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Adenoid cystic carcinoma (ADCC) is one of the malignant salivary gland neoplasm and constitutes for 1% of head and neck malignancies and 22% of all salivary gland malignancies. Palate is the most common site to be involved in the oral cavity followed by parotid region, tongue, and floor of mouth. It is commonly seen in middle age population with slight female predilection. It usually appears as asymptomatic, slow growing infiltrative growth with high recurrence, often presence of perineural invasion which appears as pain. In this present case of ADCC, a 65-year-old female patient reported with a swelling on the left side of hard palatal area since 3 months with occasional pain and history of epistaxis, which was diagnosed clinically, radiographically, and histopathologically and confirmed by immunohistochemistry as Grade III solid variety of ADCC with a poor prognosis.

Oral proliferative verrucous leukoplakia (OPVL) is a rare form of oral leukoplakia first reported in 1985. It is a longterm progressive condition, which develops initially as a white plaque of hyperkeratosis that eventually becomes a multifocal disease with confluent, exophytic, and proliferative features. It has no racial preference with female predilection, associated with various factors including human papillomavirus (HPV) association, genetic susceptibility, and long-standing low-grade traumatic factors. The malignancy transformation rate varies from 0.13 to 17.5% with frequent recurrences. Here, we have reported two cases of PVL seen over the tongue and palate. It is confirmed by clinical and histopathological features and treated with Vitamin A and its supplements and a long-term follow-up showed no recurrence, and hence, Vitamin A has proven as a potent treatment option of PVL by its antioxidant and epithelialization property.

Smith-Magenis syndrome is a rare genetic disorder involving multiple body systems, along with mental retardation and sleep disturbances. It is attributed to micro deletion at 17p11.2 chromosome region encoding for RAI1 gene. This article presents a case report of a 7-year-old patient having this rare syndrome along with his genetic analysis.

Background: Recurrent aphthous stomatitis (RAS) is a recurrent acute ulcerative lesion of oral mucosa. Till now, the exact cause and mechanism of this condition isn't very much clear; it is however believed to be multifactorial. Various studies indicate that genetically mediated disturbances of the innate and acquired immunity play an important role in the disease development. Vitamins and micro-elements deficiencies are one of the principal factors that modify the immunologic response in RAS. Aim: To probe for correlation between serum levels of Vitamin A, B12, D3, E, and RAS. Methods and Materials: The cross-sectional clinical study was conducted on persons seeking dental service at some private dental college in West Bengal, India between January 2017 and June 2018. Forty patients suffering from RAS were compared to forty normal individuals. Applying ELISA method, serum concentration of vitamins A, vitamin B12, vitamin D3 and vitamin E were measured in two groups. Statistical Analysis: The means between two groups were compared by Student's unpaired 't' test. A value of P < 0.05 was considered as statistically significant. Results: RAS patients had a significantly lower serum level of vitamin A, B12, D3 and E than normal individuals; and there were a positive relation between the serum level of vitamin B12 and vitamin E in RAS patients. Conclusion: Vitamin A, B12, D3 and E deficiency have a significant bearing on RAS; and serum level of vitamin B12 and E of RAS patients have a significant interrelationship.

Oral Lichen Planus (OLP) is a chronic autoimmune inflammatory disease of the oral mucosa. The erosive variety of OLP is multifocal, ulcerative, and painful in nature. Patients with OLP have a higher risk of developing Oral Squamous Cell Carcinomas (OSCCs). Here, authors presents a case of 49-year-old female patient presented to the Department of Oral Medicine and Radiology with the chief complaint of burning sensation in the inner aspect of right cheek, since one year. A diffuse whitish area surrounded by erythematous area was present in the right buccal mucosa. Lesion was diagnosed primarily as erosive Lichen Planus (LP). She discontinued the medication and did not come for follow-up visits because of the Coronavirus Disease-2019 (COVID-19) pandemic. After 10 months, she came back with pain and a diffuse swelling with indurated margin in the same region involving right buccal vestibule and retromolar area. After incisional biopsy it was found that the lesion has progressed to squamous cell carcinoma, and the patient was referred to the Department of Oral Surgery where segmental mandibulectomy was done with placement of free fibula graft. The OLP is considered as a potentially malignant disorder and patient should be advised to avoid additional risk factors such as tobacco and alcohol and should be followed at minimum one year interval as prognosis and patient survival is directly related to stage and grade of cancer at its initial diagnosis.

