The diagnostic dilemma of Masticator space tumor

The masticator space is an anatomical and functional entity centered on the mandibular ramus, which divides it into medial and lateral compartments. The masticator spaces considered paired supra-hyoid cervical spaces on each side of the face that extend from the angle of the mandible to the parietal bone. The masticator space contains the mastication muscles, posterior mandible, and mandibular nerve. They are separated from the nasopharynx by the parapharyngeal spaces bilaterally. Primary malignancy of the masticator space is very uncommon.Here we report a diagnostic dilemma of primary masticator space malignancy mistaken by nasopharyngeal carcinoma as the patient 40-year old gentleman presented with left lateral rectus palsy and left nasopharynx fullness.

Marginal mandibular nerve — a wandering enigma and ways to tackle it

Background This study aims to propose surgical approaches intended to localize and preserve the marginal mandibular nerve (MMN) during routinely performed head and neck surgical procedures. Main body of abstract Preservation of the functional integrity of the MMN is a critical measure in the success of orofacial surgeries involving the submandibular triangle. This study systematically reviews the anatomical description of the nerve including origin, course relative to fascial planes, relation to the parotid gland and facial pedicle, branching pattern and anastomosis of nerve and consolidate the findings of several significant studies to determine the “surgically safe” approaches to avoid iatrogenic injury to MMN. Short conclusion The systematic approaches described in this study have helped the authors precisely determine which particular MMN preserving approach to be adopted for each aspect of head and neck surgery. This has definitely enhanced the quality of surgery performed and the postoperative satisfaction of the patients.

Assessment of Knowledge and Practice of Fresh Dental Graduates, Dental Surgeons and Specialists of Multan about Different LA Techniques for Mandibular Teeth: A cross-sectional survey

Objective: To assess the knowledge about different mandibular nerve block techniques of fresh dental graduates, dental surgeons and specialists to attain mandibular nerve block for dental treatment in Multan. Design of the Study: It was a cross-sectional survey. Study Settings: This study was carried out at Department of Dentistry at Multan Medical & Dental College, Nishtar Institute of dentistry (Nishtar Medical University) and Bakhtawer Amin Dental College from August 2019 to August 2020. Material and Methods: The study involved 220 respondents. The questionnaire was administered to fresh dental graduates (house officers) and dental surgeons in 3 dental colleges of Multan, and was collected on the same day. House officers who did not return the forms were reminded personally and contacted on the phone thrice over the following week. Results of the Study: The frequency of respondants who could administer Gow-Gates without supervison was 20.9% (n=46). Participants from NID, Multan had the highest frequency (35.3%) with the lowest in BIMDC (16.6%)and MMDC(20.6%). The differences were non-significant (p=0.19). Significantly higher frequency of male respondants (10%, n=22) claimed they could administer Gow-Gates without supervison compared to female respondants (5.4%, n=12, p=0.012, Chi-Square). Training for Gow-Gates had been received by 12.7% (n=28) of the House Officers and dental surgeons. The Highest frequency of training was in NID, Multan (5.4%, n= 12, p= 0.016, chi-square). Conclusion: The majority of the dental practitioners of Multan used IANB as their primary LA technique and intraligamental injections as a supplemental LA technique in their clinics to attain mandibular molars anesthesia for general dental procedures like fillings, root canals and extractions. Keywords: Mandibular local anesthesia, Inferior alveolar nerve block, Gow-Gates technique

Maxillary Artery runs medial to the mandibular nerve unilaterally: Case report and Literature Review

Background: The maxillary artery supplies the deep structures of the face and cranium. The maxillary artery and the mandibular nerve form a clinically important relation in the infratemporal fossa. Variations of the maxillary artery may complicate dental, oral, and maxillofacial surgeries in this region. Methods: During routine academic dissection of a 91-year-old Caucasian female cadaver, the pterygoid segment of the left maxillary artery was found medial to the posterior division of the mandibular nerve in the infratemporal fossa. Results: The maxillary artery coursed superior to the point of division of the mandibular nerve and remained undivided. Conclusion: This rare unilateral variation will be of interest to anatomists and clinicians, as an understanding of anatomical variations of the maxillary artery can help decrease the risk of hemorrhage and other surgical complications. KEY WORDS: Maxillary artery, Mandibular nerve, Lateral pterygoid muscle, Infratemporal Fossa.