Outcomes of Palisade Cartilage Tympanoplasty in Chronic Otitis Media: Our Experience at a Tertiary Care Centre.

To evaluate the anatomical and functional success rates of palisade cartilage tympanoplasty in chronic otitis media. Thirty patients with chronic otitis media with subtotal perforation underwent palisade cartilage tympanoplasty and were assessed prospectively. The outcomes evaluated were graft uptake and hearing gain. Overall graft uptake was 90% with failure in 3 cases. The preoperative mean air conduction threshold was 22.087 ± 6.120 dB which was improved to 13.387 ± 5.253 dB postoperatively at 12 weeks which was statistically significant. The mean postoperative ABG closure was 8.700 dB with a p value of 0.001 which was statistically significant. Palisade cartilage tympanoplasty demonstrates that subtotal perforations, which are at high risk for graft failure, can be treated efficiently and a durable and resistant reconstruction of the tympanic membrane with reasonable hearing can be achieved.

Sudden Sensorineural Hearing Loss Associated with Oral Consumption of Hand Sanitizer: A Case Report.

Introduction: Pediatric sudden sensorineural hearing loss (SSNHL) is a rare otological emergency. With the emergence of the Coronavirus 19 pandemic, alcohol-based hand sanitizers are among the essential household items. Many hand sanitizers are frequently coupled with scents that young children may find pleasant. Case Report: A 5-year-old girl presented to our clinic with hearing loss after the consumption of alcohol-based hand sanitizer. A pure tone audiogram showed bilateral SSNHL. The child was prescribed systemic corticosteroids resulted in a slight improvement in hearing thresholds. The child was followed up at 6 and 18 months showing no further improvement in hearing thresholds. Conclusion: Although various infective, vascular, and immune responses have been proposed, alcohol-based hand sanitizer consumption has not been reported to present with SSNHL to the best of our knowledge. In the current scenario of the Coronavirus pandemic, otorhinolaryngologists must keep in mind that SSNHL may occur as a result of hazardous alcohol-based hand disinfectant consumption.

Primary Intra-Osseous Basaloid Squamous Cell Carcinoma of Mandible: Report of Rare Case with Proposed Diagnostic Criteria.

Basaloid squamous cell carcinoma (BSCC) is a distinctive variant of squamous cell carcinoma (SCC) characterised by nests of basaloid cells. BSCC is an aggressive and rare tumor of head and neck region; and is relatively rare in oral cavity in comparison to SCC. Although, infrequent, but primary intra-osseous SCC (PIOSCC) has been reported in the jaws. There are separate diagnostic criteria for this lesion and a classification for primary intra-osseous carcinoma has been described. No evidence was found in the published literature about primary intra-osseous BSCC (PIOBSCC). We, herein, present a case of giant osteodestructive lesion of the posterior mandible which was diagnosed as PIOBSCC with a correlation of histopathological and immunohistochemical features. As per the best of our knowledge, this is the first case of PIOBSCC of the jaw. There is no diagnostic criterion of PIOBSCC in the literature owing to the extreme rarity of this tumor. A diagnostic criterion is proposed here to make the diagnosis of this tumor easier.

Immunohistochemical expression of extracellular matrix metalloproteinase inducer (EMMPRIN) in normal oral mucosa, oral epithelial dysplasia and oral squamous cell carcinoma.

