Left Oral Cavity Research Articles

Integration of palliative care in the management of oral squamous cell carcinoma.

Oral Squamous cell Cancers (OSCC) is strongly associated with tobacco consumption. We here in present a case study of a OSCC patient who refused standard oncological care (SOC), to highlight the importance of integrating palliative care (PC) for improved patient outcomes. A 61 years male patient, with history of chewing tobacco for more than 20 years and diagnosed to have OSCC for 1.5 years presented with severe anaemia and a cauliflower-like growth (12 x 10 cm) in the left oral cavity and cheek with greenish-yellow discharge. Pus culture was positive for K. pneumoniae and P. aeruginosa. Patient is also a known hypertensive for 15 years and a diabetic for 7 years on allopathic treatment. However, the patient refused SOC for oral cancer and relied on siddha treatment. Packed cell transfusions were given to correct anaemia and the blood glucose levels was kept under control. Frequent wound debridement, oral care, antibiotics, balanced-diet and hydration improved wound-bed granulation. Patient and family members were counselled and explained in detail on the need for SOC by sharing previous OSCC patients' care and outcomes at our centre. Patient gained trust and courage and agreed for chemotherapy, which reduced the disease burden and improved the quality of life (QoL) considerably. Therefore, PC integration at an early stage of treatment is imperative as it reduced (i) the burden of secondary infection, (ii) pain and distress, and (iii) improved the QoL.

Buccal hemineglect: is it useful to evaluate the differences between the two halves of the oral cavity for the multidisciplinary rehabilitative management of right brain stroke survivors? A cross-sectional study

ABSTRACTBackground: Unilateral spatial neglect (USN) is the most frequent cognitive impairment after right brain stroke, characterized by inattention to sensory stimuli in the opposite hemispace. It has been recently hypothesized a novel condition defined as “buccal hemineglect,” a particular form of USN with detrimental oral effects on right stroke survivors.Objective: The aim of our study was to compare the oral hygiene between the two halves of oral cavity in right stroke survivors.Methods: In this cross-sectional study, we assessed a cohort of right-handed subjects affected by right brain stroke with left hemiparesis, divided into two groups based on the presence of USN. We administered an evaluation protocol, including New Method of Plaque Scoring, Oral Hygiene Index (OHI), Gingival Index, Oral Food Debris Index, and Winkel Tongue Coating Index (WTCI). All outcome measures were assessed in the entire cohort considering both left and right halves of oral cavity.Results: Of the 21 patients included (mean aged 64.19 ± 7.60 years), the 14 affected by USN (mean aged 64.50 ± 8.06 years) had significantly worse values in all outcome measures in the left oral cavity compared to the right one (P < .01). On the other hand, the seven patients not affected by USN (mean aged 63.57 ± 7.16 years) showed statistically significant differences only in OHI (P = .03) and WTCI (P = .03).Conclusion: Hygiene of left oral cavity was significantly worse than contralateral in right brain stroke survivors with USN. This study highlights the need to develop an adequate oral rehabilitation program in these patients.

Trigeminal neuralgia after pontine infarction affecting the ipsilateral trigeminal nerve

A 57-year-old man presented with numbness, paraesthesia and lancinating pain on the left side of the face, which had developed suddenly 10 days previously. He had hypertension and no history...

A Case of Incidentally Found Bilateral Retroperitoneal Cavernous Hemangiomas

A 59-year-old male was admitted to our hospital because of incidentally found right retroperitoneal tumor. He had undergone removal of a hemangioma in the left oral cavity four years before. An abdominal CT scan performed in our hospital revealed poorly enhanced bilateral retroperitoneal tumors adjacent to kidneys. Those tumors were of low signal intensity on T1-weighted images and high on T2-weighted images by magnetic resonance imaging. The right retroperitoneal tumor of 2.5 cm in size was surgically removed and histopathological examination indicated cavernous hemangioma. The smaller left retroperitoneal tumor of 1.1 cm in size was left untouched to be followed up, as we supposed that it has the same benign pathology. There have been no previous cases of retroperitoneal cavernous hemangioma as a presentation of multiple hemangiomas.

A case of cranio-facial trauma through gunshot wound with imminence of respiratory arrest

Purpose of the study: Cranial gunshot wounds represent most of the cranio-cerebral wounds and about 35% of head trauma deaths under 45 years, with a global mortality that reaches 90%. Materials and method: A case report is presented. Case report: The study refers to the case of a 36-year-old male patient who suffered a cranio-facial gunshot wound in a hunting accident, followed by superior airway obstruction (foreign body and blood) and tongue and soft palate swelling. Results: On hospital admission the patient had a gunshot wound with an entrance point laterally from the left oral cavity angle, a comatose state (GCS 8p) and superior airway obstruction with imminence of respiratory arrest.

Facial numbness in a man with inguinal and retroperitoneal masses

A 37-year-old Brazilian man was admitted to Massachusetts General Hospital for evaluation of left-sided facial numbness, left-sided ataxia, dizziness, and vertigo. Seven weeks prior to admission, he reported numbness of the left oral cavity and tongue after a dental procedure. Three weeks prior to presentation, he developed left-sided incoordination with dizziness and vertigo. One week later, he noticed difficulty using a box cutter at work and presented to the emergency department for evaluation. A CT scan without contrast revealed no abnormalities and he was discharged home. Three days prior to admission, the patient developed diplopia. Cranial MRI revealed a 1.6 cm irregular enhancing mass in the left middle cerebellar peduncle. Neurologic examination was significant for diminished sensation over the left face to pinprick, left-sided dysmetria, and mild lateral instability of the trunk while walking. MRI, lumbar puncture, CT scans of the abdomen and pelvis, needle biopsy of the lymph node, and paraneoplastic antibodies. Possible paraneoplastic demyelination. Orchiectomy, adjuvant radiation, and corticosteroids.