Browsing by Author "Arjun D. Mahajan"

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A Rare Presentation of Cemento-ossifying Fibroma with Inherent High Flow Vascular Malformation: A Wolf in Sheep’s Clothing
(Springer, 2025) Murtaza Ali; Arjun D. Mahajan; Vyomika Bansal; Akhilesh Kumar Singh
Background: Cemento-ossifying fibroma (COF) is a rare subtype of benign fibro-osseous lesions predominantly affecting the craniofacial region. But tumor with combination of COF and vascular malformation has not been described in literature. Case: Following is the case of 14-year-old female patient with extensive COF of right maxilla encroaching orbit, maxillary antrum, nasal cavity, and zygoma. During course of careful investigations, embedded vascular malformation based on right maxillary and facial artery was diagnosed, in which aspiration cytology played crucial role. After confirmation by computed tomographic (CT) angiography, proper vascular control was gained by superselective embolization followed by surgical resection as definitive management. © The Association of Oral and Maxillofacial Surgeons of India 2025.
Chondroblastic Osteosarcoma in an Adolescent: Are Conventional Biopsy Techniques Just Scratching the Surface?
(Springer, 2025) Neeraj Kumar Dhiman; Arjun D. Mahajan; Trupti Jain; Ajit Kumar Vishwakarma; Rahul Agrawal
Osteosarcoma, although the most common malignant bone tumor in long bones, represents only 5–8% of head and neck tumors, making it uncommon for clinicians. Conventional biopsy techniques can complicate diagnosis due to varying tissue representation in surrounding areas. This article discusses a case involving a 19-year-old female who presented with facial swelling and a rapidly growing intraoral mass. Initial panoramic radiography showed localized radio-opacity and root resorption. Incisional biopsies initially suggested diagnoses of ossifying fibroma and fibrous hyperplasia, which did not align with the clinical presentation. Repeat excisional biopsy extending to the periosteum revealed findings consistent with chondroblastic and fibroblastic proliferation, including malignant osteoid and myxomatous stroma, confirming chondroblastic osteosarcoma. The patient subsequently underwent neo-adjuvant chemotherapy followed by surgical resection and radiotherapy. This case underscores the critical importance of timely and accurate diagnosis in osteosarcoma, as delays can significantly impact patient prognosis. The article emphasizes the lessons learned from such experiences in managing this challenging malignancy. © Association of Otolaryngologists of India 2024.
Comparative Analysis of Radial Forearm Free Flap and Submental Island Flap in Reconstruction of Post-glossectomy Defects of Oral Squamous Cell Carcinoma and Quality of Life Assessment
(Springer, 2025) Akhilesh Kumar Singh; Arjun D. Mahajan; Janani Anandkumar; Naresh Kumar Sharma; Farhan Durrani; Neeraj Kant Agrawal; Pg G.Naveen Kumar; J. F. Neville
Aim: Reconstruction of tongue defects has always been a challenging aspect of onco-surgery. Although a variety of locoregional and free flaps have been advocated, it still poses a challenge due to its complex function in deglutition and speech articulation. Hence, this study aims at reducing the dilemma of flap selection for better patient outcome. Materials and Methods: Among 16 tongue carcinoma cases, 6 cases were reconstructed using submental island flap (SIF) and 10 using radial forearm free flap (RFFF). These 2 flaps were compared in terms of parameters like intraoperative time, hospital stay, overall survival, pain, cosmesis, and recreation of anatomy, and functions like deglutition and articulation of speech. Patients were followed for oncologic safety and recurrence. Obtained data were statistically analysed using IBM® SPSS®. Result: SIF showed significantly higher activity score (P = 0.001) with reduced flap harvest time (P = 0.014) but showed difficulty in deglutition (P = 0.03) compared to RFFF. It was concluded that in cases of RFFF mobility and functional outcome was superior, but flap harvest time was considerably higher. Overall patient survival rate was better in cases of RFFF in long-term follow-up, but flap survival rate was significantly higher in SIF owing to better vascularity. Conclusion: In highly compromised cases and salvage cases where microvascular flaps are contraindicated, submental flap being a local flap with comparable overall survival rate, better cosmesis hence, serves as a reliable flap for reconstruction of glossectomy defects. © The Association of Oral and Maxillofacial Surgeons of India 2024.
