Leishmaniasis of the tongue treated with liposomal amphotericin B.

A 66-year-old man, immunosuppressed because of a lymphoma and with severe ischaemic heart disease and proteinuria, presented with a swelling on the tongue due to leishmaniasis. His travel history suggested that he had acquired the infection in the Mediterranean area some years earlier. He was treated with liposomal amphotericin B for 21 days and made a good recovery despite a temporary deterioration in renal function. Oral lesions are a rare manifestation of Old World leishmaniasis. Liposomal amphotericin B is a novel treatment that may be well tolerated when there is concern about the toxicity of more established drugs.

True lateral dermoid cyst of the neck.

A case of a lateral dermoid cyst presenting in the submandibular triangle without previous intra-oral swelling is reported. Sonography provided the key to diagnosis and is the first investigation of choice.

Can post-tonsillectomy pain be reduced by topical bupivacaine? Double blind controlled trial.

A double blind controlled prospective trial investigated the analgesic effect of topical Bupivacaine in 15 adult patients undergoing bilateral tonsillectomy. Each patient had one tonsillar fossa exposed to Bupivacaine 0.5 per cent solution and the other to normal saline. When visited four to six hours post-operatively, 12 out of 15 patients (80 per cent) stated that the Bupivacaine exposed side to be more uncomfortable than the saline exposed side. On the first post-operative morning 9 out of 15 patients (60 per cent) confirmed the same. The remaining patients were unable to detect a significant difference and no patient found the Bupivacaine side to be more comfortable. These results suggest that topical Bupivacaine 0.5 per cent solution has no place in providing post-operative analgesia in adult tonsillectomy.

Acinic cell carcinoma--Plymouth's experience with postoperative radical radiotherapy.

Acinic cell carcinoma represents 2.5% of all parotid neoplasms. Experience in its management is limited and its initial clinical diagnosis may be incorrect. This paper examines six patients who received less than ideal primary surgical care. Duration of follow up ranges from 1.25 years to 10.5 years, mean 6.7 years. Prophylactic postoperative radiotherapy appears to be of marked benefit in preventing recurrence and cervical node metastases.

Does bupivacaine irrigation of third molar sockets reduce postoperative pain? A double blind controlled trial.

A double blind controlled randomised trial suggested that irrigation of third molar sockets with bupivacaine 0.75% produces significant reduction in pain scored on the first post-operative morning (p less than 0.01). However, this technique produces no significant reduction in opiate or oral analgesic consumption.

Do local analgesics injected at the time of third molar removal under general anaesthesia reduce significantly post operative analgesic requirements? A double-blind controlled trial.

A prospective, controlled, randomised, double-blind trial suggested that: 1. The use of bupivacaine 0.5% plain and prilocaine 3% with felypressin 0.03 i.u./ml. as peroperative local analgesics reduce postoperative pain scores recorded on the first postoperative morning (P less than 0.05). 2. Bupivacaine 0.5% plain reduces postoperative opiate requirements (P less than 0.025). 3. Patients do not find peroperative bilateral inferior alveolar and lingual nerve blocks with buccal infiltrations significantly unpleasant. Thus peri-operative bupivacaine 0.5% is a valuable adjunct to third molar removal under general anaesthesia.

Tuberculous submasseteric abscess: case report.

Tuberculosis is still the most fatal infectious disease worldwide.Although it can affect every organ in the body, non cervical and extralaryngeal head and neck tuberculosis is considered rare. We report a case of tuberculous submasseteric abscess:a very unusual site.

Massive sublingual haematoma following osseo-integrated implant placement in the anterior mandible.

The floor of the mouth is a very vascular area. Should perforation of the lingual cortex of the mandible occur during the placement of an osseo-integrated implant, significant haemorrhage may result. We present the case of a patient who attended our unit with acute airway obstruction. Although life threatening haematoma following the placement of osseo-integrated implants in the interforaminal area of the mandible is known to occur, there continue to be sporadic reports in the literature. This shows that some practitioners are unaware of the risks involved and place implants of the wrong size and orientation.

Ludwig's angina: an unusual sequel to endodontic therapy.

Ludwig's angina is an unusual sequel to endodontic treatment: such a case is described. Principles of management are discussed with emphasis placed on the need to secure the airway early. The literature is reviewed.