K. M. Cariappa

A Retrospective Study of Temporalis Muscle and Fascia Flap in Treatment of TMJ Ankylosis

BackgroundThis study sought to determine the efficacy of interpositional arthroplasty with temporalis muscle and fascia flap in the treatment of unilateral temporomandibular joint (TMJ) ankylosis in adults.MethodsThis retrospective study of nine cases evaluated the postoperative results of interpositional arthroplasty on temporalis muscle and fascia flap in adults. The operative protocol for unilateral TMJ ankylosis entailed (1) resection of ankylotic mass, (2) intraoral ipsilateral coronoidectomy, (3) contralateral coronoidectomy when necessary, (4) interpositional tissue transfer to the TMJ with temporalis muscle, fascia flap, and (5) early mobilization, aggressive physiotherapy.ResultsThe study evaluated nine patients with follow-up checks from 13 to 31 months (mean 18.3 months). Patients had a preoperative maximal interincisal opening of 9–19 mm (mean 11.7 mm). During the last follow-up observation after surgery, the patients had a maximal interincisal opening of 35–40 mm (mean 38.3 mm).The results of this protocol were encouraging, the functional results of interpositional arthroplasty on temporalis muscle and fascia flap were also satisfactory.ConclusionThe findings of this study support the use of temporalis muscle and fascia flap in adult patients with unilateral TMJ ankylosis. Early postoperative initial exercise, physiotherapy and strict follow-up play an important role in preventing postoperative recurrences.

Three dimensional titanium mini plates in oral & maxillofacial surgery: a prospective clinical trial.

AimThe purpose of the study was to evaluate the efficacy of three dimensional titanium miniplates as treatment modality for the stabilization of the fractured or osteotomized bone fragments in maxillofacial region.Patients and Methods24 patients with maxillofacial trauma and one patient who underwent orthognathic surgery constituted the sample of the study. All the patients with maxillofacial injuries required open reduction internal fixation of the fractures and the orthognathic surgery patient required stabilization of the osteotomized segments.ConclusionsThree dimensional plates provide good stability of bone fragments due to closed quadrangular geometric shape, and the ease of contouring and adapting. Because of better inter fragmentary stability; supplemental fixation is not necessary, thereby enhancing the overall comfort, convenience and well being of the patient.

Current Perspectives in Intra Operative Airway Management in Maxillofacial Trauma

ObjectiveMaxillofacial trauma presents a complex problem due to the disruption of normal anatomy. In such cases, we anticipate a difficult oral intubation that may hinder intraoperative IMF. Nasal and skull base fractures do not advocate use of nasotracheal intubation. Hence, other anesthetic techniques should be considered in management of maxillofacial trauma patients with occlusal derangement and nasal deformity. This study evaluates the indications and outcomes of anesthetic management by retromolar, nasal, submental intubation and tracheostomy.MethodologyOf the 49 maxillofacial trauma cases reviewed, that required intraoperative IMF, 32 underwent nasal intubation, 9 patients had tracheostomy, 5 patients utilized submental approach and 3 underwent retromolar intubation.ResultsAmong patients who underwent nasal intubation, eight cases needed fiberoptic assistance. In retromolar approach, though no complication was encountered, constant monitoring was mandatory to avoid risk of tube displacement. Consequently, submental intubation required a surgical procedure which could result in a cosmetically acceptable scar. Though invasive, tracheostomy has its benefits for long term ventilation.ConclusionIntubation of any form performed in a maxillofacial trauma patient is complex and requires both sound judgement and considerable experience.

Ramsay-Hunt syndrome complicating osteonecrosis of edentulous maxilla and mandible: report of a rare case

Review of literature revealed atleast 30 cases of post herpes zoster osteonecrosis of maxilla or mandible. To our knowledge this is a first reported case of Ramsay-Hunt syndrome with post herpetic neuralgia and post herpes zoster osteonecrosis of edentulous maxilla and mandible. We have briefly reviewed the pathophysiology and management of post herpes zoster osteonecrosis and post herpetic neuralgia.