Efficacy of arthrocentesis with intra‑articular injection of hyaluronic acid and corticosteroid in the treatment of internal derangement of temporomandibular joint
(Wolters Kluwer Medknow Publications, 2023) Neeraj K. Dhiman; Chandresh Jaiswara; Mehul S. Hirani; Nishtha Chauhan; Arjun D. Mahajan; Aswathi Krishnan
Introduction: Various techniques have been used to treat internal temporomandibular joint derangements (TMJ ID), with arthrocentesis one of the most successful in reducing symptoms and promoting function. In cases of TMJ ID, this research study compares and evaluates the efficacy of arthrocentesis with injections of corticosteroids (CS) or hyaluronic acid (HA). Methods: This prospective randomized, non‑blinded study involving 91 patients with symptoms of TMJ ID treated by arthrocentesis followed by intra articular injection of 1 ml of either corticosteroid (group A) or HA (group B) . Maximum mouth opening, lateral excursive movements, TMJ pain at rest and during function, masticatory efficiency, pre‑treatment functional TMJ limitation and subjective judgment of efficacy of treatment were assessed with millimeter scale. All the parameters measured before the procedure and further followed at 1st week, 1st month, 3rd month and 6th month post‑procedure. Results: Maximum mouth opening post procedure improved significantly in Group B at follow up visits (P < 0.05). Subjects in group B showed significant reduction in pain at rest (P = 0.001) at 1 week and 1 month follow up & increased masticatory efficiency at 6 months (P = 0.042) as compared to that of group A subjects. Conclusion: Injection of HA post‑TMJ arthrocentesis is found be comparatively more effective method of treating TMD IDs with resultant decrease in pain & improved functionality of the jaw. TMJ arthrocentesis along with injection of HA could serve as a possible alternative to treat chronic TMJ pain sufferers who are unresponsive to conservative medical therapies. © 2023 National Journal of Maxillofacial Surgery.
Management of Bilateral Mandibular Body Fractures Using Circum-Mandibular Wiring in a Limited Resource Environment in a Dog
(SAGE Publications Ltd, 2025) Arjun D. Mahajan; Anahita Kumar; Rashmi Mahajan; Kaushik Yadav; Maxmular Chakma
A 6-year-old Doberman cross-breed dog was presented at a primary veterinary care center in India with loss of appetite, irritability, and pain following a traffic accident. Upon examination there were unfavorable bilateral fractures of the body of the mandible, with ventral displacement of the symphysis due to pull from the geniohyoid and mylohyoid muscles. The fracture was reduced and fixed using circum-mandibular 18-gauge surgical orthopedic wire. Postoperatively, the dog was fed a soft and liquid diet for 3 weeks along with pain management and antibiotics. Despite there being semirigid fixation, prompt healing was observed. This article discusses the selection and use of mandibular fracture repair options and treatment for a bilateral mandibular fracture in a limited resource environment in a dog. © The Author(s) 2025
The Comparative Evaluation of Novel Second Generation Platelet Rich Fibrin Membrane and Conventional Collagen Membrane as Grafting Materials in Post-Fibrotomy Defects of Oral Submucous Fibrosis Lesions
(Springer, 2025) Arjun D. Mahajan; Neeraj Kumar Dhiman; Chandresh Jaiswara; Monika Bansal; Richik Tripathi
Oral SubmucousFibrosis(OSMF) is a premalignant condition predominantly affecting people of south-east Asian origin. Histologically, progressive submucosal fibrous band formation is a characteristic feature which requires surgical excision in advanced cases. A various grafting materials have been used to cover post-surgical defects such as buccal fat pad, nasolabial flap, platysma flap, and collagen membrane each with different advantages and disadvantages. But in today’s era of tissue engineering Platelet Rich Fibrin (PRF) based on the platelet gel therapeutic concept is gaining popularity in restorative procedures, after its development by Choukroun et al. in 2001. PRF membrane being an autogenous growth factor-rich fibrin biomaterial is compared for efficacy with widely used collagen xenograft. As per our knowledge of the literature, this study is the first comparative analysis between PRF membrane and Collagen membrane as reconstructive materials post fibrotomy of OSMF bands. 30 patients including males and females diagnosed clinically with OSMF were grouped post randomization and post-fibrotomy defects were reconstructed with PRF membrane (Group 1) and Collagen membrane (Group 2). Post-operative pain, edema, epithelization, mucosal suppleness, mouth opening, and patient compliance were noted. Data was statistically analyzed with SPSS® IBM® (version 21) software. PRF membrane group showed significant reduction in pain, rapid recovery from mucosal edema, faster rate of epithelization and improvement in mucosal suppleness. Though trend for mouth opening over the period of follow-up was similar in both groups, patient compliance for post-operative jaw physiotherapy was found to be better with PRF membrane grafted patients. With the only drawback of technique sensitivity PRF membrane is emerging as an excellent option for the reconstruction of soft tissue defects. © Association of Otolaryngologists of India 2025.
Versatility of bilateral nasolabial flap for reconstruction of subtotal lip defects in oral squamous cell carcinoma with commissural involvement: A case report and review literature
(Wolters Kluwer Medknow Publications, 2025) Vyomika Bansal; Akhilesh Kumar Singh; Naresh Kumar Sharma; Arjun D. Mahajan
Reconstruction of the lip is crucial to regaining essential functions, including oral competency, speech articulation, and aesthetics. Reconstruction is often challenging when commissure is involved as it affects the anatomy of both the upper and lower lip as well as the size of the oral stoma. Improper commissure reconstruction results in drooling and a reduction in mouth opening. This case highlights the versatility of the simultaneous use of a bilateral nasolabial flap for the reconstruction of subtotal lower-lip defects in cases where a tumor involves one of the commissures, providing satisfactory aesthetic and functional results. © 2025 National Journal of Maxillofacial Surgery.