1.The stage and treatment of malignant neoplasm of maxillary sinus
Mongolian Medical Sciences 2014;167(1):20-22
INTRODUCTION: Most patients with malignant neoplasm of maxillary sinus have no symptoms in the
early stage and therefore, many of these patients are diagnosed in the advanced stage of the
disease. The complexity of the anatomy and the proximity of the eyes, brain and cranial nerves
render complete surgical resection difficult, which leads to local recurrence, a major cause of
treatment failure. The incidence seems to vary in different parts of the world, with Asian countries
reporting high numbers of cases. Malignant neoplasm of maxillary sinus is very difficult to treatment
and traditionally has been associated with a poor prognosis.
GOAL: To study the stage and treatment of the malignant neoplasm of maxillary sinus.
MATERIALS AND METHODS: 130 patients who had been diagnosed with malignant neoplasm of
maxillary sinus at National cancer center of Mongolia between 1 January 2003 and December 2013
were reviewed. The following data were collected: malignant neoplasm staging, types of treatment.
Malignant neoplasm staging was done using the 7th edition of the American Joint Committee
on Cancer (AJCC) classification, and retrospective restaging was done in previously diagnosed
patients.
RESULTS: There were 81 (62.4%) male and 49 (37.6%) female patients with a mean age of 53.18
years. Malignant neoplasms were classified retrospectively using the AJCC Staging System tumor
classification was 5 (3.8%) were staged as II, 17 (13.1%) were staged as III, 108 (83%) were staged
as IV, none stage as I.
Malignant neoplasm of maxillary sinus to most infiltrated into nasal cavity (75 cases).
In total, there 130 patients were submitted only to surgery 20.7%, to radiotherapy 22.3%, to
chemotherapy 6.9%, to combination therapy 42.3%.
CONCLUSIONS:
1.The higher the patient’s clinical stage was, the worse his prognosis was.
2. In this study the most commons treatment was combination of therapy. Combination of therapy
may be the best treatment for patients with maxillary sinus malignant neoplasms.
2.Study results on determining the cases of bifid mandibular canal by the panoramic radiography
Bujin E ; AIdarmaa T ; Khentii L
Mongolian Medical Sciences 2011;158(4):22-25
BackgroundThe mandibular canal passes the interior mandibular from the mandibular foramen to the mental foramen, involving the inferior alveolar artery and inferior alveolar nerve. The location and configuration of mandibular canal variations are important in surgical procedures involving the mandible, such as extraction of an impacted third molar, dental implant treatment, and sagittal split ramus osteotomy.Purpose: Determine the case of the inferior alveolar nerve branching by the panoramic radiography.Materials and Methods: Especially chosen 384 (768 mandibular canal) digital panoramic radiographies of 147 males and 237 females aged above 5, who were attended the radiology cabinet of Dentistry, HSUM, in 2005-2010.Inclusion criteria:• With clear view of the mandibular canal ramus types.• No injury in mandibular, its ramus, no pathology, no operated. Radiographies of people aged above 5.The digital panoramic radiographies of mandible and maxilla were observed by l-VIEW 2D software of VERAVIEWEPOCS apparatus, MORITAcorp., Japan.Results: The 6.6% (51) case of bifid mandibular canal was determined by the panoramic radiography. Mandibular canal branching was defined in 24 males, 27 females; right mandibular canal branching was in 45.1% (23) cases, in the left - 54.9% (28). Mandibular canal bifid canal-78,4% (40), double canal-3,9% (2), trifid canal-2% (1), type with 2 foramen mandibular -15,7% (8). We classified the mandibular canal ramus by the Langlais: on the right side - Langlais I-8, Langlais II-6, Langlais III-5, Langlais IV-3, the leftside - Langlais 1-11, Langlais II-4, Langlais III-6, Langlais IV-4. 20 cases of bifid canal was detected at age 5-20, 26 cases - at 21-35 , 4 cases - at 36-55, 1 case - at 56-65, and there was no any bifid canal after 66.Conclusions:1. A total of 6,6% of the radiographs studied in the present study demonstrated mandibular canal variations. No difference in the prevalence of variations was observed in relations to age, gender and side of the jaw.2. Mandibular canals were classified as Langlais et al types; type I was dominated (19), Langlais IV - rare case (7).3. In accordance with the study the 21-35 aged persons have more (26) mandibular canal types, and for the people aged 56-65 it was rare case (1).
