Nonendoscopic intraoral approach for condylar fracture management-a systematic review.

OBJECTIVE: The recent trend favors the open reduction and internal fixation of condylar fractures to prevent long-term consequences. Nonendoscopic intraoral approach is an option for management without a visible scar. The purpose of this systematic review was to explore the evidence, armamentarium, methods of reduction and fixation, challenges, and complications. STUDY DESIGN: We have systematically reviewed published articles on the intraoral approach for condylar fracture management following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane library database, to find relevant articles from January 1980 to March 2022. Descriptive statistics were applied to obtain the results. RESULTS: Finally, 23 studies were included. The incision described for the intraoral approach was similar to sagittal split osteotomy in all studies. A wide array of specialized instruments, methods, and challenges has been outlined for visualization, reduction, and fixation. The incidence of complications in the entire review was 23% (72/306). CONCLUSION: The challenges encountered in the nonendoscopic intraoral approach for condylar fracture management can be negated with the use of specialized instruments and with experience. However, further research is warranted for a specialized set of miniature instruments to ease the procedure, make it time-efficient and optimize hardware selection.

Gender reassignment surgery - a narrative overview of anaesthetic considerations and implications.

The twenty-first century, with its transforming ideology and rising acceptance, is witnessing an increased number of transgender people applying for gender reassignment surgery (GRS). The procedure of GRS is a lengthy and complex one involving the active collaboration of multiple disciplines including psychology, psychiatry, family medicine, plastic surgery, endocrinology, otolaryngology, urology, gynaecology, maxillofacial surgery, and anaesthesiology. The considerable paucity of literature regarding the management of patients presenting for GRS places health care providers at a disadvantage. It is imperative to cautiously regard the specific medical, emotional, social, and economic concerns regarding these patients. Health care providers need to be trained well to deal empathetically with such patients. The present literature about GRS deals mainly with the surgeon's perspective, while the anaesthetist's approach remains hazy. This is because GRS imposes the need for anaesthesiologists to search for better and more efficient modes of anaesthesia so as to improve prognosis and minimize the associated morbidity. Anaesthetists should understand the associated psychological aspects and effects of hormone therapy while performing an extensive and informative pre-operative evaluation to formulate an effective strategy. Providing the optimal modes for anaesthesia and keeping a cautious watch for complications along with timely intervention in the advent of the same comprise the approach for high-quality anaesthetic care. This review aims to provide a detailed overview of significant considerations and competent peri-operative outcomes in patients presenting for GRS.

Burns and COVID-19-Initial Experience and Challenges.

The COVID-19 pandemic has brought with it many challenges in the field of healthcare around the world. Managing burn patients has its own challenges as they require a long duration of care and are more susceptible to infection. We conducted a retrospective observational study from January 30 to July 15, 2020 at our center to study the epidemiology of burns treated & patients and healthcare workers affected by COVID-19 during this period. The number of burn admissions showed a 42.6% reduction as compared to last year. A total of 17 patients (3.67%) and 29 health care workers (8.68%) tested positive for COVID-19 in the burns department. Our strategy underwent changes based on the changing dynamics of COVID-19 and changes in government and institutional policies. We have described the various challenges we faced in managing burns during this time. We found that effective screening of patients and healthcare workers, proper segregation of negative and positive/ suspect population and a low threshold for COVID-19 testing were essential to mitigate transmission of infection.

Tumor Recurrence at Donor Site of Pectoralis Major Myocutaneous Flap with Tumor-free Primary Oral Carcinoma.

Pectoralis major myocutaneous flap is an important option for post onco reconstruction in head and neck region. Among the several complications mentioned in the literature, tumor recurrence at the donor site of flap is late and rare complication. Tumor implantation at the donor site of flap is a possible explanation. The occurrence of this type case is rare. We are reporting a case of tumor recurrences of pectoralis major myocutaneous flap donor site without presence of index tumor or detectable systemic disease. The recurrence was operated in our case. Clinicians should be aware of this condition for better management of patients with similar presentation.

Camel bite: An uncommon mode of maxillofacial injury, its mechanism and fatality: Case series and review of literature.

INTRODUCTION: Maxillofacial injuries are presented with many different patterns. It mostly depends upon the mode of injury like physical assault, road traffic accidents, occupational injuries, fall, sport injuries and animal attacks. Animals bites are common with wild animals but attack from an otherwise calm animal like camel is unusual and unexpected. They may cause a severe kind of maxillofacial injury which ranges from minor lacerations to total loss of soft and hard tissues. Such incidences are frequently seen in Rajasthan, India where camels are kept as a pet. Present study throws light on literature related to animal bite injuries and their management along with our experience with camel bite injuries. MATERIALS AND METHODS: Twenty patients (19 male and 1 female) of different age groups with variable extent of maxillofacial trauma induced by camel attacks were included in the study. Among them, different patterns of maxillofacial injuries were observed involving both soft and hard tissue. RESULT AND CONCLUSION: This study provides the comprehensive incidence, pathophysiology, and management of camel inflicted injuries. Understanding the behavior patterns of this animal may prevent such severe injuries.