Assessment of the anterior and caudal extent of inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of submandibular fossa using computed tomography.

BACKGROUND: A well-versed knowledge of the precise location of various anatomical landmarks is necessary to avoid complications during surgery. The study was conducted for the assessment of the anterior and caudal extent of the inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of the submandibular fossa using computed tomography (CT). MATERIALS AND METHODS: One hundred CT scans were randomly selected for this study accounting for 200 hemimandibles. Both axial and coronal images were obtained and evaluated concurrently. Results were subjected to statistical analysis for correct inferences. RESULTS: A total of 200 hemimandibles (n = 200) from 100 patients with a mean age was 23.89 ± 1.75 years ranging from 21 to 33 years were evaluated. The mean length of the anterior loop was 0.95 mm for all of the observation combined and measurement range from 0 to 5.1 mm. The total frequency of type I, type II, and type III of mental nerve was found as 71%, 4.5%, and 24.5%, respectively. At the level of the first molar, the mean distance from the center of the inferior alveolar canal to the external surface of the buccal cortex (Q) was 5.44 ± 1.38 mm ranging from 2.4 to 10.4 mm. Furthermore, there was no statistically significant difference in MF-IMB (mental foramen to the inferior border of mandible) between the right and left sides of the mandible. (P = 0.87). CONCLUSION: Our study demonstrates that analyzing CT scans using the methods described in this study can be a useful tool in avoiding the iatrogenic injuries to inferior alveolar nerve and arteries during various maxillofacial surgical procedures.

Closure of Anterior Palatal Fistula by Tongue Flap: A Prospective Study.

AIM: To check the efficacy of dorsal tongue flap in closure of anterior palatal fistula without using any fixation devices. MATERIAL AND METHOD: It is a prospective study in which 20 patients of anterior palatal fistula, larger than 5 mm, attending the outpatient department of oral and maxillofacial surgery, Genesis Institute of Dental Sciences and Research, Ferozpur over a period of 5 years (from November 2005 to January 2011) were included. The surgical treatment was divided into 2 stages-raising of the flap on the tongue and transfer of the flap from the dorsum of the tongue to fistula site and then separation of flap and its adjustment at the site of defect after an interval of 3 weeks minimum. Follow-up was done for 3 and 6 months. RESULT: Successful closure was achieved in 90 % of the cases. 80 % patients experienced decrease in hypernasality. In none of the cases decrease in size of tongue, loss or change in taste sensation, difficulty in speech, difficulty in swallowing or bulkiness of flap was observed. CONCLUSION: The results obtained during the course of this study strongly support the method used to close the anterior palatal fistula. It is concluded that the dorsal tongue flap is the highly successful method without the need of additional fixation devices in closure of anterior palatal fistula.

Primary leiomyosarcoma of the maxilla: An investigative loom-report of a challenging case and review of literature.

Leiomyosarcoma (LMS) is a malignant neoplasm composed of cells showing distinct smooth muscle features. Majority of the tumors are located in the retroperitoneum, including the pelvis and the uterus but are rare in the oral and pharyngeal region. Intraorally, they are present as painless, lobulated, fixed masses of the submucosal tissues in middle-aged or older individuals. Lesions are usually slow growing and are less than 2 cm in diameter at the time of diagnosis. Here we report the clinico-pathological findings of a case of primary LMS of the maxilla in 63-year-old male patient with an emphasis on the judicious use of ancillary diagnostic modalities to arrive at a definitive diagnosis.

Pleomorphic adenoma of submandibular gland: An uncommon occurrence.

Pleomorphic adenoma (PA) is the most common tumor of the benign salivary gland neoplasms, and the most common gland to be involved is the parotid gland. Its occurrence in the submandibular or the sublingual gland is uncommon. We present a case of a histologically proven PA involving the submandiblular gland.

Effect of blood transfusion in combination with Dextran-40 and hypertonic saline solution on cardiopulmonary haemodynamics of endotoxin (lipopolysaccharide) shock in buffalo calves.

The intravenous (i.v.) infusion of lipopolysaccharide (LPS) of E. coli endotoxin in buffalo calves (n = 15) at 5 microg/kg bw per h for 3 h caused a significant (p<0.05) fall in plasma volume, blood volume, haematocrit haemoglobin, and systolic, diastolic and pulse pressure, mean arterial pressure and central venous pressure (CVP), with a marked rise in respiration. Treatment with a combination of i.v. infusion of 7.2% hypertonic saline solution, Plasmex-D-40 (Dextran-40) and blood successfully alleviated hypovolaemia, and raised systolic, diastolic and pulse pressure, mean arterial pressure and central venous pressure. The whole blood was collected from apparently healthy male buffalo calves 24 h prior to infusion and was transfused without cross-matching. No significant fall in haemoglobin, haematocrit and body temperature was observed after transfusion. All these values tended to remain near normal levels. However, this combination of treatment had no effect on high respiratory rate. A one-time blood transfusion did not evoke any cross-reaction and was helpful in raising haematocrit and haemoglobin close to pre-infusion values. The general symptoms of restlessness, respiratory distress, profuse salivation, violent movement of the ears, snoring, intermittent struggle, etc. were markedly reduced. All the treated animals became quiet and lay with eyes open and survived the 7 h of observation.