A Novel Technique in the Management of Superolateral Dislocation of Unilateral Condyle.

BACKGROUND: There are scarcely any reported cases of unilateral dislocation in the literature. Hence, its etiology, a possible mechanism of injury, clinical features, and effective management strategies are yet to be described. CASE: A 27-year-old male patient presented with the dilemma of unilateral dislocation of left TMJ. This was addressed by the use of a novel technique in dislocation management. Here, the author also proposes a modified classification system for the TMJ dislocation. CONCLUSION: "Wagh-Kokane's" technique of manual reduction should be encouraged in complex cases of dislocation.

Ossifying Fibroma of Maxilla in a Female Affected by Neurofibromatosis Type 1.

Ossifying fibroma is a benign fibro-osseous lesion found exclusively in jaws. It has a predilection for premolar-molar region in the mandible. The occurrence of OF as solitary lesions with no underlying disease is common in jaws. However its co-existence in patients with neurofibromatosis type 1 (NF1) has not been described in jaws. NF1, also known as von Recklinghausen's disease or peripheral neurofibromatosis, is an autosomal dominant multisystem disorder that approximately affects 1 in 2500-3000 births. The common manifestations of this disease include Café-au-lait macules, skinfold freckling, cutaneous neurofibromas, blue-red and pseudoatrophic macules on skin, plexiform neurofibroma, scoliosis, optic glioma. So far only one case of ossifying fibroma (OF) in such patients has been reported in the skull but not in the maxillofacial region. We report a case of OF of the maxilla in a 45 year old female suffering from NF1. To the best of our knowledge this is the first case report where OF occurred in the maxilla in patient with NF1.

Early Diagnosis: A Seeming Misfortune for Osteosarcoma of Mandible-Rare Case Report.

Osteosarcoma is a mesenchymal malignant tumour of long bones; it is the second most common malignancy of bone after multiple myeloma but it rarely affects jaw, accounting only for 4-8% of all osteosarcomas (Baumhoer et al. in Oral Oncol 50(2):147-153, 2014). The rare occurrence of tumour makes it challenging to diagnose either by radiographic or histopathologic examination. Here we presented a rare case of chondroblastic variant of osteosarcoma of body of mandible in a 54 year old female.

Cervical Lymph Nodes: A Hotbed For Metastasis in Malignancy.

The aim of this study was to find semblance between cervical lymph node metastasis and various malignancies. Objective was to estimate the incidence of neck node metastasis (NNM) from malignancies arising from infraclavicular region reported at a tertiary cancer centre over 10 years. Retrospective data was obtained from Hospital Management Software system from March 2012 to March 2017. 4000 patients were analysed and based on inclusion and exclusion criteria 68 patients were identified with clinically palpable and/or enlarged cervical lymph nodes. Results 41.7% patients had lung as a primary malignancy, 17.64% had breast carcinoma, 20.58% patients were with head and neck malignancy other than oral cavity malignancy, 7.3% of patients had primary malignancy in cervix. 2.94% patients had endometrial malignancy and renal malignancy each. Primary malignancies of gall bladder, pancreas, skin, prostate and vagina constituted 1.47% for each type. Conclusion understanding the pertinence of cervical lymph nodes specially supraclavicular lymph nodes with different primary tumor sites enables to plan interdisciplinary management of patients and also to correlate with the prognosis of patient.

Oral malignancy and its fickle blow off: A retrospective study.

BACKGROUND: The aim of this study was to retrospectively evaluate various patterns of failure in patients with oral squamous cell carcinoma and to estimate overall survival (OS) and disease-free survival (DFS) in failure patterns. MATERIALS AND METHODS: Retrospective data of 500 patients operated for oral malignancy were obtained from year 2011 to 2014. Incidence of local, regional, and distant failure as well as DFS and OS was calculated. Furthermore, we studied various prognostic factors such as habits and coexistent comorbid conditions, depth of invasion, histological grade of tumor, and primary site of tumor. RESULTS: Average DFS was 13.9 months and average overall survival was 55.77 months. The overall incidence of recurrence was 42.4%. Incidence of local recurrence was 24%, regional recurrence was 11.2%, and distant failure was seen in 7.2% of cases. CONCLUSION: Despite execution of standard treatment protocol comprising of surgery and chemoradiation, incidence of recurrence remains sententious in oral malignancy.

Airway management techniques in head and neck cancer surgeries: a retrospective analysis.

BACKGROUND: The aim of this study was to conduct a retrospective analysis of modalities of airway management and its impact on patients undergoing head and neck cancer surgeries. MATERIALS AND METHODS: A retrospective review of the medical record of 500 patients operated from January 2008 to December 2013 was conducted at our institute. Patients were reviewed for a mode of airway management, a total length of post-operative hospital stay (PLOS), and incidence of elderly patients in the total number of head and neck cancer surgeries posted for various diagnostic and definitive treatments. RESULTS: Out of 500 patients, 462 patients (92.4%) underwent nasal intubation, of which 320 underwent fiberoptic (FO) intubation (64%), 7 underwent tracheotomies after completion of surgery (1.4%), and 3 underwent at the beginning of surgery (0.6%). The remaining 38 patients (7.6%) underwent oral intubation. CONCLUSION: Nasotracheal intubation using fiberoptic bronchoscopy is the most preferred technique for the management of a difficult airway. Efficient airway management during the perioperative period significantly reduces the post-operative length of hospital stay and morbidity.

Diplopia-an unheralded consequence of neck dissection: case report.

INTRODUCTION: Neck dissection is a part of the standard surgical procedure in the management of head and neck malignancy. Diplopia following neck dissection is a rare entity; hence, its diagnosis and management strategies needed to be discussed for prevention of its grave consequences. CASE REPORT: A 30-year-old male patient presented with binocular horizontal diplopia following total thyroidectomy and neck dissection. On evaluation, there was internal jugular vein (IJV) thrombosis followed by cerebral venous sinus thrombosis (CVST). After meticulous medical management with diuretics and antiplatelet drugs, diplopia resolved completely and normal vision was restored. CONCLUSION: Therapeutic ligation of internal jugular vein during neck dissection may result in IJV thrombosis followed by CVST leading to raised intracranial tension (ICT). It has to be anticipated and addressed as early as possible to prevent its grave consequences like blindness and death.