Nikolsky's sign has been a very useful diagnostic tool in cases of skin disorders like pemphigus, toxic epidermal necrolysis, etc., The sign is demonstrated when lateral pressure is applied on the border of an intact blister, which results in the dislodgment of the normal epidermis and extension of the blister.

Introduction Osteoma of the mastoid region is an uncommon benign tumor of bone. Osteomas may occur in the external auditory canals but are reported to be very rare in the mastoid region, with about 150 cases reported in literature. Case Report A 20-year-old man presented with painless lump behind the right ear since last 2 years. On examination a 3x3 cm tumour was present in the right post-auricular region. HRCT scan showing hyper-attenuating area close to the right mastoid cortex, measuring approximately 3x3cm, spherical, with cleavage areas between the tumour and the mastoid external cortex. Surgical excision was performed on cosmetic grounds. Postoperative period was uneventful. Discussion Osteoma over the mastoid region is rare and mainly asymptomatic with excellent prognosis after complete removal of the lesion.

Introduction Allergic rhinitis affects around 50% of atopies in India. Vitamin D is related to both humoral and cell mediated immunity and its receptors are found in inflammatory mediators. This study was conducted to assess any possible association between Allergic rhinitis and serum Vitamin D. Materials and Methods A cross sectional study was conducted amongst 41patients with Allergic rhinitis as per ARIA guidelines attending the Otolaryngology outpatient Department of a peripheral tertiary care hospital. Vitamin D levels were assessed in patients with allergic rhinitis in terms of serum Ig-E level and absolute blood eosinophil count (ABEC). Results Among 41 patients, 31 patients (75.6%) had deficiency of vitamin D with mean Vitamin D level of 14.87±1.56ng/ml (normal vitamin D level-30-100ng/ml and low

Introduction: This present study is an attempt to study the demographic characteristics of individuals presenting with hearing loss in a peripheral tertiary care hospital using the available database of pure tone audiometry results. Materials and methods: A retrospective, observational, descriptive study was conducted over a period of 5 years in the Department of ENT of a peripheral tertiary care hospital wherein all subjects having a pure tone audiometry were included in the study. The records of PTA done were analyzed followed by systematic analysis. Results: A total of 9790 individuals inclusive of 5566 males and 4224 females were studied. Maximum no of individuals belonged to the age group of 21-30 years. Nearly 63% of total subjects suffered from Bilateral hearing loss. Sensorineural hearing loss was most prevalent type of loss. Mild degree of loss was most prevalent. Adolescents and young adults comprised the bulk of the study population. Sensorineural hearing is the most common type. Bilateral hearing loss is more frequent. Mild degree of loss is most frequent. Conclusion: This study emphasized the ‘Composite parameter distribution’ in addition to the classical single parameter demographic profile of deafness in a remote tertiary care hospital. Adolescents and young adults comprised the bulk of the study population. Sensorineural hearing is the most common type. Bilateral hearing loss is more frequent. Mild degree of loss is most frequent.

Introduction Two types of surgical procedures are performed for the treatment of Chronic otitis media (COM) mucosal disease, namely myringoplasty and tympanoplasty. In the present study, an objective, comparative evaluation between the outcomes of tympanoplasty, performed in the ‘wet ear’ and the ‘dry (non- discharging) ear’ has been undertaken. Materials and Methods A prospective study was conducted in a peripheral referral institute over a period of 37 months wherein a total of 105 patients with tympanic membrane perforation were selected, amongst which 56 patients had moist ear and 49 patients had dry ear. All of the patients underwent tympanoplasty by underlay technique. Final results were analyzed 12 months post operatively. Results In the wet ear group amongst 56 patients, 51 patients had successful graft uptake (91.07%). In dry ear group, among 49 patients, successful graft uptake was seen in 44 cases (89.79%). In the wet ear group 50 out of 56 patients had hearing improvement (89.28%). In dry ear group 44 out of 49 patients had hearing improvement (89.79%). Statistically significant results were obtained postoperatively in each group; however, inter group analyses showed no statistical significance. Conclusion Success rate of tympanoplasty does not depend upon the wet or dry state of middle ear at the time of surgery.

