Locally Advanced Orofacial Malignancy: Synopsis of Inoperable Lesions at an Urban Tertiary Health Facility in Nigeria

Background: Locally advanced inoperable orofacial malignancies do present clinically, and constitute a significant public health burden worldwide. Objective: To determine the prevalence and clinical characteristics of Stage IV locally advanced inoperable orofacial malignancies for consecutive patients. Materials and Methods: A 24‑year retrospective study was undertaken, and data obtained from hospital register, case files, and histopathological  reports of patients were recorded in a proforma. The variables studied were age, sex, type of lesion and site, duration of lesion, tobacco/alcohol use, and socioeconomic status of the patients and clinical features of the lesions. Results: Twenty‑six patients presented, giving a prevalence of 11.2%. The most common lesion was adenoid cystic carcinoma, 23.1%. Males accounted for 18 (69.2%) cases and females, 8 (30.8%) giving a male to female ratio of 2.3:1. The ages ranged from 21 to 65 years, mean (SD) 48.6 (7.3) years. The gender distribution was clinically and statistically significant in favor of the males (P = 0.001). The patients were in the low socioeconomic class and 20 (76.9%) indulged in chronic use of tobacco and alcohol. The duration of the lesions ranged from 1.8 to 3.1 years. The maxilla/facial skin was the commonest site (46.2%). Clinically and statistically, the relativity of site distribution of lesions was significant (P = 0. 002). The clinical features occurred in combination resulting in an average of 10 symptoms and  signs in each patient. Conclusion: The synopsis of these lesions shows that all have undergone metastasis; salivary gland malignancies were most common with maxilla  as the commonest site. Keywords: Inoperable, locally advanced, malignancy, orofacial, synopsi

A comparative analysis of the level of cortisol and the number of teeth extracted among patients undergoing routine dental extraction

Background and Objective: A postextraction comparative (cohort) study was carried out to determine whether the number of teeth extracted has an effect on salivary cortisol and by extension on stress.Subjects and Methods: Sixty‑three consecutive patients comprising 27 males (42.9%) and 36 females (57.1%) with a male: female ratio of 1:1.3, divided into two groups of A and B with a mean age of 25.8 ± 4.9 years, and age range of 18–37 years took part in the study. Fifty (79.4%) of them in group A (22 males and 28 females) each had a tooth extracted while 13 (20.6%) in group B (5 males and 8 females) had two teeth removed. One ml of resting saliva was collected from each patient 10 minutes after the procedure and analyzed for cortisol. All extractions and sample collections were done between 10 am and 2 pm to standardize the study and control for the diurnal variation of cortisol. Statistical analysis of the generated data was performed by using Student’s t‑test on SPSS version 17.0. The level of significance was set at 0.05 with P < 0.05 regarded significant.Result: The result showed mean salivary cortisol level of 12.914 ± 2.4684 ng/ml for group A and 12.108 ± 1.7192 ng/ml for group B though not statistically significant (P > 0.05). Females had more extractions in the two groups when compared with males. Male gender had a statistical significance difference (P < 0.05).Conclusion: This study shows that the number of teeth extracted did not have effect on mean salivary cortisol, as a result two teeth extraction does not impart more stress to the patient when compared with one, and as such no additional adjuvant stress relieving measures are needed in two teeth extractions.Keywords: Extraction, number of teeth, salivary cortisol, stres