Browsing by Author "Janani Anandkumar"

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Bipaddled Pectoralis Major Myocutaneous Flap in Complex Oral Cancer Defects- A Single Center Experience with Quality of Life Assessment
(Springer, 2023) Akhilesh Kumar Singh; Neville J F; Naresh Kumar Sharma; Janani Anandkumar; Nitesh Mishra; Arun Pandey
Introduction: Advanced stage malignancies of oral cavity commonly result in complex full thickness defects with subsequent functional and aesthetic loss. Through this article we describe our center’s experience in reconstruction of such defects with bipaddled pectoralis myocutaneous (PMMC) flap through an immediate, single-staged procedure. Materials And Methods: The study included a total of 54 patients who underwent composite resection and neck dissection followed by reconstruction of the defect with bipaddled PMMC flap. All patients were followed up post-operatively for 1 year and were monitored for flap and donor site related complications. Using University of Washington Quality of life v4 questionnaire (UW-QOL4), we assessed the QOL of 54 patients. The mean scores were compared to other similar studies. Results: The overall complication rate was 66.6%, whereas, 33.3% patients had no complications. The most common complication was wound dehiscence seen in 31.5% of cases in the recipient site and 12.9% in the donor site. Other complications were seroma, hematoma, plate exposure, orocutaneous fistula etc. Around 73.7% patients reported a good, very good or outstanding overall quality of life in the post-operative period. The mean composite QOL score was 65.84. Our study showed comparable domains of pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function and taste with other similar studies. Conclusion: Bipaddled PMMC flap proves to be a considerable alternative for microvascular free flaps in reconstruction of full-thickness defects of oral cavity owing to its reliable blood supply, accessibility, easier harvesting technique, cost effectiveness, high success rate and acceptable quality of life. © 2022, Association of Otolaryngologists of India.
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.
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.
Comparative Evaluation of Bilateral Earlobe Cleft Repair with and Without Platelet Rich Plasma Injection- In vivo Randomized Study
(Springer, 2025) Priti Talele; Lakshmi Shetty; Shreya Jeetendra Raut; V. Kulkarni; Akhilesh Kumar Singh; Madan Mishra; Janani Anandkumar
Earlobe clefts have been the major concern for aesthetic repair in the present situation. The advent of platelet-rich plasma (PRP) for enhancement of healing has never been treated for cleft earlobe repair. This study aims to compare and evaluate the efficacy of wound healing with and without platelet-rich plasma injection in bilateral earlobe cleft lobe repair. 50 patients presenting bilateral earlobe cleft were selected for this study. Earlobe repair (cross-stitch technique) was performed under local anaesthesia using 5–0 prolene sutures. On one side platelet-rich plasma was injected intra-dermally. Patient was followed up after 24 h, 8 and 15 days post-operatively for evaluation of pain and scar respectively. Statistically significant/highly significant difference seen for the values between the groups (p < 0.01, 0.05) with higher values at 8 days for group without PRP while lower values for the group with PRP, at 15 days higher values of Stony Brook Scar Evaluation Scale (SBSES) was seen for group with PRP, while lower values for the group without PRP. ELC repair using cross-stitch technique and intradermal PRP injection intra-operatively is a simple, cost effective method and gives good aesthetic results. It also promotes the healing and reduces the chances of scar formation. Length, contour and integrity of the earlobe is also maintained by this technique and this research for the first time in literature proves that such a large sample has been found effective in ELC repair with PRP. © Association of Otolaryngologists of India 2024.
Evaluation of Efficacy of 10% Dextrose Prolotherapy in Management of Temporomandibular Joint Disorders: A Prospective Study
(Springer, 2024) Shankar Singh; Naresh Kumar Sharma; Chandresh Jaiswara; Neeraj Kumar Dhiman; Preeti Tiwari; Janani Anandkumar; Arun Pandey
The aim of this study was to assess the efficacy of 10% dextrose prolotherapy in the management of temporomandibular joint disorder. Thirty patients aged between 18 and 62 years, diagnosed with Temporomandibular Disorders (TMDs) persisting for more than six months and unresponsive to other conservative treatments, were enrolled in the study. Over four subsequent visits, spaced six weeks apart, each patient received injections of 3 ml of 10% dextrose solution into the temporomandibular joint space. Parameters assessed included pain levels, frequency of luxations/dislocations, episodes of locking per month, maximal mouth opening, and clicking, evaluated every six weeks for a duration of three months. All patients exhibited improvements in Temporomandibular Disorders (TMDs), manifested as reduced pain, clicking sounds, locking episodes, and increased maximal mouth opening, following prolotherapy treatment. These improvements were found to be statistically significant (p-value < 0.05). Dextrose prolotherapy is a treatment method with broad applications and should be considered prior to resorting to long-term pharmacotherapy or surgical interventions. The use of 10% dextrose prolotherapy presents a promising treatment modality for temporomandibular joint disorders, as evidenced by its therapeutic benefits. © Association of Otolaryngologists of India 2024.
Primary tumour characteristics poorly correlate with extracapsular spread and cervical sublevel IIb metastasis in patients with oral squamous cell carcinoma and clinically N0 neck: A retrospective study
(Wolters Kluwer Medknow Publications, 2021) Akhilesh Kumar Singh; Rathindra Nath Bera; Janani Anandkumar; Aswathi Krishnan; Ravina Rajpoot
Introduction: Nodal metastasis reduces the survival by 50% in head-and-neck squamous cell carcinomas. The presence of nodal extension/extracapsular spread (ECS) further reduces survival. Current literature favors a selective level IIb sparing neck dissection in clinically N0 neck. Studies have evaluated the role of primary tumour size, number of lymph nodes, and depth of invasion (DOI) with the occurrence of extranodal extension (ENE). Patients and Methods: Patients were retrospectively reviewed who presented with oral cavity carcinomas and clinically N0 neck. Relationship was sought between tumour site, size, histological grading, DOI, and the occurrence of level IIb metastasis and ECS. A P < 0.05 was considered statistically significant. Results: The relationship showed insignificant correlation with P values (0.6643, 0.6704, 0.6779, and 0.6779) between site, size, grading, DOI, and level IIb and ENE. Discussion: Previous studies have shown DOI >5 mm and lymph node size 15 mm and multiple lymph nodes predict ECS. DOI and primary site with more than 20% for occult metastasis predicts elective neck treatment. However, in our study, no correlation was found between primary tumour characteristics and ECS or level IIb metastasis. Elective neck dissection is the standard surgical protocol from both diagnostic and therapeutic viewpoints. The only criterion for level IIb dissection is concomitant presence of level IIa involvement intraoperatively. Since ENE can occur early in the disease process, elective neck dissection remains the standard of care. © 2022 Annals of Maxillofacial Surgery Published by Wolters Kluwer-Medknow.