Introduction Mastoid operations have been in practice for over four centuries for suppurative conditions of the ear. Intact canal wall mastoidectomy has the advantage of better functional results while canal wall down mastoidectomy offers excellent exposure for disease eradication and post operative monitoring but is associated with significant cavity problems. In order to overcome the problems associated with canal wall down procedure while retaining its advantages the concept of mastoid cavity obliteration was introduced. This study analysed the outcomes of mastoid cavity obliteration and to assess the outcomes of mastoid cavity obliteration with autologous adipose tissue. Materials and Methods A prospective, experimental, randomized study was conducted over a period of 18 months among patients presenting with active squamous variety of Chronic Otitis Media. The patients were randomly allocated to two groups, A and B. Both groups underwent canal wall down Mastoidectomy followed by obliteration with autologous adipose tissue in Group B . Results In group A, the mean duration required for complete epithelialization was 10.8 weeks. In group B, the average time taken for complete epithelialization was 5.6 weeks. All cases had their graft intact at the end of 12 weeks. Debris was present in group A for a mean duration of 9.47 weeks. In group B, debris was found for a mean duration of 3.33 weeks. Patients from group A complained of discharge from their ears for a mean duration of 7.47 weeks. In group B the same symptom persisted over 3.33 weeks. Conclusion Cavity problems encountered is considerably less in the group obliterated with adipose tissue.

Introduction Foreign body in upper aero-digestive tract leads to many complications including life-threatening ones to the patients. Its management depends upon type of foreign body and site of lodgement. Materials and Methods A descriptive study was conducted from March 2013 to February 2017 to determine the different components of the epidemiological profile of the cases of Foreign body in upper Aero-digestive Tract (UADT) and its management principle. Total 192 patients were selected for this study. These patients underwent different procedures for foreign body removal and post-operative notes were taken for data analysis to note the epidemiological pattern. Results A total of 192 patients were included in the study. Epidemiological data were derived and analyzed comprehensively to present the different profiles. Conclusion Fish bone was found to be the commonest foreign body in upper aero-digestive tract, followed by coin and meat bone. Foreign bodies are commonly removed by Tilley's forceps followed by Hypopharyngoscopy.

Schwannoma is a benign neoplasm originating from the neural sheath and occurring in up to 45% of the cases of extracranial neurogenic tumors. Schwannomas of masticator spaces are rare. This article reports the case of an intraoral schwannoma occupying the masseteric and buccal spaces of a 55-year-old woman, for whom detailed imaging investigations were performed, comprising conventional extraoral radiographs, ultrasound, and plain and contrast enhanced magnetic resonance imaging. The lesion was surgically resected.

Pemphigus is comprised of a group of life-threatening autoimmune diseases that is characterized by circulating IgG antibodies targeting several types of keratinocyte antigens. After introduction of systemic steroids, survival has improved dramatically. However, mortality and morbidity were still very high due to side effects of steroids. Pulse therapy is defined as discontinuous/intermittent intravenous infusion of very high doses of corticosteroids along with certain immunosuppressive agents over a short period. This therapy was introduced to minimize the side effects of conventional corticosteroid therapy. The target is to achieve a faster response and stronger efficacy and to decrease the need for long-term use of systemic corticosteroids. As a result, this therapy has gained its popularity since three decades. The purpose of this article is to review the various available pulse therapy regimens with dosage, indications and contraindications and side effects.

Introduction The aetiology of maxillofacial fractures is greatly influenced by geographic location, socioeconomic status of the cohort, and the period of investigation. The aim of this study is to analyze and identify characteristics of maxillo-facial fractures that took place in and around Midnapore- Kharagpore city of West Bengal and who presented to a peripheral medical college hospital during a period of 1 year. Materials and Methods A detailed database analysis was performed based on data collected from the patients of Road Traffic Accidents (RTA) with sustained facial trauma admitted to General Surgery and Otorhinolaryngology ward of a peripheral medical college hospital. Detailed clinical examination as well as radiological data was collected. Results The highest frequency of maxillo-facial injury due to RTA was among the young adults 18-40 years. Most common type of injury encountered is abrasion (44%) followed by bruise and closed fracture. Mandible is the most common bone to get fractured and most common type of Le fort type is Type II. Significant number of patients having RTA were young adults under the influence of alcohol riding in two-wheeler . ConclusionWith the increasing incidence of RTA awareness must be created concerning safety rules and more policies need to be addressed.

