Effect of Octreotide in stopping post surgical chyle leak in neck Dissection-A systematic review.

Objective: Neck dissection causes an unusual and challenging complication called Chyle Leak. Octreotide, a long-acting somatostatin analogue, is one way Chyle Leak can be managed faster and effectively. The objective of the review was to evaluate the efficiency of Octreotide in stopping post surgical Chyle Leak in neck dissection. Methods: Three electronic database and manual search was undertaken to identify the literature. All the published articles, which included data about Octreotide used to stop post-surgical Chyle leak in neck dissection, published in the English language between January 1, 2010 to May 31, 2022 were included. Joanna Briggs critical assessment tool was used to assess the included studies. Results: Preliminary screening of 206 studies from data sources and ten from additional sources was done. After necessary exclusion, ten studies were included for qualitative synthesis. The data included 65 patients with neck dissections followed by Chyle leak postoperatively. Chyle leak was presented from 0-8th POD (range of 150 ml-2500 ml). 100mcg-eight hourly subcutaneously was given in maximum studies for 2-14 days. A gradual reduction in chyle leak started 2-4 days after the administration. The chyle leak completely resolved within 2-11 days in the majority of cases with conservative treatment and Octreotide. Conclusion: Octreotide Therapy with primary treatment is an effective way of stopping Chyle Leak in Neck Dissection. However, well-designed and robust randomized controlled studies are needed to confirm the results in the future.

Comparative evaluation of low-level laser therapy and ultrasound heat therapy in reducing temporomandibular joint disorder pain

BACKGROUND: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. METHODS: This prospective study included 42 patients (age range, 25–45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. RESULTS: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. CONCLUSION: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

Comparison of efficacy of 0.75% ropivacaine and 2% lidocaine with 1:200,000 adrenaline in pain control in extraction of mandibular posterior teeth: A double-blind study.

BACKGROUND: Two percent lidocaine hydrochloride is the gold standard for dental anesthesia against which newer local anesthetic agents may be compared. 0.75% ropivacaine is a newer, long-acting amide local anesthetic agent with inherent vasoconstriction property. AIM: This study aims to compare the efficacy of 0.75% ropivacaine and 2% lidocaine hydrochloride with 1:200,000 adrenaline in pain control in extraction of mandibular posterior teeth. SETTINGS AND DESIGN: This is a prospective, double-blind, and split-mouth study. SUBJECTS AND METHODS: Twenty patients were divided into two groups according to the right and left sides of patient - side A and side B. The side, where 0.75% ropivacaine was to be administered, was randomly selected by flip coin method. Then, the pterygomandibular and long buccal nerve blocks were administered with 0.75% ropivacaine and necessary dental extraction was performed. After 1 week, the same procedure was repeated using 2% lidocaine hydrochloride with 1:200,000 adrenaline. The parameters assessed were pain on injection, onset of anesthesia, pain during the extraction, and duration of anesthesia. STATISTICAL ANALYSIS USED: The nonparametric data were assessed by Mann Whitney "U" test. RESULTS: The mean onset of action for solution A was 7.15 ± 4.934 min and for solution B was 9.75±5.128 min. This was statistically significant. The mean duration of action, pain on injection, and pain during extraction were not significant. CONCLUSION: This study clearly states that there is no clear advantage of using 0.75% ropivacaine in pterygomandibular nerve block over the gold standard. However, more clinical studies with larger sample size are necessary.

The effect of alloplastic bone graft and absorbable gelatin sponge in prevention of periodontal defects on the distal aspect of mandibular second molars, after surgical removal of impacted mandibular third molar: a comparative prospective study.

AIM: Recent studies claim that haemostatic agents can be used as bone graft substitutes. The aim of this study was to compare the efficacy of alloplastic bone graft with absorbable gelatin sponge in prevention of periodontal defects distal to mandibular second molar after the surgical removal of impacted mandibular third molars. MATERIALS AND METHODS: A prospective, randomized, single-blind split-mouth study was designed. The study consisted of 25 patients requiring surgical removal of bilateral impacted mandibular 3rd molars. The surgical sites were randomly divided into 2 groups: group I: G-graft (hydroxyapatite + collagen, study group) and group II: Abgel (absorbable gelatin sponge, control group). Patients were recalled on lst and 7th postoperative days and 3rd and 6th postoperative months. Probing depth, alveolar bone levels and soft tissue wound healing were evaluated. Paired t test was used to compare pre and post-operative alveolar bone levels and probing depth (PD). Wilcoxon signed ranks test was used to compare the wound healing. RESULTS: The soft tissue wound healing, PD and the distance between the cemento-enamel junction on the distal aspect of mandibular second molar (point A) and the alveolar crest on the distal aspect of the same tooth (point B) were significantly higher in group I as compared to group II. CONCLUSION: This study reveals an increase in the alveolar bone level, improvement of PD and better wound healing in group I. Group II subjects required longer healing time than the normal. The authors disagree the claim that the haemostatic agents can be used as bone graft substitutes. However, long-term, multicenter, randomized controlled clinical trials are required.

Munchmeyer's disease-a rare case report and review of literature.

Munchmeyer's disease is a rare variety of myositis ossificans. It is a significant clinical entity, diagnosing and understanding its pathophysiology can save a patient from spurious medical workups and anxiety of a suspected neoplasm. The number of authentic cases of this disease in the literature is small. The purpose of this article is to present a case of Munchmeyer's disease and review the literature for the same to date. The rare incidence, obscure aetiology, unknown definitive treatment plan and poor prognosis make this condition an enigma.