Trismus in oral cancer patients undergoing surgery and radiotherapy.

OBJECTIVE: The aim of this study was to determine the incidence of trismus before and after surgery and subsequent radiotherapy for patients of oral cancer and to determine the risk factors for the same. METHODS: 30 patients diagnosed with oral cancer were included. Maximum mouth opening was measured for each patient as the inter incisal distance and was measured on 4 occasions - preoperatively at the time of diagnosis, post-operatively at discharge from the hospital, post-radiotherapy and at 6 months follow-up. The site of cancer, staging and grading of the malignancy, the surgical treatment performed, method of reconstruction, details of radiotherapy and compliance to physiotherapy were recorded, to evaluate the risk factors for developing trismus. RESULTS: Trismus was observed in 53.3% patients at the time of diagnosis which increased significantly post-surgery (86.7%) and post-radiotherapy (85.7%) and gradually decreased (65.4%) at 6 months. The use of flaps for reconstruction, delay in radiotherapy post-surgery and non-compliance of patients to physiotherapy were the risk factors for developing trismus, showing statistical significance (p < 0.05). CONCLUSION: Trismus is a significant complication of oral malignancies or its surgical and radiotherapy treatment, or both. Consideration must be given to its early diagnosis, to help in timely intervention and planning of preventive strategies.

Osteochondroma of the mandible: a rare case report.

Osteochondroma, also known as osteocartilaginous exostosis is a benign cartilage forming tumor that usually develops in long bones and relatively uncommon in the craniofacial region. Both the condyle and coronoid tip being the most common sites of occurrence in the mandible, it rarely appears at the symphysis region. Here, we describe a case of osteochondroma arising from the left parasymphysis of mandible.

Evaluation of fractured condylar head along the sagittal plane: report of three cases.

There are case reports of sagittal fractures of the condylar head leading to bifid condyle. However bifid condyles maybe found in patients with no history of trauma. A split in the saggital plane of the condyle is not visible with a lateral, oblique or panaromic radiographs but only with anteriorposterior, transorbital projections or CT scan of the temperomandibular joint. The chances of condyle being split in the sagittal plane may be due to the medial pole extending beyond the condylar neck, moreover the condyle is composed of cancellous bone covered by a thin layer of cortical bone. Here we are presenting three case reports of Saggital split condyles and stress the need for inclusion of these type of fractures in the classification of condylar fractures.

Aneurysmal bone cyst, a lesion of the mandibular condyle.

Benign and malignant tumors of the temporomandibular joint are rare. An aneurysmal bone cyst (ABC) of the condyle is even more unusual and usually presents as a slowly enlarging firm swelling which occasionally may be associated with pain and tenderness. Surgical curettage or excision is the treatment of choice, in an attempt to reduce the potential problem of recurrence; we undertook surgical resection of the affected bone. Immediate mandibular reconstruction using autologous bone was deferred though it is generally recommended in such type of cases.