Cystic hygroma or cystic lymphangioma is a congenital malformation of the lymphatic system that manifests itself as a soft, benign, and painless mass. It is widely accepted that they arise from the remnants of embryonic lymphatic tissue which retains the potential for proliferation. They grow in the fashion of sprouting and are capable of transgressing anatomical boundaries. They can occur almost at any anatomical site. However, 75-80% cystic hygromas are located in the head and neck region. In the neck, they are typically located within the posterior cervical triangle. The majority of cases (80-90%) are diagnosed under the age of two. We present a case of cervical cystic hygroma in a 6 year old male child which was surgically treated.

Background:Injuries from occupational accidents are associ-ated with agents of biological risk, as they are the gateway to serious and potentially lethal infectious diseases that can be spread by contact between people. Several studies have demonstrated that dental students are among the most vulnerable to blood-borne exposure.Objectives:To assess the knowledge, attitude and practice regarding risk of HIV transmission through accidental needlestick injury amongst dental students and providing supportive and proper guidelines regarding needlestick injuries and HIV infection.Study design:This was a cross-sectional study done at a dental college attached to a tertiary care hospital, which included third, fourth year students and interns. The results obtained were subjected to statistical analysis using Chi-square test.Results:Of the 120 students, 13 (11%) were not even aware that virus could be transmitted through infected needle. A significant proportion of the third year students i.e. 27 (67.5%) were not aware of correct method of disposal of disposable needles and syringes as against interns 17 (42.5%). Around 31 (26%) said that they would promote active bleeding at the site of injury and 37 (30%) said they would take post-exposure prophylaxis.Conclusion:Dental professionals are at a risk of occupational acquisition of HIV primarily due to accidental exposure to infected blood and body fluids. There is a need of correcting the existing misconceptions through education programs early in the course and providing supportive and proper guidelines regarding needlestick injuries and HIV infection.

Background Total auricular reconstruction in congenital lobule type microtia is one of the most challenging problems faced by a reconstructive surgeon as it demands precise surgical technique combined with artistic creativity. Ear reconstruction requires carefully planned procedures. Methods We present a simple method for auricular reconstruction consisting of three stages. The first stage is carving the cartilage framework from the costal cartilages of 6th, 7th and 8th ribs, lobule transposition and insertion in a skin pocket. The second stage is performed 5 months later to elevate the ear framework using a full thickness skin graft and a cartilage spare part. The third stage is done after 3-4 months later to give finer detail to the reconstructed ear. This method was used in 27 patients with lobule type microtia. Results The results of the reconstructed auricles in 27 patients were satisfactory with good aesthetic balance. The complications ranged from small localized skin infection treated with topical and oral antibiotics to catastrophic loss of the skin pocket and the framework. Conclusion Although various donor sites have been used for harvesting the cartilage, only costal cartilage provides a substantial source for fabricating total ear framework. The cosmetic outcome and least complication results in our series support this conclusion.

Aims. The aim is to present a case of rare giant granular cell ameloblastoma and to review the pertinent literature highlighting the molecular aspects of its pathogenesis by analyzing the expression of CD-68, Bcl-2, and β-catenin. Methods. H and E stained sections showed large odontogenic islands showing peripheral ameloblast-like cells and central stellate reticulum-like cells with extensive granular cell transformation surrounded by fibrous stroma. Polyclonal rabbit anti-CD 68, anti-Bcl2, and anti-β-catenin were stained immunohistochemically. Results. CD-68 showed a moderate to strong staining intensity in granular cells. Moderate staining of Bcl-2 was expressed by the peripheral columnar cells of tumor islands and negative in the granular cells. Expression of β-catenin was generally weak, except for only the focal areas that showed a moderate staining intensity and weak in peripheral cells. Conclusion. The present case of giant granular cell ameloblastoma is a rare entity. Development of monstrous size is indicative of ameloblastomas persistent growth. Granular cell transformation in ameloblastomas probably occurs as a consequence of extensive molecular changes. Immunohistochemical studies help us to know the pathogenesis of this granular cell ameloblastoma. Therefore, an effort has been made here to study the expression of Bcl-2, CD-68, and β-catenin.

Background This study sought to determine the efficacy of interpositional arthroplasty with temporalis muscle and fascia flap in the treatment of unilateral temporomandibular joint (TMJ) ankylosis in adults. Methods This retrospective study of nine cases evaluated the postoperative results of interpositional arthroplasty on temporalis muscle and fascia flap in adults. The operative protocol for unilateral TMJ ankylosis entailed (1) resection of ankylotic mass, (2) intraoral ipsilateral coronoidectomy, (3) contralateral coronoidectomy when necessary, (4) interpositional tissue transfer to the TMJ with temporalis muscle, fascia flap, and (5) early mobilization, aggressive physiotherapy. Results The study evaluated nine patients with follow-up checks from 13 to 31 months (mean 18.3 months). Patients had a preoperative maximal interincisal opening of 9-19 mm (mean 11.7 mm). During the last follow-up observation after surgery, the patients had a maximal interincisal opening of 35-40 mm (mean 38.3 mm).The results of this protocol were encouraging, the functional results of interpositional arthroplasty on temporalis muscle and fascia flap were also satisfactory. Conclusion The findings of this study support the use of temporalis muscle and fascia flap in adult patients with unilateral TMJ ankylosis. Early postoperative initial exercise, physiotherapy and strict follow-up play an important role in preventing postoperative recurrences.