Browsing by Author "Arjun Mahajan"

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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, 2024) Akhilesh Kumar Singh; Arjun Mahajan; Janani Anandkumar; Naresh Kumar Sharma; Farhan Durrani; Neeraj Kant Agrawal; P. 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.
Effects of curcumin on oral cancer at molecular level: A systematic review
(Wolters Kluwer Medknow Publications, 2023) Akhilesh Kumar Singh; Naresh Kumar Sharma; Nitesh Mishra; Arjun Mahajan; Aswathi Krishnan; Ravina Rajpoot; Janani Anand Kumar; Arun Pandey
This systematic review mainly focuses on the effects of curcumin on oral cancer cells at the molecular level and summarizes the results of the studies. We searched and analyzed various databases such as Pub Med, ProQuest, Google Scholar, Science Direct, and Scopus. Searches were conducted from 2006 to 2021. This systematic review evaluated various effects of curcumin on oral cancer at the molecular level. All the studies related to the effects of curcumin on oral cancer, both in‑vivo and in‑vitro, were included. After abstract and text screening a total of 13 articles were finally selected for the study based on the inclusion and exclusion criteria. All most all the included studies reported that after treating the cell lines with curcumin there is a reduction in cell proliferation and cell growth, analyzed using MTT (3‑(4,5‑dimethylthiazol‑2‑yl)‑2,5‑diphenyl tetrazolium bromide) assay. Curcumin also induces S phase cell cycle arrest and also prevents Tregs migration. The curcumin reverses the process of epithelial mesenchymal transition (EMT) back to mesenchymal epithelial transition (MET). From this review, it is concluded that curcumin inhibited proliferation, migration, invasion, and metastasis, and induced apoptosis via modulating multiple signaling pathways in oral cancer cell lines. But further clinical trials are needed for a detailed evaluation of the effects of curcumin on patients with oral cancer. © 2023 National Journal of Maxillofacial Surgery.
Hara Hara Mahadev (HHM) maneuver: Simple Yet Effective Way of Post-Operative Physiotherapy after Reconstruction with Pectoralis Major Myo-cutaneous Flap in Oral Cancer Defects
(Springer, 2023) Arjun Mahajan; Akhilesh Kumar Singh; Naresh Kumar Sharma
Introduction: Pectoralis major myo-cutaneous flap remains time-tested work horse for reconstruction of postsurgical oral cancer defects despite of popularity of free flaps. But postoperatively majority of attention is provided to recipient site and its complications and donor site complications are often overlooked. Reduced post-operative mobility of shoulder joint and drooping shoulder’ after injury to spinal accessory nerve being the most commondonor site morbidities. Method: To overcome this complication, we have introduced a novel Physiotherapeutic maneuver named “Hara Hara Mahadev” (HHM) Maneuver. Wherein postoperatively patients were advised to do this novel physiotherapeutic maneuver regularly. Results: With continued practice encouraging results with drastic increase in range of motion and shoulder mobility was observed. © 2023, The Association of Oral and Maxillofacial Surgeons of India.
Hyena bite: A rare intriguing mode of maxillofacial injury, its management, risks involved, scenarios to avoid
(Wolters Kluwer Medknow Publications, 2024) Arjun Mahajan; Chandresh Jaiswara; Neeraj Kumar Dhiman; Aswathi Krishnan
The striped hyena (Hyaena hyaena) is a rarely spotted carnivore in India listed as Near Threatened (red list) by International Union for Conservation of Nature (IUCN) in 2014. Hyena is considered as scavenger but also executes rare opportunistic attacks on humans. In India, reported cases of hyena attack on humans are very rare, because of remote locations of these attacks majority of which go unreported to higher medical centres. This article describes about the circumstances and management of Hyena inflicted maxillofacial injury in North India, which is as per our knowledge first scientifically documented maxillofacial injury caused by Hyena in Indian subcontinent. © 2024 National Journal of Maxillofacial Surgery | Published by Wolters Kluwer - Medknow.
