Nishant Khare

Mouth opening among different population has been shown to vary considerably and its range is specific for a given population. The present study is an attempt to calculate the normal mouth opening in adult Indian population. A total of 894 adults, 463 males and 431 females, in the age range of 21 to 70 years were studied. The subjects were asked to open their mouth maximally till no further opening was possible. The distance from the incisal edge of the upper incisor teeth to the incisal edge of the lower incisor teeth was measured using a calibrated fiber ruler. To determine correlation of mouth opening with age a Pearson correlation analysis was performed and statistical significance was tested by the application of t test. The mean maximal mouth opening for males was 51.3 mm (SD 8.3) (Range 39–70 mm). The mean maximal mouth opening for females was 44.3 mm (SD 6.7) (Range 36–56 mm). There was significant difference between the mouth opening of male and female in all the age groups with P value <0.05. A linear relationship was observed between the mouth opening and age in both males and females and the mouth opening decreased as the age increased. The mean maximal mouth opening for Indian males is 51.3±8.3 mm and for females is 44.3±6.7 mm. The mouth opening seems to decrease with age. The mouth opening of females is significantly less than the males in all the age groups.

Background: Resection of eyelid malignancies leads to complex reconstructive problems due to the functional and aesthetic importance of an eyelid. Hence, a large number of such cases are referred to plastic surgery facilities. Eyelid malignancies are of varied histological types and the western and Asian data have considerable variations in case distribution and presentation. This study is an attempt to characterise these tumours in the Indian population. Materials and Methods: The present study is a retrospective analysis of 85 consecutive cases of eyelid malignancies that reported to a tertiary health care facility in central India over a 15-year period starting from January 1996 up to December 2009. The cases were analysed for their age of presentation, sex distribution, tumour location, delay in seeking treatment, recurrence rate and variations with respect to the pathological subtype. Observations: Mean age of presentation for all the malignancies was 59 years. The median age of presentation was 65 years for basal call carcinoma (BCC), 58 years for sebaceous gland carcinoma (SGC), 55 years for squamous cell carcinoma (SCC) and 45 years for malignant melanoma. There was slight female preponderance as 56.28% of the patients were females. The most common location of the tumour was lower lid (58.2%) for all the malignancies. BCC was the most common malignancy (48.2%) followed by SGC (31.2%) and SCC (13.7%). Mean duration of symptoms was 9 months (range 3-21 months). The most common presenting complaint was mass with ulceration across all histological subtypes. Other associated complaints included itching, discharge from eye, pain and ptosis. The mean size of tumour at diagnosis was 2.34 ± 0.4 cm for BCC, 2.19 ± 0.6 cm for SGC and 1.99 ± 0.7 cm for SCC. The mean rate of growth of BCC was 1.39 cm/year. The corresponding values for SGC and SCC were 3.63 and 4.89 cm/year, respectively. The rate of follow-up was 89% at 3 months, 71% at 6 months, 62% at 1 year and 31% at 5 years. Recurrence rate was 1.9% for BCC and 12.7% for SGC. Surgical methods used included wedge excision and primary closure, excision and skin grafting, and tarso-conjunctival flap. Conclusions: We recommend that the surgeons treating eyelid malignancies in India should have a high index of suspicion for SGC. A wider margin of 10 mm is recommended for SGC excision as opposed to 5 mm for BCC.

Background: The shapes of the eyebrow and upper eyelid are distinctive facial landmarks. In cosmetic and reconstructive procedures, maintenance of th

We are experiencing greater demand for aesthetic surgery from rural populations. The present study attempts to understand their concepts and beliefs. A double-blinded survey with random sampling was done in 34 villages in central India. Sample population consisted of 1,000 unmarried rural women in the age range of 18–30 years. Subjects were interviewed in person and a questionnaire was filled out based on their response. The response rate was 87.2%. Of the 872 respondents, 829 (95%) were aware of aesthetic surgery. Television was the most common source of information (61%). Health-care providers were a source of information for 2.5% of respondents. Aesthetic surgery was associated with “some change in face” by 35.7% of subjects. Surprisingly, 29.1% associated aesthetic surgery with face transplantation. The need for aesthetic surgery was perceived by 85.7% respondents. The face was the most common part of the body perceived to require aesthetic surgery (40.9%). Fifty-seven percent of respondents failed to identify the procedure required for aesthetic correction. Of the 711 respondents who perceived the need for an aesthetic procedure, 83.8% were willing to undergo surgery. Improved marriage prospects were the most common reason for seeking surgery. Cost was the most important variable considered while choosing surgery (49.3%). Cost was also the most frequent response when asked about the biggest fear (63.1%). We recommend that scientific knowledge should be provided to the rural population, cost should be limited to a reasonable level, and the social needs of these patients should be fulfilled to ensure a greater reach of aesthetic procedures.

Background: The past decade has seen tremendous changes in the management of cleft deformities with the advent of the Smile Train project. The present study evaluates the effect of the Smile Train project on the demographics of cleft deformities. Method: Data collected over the past three decades were studied retrospectively. The number of cases, age at presentation, and relative proportion of cleft lip–cleft palate patients were analyzed. Thirty patients operated on at the authors' institute for cleft lip deformity were evaluated for their awareness of cleft deformities, and the results were compared with those of 22 patients operated on elsewhere in camp settings. Results: The numbers of patients with cleft deformities treated at the authors' institute from 1980 to 1989, 1990 to 1999, and 2000 to 2009 were 1189, 1050, and 374, respectively. However, the number with cleft palate has remained nearly constant over the three decades. The mean age of reporting for treatment of cleft palate was 16 months after being operated on for cleft lip at the authors' institute and 41 months after being operated on elsewhere in camps. All patients operated on at the authors' institute expressed awareness of holistic treatment of cleft deformities. Of the 22 patients operated on at other camps, 16 were ignorant about the time scale and 19 were unaware of the consequences of nonadherence to the treatment protocol. Nineteen of the 22 patients felt that enough information was not provided to them at initial surgery. Conclusion: The authors recommend that cleft counseling, continued cleft care for the complete complex of deformities, and responsible behavior by the initial operating team should be the goals for the future.