2011 for extractions and minor oral surgical procedures. Each patient was required to undergo preoperative assessment of prothrombin time (PT) and measurement of the international normalized ratio. Fifty-six patients with preoperative PT values within the therapeutic range 3-4 were included in the study. The patients' age ranged between 30 and 75 years. Application of surgispon was done following the procedure. Extraction of teeth performed with minimal trauma to the surrounding tissues, the socket margins sutured, and sutures removed after 5 days. RESULTS: There was no significant incidence of prolonged or excessive hemorrhage and wound infection and the healing process was normal.

Lymphangioma of the tongue - a case report and review of literature.

Lymphangiomas are benign tumours resulting from a congenital malformation of the lymphatic system. They are relatively uncommon and usually diagnosed in infancy and early childhood. Commonly located at head and neck, they rarely occur in the oral cavity. Intraoral lymphangiomas occur more frequently on the dorsum of tongue, followed by palate, buccal mucosa, gingiva, and lips. Lymphangioma of the tongue is a common cause of macroglossia in children associated with difficulty in swallowing and mastication, speech disturbances, airway obstruction, mandibular prognathism, openbite and other possible deformities of maxillofacial structures. We present the case of a 13-year-old female with lymphangioma of tongue. The clinical, radiological, and treatment modalities of this case are discussed.

The baffling human body and the boundless nanomaterial boon-a trap for cancer crab.

Life is a balance of infinite physiochemical balanced harmonies and the basic unit cell is responsible in maintaining it. Cardiovascular diseases and Cancer are the prime causes of death worldwide. Cancerous cells break the harmonious balance and result in uncontrolled growth and spread. Emerging among the existing modalities for management of cancer, as a ray of hope is Nanotechnology based treatment. Dendrimers, Quantum dots and nanobubbles contribute significantly as part of nano based diagnosis and treatment in the management of cancer. Dendrimers are nanoparticles which employ the principle of Trojan horse strategy in that encapsulation and conjugation of anti cancer agents helps in targeting the cancerous cells specifically without affecting the adjacent healthy cells. Quantum dots are cadmium based nanoparticles which when exposed to UV light glow and help in destroying the cancerous cells in the incipient stage. Nanobubbles are generated with short pulses of laser, which helps in identifying the individual cancerous cells and explodes them. Apart from them other technologies such as liposomes, fullerenes, carbon nanotubes, nanoshells, paramagnetic nanoparticles, nanoburrs, respirocytes, microbiovores, nanopores, smart coating and nano bandaid contribute a great lot as boundless nanomaterial boon for the management of cancer, cardiovascular problems and overall systemic health.

CBCT Cyst Leasions Diagnosis Imaging Mandible Maxilla.

The bony anatomy and the soft tissue contours of the maxillofacial region, along with the oro dental tissues, is very complex. In earlier times, analog radiographs of the skull, the mandible and the sinuses, along with intraoral films, were the only tools which were available for dentists. The past decade has seen a revolution in dental imaging, with the introduction of Cone beam computed tomography/cone beam volumetric tomography (CBCT/CBVT). In this article, we have discussed the value of CBCT in diagnosis and treatment planning which we observed in four cases of maxillofacial cystic lesions. It proved to be a multifaceted win-win situation for the diagnostician, the patient and the operating surgeon. The 3D imaging led to a precise pre-operative surgical planning, resulting in a surgery that was minimally invasive, minimally morbid and time saving and at the same time, conservative, yet complete.

Double-hook retractor for microlumbar discectomy and foraminotomy.

Aiming to achieve better results in microlumbar discectomy and foraminotomy, a double-hook retractor has been designed to retract lumbar paraspinal muscles away from the spinous process. A double-hook retractor obviates the limitations of single-hook systems.

A radiological evaluation of allografts (ethylene oxide sterilized cadaver bone) and autografts in anterior cervical fusion.

Serial roentgenograms of 40 patients who had 70 cervical intervertebral spaces grafted with ethylene oxide sterilized cadaver bone and 28 patients who received 44 iliac crest auto grafts for anterior cervical spine fusion, were studied. The radiological evaluation was made on the basis of settlement of intervertebral spaces, fusion rate, delayed union, non-union, graft collapse and extrusion of the graft. Indigenous methodologies were designed for the assessment of settlement of grafted intervertebral spaces in percentage. Disc space settlement was more common in autografts (93% cases) than in allografts (80% cases). The average percentage of settlement of intervertebral disc space (S%) was 22 in autografts and 28 in allografts during the first four months. By the end of eight months, allograft disc spaces settle more. No significant difference was noted in fusion rate at the end of one year viz. allografts (90% cases) and autografts (93% cases). Autograft and allograft (ethylene oxide sterilized cadaver bone) are equally useful in anterior cervical spine fusions.