Online ISSN: 2515-8260

Keywords : Oral squamous cell carcinoma


“INCIDENCE OF METASTATIC INVOLVEMENT OF CAROTID SHEATH IN ORAL SQUAMOUS CELL CARCINOMA”-A Cross Sectional type of study.

DR. HARDIK G. KARIA; DR ANENDD JADHAV; DR NITIN BHOLA; Dr. HARDIK G. KARIA

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1185-1190

Background: Surgery is the most well established mode of initial definitive
treatment for a majority of oral cancers. Over the past few decades, the surgical technique
of neck dissection has evolved from Radical neck dissection to Modified radical neck
dissection and then to Selective Neck Dissection.
Objectives: The main purpose of this research is to evaluate the incidence of pathologic
incursion of the carotid sheath, when noticed grossly uninvolved while doing surgery in
the patients with neck dissection for head and neck squamous cell carcinoma (HNSCC).
Methods: 80 neck dissections will be performed. Carotid Sheath will be removed separately
and methodically evaluated by well experienced head and neck pathologists by performing
hematoxylin and Eosin staining and Immunohistochemistry Analysis with Markers like
Pancytokeratin and CD34 for tumour infiltration and the occurrence of lymphatic 
tissue. Hence, if found negative than it will strongly indicate that we can modify the neck
dissections limiting upto the level of carotid sheath.
Results: Carotid Sheath is not grossly involved, removal of Carotid Sheath is not
recommended. Histologically Carotid Sheath may harbour dilated lymphatic vessels,
lymphocytes aggregates and neutrophils. Carotid Sheath, however, would not harbour any
metastatic tumour emboli from primary Oral Squamous Cell Carcinoma.
Conclusion: Not only for surgical safety but also for the shield it provides post operatively
against adjuvant radiation therapy and any infection in neck and even trickling of saliva
down the neck postoperatively by protecting vital structures it encases like Common carotid
artery, Vagus Nerve and Internal jugular vein. So far there is paucity of data in presence
of metastatic involvement of carotid Sheath. This study will give basis for preservation of
Carotid sheath during neck dissection which will reduce postoperative morbidities in head
and neck squamous cell carcinoma patients.

―Comparison of Pectoralis Major Myocutaneous Flap with and without Lateral Axillary Incision in Reconstruction of Soft Tissue Defect in Head and Neck Region‖- A Pilot Study

Dr. Manan Gupta; Dr. Nitin Bhola

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2105-2115

Abstract: Background - Major ablative surgeries leads to soft and hard tissue defects which
require reconstruction which gives better functional and aesthetic outcomes. Pectoralis
major myocutaneous (PMMC) flap is a workhorse flap for soft tissue reconstruction owing
to its merits. The conventional technique of harvesting PMMC flap is associated with
donor site complications such as functional deformity and scar contracture. A modified
technique without lateral axillary incision for harvesting PMMC flap may provide better
results. Aim - To compare the two incision designs of harvesting PMMC flap (with lateral
axillary incision and without lateral axillary incision) in soft tissue defect reconstruction in
head and neck region. Methodology – A prospective pilot study will be performed on 16
patients diagnosed with OSCC requiring resection, neck dissection and reconstruction with
PMMC flap. These patients will be allocated to two groups by alternate randomization,
Group A PMMC flap harvest with lateral axillary incision and Group B PMMC flap
harvest without lateral axillary incision. The patients will be subjected to General
anaesthesia and surgery will be performed by single experienced surgeon. Parameters
assessed will be time taken for harvesting the flap, time required for closure of donor site,
flap survival, range of motion (ROM) of shoulder (Degree of endorotation and
exorotation), complications (hematoma, seroma, dehiscence, marginal necrosis, infection)
and scar formation. The obtained data will be filled in MS excel sheet and statistical
analysis will be done. Expected result – The modified technique would prove better in
terms of function and aesthetic with minimal complications and that it will provide new
insight in choosing the best approach with minimal complications for harvesting of PMMC
flap. Conclusion - The results if favours the modified technique with respect to time of
harvesting, time of closure of donor site and complications, will help in the reconstruction
of such defects with minimal donor site complications and improved outcomes.