Introduction Foreign body in upper aero-digestive tract leads to many complications including life-threatening ones to the patients. Its management depends upon type of foreign body and site of lodgement. Materials and Methods A descriptive study was conducted from March 2013 to February 2017 to determine the different components of the epidemiological profile of the cases of Foreign body in upper Aero-digestive Tract (UADT) and its management principle. Total 192 patients were selected for this study. These patients underwent different procedures for foreign body removal and post-operative notes were taken for data analysis to note the epidemiological pattern. Results A total of 192 patients were included in the study. Epidemiological data were derived and analyzed comprehensively to present the different profiles. Conclusion Fish bone was found to be the commonest foreign body in upper aero-digestive tract, followed by coin and meat bone. Foreign bodies are commonly removed by Tilley's forceps followed by Hypopharyngoscopy.

Pemphigus vulgaris (PV) is an autoimmune, potentially life-threatening disease causing blisters and erosions of the skin and mucous membranes associated with intraepithelial acantholysis. The underlying mechanism responsible for causing intraepithelial lesions is the binding of immunoglobulin G autoantibodies to desmoglein 3, a transmembrane glycoprotein adhesion molecule present on desmosomes. Histological features comprise intraepithelial cleft and Tzanck cells. Corticosteroids remain the mainstay of the treatment plan. In this article, we have discussed about the diagnosis of three patients suffering from PV, the treatment rendered, and the outcome of the same.

Background: Pyogenic granuloma is a common, non-neoplastic reactive growth of the oral cavity. Treatment consists of conservative surgical excision, cryosurgery, or laser surgery. These are usually adequate but often result in scars and recurrence. Therefore, this study was undertaken to determine the effectiveness of sclerotherapy in the treatment of oral pyogenic granuloma. Materials and Methods: Forty clinically diagnosed cases of oral pyogenic granuloma were included in the study. After topical anesthesia application, 0.2–0.5 mL of sodium tetradecyl sulfate was delivered by insulin syringe into the base of lesions till the solution leaked out. Each patient was recalled after 1 week and evaluated. If the lesion did not resolve, second and third injections were given consecutively. Results: All the 40 patients showed complete regression of the lesion after one to four consecutive shots in weekly interval. Conclusion: Intralesional sclerotherapy can be considered as an effective non-surgical treatment procedure for oral pyogenic granuloma.

Gorham’s disease is a rare and atypical disorder epitomized by progressive osteolysis of bone with eventual total disappearance of bone. The etiology is poorly understood with variable clinical presentation. Most times it is initially misdiagnosed as temporomandibular joint dysfunction, periodontal disease or odontogenic tumors clinically and radiographically in routine dental practice. Radiographic examination, such as Cone Beam Computerized Tomography (CBCT) play a vital role in diagnosing such disorder resulting in disappearance of the involved bone entirely, which is a definitive distinguishing feature of this condition. Regarding the rarity of the condition, the current study presents a case of Gorham’s disease with distinctive clinical, radiological, and histological, features involving maxilla and mandible.

Aim: The current study was designed to determine prevalence of various tongue lesions and their association with age, gender, systemic illness, deleterious habits, and distribution over the surfaces of tongue. It also explored the awareness and knowledge of subjects in relation to presence of tongue lesions, etiological factor, symptoms, and treatment received if any. Methods: The present study was conducted on 1360 randomly selected dental outpatients from 1/10/2013 to 30/09/2014. Examination of tongue included surface changes, size, movements, and the presence of mucosal lesions. The subjects were asked about the knowledge, symptoms, and treatment obtained in case of awareness regarding the lesion. Results: The prevalence of tongue lesions was found to be 13.75%. The most prevalent lesion was found to be coated tongue. The majority of the lesions were located on dorsum of tongue and not related with age, gender, habit, and systemic condition. A considerable number of subjects were aware of the changes on their tongue but negligible number sought any treatment. Conclusions: The presence of tongue lesions in the study population was found be significant. Hence, general dental practitioners and health care providers should be educated about the diagnosis, etiology, investigations, and proper management of such tongue lesions.

