Browsing by Author "Mishra, Nitesh"

Now showing 1 - 7 of 7
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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) Singh, Akhilesh Kumar; J F, Neville; Sharma, Naresh Kumar; Anandkumar, Janani; Mishra, Nitesh; Pandey, Arun
    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.
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    Effects of curcumin on oral cancer at molecular level: A systematic review
    (Wolters Kluwer Medknow Publications, 2023) Singh, Akhilesh Kumar; Sharma, Naresh Kumar; Mishra, Nitesh; Mahajan, Arjun; Krishnan, Aswathi; Rajpoot, Ravina; Kumar, Janani Anand; Pandey, Arun
    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.
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    En Block Versus Separate Management of Cervical Nodes in Tongue and Floor of the Mouth Cancers- Is There a Difference? An Analysis of 85 Cases in a Tertiary Care Institute
    (Springer, 2022) Neville, J.F.; Tilak, Mandar; Singh, Akhilesh Kumar; Sharma, Naresh Kumar; Kumar, Janani Anand; Mishra, Nitesh; Durrani, Farhan
    To evaluate difference in local recurrence, regional (neck) recurrence as well as distant metastases between cases operated with en-block excision of primary cancer and neck nodes versus their separate removal, in squamous cell carcinomas of anterior 2/3 of tongue and floor of the mouth. A total 85 patients of cT1-T4a N0-N2b of carcinoma�anterior 2/3 of tongue and floor of mouth�were evaluated. Amongst these patients�39 cases of in-continuity en-block neck dissection and 46 cases of discontinuous neck dissection were evaluated for post-operative�complications�as well as oncological outcome for a follow up period of 3�years. Patient population was similar in both groups with tongue cancers being the commonest�site�and tobacco being the most common addiction. Primary site hematoma was seen more in the in-continuity en-block neck dissection group with a p-value of 0.0276, which was statistically significant. Post-operative oro-cutaneous fistula occurred more in in-continuity�enblock�neck dissection as compared to discontinuous neck dissection, but the difference was not statistically significant. Local recurrence rate was significantly more in cases of discontinuous neck dissection (19.565) as compared to in-continuity en-block neck dissection (5.12%) with a p-Value 0.0481. A statistically non-significant but higher loco-regional recurrence was observed in cases of discontinuous neck dissection as compared to cases of�in-continuity en-block neck dissection (10.56% vs 2.56). In the present study recurrence-free survival RFS 3�year in cases of en-block in-continuity neck dissection (84.06%) cases as compared to discontinuous neck dissection cases (63.04%) with p Value 0.025698. In-continuity�en-block in continuity neck dissection has lower loco-regional recurrence and may impact overall distant metastases. Though early postoperative complications are more in in-continuity�en-block in continuity neck dissection as compared to discontinuous neck dissection, most are managed conservatively. Further studies with a larger sample size are needed to evaluate its outcome in a comprehensive manner. � 2021, Association of Otolaryngologists of India.
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    Evaluation of Arthrocentesis with and Without Platelet-Rich Plasma in the Management of Internal Derangement of Temporomandibular Joint: A Randomized Controlled Trial
    (Springer, 2021) Singh, Akhilesh Kumar; Sharma, Naresh Kumar; Kumar, P. G. Naveen; Singh, Shreya; Mishra, Nitesh; Bera, Rathindra Nath
    Purpose: The purpose of this study was to compare the efficacy of intra-articular injection of platelet-rich plasma after arthrocentesis versus arthrocentesis alone as a treatment modality in patients with internal derangement of temporomandibular joint. Methods: Twenty-four patients suffering from internal derangement of temporomandibular joint were included in the study. The patients were randomly divided into two groups as follows�twelve patients underwent arthrocentesis followed by intra-articular injection of platelet-rich plasma (study group) and the other twelve were treated by arthrocentesis alone (control group). Pain intensity was recorded on visual analogue scale (VAS); maximum mouth opening and joint sound were measured before and after intervention. The patients were clinically evaluated at the intervals of 1�month, 3 and 6�months subsequently. Results: There was no statistically significant difference in all the parameters between the groups. Intra-group analysis showed statistically significant improvement in all the parameters. Conclusion: In both groups, improvement of pain, maximum mouth opening and TMJ sound were observed at all intervals, but there was no statistically significant improvement in arthrocentesis with PRP group when compared with arthrocentesis alone. � 2019, The Association of Oral and Maxillofacial Surgeons of India.
