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OMFSurgery, Dental & Maxillofacial Centre

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OMFSurgery, Dental & Maxillofacial Centre

A better solution towards Oral & Maxillofacial Surgery Problems,
Case discussions, sharing knowledge

24/02/2022

All cases related to Oral & Maxillofacial Surgery (Trauma and Pathologies including Squamous Cell Carcinoma and Mucormycosses) now covered by at Qaisrani Medical Centre, Jail Road, MDA Chowk Multan.
Referrals will be highly welcomed with Hi-Tea for Doctors😁
Regards :
Assistant Professor Dr Samar Nazir.
Consultant Dr Usman Haider Qaisrani
0321-2562256 , 061-4545784

19/07/2021

ORAL MYIASIS:
48 yr old alcoholic ,k/c of IDDM, psychiatric pt in an uncomfortable painful state presented with v foul smell and soft tissue growths (soft in consistency) on the palate from almost 4 months with necrotic and ulcerative areas and sloughed off palatal mucosa. Left anterolateral margin has typical ulcer with everted margins and slight oozing of the blood. Maggots were observed in the lesion, and removed using TERPUNTINE OIL wash.
Live maggots were removed using hemostat.
Saline irrigations and irrigation with IVERMECTIN SOLUTION(12MG DISSOLVED IN 50mg N/SALINE). He was advised talet ivermectin 6mg oral for 3 days , inj clindamycin 300mg/2ml every 6 hour, inj metronidazole 500mg/100ml.
Rinses with N/Saline and ivermectin solution every day advised.
After maggots removal pt sent for CT Scan and baseline investigations for suspected malignancy.

06/07/2021

47 year old Male pt with NIDDM presented of OMFSurgery Centre with 3 year h/o unilateral neck pain (R). Pain radiating to R ear. He had recurrent sore throats, snoring , sevre hallitosis and limited mouth opening. 6 months back he noticed soft tissue bulge in post palatal area with redish overlying mucisa. On palpation swelling was firm to hard freely moveable and not fixed to underlying and overlying structires. No lymphadenopathy observed .
This pt had been visiting many physician and surgeons. Scans and multipl labs were done but all were non specific. Pt wss operated under GA and stones (one giant stone of almst 4x4cm and some smaller oneas) were extracted from palatine tonsillar area.
PT IS PAIN FREE AND NO DISCONFORT.

23/04/2021

21 year old Pt with 3 day old RTA ( bike collision) fully oriented to time space and person, presented with complain of Limited mouth opening and pain on jaw movements. Occlusion was distrubed. Step deformity and tenderness in Rt Parasymphysis and Lt Angle area.Occlusion was mantained at Pre Traumatic state. Intra oral approach used & ORIF done under GA for Rt Parasymphysis and Lt Angle of mandible fracture.

$23 year old female pt with h/o RTA having panfacial trauma ( bilateral parasymphysis fracture, lefort II fracture, Rt Zy...$

18/04/2021

23 year old female pt with h/o RTA having panfacial trauma ( bilateral parasymphysis fracture, lefort II fracture, Rt Zygomatic complex fracture, Rt infra orbital floor fracture, Anterior table with orbital rim and NOE fracture). Hemicoronal approach, mid tarsal, intra oral vestibular incisions with and pre existing lacerations were used. ORIF done and orbital flor repaired using titanium mesh.

24/02/2021

50 yr male pt k/c of NIDDM presented with Rt sided soft palate swelling since 3 days preceeded by Rt neck swelling of 4x4cm frm 8 days. He got RCT of Rt lower 1st molar tooth from quack 1 month ago.
Rt angle of mandible was nt palpabl and swelling extnding inferiorly along th ant border of SCM and medially th inferior border of body of mandible.. Soft palat swelling whch appeared 3 days back was soft and distended with medial bulging and deviation of uvula to the left side.
Radiograph revealed broken instrumnt in distal root and incmplete RCT followd by restoration in rt lowr 1st molar tooth.
USG neck revealed ill defined collction of fluid wid dense internal echoes at R angl.of mandibl. B/L parotids and S/Mandibular glamds appear normal.
Diagnosis of Sub Mandibular space infection communicating with Lateral pharyngeal space was established.
14ml pus was aspirated from peri tonsillar area, immediately releving pressure nd discomfort from neck area. The offending tooth was extracted under L/A. And pt was medicated.
Case done by Dr Bilal Shah Shirazi.
(although infection of lower 1st molar usually not drains into s/mandibular space but may do so depending upon th attachmnt of mylohyoid muscle) communicates with deep neck spaces: directly (by passing around post belly of digastric muscle to enter lat pharngeal space). And Indirect communication through buccopharyngeal gap(where styloglossus and stylohyoid muscles pass btween superior and middle pharyngeal constrictr muscle ) to enter pterygomandibular space and thn lat pharyngeal space.
Lateral pharyngeal space infection tends to cause medial displacemnt of lateral pharyngeal wall ( the pharyngeal drapping) and tonsils, and contralteral deviation of uvula.

20/02/2021

Sharing a case for knowledge and discussion about TMJ:
50 yr old pt with IIO of 1.5fingers and pain in TMJ for about 2 years. No significant h/o trauma. On opening she deviates lower jaw to lft side. B/L condyles are tender. Masseter and temporalis muscles also tender on clenching. Painful closure of jaw if closed against a force. Pt doesnt occlude her teeth properly but on manual guidence occlusion may be achieved. OPG reveals condyls placed anteriorly. CT images reveal an osteophyte lying freely in anterosuperior relation to left condyl. OSTEOPHYTE is hallmark of TMJ degenerative disease.
is an attempt to stabilize the overload may be caused by occlusal forces, representing areas of newly formed cartilage.
Pt was prescribed NSAIDS (COX-2 inhibitr, celecoxib BD), muscle relaxant( cyclobenzaprine HCL 6mg HS), vit E( Evion caps), massage with voltral emulgel, heat applicationand the routine TMJ instructions.

19/02/2021

46 year old male pt from Mandi Bahauddin, k/c of HTN and Hep C, presented with almost 6x6 cm painful swelling in Rt S/Mandibular area for last 7 months and was increasing in size. swelling was firm in consistency with normal overlying skin, non tender on palpation and no neuronal disturbance was noted. R/E showed no evidence of calculus, no bone resorption. Surgical Excision of the mass was performed under G/A. Entire tumor was completely excised. Histopathology revealed it as "ADENOCARCINOMA NOS" OF SUB MANDIBULAR GLAND.
Adenocarcinoma Not Otherwise Specified, they have enough microscopic features to tell that they are adenocarcinoma, but not enough details to classify them further, OR, the diagnosis of exclusion (neither metastatic nor another salivary gland carcinoma).
Pt was observed for one year and no recurrence was reported.

22/01/2021

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