Pseudoaneurysm of internal maxillary artery--an untold complication following distraction osteogenesis--a case report.

Pseudoaneurysm of the internal maxillary artery is very rare and only a handful of cases have been reported in the literature thus far and none after placement of a prosthetic condyle and a distraction device. This case report highlights the need for early diagnosis, appropriate steps in management, and a multidisciplinary approach in a tertiary care center in treating this life-threatening condition and proper treatment planning to prevent this condition.

Pleomorphic Adenoma - A Case Report on an Abnormal Mass.

Rationale: Pleomorphic adenoma (PA) is the most prevalent salivary gland tumour, accounting for 60%-80% of all benign salivary gland tumours, and frequently affects the parotid gland. Their epithelial and connective tissue origins can explain the 'pleomorphic' nature of tumours. This tumour is most common in women between 30 and 50 years. Patient Concerns: A 45-year-old female came with the chief complaint of a slow-growing, painless swelling on the left side of her face that had been present for 25 years. Diagnosis: PA of the parotid gland was diagnosed using computed tomography and fine-needle aspiration cytology. PA is a slowly progressing, asymptomatic swelling that rarely exceeds 6 cm in its greatest dimension; in our case, it was 13 cm × 10 cm and weighed 5 kg. Treatment: The ideal management is the surgical removal of the tumour mass, which was done under general anaesthesia. Early diagnosis and treatment planning was critical. Complete removal of the tumour without remnants is crucial to prevent a recurrence. Total parotidectomy was done in this case. Outcomes: There was no evidence of recurrence after comprehensive local surgical resection of the tumour during the follow-up period. Take-away Lessons: This case report is significant as it sheds light on the successful treatment approach for a large pleomorphic adenoma. It can provide valuable insights into the management of similar cases, potentially leading to improved patient outcomes and guiding future treatment strategies.

Case Report: Ludwig's angina - 'The Dangerous Space'.

Background: Ludwig's angina is a potentially life-threatening disease characterized by diffuse bilateral cellulitis with an odontogenic origin. This unique infection is now rare owing to the antibiotic era. Case: This patient presented to the emergency room with trismus, jaw and neck swelling, mild respiratory distress with tachypnea, hyperthermia, and panic. Clinical examination and radiographic evaluation confirmed the diagnosis of Ludwig's angina. As it is a quickly spreading infection, the patient was taken up for immediate surgical decompression leading to pus drainage, removal of the offending tooth, bacterial culture and sensitivity, and administration of empirical antibiotics. As we had operated promptly, there was no need for emergency airway intervention, and the patient had immediate relief from airway distress. Conclusions: Early accurate diagnosis with conservative surgical decompression, thereby negating the need for airway intervention, was vital to avoiding mortality which is always possible in such an expeditious infection.

Comparision of Vital Surgical Parameters, after Administration of Midazolam and Dexmedetomidine for Conscious Sedation in Minor Oral Surgery.

AIM: The aim of this study is to compare the efficacy between midazolam and dexmedetomidine in relation to vital parameters, sedation score, pain score, cognitive judgment, and postoperative amnesia to the event in conscious sedation for minor oral surgical procedure. MATERIALS AND METHODS: A sample size of 30 patients were selected in each group: Group M (midazolam) and Group D (dexmedetomidine). RESULTS: The mean heart rate (HR) and systolic and diastolic blood pressure measurements were significantly higher in Group M after the 20th min when compared to Group D. The visual analog scale (VAS) scores of pain were not statistically significant between the two groups during the procedure, but at the time of discharge, statistically significant VAS scores were found between the two groups. Nine (30%) patients in Group D and 21 (70%) patients in Group M showed cognitive judgment impairment with the Stroop Color and Word Test at the 30th min. CONCLUSION: The dexmedetomidine group of patients had reduced blood pressure and HR. No significant differences were noted in oxygen saturation or in respiratory rate between the two drugs. Patients had better sedation, analgesia, lesser cognitive impairment, and amnesia in the dexmedetomidine group.

Comparison of Bite Force After Administration of Midazolam and Dexmedetomidine for Conscious Sedation in Minor Oral Surgery.

AIM: The aim of this study was to compare the bite force and sedation score in moderate/conscious sedation for minor oral surgical procedure. MATERIALS AND METHODS: A sample size of 30 was selected in each group (group M [midazolam] and group D [dexmedetomidine]). RESULTS: Dexmedetomidine group had a statistically significant sedation score than midazolam. A statistically significant increase in the bite force was observed in both midazolam and dexmedetomidine groups, but there was no significant difference between the two groups. CONCLUSION: Dexmedetomidine and midazolam significantly increased the bite force because of the loss of proprioceptive function of periodontal ligament, but there was no significant difference between the drugs regarding bite force.