Background: Though not common, maxillofacial osteosarcomas present a unique challenge in management due to a multitude of factors, such as difficulty in diagnosis and local complex anatomy, making surgical excision difficult as well as debate necessary on the usefulness of adjunct treatment modalities, such as chemotherapy and radiotherapy. Nonetheless, osteosarcomas are a significant health burden because of their high morbidity and mortality. Method: Retrospective cross-sectional study of records archived in the School of Dental Sciences, University of Nairobi. Results: 25 cases of maxillofacial sarcomas were seen over 26 years. Mean age of occurrence was 35.68 years with a preponderance for females (17 cases). The mandible was the most affected site, accounting for 18 cases. Discussion: The management of maxillofacial sarcomas in our setting presents significant challenges arising from multiple factors such as lack of standardised treatment protocol, late presentation of patients, diagnostic challenges and loss to follow-up.

Study design: Descriptive cross-sectional study. Objective: To determine the variations in origin of the LA and its relationship to surgical landmarks. Background: The Lingual artery (LA) is a branch of the External Carotid Artery (ECA) that constitutes the principal supply to structures within the oral cavity and floor of the mouth. Knowledge of its variant anatomy is therefore vital during radiological and surgical procedures performed in the head and neck region since they may predispose it and other branches of the ECA to iatrogenic injury. There is, however, a dearth of regional data on the same. Materials and Methods: A total of 70 LA dissections were performed bilaterally on 35 human cadavers. The borders of the carotid triangle were identified after which the external carotid artery and its branches were exposed. The pattern of origin and the diameter of the LA was noted and distances from its origin to the CB, GCHB and the HN were measured. Similar measurements were carried out for any variant trunks. Data was collected and analyzed using SPSS (IBM version 27). A paired t-test was used to compare side differences. Representative photos of the vessel and its variations were taken. Results: The LA was found to be present in all cadavers dissected and was bilaterally symmetrical in 43% of cases. Four (4) types of branching patterns were encountered in the present study, the most commonly observed being the solitary LA followed by the LFT, TLT and finally the TLFT. The average diameter was least in the solitary pattern and greatest in the TLT. In relation to the CB, the solitary LA originated at a distance of 1.51 ± 0.89 cm while the LFT, TLT and TLFT originated at a distance of 1.80 ± 0.73 cm, 1.02 ± 0.64 cm and 1.25 ± 0.01 cm respectively from the CB. The mean distance from the origin of the LA to the GCHB was least in the TLT and greatest in the TLFT. With reference to the hypoglossal nerve, the LA was at an average, 0.82 ± 0.15 cm from the HN for the solitary pattern, 1.34 ± 0.86 cm for the LFT, 1.34 ± 0.90 cm for the TLT and 1.38 ± 0.93 cm for the TLFT. Conclusion: The LA in the Kenyan population exhibited a high frequency of variation in comparison to other populations regarding its pattern of origin and relationship to landmarks such as the CB, GCHB and HN. These findings may provide further insight into the understanding of the vascular anatomy to the radiologist and the surgeon to avert complications and improve overall treatment outcome.

Alveolar bone grafting is a complex procedure utilized in alveolar cleft repair; however, the ideal site of bone graft material remains highly debated. In this study, we describe the management of a 14‐year‐old girl with bilateral alveolar clefts using alternative intraoral donor sites for bone graft harvest.

Background: The deep circumflex iliac artery (DCIA) is a large caliber artery which branches laterally from the external iliac artery (EIA), directly opposite the origin of the inferior epigastric artery (IEA). Population variations have been reported in its origin, length, and branching patterns. These may alter its relationship to palpable surgical landmarks such as the anterior superior iliac spine (ASIS) and the pubic tubercle (PT) which are used to locate the artery preoperatively, thus predisposing it iatrogenic injury. Despite this, there is paucity of data from the Kenyan setting. Study design: Cross-sectional study design. Objective: To determine the variations of the anatomy and bony landmarks of the Deep circumflex iliac artery in a select Kenyan population. Methods: A total of 104 DCIA from 52 formalin fixed adult cadavers were dissected to expose the DCIA, following which its vessel of origin and distance from the ASIS and PT, relation to the inguinal ligament (IL), length and branching patterns were noted. The average of the measurements were calculated. All data were collected and analyzed using Microsoft Excel 2007 (Microsoft Corporation, Redmond, WA). Representative photos of the vessel and its variations were taken. Results: The DCIA was found to be present and bilaterally symmetrical in all cadavers. In all cases observed, it originated as a lateral branch from the EIA (100%), opposite the IEA and directly behind the IL in 98% of the cases. Its average distance from the ASIS along the IL was 7.28 ± 0.99, while it was 5.91 ± 1.03 from the pubic tubercle to its origin. Its length ranged from 3.7 cm to 9.5 cm, with an average length of 3.86 cm in the right limb and 3.67 cm in the left limb. As regards its branching patterns, in 78% of the cases, it bifurcated into the horizontal and ascending branches, in 6%, it trifurcated and in 4%, it divided into more than 3, exhibiting a fine tree-like branching (arborization). Conclusion: The DCIA in our setting exhibited variations from other settings and an increase in awareness of these variations will probably reduce future iatrogenic lesions of the DCIA and its major branches in Kenya.

Study Design: Descriptive cross-sectional. Objective: The origin of the lingual artery (LA) has been well studied due to its implication in neck dissection, but the course thereafter to the oral cavity is less described. This cadaveric study traced the journey of the LA from the external carotid artery to its terminal branches in the tongue. Methods: Following bilateral neck dissections in 35 black Kenyan cadavers, the incidence of Beclard’s, Lesser’s and Pirogoff’s triangles, the types of LA origin with its length, relationship to the hyoglossus muscle and anastomosis with other vessels were documented. Results: Beclard’s triangle was found in 64 dissections (91.42%), Lesser’s in 46 dissections (65.71%) and Pirogoff’s in 39 dissections (55.71%). The LA presented either as a solitary branch (67.15%) or as a branch of either the linguofacial (LFT–24.29%), thyrolingual (TLT–2.72%) or thyrolinguofacial (TLFT–2.86%) trunk. The solitary LA was the longest at 6.93 mm, followed by the TLT branch (6.58 mm), LFT branch (6.12 mm) and TLFT branch (5.65 mm). The majority of solitary LA and LA branches of LFT and TLFT passed through the hyoglossus, while all LA branches of the TLT coursed medial to the muscle. All variants of LA have been found to anastomose with the submental artery (SMA) at frequencies that ranged from 11.10% to 100%. Conclusions: The LA was found in all cadavers and all Beclards’ triangles. There is a significant incidence of LFT and TLFT variants in the Kenyan population. The LA passed either through or medial to the hyoglossus with no lateral relationship being observed.