Lipomyelocele with osseous dysraphic hamartoma: A rare case report.

Lipomyelocele is the most common occult spinal dysraphism. However, it can rarely be associated with aberrant tissues such as bone--making it one of the rarest of spinal dysraphism type, called as "osseous dysraphic hamartoma." The authors report such a rare case of lipomyelocele with osseous dysraphic hamartoma. CT and MRI play a complimentary role in accurate diagnosis of this rare dysraphism. Detection of aberrant bone helps plan the surgery.

Comparative evaluation of different osteosynthesis modalities with respect to lingual splaying in mandibular interforaminal fractures using CBCT: A prospective study.

Introduction: The management of interforaminal fracture can prove to be challenging because of its unique anatomy and muscular forces. Often, lingual splaying has been found either postoperatively or even during the procedures in such fractures and can be challenging when it comes to managing them. Various modalities such as miniplates, lag screws, and three-dimensional (3D) miniplates have been utilized to manage these fractures. This article compares these three modalities in the management of lingual splaying. Material and Methods: Thirty patients were allotted randomly to either of the aforementioned modalities randomly in this prospective study. The patients were operated and followed up for the period of 6 months. Results: It was found that no significant difference exists between the modalities in terms of reduction in lingual splay. Conclusion: All three modalities have different ventures to offer. A larger sample size study may be warranted to elucidate the obtained results.

A comparative study on efficacy of immediate and delayed placement of cylindrical and tapered dental implants: A clinical prospective study.

Introduction: The study deals with improving the understanding of implant design in various situations. Materials and Method: 40 implants were placed out of which 20 were tapered and rest were cylindrical. These were further divided into immediate and delayed settings. The patients were followed upto 6 months and the results were compiled. Result: Statistically significant difference were found between tapered and cylindrical implants in terms of quality of osseointegration and maintenance of crestal bone height. Conclusion: It has been gathered from the study that while delayed placement suggests waiting time period varying between 3 and 6 months, it offers a predictable procedure in terms of visibility, good implant-bone contact, and closure all of which, promote a better outcome for dental implant therapy. Immediate implant placement solution is very viable in reducing the time period involved in dental implant therapy. Apart from few to minimum contraindications, it can be predictably performed.

Trigeminocardiac reflex during maxillary third molar extraction: Our experience.

Trigeminocardiac reflex (TCR) is a cascade of physiological response secondary to the stimulation of any of the sensory divisions of the trigeminal nerve, which is the largest cranial nerve and provides sensory supply to the face, scalp, mucosa of the nose, and mouth. This response usually presents as a triad including bradycardia, apnea, and gastric motility changes. On the another side, transient loss of consciousness or vasovagal syncope, a well-known phenomenon in dentomaxillofacial surgery with its pathophysiology fully elucidated, is thought to be mediated by TCR and sometimes termed as dentocardiac reflex. Thus, it is imperative to know about TCR and its association with routine dental and maxillofacial surgery procedures. It can potentially happen during any minor or major oral surgical procedures ranging from simple third molar extractions, soft tissue surgeries, root canal treatments, or management of maxillofacial fractures. This paper presents two case reports demonstrating TCR which presented during maxillary third molar extraction and author(s) own experience in managing the same.

Relationship Between Left Ventricular Strain Assessment by Cardiac Magnetic Resonance Imaging and Response to Cardiac Resynchronization Therapy.

Although cardiac resynchronization therapy (CRT) is an established treatment for heart failure with reduced ejection fraction, 30 to 50% patients are non-responders. In this retrospective single-centre study, 19 patients underwent cardiac MRI pre-CRT, and global left ventricular (LV) strain and late gadolinium enhancement (LGE) were measured by a blinded reader. LV reverse remodeling was independently assessed using transthoracic echocardiogram before and after CRT implant. Both LV strain and extent of LGE correlated significantly with measures of reverse LV remodeling (reduction in LV volume and improvement in LV ejection fraction). These findings suggest that CMR derived strain analysis and scar evaluation may be useful preimplant predictors of response to CRT. Larger prospective multi-center studies are needed to confirm these findings and to further evaluate the role of CMR strain imaging in guiding CRT treatment decisions.

Atypical Intratemporal Meningioma Masquerading as Otitis Media-Clinical and Radiological Diagnostic Dilemma.

Meningiomas are the most common intracranial extra-axial neoplasms with mostly straightforward radiological diagnosis; however, they can have unusual clinical and imaging manifestations posing diagnostic dilemma for radiologists and clinicians. The objective of this case report is to highlight the infrequent and misleading presentations of meningiomas to make an accurate diagnosis. A 65-year-old male patient presented with complaints of left recurrent otitis media and facial nerve palsy for past 6 months. On imaging, an aggressive predominantly cystic intracranial neoplasm was found in the left temporal fossa extending into the middle and external ear. Histopathological examination of the excised tumor revealed WHO grade I meningothelial meningioma. Meningiomas can show atypical imaging features such as large meningeal cysts, heterogenous or ring enhancement and aggressive features such as bone erosion. They can invade the middle ear and should be thought of while dealing with nonresponsive cases of otitis media.

