Shruti Chhabra

Diagnostic Modalities for Squamous Cell Carcinoma: An Extensive Review of Literature-Considering Toluidine Blue as a Useful Adjunct

IntroductionOral Squamous Cell Carcinomas have been considered as the most prevalent malignancies in the head and neck region and are frequently undiagnosed until symptomatic with an advanced stage of disease. So there is an urgent need to device methods for the detection of oral premalignant lesions and oral cancer at an early stage in order to improve the survival rate for patients. A number of tests have been done for the detection of oral cancer which include oral brush biopsy, the Vizilite, oral autofluorescence including chemiluscence, photodynamic detection, toluidine blue staining, methylene blue staining, incisional biopsy and many more.MaterialThe article reviews various diagnostic modalities available at present for detection of squamous cell carcinomas and oral epithelial dysplasias based on advanced PUBMED search of the English language literature from the year 1972 to present in order to help us select the most suitable among them fulfilling the desired criteria of being non-invasive, highly specific and sensitive, economically viable, having a scope to be used for mass screening, easy to process, having low inter examiner variability and possibly not requiring high expertise to conduct and interpret the results.ConclusionAfter reviewing various diagnostic modalities, we conclude that toluidine blue staining emerges as a clear winner among all these and it can act as a valuable adjunct to incisional biopsy in detection of oral cancer and may not substitute it except in certain circumstances when its results are carefully correlated with the patient history and clinical characteristics of the mucosal disorder, considering the fact that incisional biopsy has been reported to cause dissemination of cancer cells in the circulation there by increasing the possibility of metastasis. We must emphasize that toludine blue is a screening modality and not a diagnostic procedure like biopsy and hence cannot replace a confirmatory biopsy as a whole

Maxillofacial injuries due to animal bites.

IntroductionAnimal bites are a significant public health problem, with the majority of bites coming from dogs, cats and humans. These may present as punctures, abrasions, tears, or avulsions. The force and relative bluntness of the teeth also increases the possibility of a crush injury with devitalized tissue .The clinical presentation and appropriate treatment of infected bite wounds vary according to the animal and causative organisms. These wounds have always been considered complex injuries contaminated with a unique polymicrobial inoculum.MaterialsThis article reviews animal bite wound incidence, bacteriology, risk factors for complications, evaluation components, recommended treatment and prevention based on advanced PUBMED search of the English language literature from the years 1970 to present.ConclusionAs the bite wounds are frequently located on the face, an oral and maxillofacial surgeon needs to be familiar with the treatment of animal bites, pitfalls in management and to educate patients on ways to avoid future bite injuries. The management of animal bites is an evidence poor area and most recommendations are based on small case series, microbiological data and expert opinion. The main controversies include whether wounds should or should not undergo primary closure and the use of prophylactic antimicrobials.

Evaluation of Two Different Methods of Arch Bar Application: A Comparative Prospective Study

PurposeTo comparatively evaluate the efficacy of a pencil type wire twister and the normal wire twister in terms of various parameters during arch bars application.MethodThe study involved residents of the department enrolled in MDS course. Two study groups of 60 patients each were made by randomly selecting the patients from the outpatient department of Oral and Maxillofacial surgery who required arch bar application. Group A included the patients who underwent upper and lower arch bar application with the use of a pencil type twister and group B included patients who underwent arch bar application with a normal wire twister. All respondents were given a questionnaire after the completion of procedure involving the use of medical sharps. The paired samples t test was used for statistical analysis.ResultAmong group A, mean glove perforations, actual wire stick injuries, mean time taken to complete the procedure, mean wire breakage during the procedure was less than in group B. Comfort level of patients and Ease of operator while performing the procedure was more in group A than in group B. Frictional abrasion of the finger was not associated with the use of pencil type twister. Overall rating of the procedure was more in group A than group B.ConclusionThe use of pencil type wire twister outweighs normal wire twister in various ways. It increases the overall efficacy of the operator during the procedure.

Use of a calibrated beaker in TMJ arthrocentesis

omplications of puncture of the temporomandibular joint TMJ) are mainly caused by arthroscopic surgery, and rarely y arthrocentesis and arthrography. Complications associated ith arthrocentesis, though rare, may range from infection, xtravasation of fluid, and injury to the nerve.1,2 The incience of these can be lowered by strict asepsis and using he least traumatic technique, particularly the avoidance of xtravasation of fluid. Irrigating fluid can be extravasated lateral to the TMJ and s seen as a swelling of the respective preauricular region. edial extravasation of fluid can occur through the medial

Recurrent Mandibular Dislocation in Geriatric Patients: Treatment and Prevention by a Simple and Non-invasive Technique

Dislocation is defined as the complete loss of articular relationship between the articular fossa of the temporal bone and the condyle-disk complex. Most common aetiology of dislocation is wide mouth opening, trauma and use of certain drugs. It is classified as acute, chronic and recurrent. Chronic recurrent dislocation of mandible is a distressing condition especially for geriatric patients. Various non-surgical methods of reduction include Hippocratic method, Awang’s gag reflex method, wrist-pivot technique, combined ipsilateral staggering technique, recumbent approach, intermaxillary fixation, injection of a sclerosing solution, autologus blood transfusion and botulinum toxin. In geriatric population, the ridges become atrophic with time and use of any method of reduction which exerts force on mandible increases chances of fracture of mandible. Awang’s gag reflex method is a non invasive technique which helps in treatment of chronic recurrent dislocation in geriatric patients. Along with this technique the use of a cervical collar has been reported in this article, which not only acts as a restrainer but also is helpful for cervical spondylosis, a common condition encountered in geriatric population.

Use of hypertonic saline in the management of parotid fistulae and sialocele: a report of 2 cases

Parotid fistula is a well known complication of parotidectomy or penetrating injury of the parotid gland. Fistulae may be internal or external, but simple internal fistulae are of no surgical interest. In cases of external fistulae, the principles of management aim at the return of normal parotid function in both acute and chronic parotid injury, but sometimes the alternative is to depress parotid secretions to allow natural healing process to seal the injury.The paper highlights the indications, techniques, advantages and disadvantages of using osmotic sclerosant for the management of parotid fistulae. We used warm hypertonic saline injections within the glandular substance to cause rapid fibrosis of the gland in 2 patients of chronic parotid fistulae.This technique is a simple and effective method of dealing with salivary leak. Its ease of performance, effectiveness; minimal surgical risk and minor cost are the advantages over other available options.

Wound Healing Concepts in Clinical Practice of OMFS

BackgroundWound healing is a complex and dynamic process and a thorough knowledge of the basics of physiology of wound healing is a must to implement principles of chronic wound care. Understanding wound healing at multiple levels—biochemical, physiologic, cellular and molecular provides the surgeon with a framework for basing clinical decisions aimed at optimizing the healing response.ObjectiveThis review article describes the classification of wounds and aims to highlight the fundamentals of wound repair, enumerating the dressings used commonly and also, the newer concepts of wound healing.Materials and methodsSearch engines and medical databases were tapped to gather information on the subject. Search words employed were “Wounds”, “wounds in OSMF”, “Wound healing”, “Repair”, “Dressings in OMFS”.ResultsThe search resulted in total of 153 articles which we reviewed to add to the literature the concepts of wound healing and to throw some light on recent advances in wound care.ConclusionsWound healing remains a challenging clinical problem and correct, efficient wound management is essential to positively influence the wound healing course and reduce potential complications.