In our study, we concluded that autogenous calvarial bone grafts have better mechanical, biologic, and immunologic properties. This procedure allows the surgeon to reconstruct moderately large cranial defect with ease of access within single or adjacent incision to the operating site with minimal postoperative morbidity and discomfort.

Breach in the palatal vault leading to an abnormal communication between oral and nasal cavity is known as oro-nasal communication. It is an uncommon presentation in day-to-day clinical practice except in some patients of cleft lip and palate.Etiology may be congenital or acquired. Alveolar and palatal cleft defects are the most common etiological factor. The acquired causes may be trauma, periapical pathology, infections, neoplasms, postsurgical complications, and radio and chemo necrosis.Clinical features like nasal regurgitation of food, defective speech, fetid odor, bad taste, and upper respiratory tract and ear infection are associated with oro-nasal communication.Management depends upon the size and site of defect, age of patient, and associated comorbidity. The definitive management is always surgical. Two layered closure provides greater support and stability and reduces the risk of failure. Palatal rotational flaps are suitable for smaller defects. The other local flaps are buccal mucosal flap, tongue flap, and facial artery myomucosal flap. Temporoparietal galeal flap, turbinate flap, free radial forearm flap, and scapular flap have also been successfully used for closure of oronasal communication. Newer procedures like the use of bone morphogenic protein, acellular dermal matrices, human amniotic membrane, and distraction osteogenesis have been tried successfully. The rate of recurrence is high.Unsuccessful surgical attempts and larger defects associated with compromised medical conditions are better managed nonsurgically with obturator incorporating the missing teeth.

. Purpose:  To compare macular thickness following uncomplicated phacoemulsification with foldable acrylic lens and manual small incision cataract surgery (MSICS) with non‐foldable polymethyl methacrylate (PMMA) lens implantation. Methods:  Prospective study was carried out with one eye each of 224 patients with senile cataract randomized into two groups, phacoemulsification and MSICS, by simple 1:1 randomization. Following surgery by either of the two methods, macular thickness was measured by optical coherence tomography (OCT) on the 1st, 7th, 42nd and 180th postoperative day. Main outcome measure was postoperative macular thickness. Results:  On the first postoperative day, central subfield mean thickness (CSMT) in MSICS group was 192.8 ± 17.9 μm and that in phacoemulsification group was 192.1 ± 27.4 μm, with no significant difference (p = 0.12). On the 7th day, CSMT in MSICS group (198.9 ± 21.4 μm) was significantly (p = 0.04) more than that in phacoemulsification group (193.1 ± 19.3 μm). On the 42nd day, CSMT in MSICS group was 207.8 ± 26.3 μm and that in phacoemulsification group was 198.3 ± 23 μm, the difference being significant (p = 0.007). Clinically macular oedema was not diagnosed in any of the patients at any visit. The increase in macular thickness was sub‐clinical and did not affect final visual outcome in any patient. Conclusion:  In spite of the greater theoretical risk of increased postoperative inflammation following MSICS, there was no evidence of cystoid macular oedema, either clinically or on OCT. However, chance of sub‐clinical increase in CSMT was more following MSICS compared to phacoemulsification.

Maxillary position improved in relation to the cranial base. This study showed that the RED was versatile in midface advancement.