Efficacy of Platysma myocutaneous Flap in Oral Defects.

Introduction: Clinicians are baffling for reconstruction of small- to medium-sized defects of the oral cavity since time immemorial, each and every flap has its own limitations, ideal flap should be pliable, easily transferrable that can result in a better restoration of form and function of oral mucosa, we have platysma for the same purpose. Aims: We aim to provide surgical technique of the superiorly-based platysma myocutaneous flap with a single neck incision in this study, as well as the flap design, results, and complications associated with age, gender, the recipient site, and the size of the defect. Materials and methods: Study included 20 patients with oral potentially malignant disorders operated under local anaesthesia with wide local excision and reconstruction with platysma myocutaneous flap at a single tertiary care centre. Statistical Analysis: The association between the variables was calculated using Chi-square tests and paired t tests. P < .05 was considered significant. Results: Five cases of dehiscence were found at varied sites and flap viability was significantly influenced by location of skin paddle. In between anterior jugular vein and posterior external jugular vein it was 100% viable while on and posterior to the vein, had skin paddle loss. Significant improvement in mouth opening was also seen in Oral Sub-mucous Fibrosis patients. Conclusion: The platysma flap is a technique sensitive, and its results are promising for the reconstruction of oral defects.

Complications of platysma myocutaneous flap in patients with oral submucosal fibrosis: A systematic review.

Objective: This systematic review aims for the explanation of possible postoperative complications, efficacy and limitations of Platysma myocutaneous flap (PMF) in patients with oral submucosal fibrosis (OSMF). Method: An electronic search of the literature was undertaken using PubMed, Cochrane Library, clinical trials.gov in the year 2021, using MeSH terms and keywords to identify prospective, retrospective and observational studies, controlled trials as well as case reports over the period 1913 to December 2021, addressing the patients with a mouth opening <25 mm and habit of gutkha chewing. PMFs are used as a form of intervention. Patient follow up period should be mentioned. Results: A total of 5 publications were included. 2 were prospective studies and 3 were case reports with 79 subjects between the ages of 18 and 45. All included studies reported complications in a non-significant way (p-value = 0.870) with positive results as they impact the patient's functional outcome (mouth opening) in a statistically significant manner (p < 0.0001 and 95% CI) with good patient compliance. Conclusion: PMF is rarely used in routine practice due to their technical difficulty and potential complications like venous congestion and necrosis. In this systematic review, the authors provide valuable insight into the causes of complications and the efficacy of PMFs in OSMF patients. In the process of platysma flap harvesting, it is especially important to preserve the skin flap, arterial perforators and arteries, veins in supra and sub-platysmal flap elevation. Aside from proper flap placement and tunnelling, postoperative care is equally important.

Helmet shielding effect in mandibular fractures during road traffic accident.

OBJECTIVE: The objectives of this study are to evaluate the proportion of helmeted and nonhelmeted patients sustaining mandibular fractures. MATERIALS AND METHODS: A retrospective study was conducted on 200 patients reporting to oral and maxillofacial surgery (OMFS) unit, trauma center, and department of OMFS. A predesigned questionnaire was used to collect the necessary data. Patients were evaluated for age, gender, mode of transport (2/4 wheeler), presence of safety measure at the time of accident (helmet/seatbelt), maxillofacial injury in two wheeler (with helmet and without helmet), type of impact, and its association to maxillofacial fractures, particularly site of maxillofacial fractures. The association between mode of injury, presence of safety measures, impact type, and site of maxillofacial injuries was assessed using the Chi-square test. P < 0.5 was considered statistically significant. RESULTS: The mean age of patients was 30 years, and approximately 92.5% of accidents patients were male. In this study, 35% nonhelmeted riders were reported head injury and 5% of the helmeted rider reported head injury. 54.5% of the patients suffered frontal impact, 28% collision, and 17.5% lateral slide collision. Head injuries are the main cause of death among the riders of all two wheelers. Lateral sliding collision injuries (17.5%) resulted 60.6% of the fractures mandible, 24.2% midface injury, and associated injury (15.15%). CONCLUSION: The use of helmet is strongly recommended to prevent head injuries and facial injuries. In the nonhelmeted riders in motorcycle accidents, the incidence of mandible fractures increases proportionally.

Diagnostic efficacy of neutrophil to lymphocyte ratio (NLR) in oral potentially malignant disorders and oral cancer.

BACKGROUND AND AIMS: Inflammation is considered to be the seventh hallmark of cancer and plays a pivotal role in all stages of tumor development. Systemic inflammatory responses in particular neutrophil to lymphocyte ratio (NLR) have garnered immense attention of current researchers and its role is well proven in various solid malignancies. Its prognostic role in oral cancer have been extensively studied. However, its diagnostic role is yet to be explored. The current study aims to investigate diagnostic utility of NLR in oral potentially malignant disorders and oral cancer, when compared to normal subjects. METHODS: A total of 150 subjects were involved in the study, a total of 2.5 ml of blood was drawn from the median cubital vein of the patient in an EDTA vial and hematological parameters were assessed using Erba-Transasia B7256 Autoanalyzer and reassessed manually by two experts. STATISTICAL ANALYSIS: The NLR values were recorded and tabulated as Mean ± S.D. and comparisons were analyzed using Kruskal Wallis and Mann Whitney post hoc U test. ROC curve analysis was performed to estimate cut-off values. RESULTS: The NLR values when compared between the 3 groups were statistically significant (P < 0.001). The cut off value between disease and normal subject was 2.33, while the cut-off value between potentially malignant and malignant condition is 3.20. CONCLUSION: NLR can be a valuable diagnostic adjunct in oral cancer and potentially malignant disorders of oral cavity.

Head and Neck Sarcomas-clinicopathological Findings, Treatment Modalities and Its Outcome - A Retrospective Study.

Introduction: Sarcomas are malignant neoplasms constituting an important group of tumours due to their high morbidity and mortality. They can arise either from soft tissue or bone. Soft tissue sarcomas are common, but bone sarcomas are rare. The aims and objective of this study are to carry out the study of head-and-neck sarcomas between January 2006 and May 2020. Materials and Methods: Eighty-two patients of head-and-neck sarcoma were included. Study of demographic and clinicopathological characteristics including age, sex, gender, presenting symptoms, origin, primary anatomical location, size, tumour grade, staging, treatment modality, recurrence, metastasis, and patient status during the recent visit. Results: Fifty-six (68.3%) were males and 26 (31.7%) were females. The male/female ratio was 2.28:1. The most affected age group was 0-19 years. Tumour size of >5 cm in greatest dimension was seen in 67.1% cases and tumour size of <5 cm in 32.9%. Chemotherapy + radiotherapy (CT + RT) was given in 23.8% followed by surgery in 13.9%. Recurrence was seen in 19.5% and metastasis in 18.3%. Discussion: Rhabdomyosarcoma was the most predominant histological type. Maximum patients reported in late stage. The most commonly used treatment was the combination of CT and RT. Recurrence was seen in 19.5% and distant metastasis in 18.3% patients. Head-and-neck sarcomas are rare so epidemiological studies involving more cases must be carried out for better understanding and better outcome.