Protostylids are superstructures on maxillary or mandibular molars, which have rarely been reported in literature, and the significance of their presence has also been underestimated. The dental practitioners may easily misdiagnose a tooth, with such conical tubercles as malformed tooth. Interestingly, this is neither a malformation nor an anomaly but rather an important morphological trait of an individual. Once in a while, one may come across such a distinct morphological trait without being able to diagnose. To the authors' best knowledge, only one similar case has been reported previously, and the second such case internationally. Bearing all such facts in mind, the authors attempt to educate the readers towards the existence of such a trait so that it can be identified and studied in larger numbers. Hence, it is the authors' endeavor to report an unusual case of dual cusped maxillary protostylid along with its clinical significance.

Tuberous sclerosis complex is an unusual autosomal dominant neurocutaneous syndrome characterized by the development of benign tumors affecting different body systems affecting the brain, skin, retina, and viscera. It is characterized by cutaneous changes, neurologic conditions, and the formation of hamartomas in multiple organs leading to morbidity and mortality. The most common oral manifestations are fibromas, gingival hyperplasia, and enamel hypoplasia. The management of these patients is often multidisciplinary involving specialists from various fields. Here, we present a case report of a 26-old-year male patient with characteristic clinical, radiological, and histological features of tuberous sclerosis complex.

Bifid condyle is a rare anatomic modification of mandibular condyle caused by developmental or traumatic reasons, and often diagnosed incidentally on routine radiographic examination. Eagle's syndrome (ES) occurs when an elongated styloid process or calcified stylohyoid ligament causes recurrent throat pain or foreign body sensation, dysphagia, or orofacial pain. On the other hand, Ely's cysts are focal subchondral cysts resulting from bony remodelling and osteoarthritic changes. Here, we report a case depicting an interesting combination of all the abovementioned entities in a single patient.

Muscular dystrophies are a clinically and heterogeneous group of disorders that all share clinical characteristics of progressive muscular weakness. Duchenne muscular dystrophy (DMD) is the most common X-linked disorder muscular dystrophy in children, presenting in early childhood and characterized by proximal muscle weakness and calf hypertrophy in affected boys. There is usually delay in motor development and eventually wheelchair confinement followed by premature death from cardiac or respiratory complications. Treatment modalities such as corticosteroid therapy and use of intermittent positive pressure ventilation have provided improvements in function, ambulation, quality of life, and life expectancy, although novel therapies still aim to provide a cure for this devastating disorder. Here, we present a case of DMD in a 12-year-old male with remarkable clinical and oral manifestations.

Alexander Disease (AD) is an autosomal dominant leukodystrophy and occurs predominantly in infants and children. It usually results in death within ten years after onset. Among the four subtypes, infantile form comprises the most of affected individuals. It presents in the first two years of life, typically with progressive psychomotor deficiency, loss of developmental milestones, seizures, and pyramidal signs. Clinical and magnetic resonance image findings usually establish diagnosis of AD. Here, we present a case of Infantile AD with characteristic clinical and radiological features.

Background. Oral mucocele is a common lesion resulting from an alteration of minor salivary glands due to mucus accumulation. Rapid appearance, specific location, history of trauma, bluish colour, and consistency help in the diagnosis. Conventional surgical removal is the treatment of choice but has several disadvantages like damage to adjacent ducts with further development of satellite lesions. Therefore, the present study was undertaken to evaluate the efficacy of intralesional corticosteroid injection (betamethasone) as a nonsurgical treatment procedure in oral mucoceles. Material and Method. A total of 20 cases (males and females, 10–30 years of age) with clinically diagnosed oral mucoceles were given 1 mL of betamethasone intralesionally. All the patients were examined after a period of 7, 14, and 21 days to evaluate the response of the lesion towards treatment and consequently given the 2nd, 3rd, 4th injections. If the lesion resolved after one or two injections, the treatment was discontinued. Results. Out of the 20 cases, 18 of them showed complete regression of the lesion whereas the remaining 2 cases showed decrease in size. All the patients received maximum of 4 consecutive shots in weekly interval. Conclusion. Intralesional corticosteroid therapy can be considered as the first choice in the treatment of oral mucoceles.