Locally advanced oral cancers extending to infratemporal fossa (ITF) are a challenge to head and neck surgeons. These tumors are classified as T whenever the masticator space (MS), pterygoid muscles (PM), and pterygoid plates (PP) are involved according to AJCC classification. Until recently, these tumors were considered inoperable and treated only with palliative intent. However, a few studies in the last decade showed that many of these tumors could be resected with a reasonably favorable prognosis by compartment resection of ITF, particularly when the tumor was below sigmoid notch of mandible. A few studies attempted to downstage these tumors by neo-adjuvant chemotherapy before attempting resection. Oral Squamous cell carcinoma has a high prevalence in South India. Majority of these patients are females addicted to tobacco quid chewing and present with locally advanced disease. In this retrospective analysis, we evaluated the outcome of treatment of oral squamous cell carcinoma extending to ITF and staged T in 52 patients. All patients underwent Composite resection including compartment resection of ITF followed by adjuvant treatment. 20 patients had received neo-adjuvant chemotherapy. Pectoralis major myocutaneous flap was the mainstay of reconstruction. After mean follow-up of 2 years, 31 patients are alive and disease free. 14 patients had local recurrence in ITF and 2 patients had recurred in cervical nodes. 8 patients died due to disease and 6 are on palliative care. Neo-adjuvant chemotherapy did not benefit the outcome. Close margins of resection, extra nodal spread from lymph nodes and supra notch and involvement of posterior part of ITF were factors which predisposed to recurrence.
<p class="abstract">The aim was to study the impact of temporal bone dissection demonstrations on understanding anatomy of the ear among medical students. During a period of six months from October 2017 to March 2018, 10 cadaveric temporal bones dissections were demonstrated using ZEISS microscope and in the presence of medical students headed by a Consultant Otolaryngologist in the department of ENT, Sri Devaraj URS Medical College and Research Centre, Kolar. Anatomy of the middle ear and inner ear and various operative procedures were demonstrated. The students were divided into 2 groups. Group I comprised students who attended the temporal bone dissection and Group II included those who didn’t attend dissection. After the session both the groups were assessed by the consultant. Scores were given to the group individuals based on the ability to answer the questions. 10 Temporal bone dissections were demonstrated in 6 months period to medical students who were divided into 2 groups based on their attendance of the demonstration. The students of both groups were assessed. Scores were given by Likert scale-5point scale question. The results of our study proved that those students who attended the temporal bone dissection (Group-I) had better understanding of the anatomy and operative procedures of the ear as compared to students in group II. Demonstration of temporal bone dissection to the medical students had a good impact on their understanding of the three dimensional anatomy of the ear.</p>
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