Our aim was to observe if there was any appreciable difference in the etiology and pattern of maxillofacial fractures during the pre-COVID-19 and COVID-19 periods in Central Kerala, South India. This retrospective study was conducted with data over a period of two years from the central database registry of our hospital. Age, sex, etiology, date of injury, and site of facial fractures were recorded and compared between both the time periods. Increase in facial fractures due to fall at home (p value < 0.01) and decrease in mass casualty cases (p value < 0.01) were observed during the COVID-19 period. Pedestrians involved were significantly more in the pre-COVID-19 period (p value < 0.01) and heavy vehicle accidents producing facial fractures were significantly more in the COVID-19 period (p value < 0.01). Frontal bone ( p value = 0.008), nasal bone ( p value < 0.001) and zygomatico-maxillary complex fractures ( p value < 0.001) occurred significantly more in the COVID-19 time period whereas naso-orbito-ethmoidal ( p value = 0.003), mandibular ( p value = 0.011) and dentoalveolar fractures ( p value < 0.001) were seen significantly more in the pre-COVID-19 period. There was decrease in the total number of maxillofacial cases during the COVID-19 period. However, this was not significant when only the number of facial fractures were compared between the two periods. This study provided an insight on the differences in etiology and pattern of maxillofacial fractures during the pre-COVID-19 and COVID-19 periods. Road traffic accidents involving two wheelers predominate during the COVID-19 period also, prompting further critical exploration of the reasons behind this finding.

The management of odontogenic infections is established and several guidelines have been proposed for its effective treatment. Outbreak of COVID-19 has posed serious challenge in the management of odontogenic infections, further complicated by immunocompromised status of the patient, where adequate evaluation and prompt attention is mandatory to avoid untoward consequences. Ludwig's angina being a life threatening infection by itself, association or simultaneous presentation with COVID-19 infection can add further complexity in the management for a maxillofacial surgeon. Here we present a case report of Ludwig's angina in a patient who tested positive for Coronavirus infection and how we treated her successfully.

Also called as Abrikossoff's tumor, the granular cell tumor (GCT) can occur in any part of the body, most of them occur in the head and neck especially in the tongue, cheek and palate. Almost three fourth of the lesions seen in head and neck are present over the tongue, oral mucosa or hard palate. Both benign and malignant lesions have been reported; although occurrence of malignancy is rare, comprising of 2% of all granular cell tumors. Here we present a case report of granular cell tumor of tongue at two different sites in a 17-year-old girl with a brief review of literature on granular cell tumors. Although oral GCTs exhibit a benign behavior they may demonstrate a wide variety of features and architectural patterns. Rather than a true neoplasm, GCTs could be regarded as lesions that reect a local metabolic or reactive change.

No abstract

The present paper discusses the diagnostic challenges we faced in a 60‐year‐old woman with a history of schizophrenia, presenting with left unilateral facial pain for the past three months. Based on the elaborate clinical examination and diagnostic nerve blocks, the patient was diagnosed with trigeminal neuralgia (TN) and non‐surgical therapy commenced. Further investigations with magnetic resonance imaging (MRI) and ultrasound‐guided fine needle aspiration cytology (FNAC) revealed the presence of an extracranial schwannoma involving a branch of the maxillary nerve. The patient was symptomatically relieved after surgical excision of the benign tumor under general anesthesia. Hence, we emphasize the need for special care and attention in psychiatric patients presenting with orofacial pain.