Browsing by Author "Chauhan, Nishtha"

Now showing 1 - 5 of 5
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    Comparative Evaluation of Nasolabial Flap, Buccal Fat Pad and Platysma Myocutaneous Flap for Reconstruction of Oral Sub Mucous Fibrosis Defects
    (Springer, 2023) Singh, Akhilesh Kumar; Bera, Rathindra Nath; Neville, J.F.; Tripathi, Richik; Sharma, Naresh Kumar; Kumar, Jananni Anand; Hirani, Mehul Shashikant; Chauhan, Nishtha
    Moderately advanced (stage III) and advanced (stage IV a & b) OSMF requires surgical intervention for management A number of options are available for reconstruction of post OSMF oral cavity defects. In our study we retrospectively compared buccal fat pad, nasolabial flap and platysma flap for reconstruction of the buccal mucosal defects. Patient records were obtained from the medical records section of the Institute and divided into three groups; group A (buccal fat pad), group B (nasolabial group) and group C (platysma flap). Maximal mouth opening and intercommisural distance were the primary outcomes. Kruskal Wallis test was used to test the mean difference between three groups. Mann�Whitney test was used for intergroup comparisons. Wilcoxon signed rank test was used to evaluate the mean difference in outcomes at each follow up interval. A p value of < 0.05 was considered as statistically significant at 95% confidence interval. After 1�year follow up patients in platysma group had significantly better mouth opening (39.84 � 1.65�mm) compared to both buccal fat pad (36.69 � 3.41�mm) and nasolabial groups (37.94 � 0.43�mm). Inter commisural distance was significantly better in patients reconstructed with platysma flap (59.21 � 0.99�mm) compared to both buccal fat pad (54.11 � 1�mm) and nasolabial flap (56.84 � 1.48�mm). Platysma flap lead to significantly better maximal mouth opening compared to both nasolabial and buccal fat pad. Both buccal fat pad and nasolabial lead to comparable mouth opening. Inter commissural distance is maximum with platysma flap followed by nasolabial flap and buccal fat pad. � 2023, Association of Otolaryngologists of India.
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    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) Dhiman, Neeraj K.; Jaiswara, Chandresh; Hirani, Mehul S.; Chauhan, Nishtha; Mahajan, Arjun D.; Krishnan, Aswathi
    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.
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    How far we have come with the Management of Condylar Fractures? A Meta-Analysis of Closed Versus Open Versus Endoscopic Management
    (Springer, 2022) Bera, Rathindra Nath; Anand Kumar, Janani; Kanojia, Shweta; Mashhadi Akbar Boojar, Fargol; Chauhan, Nishtha; Hirani, Mehul Shashikant
    Background: The treatment approaches for condylar fractures of the mandible include functional, closed reduction and open reduction�internal fixation. Recently endoscopic management of condylar fractures has been emphasized in the literature. We systematically review the studies comparing closed versus open versus endoscopic-assisted condyle fracture management with regard to the indications, effectiveness and complications of each modality. Methods: A total of 11 articles were selected based on the inclusion and exclusion criteria from PubMed, Cochrane and clinical trials.gov. Differences in means and risk ratios were used as principal summary measures with p value < 0.05 as significant. For detection of any possible biases in sample sizes, the OR and its 95% CI for each study were plotted against the number of participants. Chi-square test, I2 test and the Cochrane bias tool were used to assess the bias in and across studies. Results: Except for deviation on opening there was no significant difference between open versus closed treatment of condylar fractures. Endoscopic approach and open surgical approaches differed only in terms of operating time and TMJ pain. There was no significant difference in facial nerve injury among the two groups. Discussion: Closed reduction is particularly indicated for minimally displaced fractures; for moderate to severe displacement, open reduction is preferred. Open reduction can also be preferred over endoscopic approaches as there is no significant advantage of using latter. Limitations of the study included specific treatment according to the site of fracture not addressed, limited data regarding pediatric condylar fracture, lack of homogenous classification schemes, etc. � 2021, The Association of Oral and Maxillofacial Surgeons of India.
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    Kite String (Manjha) Injuries Among Children: Single Center Experience Over Four Years
    (Springer, 2023) Tiwari, Preeti; Chauhan, Nishtha; Patel, Rahul; Bera, Rathindra Nath; Pandey, Vaibhav
    We reviewed hospital records for kite-string injuries among children over four years (2017�2022). Of 42 affected children, mortality was 9.5%. The mean (SD) Pediatric Trauma Score (PTS) was 8.02 (2.66), with passively involved children facing greater severity [mean (SD) PTS, 5.58 (2.23)]. Kite-string injuries, alarmingly, endanger even bystanders, urging stricter preventive strategies. � 2023, Indian Academy of Pediatrics.
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    The clinical utility of steroids in facial trauma: A retrospective study of 638 patients
    (John Wiley and Sons Inc, 2022) Tiwari, Preeti; Bera, Rathindra Nath; Chauhan, Nishtha
    Glucocorticosteroids reduce post-operative swelling, trismus and pain after third molar extraction, maxillofacial trauma and orthognathic surgery. Steroids may affect immune system and retard wound healing. However, the use of steroids may or may not lead to infection. Patients were divided into two groups based on steroid therapy. The minimum follow-up was for 6�months. Independent t-test and chi-square statistics were used for quantitative and categorical data respectively. A p�<�0.05 was considered significant at 95% confidence interval. A total of 638 patient records were divided into two groups; group A (steroid group) and group B (non-steroid group). After 6�months 45% of group A patients and 2% of group B patients had infection (p value-0.077). The mean duration of analgesic requirement in group A was 3.9���1.5�days compared to 4.4���2.1�days in group B (p�=�0.01). Oedema was present in 9% of patients in group A compared to 12.5% in group B after 1�week (p�<�0.0001). The mean VAS score at 1�week was 0.03���0.18 in group B compared to 0 in group A (p�<�0.001). Use of steroids does not increase the risk of infection. It significantly reduces the duration of analgesic requirement with the reduction in oedema and pain. � 2022 British Association of Oral Surgeons and John Wiley & Sons Ltd.