AN UNUSUAL ECTOPIC OSSEOUS TONGUE MASS - A case report.

We report a case of tongue swelling resulting from ectopic osseous proliferation within a pseudocystic stroma in a 24 year old healthy female. The patient presented a history of dull pain and gradual onset of a swelling at the ventral aspect of the tongue. The lesion had a mixed consistency with areas of sponginess andfluctuancy interspersed with nodular bony hardness and yielded a sanguinous aspirate. Doppler ultrasonographic scan and magnetic resonance imaging revealed a pseudocystic mass containing nodules of calcified bodies. Excision biopsy under general anaesthesia and histopathologic studies confirmed a case of ectopic osseous proliferation within the tongue. The lesion was marginally excised, wound healed satisfactorily with no complications as at 8(th) month follow-up period. This is a case of a lesion with conflicting clinical and histological characteristics. It underscores the need for routine immunohistochemistry and comprehensive aspirate analysis in our environment. The case has been reported to sensitize clinicians to a new possibility in the differential diagnosis of tongue swelling.

Identification and interpretation of maxillofacial plain radiographs by junior dental trainees.

BACKGROUND: Accurate identification and interpretation of plain maxillofacial radiographs is key to making correct clinical decision. OBJECTIVE: To assess the ability of junior dental trainees to correctly identify and adequately interpret oral and maxillofacial plain radiographs. STUDY DESIGN: Comparative analysis Setting: University of Port Harcourt Teaching Hospital, Port Harcourt and University College Hospital, Ibadan. MATERIALS AND METHODS: Twenty six plain film radiographs were selected and serialized. The films were presented to three specialislts; a radiologist and two oral surgeons for independent identification and interpretation. The level of agreement between them was tested using kappa statistics (k) and intraclass coefficient (ICC). Minor areas of discrepancy were finally reconciled and the correct identification and interpretations of every radiograph confirmed. The same set of radiographs was subsequently presented to twenty junior dentists (House officers and Registrars) for identification and interpretation. Accuracy of performances in identification and interpretation exercises was assessed by a test of agreement using kappa statistics and a mathematical performance rating method respectively. RESULTS: In terms of identification, the agreement between the three specialists was very strong with ICC of 0.96. Kappa (k)-values of 1.00 suggesting perfect agreement was observed between the two oral surgeons. Agreement between each oral surgeon and the radiologist was very good (k= 0.84). The k-value for agreement in identification between trainees and specialists ranged between 0.23 and 1.00. As for interpretation, the percentage accuracy of the junior dental trainees ranged between 60.5% and 87.2% compared to specialists' range of 89.5% to 95.3%. The common areas of discrepancy in identification and interpretation are highlighted. CONCLUSION: Based on this study, dental trainees demonstrate varying levels of expertise in identification and interpretation of maxillofacial plain radiographs. Knowledge gaps were identified and modification of teaching method suggested.