BACKGROUND: In oral squamous cell carcinoma (OSCC), extracellular matrix metalloproteinase inducer (EMMPRIN) expression has been noted in the cell membrane throughout the epithelium of the lesion, suggesting its increased expression. OBJECTIVES: The present study was conducted to evaluate and compare the expression of EMMPRIN in the normal oral mucosa (NOM), different histological grades of oral epithelial dysplasia (OED) and OSCC. MATERIALS AND METHODS: A total of 100 formalin-fixed paraffin-embedded tissue blocks of NOM (n = 10), 20 cases each of mild, moderate and severe (OED) (n = 60), and 10 cases each of well differentiated, moderately differentiated and poorly differentiated carcinomas (n = 30) were included in the study. The tissues sections were immunohistochemically stained and were evaluated for intensity and area of expression in different groups. RESULTS: Out of 60 cases of OED, 29 (48%) cases showed intense dark brown staining in the epithelium. The stroma in 38 (63%) cases showed positive immunoexpression. The expression of EMMPRIN in OSCC revealed intense dark brown staining in 9 (90%) cases of well differentiated, and a decent thereon in 8 (80%) cases of moderately differentiated and 4 (40%) cases of poorly differentiated carcinomas. CONCLUSION: The role of EMMPRIN in precarcinogenesis and early carcinogenesis needs to be studied on considerable sample size. This can enable oncologists to detect cancer at an early stage before it progresses to malignancy.

Central Giant Cell Granuloma with Aneurysmal Bone Cyst in a 28-Year Male Patient: A Rare Concurrence.

Central Giant Cell Granuloma (CGCG) is a benign tumor of jaw. As compared to males, females are more commonly affected. Mandible is the common site of occurrence. Aneurysmal bone cysts (ABCs) are cystic lesions which are expansile osteolytic blood-filled lesions. These are commonly seen in the mandible, and they also show gender-predilection towards females. Concurrence of both the lesions is rarely reported. The treatment of both CGCG and ABC depends upon the extent of the lesions as well as on their nature. Due to aggressive nature of the lesions, these usually cause disfigurement of the patients' face. Wide excision is the treatment modality for aggressive lesions to avoid recurrence. We present a case of 28-year male who showed CGCG along with ABC in the same lesion, a rare concurrence.

Central Acinic Cell Carcinoma of the Mandible Simulating as Benign Odontogenic Lesion: A Case Report.

Centrally occurring salivary gland tumors are rare. Because of a considerable overlap between the clinical and histopathological features, this group of tumors often produces a diagnostic difficulty to the clinicians and oral pathologists. Acinic cell carcinoma (ACC) is an unusual, low-grade, malignant salivary gland tumor that represents approximately 2% of the salivary gland tumors with almost 90% arising in the parotid gland. The rest involve the submandibular and the minor salivary gland. ACC of the jaw is extremely rare and, to our knowledge, only 8 cases have been reported in the English literature. Herein, a case of primary intraosseous ACC of the mandible in a 31-year-old woman is presented. The present case is unique, as the central ACC has never been reported in a patient in the third decade of life. The complete surgical removal of the tumor was carried out under general anesthesia along with the extraction of teeth #31, #32, #41, and #42. The follow-up period of 1-year was uneventful.

Basal Cell Adenoma of Hard Palate Involving Maxillary Alveolus.

Minor salivary glands are relatively rare location for these tumors. Microscopically, they are composed of isomorphic cells, similar to basaloid cells with palisading arrangement and distinctive basement membrane like material. Herein, we report a case of BCApresenting as a soft tissue growth of left hard palate involving maxillary alveolus of a 41-year male.

Prognostic Potential of N-Cadherin in Oral Squamous Cell Carcinoma via Immunohistochemical Methods.

OBJECTIVE: To assess the prognostic potential for N-cadherin in oral squamous cell carcinoma and oral epithelial dysplasia. STUDY DESIGN: Across-sectional study, analytical study. PLACE AND DURATION OF STUDY: Maharishi Markandeshwar College of Dental Science Research (MMCDSR), Ambala, India, from 2011 to 2014. METHODOLOGY: Immunohistochemistry was used to observe the N-cadherin expression in 100 cases having epithelium with normal oral mucosa, oral epithelial dysplastic lesions and oral squamous cell carcinoma (OSCC). For statistical significance, SPSS 13.0 was used to calculate the data by Mann-Whitney and Kruskal-Wallis tests. RESULTS: In OSCC, N-cadherin expression was more evident than in oral epithelial dysplasia followed by the normal oral epithelium that did not show any dysplastic changes (p=0.001). Conversely, N-cadherin expression was not significant among the histological grade of OSCC. CONCLUSION: N-cadherin can be used as a potential biomarker for early diagnosis of OSCC. However, the N-cadherin expression did not show any correlation with the histological grade of OSCC.