Platelet-rich fibrin combined with synthetic nanocrystalline hydroxy apatite granules in the management of radicular cyst

Radicular cysts are inflammatory jaw cysts confined to the apices of teeth with infected and necrotic pulp. They arise from the epithelial residues in the periodontal ligament as a result of inflammation, following the death of pulp. The treatment of such lesions vary with regard to their sizes; the small cystic lesions heal after an endodontic therapy, but larger lesions, may require additional treatment. Apical surgery for radicular cysts generally involves apical root resection and sealing with endodontic material. This case report, describes the treatment of a cyst related to the maxillary central and lateral incisors using platelet rich fibrin along with synthetic nanocrystalline hydroxyapatite granules for the regeneration of lost tissues. A follow-up evaluation at 6 months and 1-year revealed a significant radiographic bone fill with satisfactory healing at the surgical site.

Hybrid ameloblastoma: An Amalgam of Rare and Conventional Ameloblastoma

Ameloblastoma is a common benign odontogenic tumor with multiple histologic types. This case report describes an unusual type of ameloblastoma called “Hybrid Ameloblastoma” with features of both follicular and desmoplastic ameloblastoma in a 50-year-old female. This is a very rare form of ameloblastoma as <30 cases have been reported so far in literature. Though this rare form of ameloblastoma is only a histologic variant, it poses a great challenge to diagnosticians and thus to surgeons as there will be mismatch of biopsy reports at different sites in the same tumor thereby changing the treatment plan. This case report is one such example of diverse presentation of this ameloblastoma with conflicting histopathological diagnosis at initial biopsy and on surgical excision.

Subcuticular Suture Technique: Alternative to Frost Suture to Prevent Ectropion After Transcutaneous Incision of Lower Eyelid

IntroductionAn ectropion is a complication that can arise from reconstruction in the infraorbital region. Often, this complication occurs despite proper positioning of the lower lid at the time of closure. Various transcutaneous approaches to orbit skeleton have investigated in view of complication arising from them. A subtarsal approach with a postoperative Frost suture gives an advantage to reduce the occurrence of ectropion especially after treatment of orbital floor fractures.Material and methodsThis case describes a method of subcuticular suturing technique for subtarsal incision of lower lid which can be used to support the lid during healing period, thus decreasing the rate of ectropion.ConclusionThe technique described here is an alterative method for frost suturing with certain advantages.

An Erupted Silent Tumour

Odontomas are the most common odontogenic tumors of the oral cavity which are nonaggressive, hamartomatous in nature consisting of enamel, dentin and cementum. They are called as composite because they contain more than one type of tissue. They are generally asymptomatic, hence recognised on routine radiologic examination. The compound odontoma is composed of multiple small tooth like structures, whereas the complex odontoma consists of a conglomerate mass of enamel and dentine, which bears no anatomical similarity to the tooth. The eruption and infection of odontoma are uncommon, only few cases of erupted complex odontoma are reported in the literature. We report a case of silent erupting complex odontoma.

Bilateral hypoplasia of the coronoid process.

Andrew Rennie ∗ Victoria King Liviu M. Hanu-Cernat Department of Oral & Maxillofacial Surgery, University hyperplasia or hypoplasia of the bone.1 The coronoid proce develops as a discrete entity within the mass of the tempo ralis muscle anlage, and unites with the main portion of th mandibular ramus at around eight weeks of age.2 The mo Hospitals Coventry & Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom 6. . ), t)

Lefort-2 osteotomy for the treatment of nasomaxillary hypoplasia: a case report

Nasomaxillary hypoplasia clinically presents as a class lll deformity with hypoplasia or retrusion of the nasal bones and maxilla, which manifests as deficient projection of the nose.Lefort 2 osteotomy though introduced in 1950s, did not get its due attention till Henderson and Jackson published their landmark article, for the correction of Nasomaxillary hypoplasia in 1973. Accomplished surgeons can achieve a lot more in this rarely performed surgery when used in appropriate cases.