Efficacy of Microplates versus Miniplates in the Management of Maxillofacial Fractures.

INTRODUCTION: Increased facial trauma has led to advances in techniques of internal fixation, improvements in plating system, refinements in exposure of facial skeleton fueling the rapid use of internal fixation for the management of facial fractures. Evaluating 40 patients with confirmed midfacial (Le Fort I and II) and mandibular fractures, this study presents the efficacy of microplate in comparison with miniplate in terms of load bearing capacity, stability at the fracture site and postoperative palpability. OBJECTIVES: To evaluate the efficacy of microplates in comparison with miniplates in maxillofacial trauma. MATERIALS AND METHODS: Study sample consists 40 subjects, 20 each in two groups clinically and radiographically diagnosed with Group 1 (maxillary) and Group 2 (mandibular fractures) which were subdivided into 10 each treated with miniplate and microplate respectively. Postoperatively, stability of fracture, bite force, need for postop MMF, pain, infection, wound dehiscence, mouth opening, occlusion and palpability was noted. All cases have been evaluated clinically for various parameters for minimum of 3 months to assess any postoperative complications. RESULTS: We found microplates are stable enough and have adequate load bearing capacity. Due to close adaptability and less hardware, postoperative palpability is less but larger sample study with long term follow up is necessary to conclude its efficacy in load bearing fracture sites.

Enchondroma of the Mandibular Body: An Occult Entity.

Cartilaginous tumors are commonly encountered tumors that can involve almost any bone and very rarely found in the maxillofacial region. These tumors may have varied presentations ranging from a simple enchondroma to a high-grade osteo or chondrosarcoma. Owing to their membranous development they are reported to occur usually in the cartilage bearing areas of the jaws like condylar process of the mandible. This article is intended to present a rarest of rare case of enchondroma of the mandibular body which to the best knowledge of authors', is not reported in the literature so far.

Efficacy of hybrid implants in oral and maxillofacial surgery: A clinical prospective study.

AIM: The present study was aimed to evaluate the efficacy of hybrid implants in replacement of missing teeth in either jaw. MATERIALS AND METHODS: Twenty hybrid implants were placed in maxilla and mandible and the implants were assessed for pain,implant exposure, mobility, infection and wound dehiscence at first, third and sixth month postoperatively. RESULTS: According to our study the statistical data showed that all the parameters which were seen clinically were nonsignificant. CONCLUSION: Hybrid implants being a new option in this field, our study provides a platform for further research with larger sample size with longer follow ups to be judgemental on their efficacy.

A clinical prospective randomized comparative study on ostyeosynthesis of mandibular anterior fractures following open reduction using lag screws and miniplates.

INTRODUCTION: The aim of the present study was to compare fixation of mandibular anterior fractures following open reduction using lag screws or miniplates. MATERIALS AND METHODS: This prospective study was conducted on 20 patients diagnosed with cases of displaced mandibular anterior fractures treated with open reduction and internal fixation. The patients were then randomly allocated to either of two groups - Group A: two 2.5 mm stainless steel lag screws were placed in 10 patients. Group B: two 2.5 mm miniplates were placed in 10 patients for the fixation of fractures. Subsequent follow-up was done on the 1st day, 1st, 4th, and 36th week postoperatively. During every follow-up, patient was assessed clinically for infection, malocclusion, loosening of plate/screw, malunion/nonunion, and masticatory efficiency. Radiographs (orthopantogram) were taken preoperative, 1st, 4th, and 36th postoperative week to compare the osteosynthesis between the two groups. Pain was objectively measured using a visual analog scale. The data collected was subjected to unpaired t-test and paired t-test for statistical analysis. RESULT: It was found that lag screw placement was rapid in comparison of miniplate placement. 3rd month postoperative assessment revealed Lag screw group to have better biting efficiency, and better bone healing which was statistically significant when compared with miniplate group. CONCULSION: Our study suggests that lag screw osteosynthesis can be advocated as a valid treatment modality in the management of mandibular symphysis and parasymphysis fractures.

Intercostal artery pseudoaneurysm complicating corrosive acid poisoning: Diagnosis with CT and treatment with transarterial embolisation.

Pseudoaneurysms of intercostal artery are very rare. All the published cases have been caused by trauma, either iatrogenic or otherwise. They can cause hemothorax, retroperitoneal hemorrhage or can present as pulsatile chest mass. Doppler ultrasound, contrast-enhanced CT and conventional angiogram can accurately diagnose this condition. All the reported cases have been treated by embolisation, stenting or surgery. We report an unusual case of intercostal artery pseudoaneurysm arising as a complication of corrosive poisoning presenting with hematemesis and treated by glue embolisation. The authors believe this to be the first case of intercostal artery pseudoaneurysm that is non-traumatic, complicating corrosive poisoning and presenting with hematemesis.