Multiple Mott Cells in Periapical Lesion of the Oral Cavity.

An entity of bizarre plasma cells has been observed, containing spherical inclusions of immunoglobulins within the cytoplasm. These cells are termed as Mott cells and are believed to occur commonly in cases of chronic inflammation. Until now, they were reported to occur in systemic diseases, various hematolymphoid malignancies and in some syndromes; but their occurrence in chronic periapical infections of the oral cavity, given the paucity of available literature, raises questions about their obscure nature. In the present case report, a 24-year male presented with a draining sinus and periapical lesion involving the maxillary right incisors. After clinical and radiographic examination, an excisional biopsy sample of the periapical lesion was obtained. Histopathological examination revealed multiple bizarre Mott cells in the connective tissue stroma. The significance, nature or fate of these Mott cells is still unknown. Frequently overlooked or a chance occurrence, the presence of these multiple Mott cells in chronic inflammatory lesions of the oral cavity could be of some significance and demand increased awareness and further research.

Angiomyxolipoma of Tongue.

Angiomyxolipoma is a rare histological variant of lipoma, characterized by proliferation of adipose tissue associated with a variable amount of myxoid stroma with numerous thick- and thin-walled blood vessels. An exhaustive literature review could reveal only 12 cases of angiomyxolipoma affecting subcutaneous tissue, subungual area and spermatic cord. In oral cavity, only 2 cases of angiomyxolipoma have been reported to date, one case in the buccal mucosa and one case in the floor of the mouth. Hence, this is only the third case of angiomyxolipoma affecting oral cavity and the first case of angiomyxolipoma of the tongue. We report a case of a 51-year male presenting with a swelling on the right lateral border of the tongue. The lesion was excised and microscopical examination confirmed the diagnosis of angiomyxolipoma.

Glandular Odontogenic Cyst.

The glandular odontogenic cyst (GOC), though rare, has now become a well known entity. The frequency of GOC ranges from 0.012% to 1.3% of all jaw cysts and its worldwide prevalence is 0.17%. The GOC's microscopic features have been well documented, and are also included in the list of World Health Organization. We report a case of GOC presenting as a unilocular osteodestructive lesion of anterior mandible in a 28-year female. The diagnosis was made on the basis of characteristic histological findings.

Osteogenic Sarcoma of Mandible.

Osteosarcoma (OS) is a malignant neoplasm characterised by the formation of osteoid matrix by neoplastic cells. It is the most common primary malignant bone tumor accounting for 20% of all sarcomas, although its occurrence in the jaw is rare. It shows typical clinical behaviour but varied radiological and histopathological features. It presents various histological aspects. We report a case of 30-year male presented with a painful swelling of mandible, diagnosed as OS after histopathological evaluation.

Large-scale reorganization of the somatosensory cortex following spinal cord injuries is due to brainstem plasticity.

Adult mammalian brains undergo reorganization following deafferentations due to peripheral nerve, cortical or spinal cord injuries. The largest extent of cortical reorganization is seen in area 3b of the somatosensory cortex of monkeys with chronic transection of the dorsal roots or dorsal columns of the spinal cord. These injuries cause expansion of intact face inputs into the deafferented hand cortex, resulting in a change of representational boundaries by more than 7 mm. Here we show that large-scale reorganization in area 3b following spinal cord injuries is due to changes at the level of the brainstem nuclei and not due to cortical mechanisms. Selective inactivation of the reorganized cuneate nucleus of the brainstem eliminates observed face expansion in area 3b. Thus, the substrate for the observed expanded face representation in area 3b lies in the cuneate nucleus.