Peripheral Ameloblastoma: A Case Report and Review of Literature

Peripheral ameloblastoma, a rare and unusual variant of odontogenic tumour, comprises about 2–10% of all ameloblastomas. The extraosseous location is the peculiar feature of this type of tumour, which is otherwise similar to the classical ameloblastoma. This paper describes a case of peripheral ameloblastoma in a 67-year-old female affecting the lingual alveolar mucosa of the mandibular 32–34 region which was clinically diagnosed as pyogenic granuloma. This paper becomes important due to availability of all data, makeing it a well-documented case

Oral cancer in the young with no tobacco exposure: A distinct epidemiological subset?

Objectives: To describe oral squamous cell carcinoma (OSCC) in the young (<45 years) with no tobacco exposure and identify the determinants of locoregional control and survival. Materials and Methods: This is a retrospective analysis of 82 young patients of OSCC with no tobacco exposure treated with surgery and adjuvant therapy. Survival analysis was performed, and determinants of control and survival were identified by Cox proportional hazards regression model. Results: Overall 67% were male, and the median age was 40 years. Survival was excellent: for Stages I, II, III, and IV, 5-year overall survival was 97%, 95%, 75%, and 64% and disease-free survival (DFS) was 84%, 79%, 57%, and 59%, respectively. On multivariable analysis, perineural invasion (PNI) predicted DFS and local and distant control. Conclusion: This cohort had excellent survival when treated appropriately with adjuvant therapy. PNI may represent the need for treatment escalation. Further study is required to identify if this is a biologically distinct cohort

Predictors of postoperative pneumonia in patients undergoing oral cancer resections and its management

Background: Head-and-neck resections carry a major risk of postoperative pulmonary complications. It adds to morbidity and mortality, adversely affects recovery, and contributes to financial burden. The objective of this study is to find out the incidence of pneumonia and the utility of our institution protocol in the prevention of postoperative pneumonia (POP). Materials and Methods: Retrospective study including patients undergoing oral cavity resection at the tertiary hospital from August 2017 to July 2018. The patients were analyzed in terms of demographic profile, operative findings, and postoperative course. Diagnosis of pneumonia was established by intensivist based on symptoms and signs. Results: Incidence of pneumonia was 5.79% (15 out of 239). Average age of patients with pneumonia was 64.8 years and 60% were male. All had multiple comorbidities. Average preoperative serum albumin was 3.49. POP was seen commonly in patients who had composite resections involving alveolar arch and tongue (26.67%). Majority had reconstruction in the form of free flap (46.6%) with fibula flap being most common. Average intraoperative time was 10.5 h. The most common isolate was Pseudomonas aeruginosa (40%), followed by Klebsiella pneumonia (33.3%). About 26% were multidrug-resistant strains. Average hospital stay was found to be 30.6 days in patients of pneumonia. Conclusions: Data from our cohort indicated a much lower incidence compared to published literature. We attribute this to our routine practice of intensive care unit care in the immediate postoperative setting with a nursing care ratio of 1:1, postoperative early mobilization, frequent tracheal toileting, chest physiotherapy, early diagnosis of pneumonia, and prompt initiation of treatment

Imaging advances in oral cavity cancer and perspectives from a population in need: Consensus from the UK-India oral cancer imaging group

Oral squamous cell carcinoma (OSCC) accounts for a third of the cancer burden in India, with a correspondingly high cancer-specific mortality. Although treatment of OSCC in India mirrors that of high-income nations, extreme burden of disease, late presentation, and the associated advanced stage of disease pose unique challenges in a resource-constrained environment. Despite a multimodal treatment paradigm, survival rates are low. Often the cause for late presentation is the delayed diagnosis, inappropriate investigation and referral, and compromised or incorrect treatment, leading to poor patient outcomes and costs to the health-care provider. To address these issues, the first UK-India Symposium on Advances in Oral Cancer Imaging Symposium was organized in Bangalore, India, in April 2019; participants included radiologists, imaging scientists, clinicians, and data scientists from the United Kingdom, India, Singapore, and the United States. Following the discussions held during this meeting, in this manuscript, we present evidence-based guidance for the role of imaging in OSCC, recommendations for service development, and details of future potential for evolution in head and neck imaging