Impact of age on elderly patients with oral cancer.

INTRODUCTION: In this study we have tried to analyze the impact of age on various clinico-pathological parameters, treatment completion and subsequent survival in older patients. MATERIALS AND METHODS: This is a retrospective analysis of 140 elderly (> 65 years) patients of oral cancer operated between January 2012 and December 2013. The patients were divided into two groups based upon their age that ≤ 70 years and > 70 years.Association of distribution of various clinico-pathological factors between different groups was assessed by using Chi-square test. Survival analysis was done using Kaplan Meir analysis. Univariate and multivariate analysis were performed. RESULTS: The two groups had similar distribution of various clinico-pathological factors. Disease free survival for the group ≤ 70 and > 70 years was 37.6 months and 36.4 months (p < 0.594). 13.5% and 7.8% patients > 70 years and ≤ 70 years were either advised or received sub-optimal adjuvant therapy (p < 0.002). CONCLUSION: There is no difference distribution of various clinico-pathological factors and survival in patients of oral cancer ≤ 70 and > 70 years of age. Age did not affect survival. Majority of patients could complete the adjuvant therapy advised. Still, significantly more number of patients > 70 years could not receive/complete appropriate adjuvant therapy. Thus treatment needs to be tailored keeping in mind the individual's performance status and the co-morbidities.

Comparative study of functional outcomes following surgical treatment of early tongue cancer.

BACKGROUND: Speech and swallowing are important outcomes following resection in early tongue cancers. AIM: This prospective study was performed to compare speech, swallowing, and tongue mobility between secondary intention healing (SH) and primary closure (PC) in glossectomy for early tongue cancers. METHODS: Forty T1/T2 tongue cancers underwent wide excision followed by either PC or SH. Operative time, tube feeding, complications, speech, and swallowing were assessed in both groups at 1, 6, 12, and 24 weeks after surgery. RESULTS: SH showed better tongue mobility, less errors in continuous speech, and articulation as compared to PC at all-time points. Operative time, bleeding, duration of tube feeding, and pain scores were comparable in both groups. There were no major complications except minor secondary hemorrhage in one patient with SH. CONCLUSION: Following early tongue cancer resection, secondary intention healing can result in better speech and tongue mobility with minimum morbidity.

Management of maxillofacial injuries in bear mauling cases: a review of 20 cases.

OBJECTIVES: As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred. MATERIALS AND METHODS: Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications. RESULTS: Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment. CONCLUSION: Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.

Unusual mandibular condylar pathology: Aneurysmal bone cyst, a case report and review on reconstruction.

Aneurysmal bone cysts (ABCs) involving condyle are unusual clinical presentation affecting younger group of society with only 12 cases reported till today in English literature. In this case of ABC condyle following resection, reconstruction of temporomandibular joint was done by alloplastic condylar prosthesis as a primary choice. Monthly basis follow-up was done for 1-year with a successful result. Reviewing the reconstructive options used in ABC condyle cases we found that the condylar head add-on system has shown a satisfactory result in comparison to costochondral graft with no donor site morbidity. We recommend condylar head add-on system should be preferred as a primary reconstructive option, reserving the autograft for recurrence cases.