Introduction: The ideal surgical approach to treat craniomaxillofacial skeleton should provide maximum exposure of the facial skeleton, ensure less potential for injury to facial structures and allow for good cosmetic result. Several designs have been described such as hemicoronal, preauricular, lateral eyebrow, and bicoronal approach. Although the bicoronal flap gives superior long-term cosmetic results, it has a few disadvantages. We conducted this study to assess neurosensory disturbances and motor deficit following craniomaxillofacial reconstruction using bicoronal flap. Materials and Methods: A prospective study was carried out in the Department of Oral and Maxillofacial Surgery, North Karnataka, India. Forty patients with craniomaxillofacial trauma requiring fixation of fracture or reconstruction were included in the study. Postoperative neurosensory evaluation is carried out at intervals of 1 week, 1 month, 3 months, and 6 months clinically using mechanoreceptive and nociceptive testing. Results: Among 40 cases, 11 (27.5%) had postoperative paraesthesia affecting the supraorbital region; 9 (22.5%) of them had return of normal sensation within 6 months and 2 (5%) patients became normal after one year. Four patients had unilateral frontalis weakness on the right side for a period of 6 months. Discussion: The bicoronal flap is a preferred approach for access to the craniofacial skeleton and orbit with minimal sensory and motor complications. However, before choosing the same, the advantage of raising such a wide flap should be weighted comparing the benefits and complications.

Odontogenic keratocysts are locally aggressive, benign, developmental odontogenic cysts. It occurs commonly in mandible and has high recurrence rate. It is the third most common odontogenic cyst. Various modalities of treatment are described in the literature which includes enucleation, marsupulization, (marsupialization) liquid nitrogen cryotherapy, chemical/ cryo-cauterization, resection etc. Though resection remains the gold standard of treatment in preventing recurrence, conservative methods are the first line of choice to prevent the morbidity associated with resection. However close follow up is necessary to identify any recurrence at an early stage. Here we present a case of odontogenic keratocyst of mandible in a 30 years old female patient.

Background Oral submucous fibrosis is a chronic, progressive, scarring, precancerous condition of oral mucosa which on progression causes severe trismus. Aim and Objectives To compare and evaluate the efficiency of buccal fat pad, platysmal mucocutaneous flap, nasolabial flap, collagen membrane graft, split thickness skin graft and temporoparietal fascia in reconstruction of surgical defect created by excision of fibrous bands in oral submucous fibrosis. Results After 6 months of follow-up, the interincisal mouth opening was 40.0 mm in case of buccal pad fat, 24.5 mm in temporoparietal fascia flap group, 33.8 in collagen membrane graft group, 34.5 mm in platysma flap group, 34.7 mm in nasolabial flap group, 29.3 mm in split thickness skin graft. ANOVA statistical analysis for postoperative interincisal distance at various time intervals and between pre-, intra-and postoperative interincisal distances were carried out which showed the results were significant at p value \ 0.05 in all groups. No postoperative complications were noted in buccal fat pad group, split thickness skin graft group and collagen membrane group. However, platysmal group had flap necrosis and temporoparietal flap group patients had to undergo a second debulking procedure after one month. Conclusion From our study, we concluded buccal fat pad yields superior results with respect to postoperative mouth opening and related complications.

Peter Martell, First Raise a Flag: How South Sudan Won the Longest War but Lost the Peace, Oxford University Press, 2019, 332 pp.

No abstract