DISCUSSION
Cases of caustic soda ingestion and subsequent surgery have been rarely reported in the literature. Many grafting materials are tried in the reconstruction.[1] Skin graft was also used by many surgeons in the past, but was not considered as a popular choice of graft material in such situations, because of dehiscence and further loss of the skin graft and thereby relapses, but in our case skin graft was taken up very well. Even after 1 year of the surgery, no complication has been reported. In this particular case, tongue was totally fixed to the floor of the mouth (no movement). Releasing the tongue from the floor and placement of skin graft at the ventral side of the tongue produced an excellent result with sufficient mobility of the tongue.
OSMF is still a condition present very commonly especially in developing countries due to known reasons of chewing tobacco, pan, etc. Various medicinal and surgical treatments are being recommended and performed, depending on the severity and duration of the disease.[2] Our case was diagnosed as OSMF 10 years back and she was given all the possible medicinal treatments including intralesional corticosteroid injection but the patient was not relieved of the disease. When she came to us, we proposed the surgical option and did bilateral resection of the bands, coronoidotomy and reconstruction using buccal pad fat graft, followed by vigorous physiotherapy. Though it was a tough decision for the patient to be ready for this kind of surgery, she gave the consent and the result of buccal pad graft is also very encouraging.
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Space infections can cause trismus; timely intervention in the form of incision and drainage is the key in such a situation.
Patients of temporomandibular ankylosis have trismus and limited mouth opening ranging from zero to a few centimeters. The first goal was to achieve adequate mouth opening and the second goal was to maintain this by the physiotherapy. We got excellent result by osteoarthroplasty.
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Zygomatic arch fracture, if depressed, restricts the movement of coronoid process and can cause temporary trismus which can be simply corrected by elevating the arch. Sometimes, the zygomatic arch/bone unite with the coronoid process (malunited fracture). Patients go in a trismus which can be corrected by refracturing the arch and the coronoid process and achieving the mouth opening.
Although cases of trismus condition come to clinician not quite often and it seems that these cases are sometimes difficult to diagnose, if we take proper history and do thorough clinical examination and investigations, one can treat these cases very efficiently.
We encountered a few cases of trismus with varied etiologies. But each one of them had undergone the treatment according to the underlying cause.
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Category: WHY
