Malignancy and "Violated Neck" Rates in Consecutive Cohort of 79 Adult Patients With Solitary Cystic Neck Mass-Lessons Learned and Recommendations for Clinical Practice Guidelines.

OBJECTIVE: The neck region is a common site for solitary cystic neck mass (SCNM) of various etiologies, including congenital, inflammatory, and neoplastic. In adults, the primary focus is excluding malignancy. The objective of this study was to retrospectively analyze the accuracy of available diagnostic technologies for the differentiation of benign and malignant SCNM in adult patients. The study aimed to develop new clinical practice guidelines for evaluating and managing SCNM. METHODS: The primary predictive variables were the diagnostic utilities of fine-needle aspiration cytology (FNAC), ultrasound (U/S), multislice computed tomography, and magnetic resonance imaging. The study's endpoint was the overall diagnostic accuracy in differentiating between benign and malignant SCNM. The final diagnosis was based on histopathology. RESULTS: The study included 79 adult patients: 55 (69.62%) male and 24 (30.38%) female ( P <0.05). The mean age at presentation was 42.1 years (range: 18-84 years). Solitary cystic neck mass was distributed in the anterior neck region in 30 (37.97%) patients and the posterolateral neck regions in 49 (62.03%) patients ( P <0.05). The posterolateral neck regions had a significantly higher rate of malignant SCNM than the anterior neck region [19/49 (38.78%) versus 1/30 (3.33%)] ( P <0.05). There was no statistically significant difference between the U/S+FNAC and U/S+FNAC+multislice computed tomography and/or magnetic resonance imaging groups in differentiating benign and malignant SCNM (40/42 versus 36/37, P >0.05). "Violated neck" was recorded in 2 cases. CONCLUSION: A systematic investigation protocol should be applied to evaluate adult patients with SCNM.

Perceived Satisfaction of Patients and Related Factors for Oral Surgery Student Dental Clinic: Evidence From Sri Lanka.

We assessed perceived satisfaction of patients and related factors for treatment provided by the oral surgery student dental clinic of the only Sri Lankan dental school. A descriptive cross-sectional study was conducted among 288 consenting patients who received oral surgery treatment at the student dental clinic of Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. A self-administered, validated questionnaire and a 19-item multidimensional patient satisfaction scale were used for data collection. Patients of all ages were represented, but were dominated by females, aged 30 to 44 years, possessing educational attainment up to General Certificate of Education ordinary or advanced level of which 54.9% were unemployed. They had travelled distances of less than 10 and 10 to 20 km (28.1% and 27.5%, respectively) predominantly to receive tooth extractions exacerbated by symptoms. Overall, 90% of responding patients were highly satisfied with the items of many dimensions of dental treatment. Despite high levels of perceived satisfaction expressed, further improvements were warranted for waiting time, optimal pain control with more kind, and courteous staff.

Awareness of feeding, growth and development among mothers of infants with cleft lip and/or palate.

BACKGROUND: Awareness of feeding among mothers plays an important role in the growth and development of children with cleft lip and palate. Mothers' increased awareness provides the right care and nutrition to these children in order to grow and achieve their developmental milestones. OBJECTIVES: This study aimed at (1) assessing mothers' awareness on breastfeeding and formula-milk feeding, weaning, growth, and development of infants with cleft lip and palate and (2) the relationship of mothers' awareness with their level of education and monthly household income. METHODS: This cross-sectional pilot study included all the mothers of infants aged up to one year who had cleft lip and/or palate attended Dental Teaching Hospital, Peradeniya between the years 2015 and 2016. Mothers of infants with oral clefts associated with other syndromic features and chronic illnesses were excluded. A pre-tested interviewer-administered questionnaire was designed to collect data. To assess the clarity of the questions, prior to the study, the questionnaire was pre-tested in 10 mothers of infants with an oral cleft but not selected for the study. Frequency distributions and descriptive statistics were used to describe study variables. Spearman Rank test was used to determine the association of mothers' awareness with their level of education and monthly household income with a 95% confidence interval. RESULTS: The sample consisted of 101 mothers who had infants born with a cleft and the response rate was 100%. Except one, all mothers reported that they have received overall feeding instructions either from a doctor, nurse, cleft center staff or a midwife. Over 65.3% of mothers were aware of feeding-related factors including; breastfeeding, formula-milk feeding, and weaning of infants with a cleft. Overall more than 80% of mothers were aware of factors related to growth and development of the child including urination, sleeping pattern, weight and growth charts. The education level of mothers was not significantly associated with mothers' awareness of any factors related to breastfeeding, formula-milk feeding, weaning and growth, and development. Further, mothers' awareness of breastmilk as the best food for babies under 6 months (p = 0.028), weaning at 4-6 months (p = 0.024), replacing milk feeds by weaning foods (p = 0.02) and not providing junk foods to infants in between main meals (p = 0.01) were significantly associated with monthly household income. CONCLUSIONS: The findings of this study suggest that mothers were aware of factors related to feeding infants with a cleft lip and palate and their growth and development. The awareness of mothers about certain factors related to feeding and weaning was significantly associated with monthly household income.

An unusual foreign object mimicking an odontoma in a patient with cleft alveolus: a case report.

BACKGROUND: The habit of inserting foreign objects into body cavities is seen in children and in adults with intellectual disability. Usually, the foreign objects cause chronic inflammation and local tissue destruction, which give rise to symptoms. Diagnosis at an asymptomatic stage is uncommon when the history is not suggestive. We describe a rare case where a foreign object was misdiagnosed as an odontoma in a patient with an alveolar cleft. CASE PRESENTATION: A radiopaque round mass was noted on the radiograph of a 12-year-old Sinhalese boy who was awaiting an alveolar bone graft. Apart from problems related to the alveolar cleft and mild halitosis, he was otherwise healthy. This was suspected to be an odontoma in the cleft region. During alveolar bone graft surgery, a button battery was recovered that was later confirmed as having been self-inserted by the child. Alveolar bone graft surgery was delayed because of local chronic inflammation due to the foreign object. Three months later, complete healing of the site was noted when reexplored for alveolar bone grafting. CONCLUSIONS: It is important to include foreign objects in the radiological differential diagnosis in asymptomatic children. Furthermore, cone beam computed tomography should be considered in suspected cases. Early removal with thorough debridement causes minimal tissue destruction.