Standard treatment of mandibular angle fracture with miniplates according to recommendations of Champy et al. (1976) consists of fixation with one miniplate at superior border of mandible ventral to external oblique line. In certain constellations, second miniplate at lower border may provide additional stability. In this retrospective study 80 patients with mandibular angle fracture were divided into 3 sub-groups reported at DIRDS Faridkot were treated by intraoral, extraoral and combined intraoral and transbuccal approach. There was no significant difference in complication rates encountered with these techniques. Decision regarding treatment approaches for open reduction of mandible fracture often relates to surgeon's experience and training. In some cases, choice is affected by availability of equipment. More difficult cases involving endentulous atrophic mandible or comminution should be considered for extraoral approach. Intraoral open reduction and fixation was used for non-comminuted and non-complicated fractures. The combined transbuccal/ Intraoral procedure is now preferred method because of ease of use and facilitation of placement of plate in neutral mid point area of mandible.
The aim of the present study was to evaluate the role of Magnetic Resonance Imaging (MRI) to localize and characterize the MR imaging features of cerebellopontine angle schwannomas and to compare with surgical/ histopathological findings. It was a prospective study which included 19 patients, who presented with signs and symptoms s/o any lesion in the CP angle and were referred to the radiology department for MRI. All patients included in the study were subjected to detailed clinical history and physical examination following which MRI was carried out on Philips Gyroscan Achieva 1.5 Tesla unit and the standard protocol consisted of T1WI, T2WI, DWI and FLAIR images in axial, sagittal and coronal planes. Hearing abnormality was the most common presenting complaint in patients with CP angle schwannoma's followed by headache and tinnitus. Vestibulocochlear nerve was the most commonly involved nerve in patients with these lesions followed by involvement of trigeminal nerve. MRI was erroneous in giving provisional diagnosis of schwannoma in one case, which on subsequent surgery and histopathology was found to be a meningioma. The sensitivity of MRI for correctly diagnosing vestibular schwannoma was 100 % and specificity was 92.86 % with a positive predictive value of 94.12 % and accuracy of 96.67 %. MRI is considered as an excellent noninvasive investigation for CP angle schwannoma's. It can identify the site and extension of the lesions as well as the characteristic signal. Apart from diagnosing, MR imaging plays an important role in stratifying patients into appropriate treatment options.
Ependymomas are common in intramedullary location and extradural location of the spinal cord is very rare. A few cases in the lumbosacral region have been reported. This report presents a cervical dumb-bell ependymoma with a small intraspinal extradural component and a large extraspinal component in the posterior triangle of the neck. The tumor was excised in two stages. This is probably the first such case report in the cervical region in the world literature. Possible histogenesis of ependymoma in this location is also discussed.
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