Quality of life assessment in patients with long-term neurosensory dysfunction after mandibular fractures.

BACKGROUND: Long-term neurosensory dysfunction after mandibular fractures can have a significant impact on daily performances and quality of life (QoL) of the patient. The daily activities such as eating, speaking, shaving, kissing, and other social interactions can be affected due to the impaired sensation in the face and lip region. METHODS: A cross-sectional QoL assessment was done for the patients with inferior alveolar nerve dysfunction (IAND) from mandibular fractures at the 6-month follow-up visit. An interviewer-administered oral impacts on daily performances (OIDP) questionnaire was used. The OIDP scores were compared against the age and the severity of IAND. RESULTS: A total of 232 patients with mandibular fractures were initially examined, out of which 145 patients had IAND. At the end of 6 months, 52 patients still had some form of IAND and were included in this study. In our study, most affected activities were eating food (96.2%) and speaking clearly (98.1%) whereas the least affected were relaxing (9.6%) and doing major work (9.6%). Smiling (P<0.001), emotional state (P<0.001), and contact of other (P=0.02) were affected significantly more in younger patients than in older patients. Patients who had severe IAND at 6 months had problems with activities like cleaning teeth (P=0.04), doing light physical activity (P=0.007), going out (P=0.003), sleeping (P=0.012), and relaxing (P=0.03). CONCLUSIONS: Long-term IAND causes a significant impact on daily activities. This impact on QoL is particularly high and more frequent in the younger age group and patients with more severe IAND.

Dermatofibrosarcoma protuberans - a recurrent lesion with unusual presentation in the parotid region.

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous malignant neoplasm consisting of relatively monomorphous mononuclear spindle cells that show diffuse CD34+ positivity. Management of this lesion poses problem because of its infiltrative margins and high propensity for local recurrence and rare distant metastasis. It is said that clear margins with minimal removal of normal tissues can be achieved by Mohs' micrographic surgery, which is particularly important in head and neck locations where the presence of vital anatomical structures and aesthetic considerations hinders a wide surgical excision. A case of DFSP, at a very uncommon site of parotid region, which recurred within 9 months after initial surgical treatment, is being reported.