Novel Tripartite Classification for Fractures of Coronoid Process of Mandible: A Retrospective Tertiary Center Study
(Springer, 2024) Arjun Mahajan; Akhilesh Kumar Singh; Naresh Kumar Sharma; Vyomika Bansal; Sudeep Kumar; Sharanya Mani; Zainab Akram
Introduction: Coronoid process of mandible is seldom fractured during maxillofacial trauma. Majority of the cases of coronoid fracture are treated conservatively, but some lead to complications which are often overlooked. At present, the literature on coronoid fractures is inadequate for meta-analysis. Also, there exists no standardized classification in the literature. Hence, the purpose of this study was to analyze the incidence and establish a novel ‘tripartite’ classification. Material and Methods: In this study carried out at level 1 trauma center, all patients with coronoid fracture with or without associated maxillofacial fractures were included. Relevant data were noted from Hospital records and CT scans (computer tomographic scans). These cases were classified according to ‘tripartite’ classification and treated. Data feed was given to IBM® SPSS® statistics (version 21) for analysis. Results: Among 33 coronoid fracture patients, majority (57.57% cases) were from age group of 21–40 years with 82.85% cases attributed to road traffic accidents. 11.43% cases were bilateral, and the rest unilateral cases revealed right-side predilection. Conclusion: Novel tripartite classification allows us to easily categorize and visualize the coronoid fractures. Horizontal types 1 to 3 and vertical types 4 to 6 are in increasing order of incidence, which makes it easy for communication, treatment approach and record maintenance. © The Association of Oral and Maxillofacial Surgeons of India 2024.
Oral Manifestations of Malignant Immunoglobinopathy Hidden in Plain Sight - A Rare Case Report
(Wolters Kluwer Medknow Publications, 2023) Naresh Kumar Sharma; Akhilesh Kumar Singh; Mehul Shashikant Hirani; Aswathi Krishnan; Arjun Mahajan; Ravina Rajpoot
Rationale: Radiolucent lesions over the angle-body region of the mandible are frequently difficult to diagnose but crucial to provide patient-centred care. Patient Concerns: An elderly female presented with a painless slow-growing swelling over her left lower face for one year, radiographically appearing as a well-defined unilocular radiolucency over the left body of the mandible. Diagnosis: Aspiration was negative, and biopsy was inconclusive. Further imaging, bone marrow biopsy, immune profile and serum electrophoresis confirmed the diagnosis of multiple myeloma. Treatment: She was referred to Medical Oncology for chemotherapy of lenalidomide, bortezomib and dexamethasone regimen cycle that was repeated every 21 days. Outcomes: There was no increase in swelling, and radiographically 'punched-out' lesions were reduced significantly. Take-Away Lessons: Maxillofacial clinicians should be attentive to the oral manifestations of underlying disease, have a high index of suspicion and start the treatment promptly to increase chances of a favourable outcome. © 2023 Annals of Maxillofacial Surgery.
Quality of Life Assessment and Comparative Analysis of Anterolateral Thigh Flap and Pectoralis Major Myo-cutaneous Flap for Reconstruction of Post Excision Defects of Oral Squamous Cell Carcinoma
(Springer, 2024) Arjun Mahajan; Janani Anand Kumar; Akhilesh Kumar Singh; Naresh Kumar Sharma; Farhan Durrani; Neeraj Kant Agrawal; Neville JF
Present study is a comparative evaluation of the financial impact on choice of flap, clinical results as well as post resection quality of life assessment of cancer patients reconstructed with anterolateral thigh(ALT) flap and pectoralis major myo-cutaneous(PMMC) flap. Ethical clearance was obtained from institutional ethical committee. In this non-randomised, prospective study design among 49 oral squamous cell carcinoma cases, 39 cases were reconstructed using PMMC flap and 10 using ALT flap from year 2020 to 2022. These 2 flaps were compared in terms of parameters like time utilised for reconstruction, hospital stay, overall survival and Washington University Quality of Life index(UW-QOL) for head and neck cancer. Patients were followed regularly for post-operative complications. The University of Washington Quality of Life score (UW-QOL) questionnaire, version 4, was completed at six months post-operatively. Obtained data was statistically analysed using IBM® SPSSⓇ. Washington University Quality of Life index scores and esthetics are better with Antero-lateral thigh flap, with less overall post-operative complications. On the other hand Pectoralis myocutaneous flap has less surgical time and more salvage potential. Despite of Antero-lateral thigh flap having Good Washington University Quality of Life index scores, lesser post-operative complications and better esthetics; scale of developing nations is still tipping towards economical, less time consuming and less technique sensitive Pectoralis major myocutaneous flap. © Association of Otolaryngologists of India 2024.