Incidence and Clinical Analysis of Complications of Neck Dissection.

The aim of the study was to assess and evaluate the incidence of complications related to type of neck dissection to different variables. Retrospective study was conducted on patients who reported to our craniofacial centre between 2010 and 2019 and underwent neck dissection for evaluation of complications related to it. Records of all patients were analysed for complications which were alienated into intra-operative, immediate post-operative (within 10 days) and post-operative complications. 256 patients, 141 male and 115 female aged between 25 and 70 years operated for squamous cell carcinoma were included. The overall incidence of complications was 32.8%. Intra-operative complications were haemorrhage 14%, nerve injury 5.4%, inadvertent internal jugular vein ligation 0.3%, chyle leak 0.3%. No incidence of carotid blow out. Immediate post-operative complications were hematoma formation 7%, salivary fistula in 2.3% and re-exploration was done in 1.5% cases. Post-operative complications noted were wound dehiscence in 22.6%, infection in 20.7%, hematoma in 2.7%, salivary fistula in 11.7% and nerve injury in 0.3% cases. Neck dissection is a challenging and therapeutic procedure. Prevention of major complications like carotid blow-out, injury to brachial plexus, vagus nerve or hypoglossal nerve requires thorough knowledge of neck anatomy.

Unusual Gigantiform Angiomatosis of Jawbone.

ABSTRACT: The purpose of this paper is to highlight rare highly infiltrative massive Angiomatosis and depict surgical outcome of a rare case series of gigantic lesions in the maxillofacial region. Data were recorded from the medical records of patients. Predictor variables were drawn from demographics, age, gender, site, evaluation of surgical treatment. The outcome variables were the challenges encountered and related complications. Out of 6 patients, the youngest was 10 and the oldest was 26 years old. Soft tissue and jawbone involvement were seen in 3 patients each with a single massive lesion involving both maxilla and mandible. All 6 patients had wide excision of the lesion with one patient having 2 stage procedures. No complications or recurrence was seen at 1-year follow-up. Angiomatosis is a rare and benign lesion in the head and neck region. its diffuse infiltrating nature may give a false malignant picture. it clinically mimics Hemangioma or Arteriovenous (AV) malformation thus requires thorough evaluation and its surgical intervention is challenging as described in this case series because of its magnitude and infiltrative nature.

Incidence and Treatment Protocol for Maxillofacial Fungal Osteomyelitis: A 12-Year Study.

PURPOSE: The aim was to retrospectively determine the incidence of fungal osteomyelitis and outcome of the surgical protocol and complications. MATERIALS AND METHODS: Data were recorded from the medical records of patients treated from 2006 to 2018. Predictor variables were drawn from demographic characteristics (age and gender), etiology, most common site, associated comorbidities involved, and treatment protocol followed. The outcome variables were the success rate and associated complications. RESULTS: We identified 50 patients with fungal osteomyelitis out of 153 who were treated for various types of osteomyelitis for 12 years. The incidence was 32.6%; men were affected more than women, at a ratio of 2.5:1; and most common site was the maxilla (56%), followed by the mandible (32%) and other sites (12%). Treatment protocols were dependent on the nature of the lesion, site, and optimization of underlying comorbid conditions. The outcome of our protocol showed that 28 patients (56%) healed well. Patients with complications such as palatal fistula (13 [26%]) underwent revision surgery using a local advancement flap and the buccal fat pad. During the immediate postoperative period, 2 patients (4%) had wound dehiscence; 2 patients (4%) had nasal regurgitation; and 1 patient (2%) had a reduced mouth opening that was managed with a mouth-opening exercise regimen. In 1 patient (2%) with recurrence, secondary correction was performed after 6 months and postoperative antifungal therapy was administered for 3 months. CONCLUSIONS: The incidence of fungal osteomyelitis was high owing to associated comorbidities. The surgical outcome was markedly influenced by a prompt diagnosis based on the clinical presentation and histopathology, identification and optimization of comorbidities, correction of electrolyte imbalances, 2 doses of amphotericin B preoperatively under an intensive care unit setup, intraoperative collection of specimens for fungal culture by a microbiologist, curettage and debridement of the soft tissue and bone, closure of the defect with either a local or regional flap, and postoperative antifungal therapy.