AUDIT ON SUTURE TYPES USED FOR NECK DISSECTION WOUND CLOSURE IN ORAL SQUAMOUS CELL CARCINOMA PATIENTS

Jembulingam Sabarathinam; Kathiravan Selvarasu; Dr Madhulaxmi M

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 889-896

A suture is a device, either natural or synthetic, which is used for ligation of blood vessels and in wound closure following surgery. Its major functions are to hold tissues together following wound closure or surgery. Neck dissection procedures leave open wounds which need to be approximated for the process of wound healing and aesthetic considerations. Henceforth the aim of the current study is to assess the type of sutures used in surgical wound closure of neck in patients with oral squamous cell carcinoma following radial neck dissection in private institutional setup in chennai. Data was procured from the case sheets of patients undergoing radial neck dissection following surgical management of oral squamous cell carcinoma. The data was tabulated in MS-Excel and analysed by SPSS software (Version 20). The results were inferred. 60% of the external surgical wound closure were sutured using silk sutures while 40% where sutured using polyglactin and nylon sutures. 60% of the internal wound closures were closed using polyglactin while 40% was using polypropylene and nylon.Polyglactin 910 and silk were the most predominantly used suture materials for internal and external surgical wound closure in an private institutional set up in Chennai.

KNOWLEDGE AWARENESS AND ATTITUDE TOWARDS ORAL MANIFESTATIONS OF VIRAL INFECTIONS AMONG DENTAL STUDENTS- A QUESTIONNAIRE BASED STUDY

Sneha Sree. S; Abilasha Ramasubramanian; Jayanth Kumar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 600-615

A virus is composed of nucleic acid either DNA or RNA, surrounded by a protein coat.It requires a living cell to multiply. A viral infection can lead to a spectrum of symptoms from asymptomatic to severe disease.Worldwide,5% of health-care-related infections are being transmitted. Dentists are considered being a high risk group for cross-infection.Therefore it is important that dental students have adequate knowledge and awareness of viral infections.The aim of the study is to evaluate the knowledge, awareness and attitude about oral manifestations of viral infections among dental students.A self explanatory questionnaire comprising 20 questions was presented to 205 students. The questionnaire enquired about oral manifestations of different viral infections and their precautionary infection control measures .Out of 205 students 86.34% were males and 13.66% were females,189 of them knew that the most common oral manifestation in HIV patients is candidiasis.92.6%agreed that a dentist could get Herpetic paronychia.When asked if treatment of patients with viral infections required special clinics 68.1% responded yes.Our study showed that the dental undergraduate students had adequate knowledge on oral manifestations of viral diseases but lacking knowledge about infection control protocol for the various diseases. Hence students should improve their attitude towards them in their dental practice.

RADIOGRAPHIC ANALYSIS OF OSSEOUS CHANGES IN ORAL SQUAMOUS CELL CARCINOMA

Abarna jawahar; G.Maragathavalli .; Manjari Chaudhary

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1751-1761

Oral squamous cell carcinoma(OSCC) primarily affects the soft tissues,but involvement of jaw bones is seen in about 12–56% of patients.In these cases,radiographic analysis is essential inorder to observe the pattern of bone involvement.A retrospective study was conducted on patients who visited the department of oral medicine from march 2019 to march 2020.The clinical findings,histopathological diagnosis of OSCC patients who showed bone involvement in the digital panoramic radiographs were reviewed from electronic database.Descriptive statistics were used to analyse the radiographic findings.We observed that the majority of patients presenting with oral squamous cell carcinoma involving the jaw bone belonged to the age group 40-50 years with male predilection(76.9%).Mandible was most commonly involved with the right posterior alveolar region being the most commonly affected site.The radiographic changes observed predominantly in the lesions were smooth borders(53.85%) with an altered trabecular pattern (46.15%).The effect of the lesion
on the surrounding structures were spiked root appearance in 84.62% and floating tooth appearance in 69.23% of cases.Presence of saucerization was seen in 76.92%.Hence digital panoramic radiographs are valuable aids in diagnosing the involvement of jaw bones in oral malignancy and thereby help in devising the treatment plan.