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    Management of Maxillary Sagittal Fracture by using Pre-activated Rapid Maxillary Expansion (RME)
    (Springer, 2022) Tiwari, Preeti; Mishra, Nitesh; Rashid, Mohammed; Hirani, Mehul Shashikant
    Introduction: Different techniques of the management of sagittal maxillary fractures have been described with different advantages and disadvantages. We herein present our experience and results of managing these cases by reversing pre-activated maxillary expanders and evaluation of its efficacy. Patient and Methods: A prospective study was conducted from April 2016 to February 2020 including all the patients managed for sagittal palatal fractures using the modified technique. The patients were evaluated for healing, occlusion and complications. Results: A total of five patients with sagittal palatal fracture were managed. The mean Glasgow Coma (GCS) score and injury severity score (ISS) of patients were 11.6 � 2.4 and 15.2 � 4.3, respectively. Both had a significant strong negative correlation with a correlation coefficient of ? 0.889 (p = 0.44). The median duration for initiating the treatment for facial fractures was 2�days (range 2�12�days). All patients achieved satisfactory outcomes and tolerated this technique well. No obvious complications were found. Conclusion: This method could produce enough transversal force to reduce fractured fragments and then serve as an external fixator to maintain stability for bony healing. � 2021, The Association of Oral and Maxillofacial Surgeons of India.
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    Systematic Review of Intra Parotid Facial Nerve Schwannoma and a Case Report
    (Springer, 2022) Singh, Akhilesh Kumar; Kumar, Janani Anand; Sharma, Naresh Kumar; Pandey, Arun; Mishra, Nitesh; Bera, Rathindranath
    To evaluate the clinico-epidemiological aspects, pathological features, diagnostic methods, management protocol and functional outcome of the intra-parotid facial nerve schwannoma (IFNS) and to present a case report on intra parotid facial nerve schwannoma. PubMed, ProQuest, Google scholar, Science direct and Scopus were screened for studies. Article selection and data extraction was done by one investigator and other investigator confirmed its accuracy. After abstract and text screening a total of 69 articles were finally selected for the study with the inclusion and exclusion criteria of the systematic review as per PRISMA guidelines. With addition of one case reported to our department. The mean age of diagnosis was 43 � 16�years with a slight female predominance. The mean duration of the tumour was 29.5�months and the mean size of the tumour on initial diagnosis was 3.6 � 1.67�cm. Pleomorphic adenoma was the primary diagnosis in 44 cases. Superficial parotidectomy was done in 64 cases followed by resection in 47 cases. Reconstructive treatment was carried out by an end-to-end anastomosis in 3 patients and by facial-hypoglossal anastomosis in 16 patients, GAN cable grafting in 5 patients, a greater auricular nerve graft was done in18 patients and end-to-side interposed sural nerve graft in 8 patients. The type D tumours are treated by extended resection of the facial nerve, which is difficult to reconstruct and also employs a nerve graft that does not often give acceptable recovery of facial function. Facial nerve schwannomas being a rare entity poses a dilemma in diagnosis and management. Managing the lesions is also difficult as intraoperative adherence to the nerve makes a tumour free margin difficult without sacrificing the nerve. At present there is no consensus regarding the management of various types of intra-parotid facial nerve shwannoma. � 2021, Association of Otolaryngologists of India.
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    Temporomandibular joint ankylosis: A tertiary center-based epidemiological study
    (Wolters Kluwer Medknow Publications, 2021) Mishra, Nitesh; Sharma, Naresh Kumar; Dhiman, Neeraj Kumar; Jaiswara, Chandresh; Tiwari, Preeti; Singh, Akhilesh Kumar
    Introduction: Limitation of mouth opening can be caused by bony or fibrous ankylosis of the temporomandibular joint (TMJ) as a sequel to trauma, infection, or autoimmune diseases. The incidence of TMJ ankylosis differs significantly in different parts of the world. The purpose of this study was to analyze the etiological incidence of TMJ ankylosis at our tertiary-level center, which covers a huge population from parts of Bihar and eastern Uttar Pradesh. Materials and Methods: This study was conducted from July 2016 to April 2019, and a total of 1607 children were screened in the duration of 33 months. Participants were included in this study as per the inclusion and exclusion criteria. Results: After screening of the 1607 children, 128 TMJ ankylosis cases were identified. Out of the 128 cases of TMJ ankylosis, 33 cases were bilateral and 95 cases were unilateral (48 left sided and 47 right sided). Most of the patients (83.5%) were in the 10�15-year-old age group (mean age was 12.1 � 2.83 years). There was a female preponderance, and the male-to-female ratio was 7:10. Overall, the most common cause of ankylosis was found to be childhood trauma. Conclusion: The major etiologic factor of TMJ ankylosis was found to be birth/childhood trauma. TMJ ankylosis cases were detected in significant numbers in this study. This increased prevalence may be due to the lack of knowledge about this pathological entity among the general population and health-care professionals at primary level, which leads to poor initial management. � 2021 National Journal of Maxillofacial Surgery.