3.CLINICAL FEATURES AND SITE DISTRIBUTION OF TONGUE CANCER
Oyuntsetseg D ; Urjinlkham J ; Khentii L
Innovation 2017;11(4):46-51
BACKGROUND: The incidence of oral cancer is differed in the world. Oral cancer incidence was high in Melanesia, South-Central Asia, East and Central European countries,3 while it was likely to be low in Africa, East Asia, and Central American countries.
METHODS: The study was carried out by retrospective method, by using the medical reports obtained from the National Cancer Center of Mongolia.
This study, based on retrospective method was conducted from medical reports of 68 patients who were diagnosed with squamous cell carcinoma of the tongue and at the Department of Head and Neck Surgery, Radio and Chemotherapy of the National Cancer Center of Mongolia between 2005 and 2014.
The data was analyzed using SPSS 20.0 software; descriptive and detailed statistical analysis was made. Assumptions were examined by H2 testing method; it shall be statistically significant when P value is less than 0,05.
RESULTS: The median age of the 68 patients at diagnosis was 58 years (range=31-85 years) and were 57% (39) men, 43% (29) women with a male to female ratio of 1.3:1
The most common cancer sub-sites reported were lateral border (60%)
Considering the composite stage of the disease, 25% patients were in early stages (I-8.8% and II-16.2%) whereas 75% were in advanced stages (III- 36.8%, IVA- 20.6%, IVB-17.6%).
At the time of presentation, majority of the patients had T3 lesions 44.1%, followed by T1 in 11.8%, T2 in 29.4%, T4 in 14.7%. Regional lymph node involvement was present in 54.4% (N1-25%, N2-17.6%, N3-11.8%) Considering the correlation between tumor size and cervical lymph node metastasis was present in 25% of of T1 tumours, 45% of T2 tumours, 66.7% of T3 tumours 60% of T4 tumours. There was no correlation between the tumor size at the primary site (T-status), and the presence of lymphatic spread (N-status) p=0.357.
CONCLUSION: Our study showed that oral tongue cancer is majority occur in fifth and sixth of life and with a male predominance. Tongue cancer had more occurred at the lateral border (60%) and majority of the incidence (75%) is in the advanced stages III or IV. Based on the data in this study, it is possible to conclude that health education and health promotion must be encouraged by public health policies in order to diagnose in early stage and reduce the incidence and mortality rates of tongue cancer.
4.The risk factor and clinical type of tongue cancer
Oyuntsetseg D ; Khentii L ; Urjinlkham J
Innovation 2018;12(4):49-
The incidence of oral cancer is differed in the world. Oral cancer incidence was high in Melanesia, South-Central Asia, East and Central European countries,3 while it was likely to be low in Africa, East Asia, and Central American countries.
Our study purpose was to determine the risk factor of tongue cancer and to study between correlation T, N stage and type of tongue cancer.
The study was carried out by retrospective method, by using the medical reports obtained from the National Cancer Center of Mongolia.
This study, based on retrospective method was conducted from medical reports of 68 patients who were diagnosed with squamous cell carcinoma of the tongue and at the Department of Head and Neck Surgery, Radio and Chemotherapy of the National Cancer Center of Mongolia between 2005 and 2014.
The data was analyzed using SPSS 20.0 software; descriptive and detailed statistical analysis was made. Assumptions were examined by H2 testing method; it shall be statistically significant when P value is less than 0,05.
The median age of the 68 patients at diagnosis was 58 years (range=31-85 years) and were 57% (39) men, 43% (29) women with a male to female ratio of 1.3:1.
Of 37 patients who were tobacco users 66.7% (26) were male, 37.9% (11) were female, among the alcohol consumers (35.9% (14) were male, 10.3% (3) female). This difference between male and female consumption was significantly different according to the test Pearson p=0.019 for tobacco, p=0.016 for alcohol.
There was trend toward more higher N stages in endophytic tumors, with 69.3%, in ulcerative tumors, with 66.7% of these cases presenting with nodel involvement, 45% of patients with exophytic tumors.
Our study showed that oral tongue cancer in majority occur in fifth and sixth of life and with a male predominance. Smoking and drinking alcohols are two major risk factors for SCC of tongue cancer. Although not significant, it has been suggested that endophytic tumors have a higher propensity to metastasize to cervical lymph nodes than exophytic tumors.
5.A comparison result of primary cleft palate repair by various techniques
Erdenetsogt J ; Ayanga G ; Batbayar B ; Khentii L
Mongolian Medical Sciences 2021;198(4):20-26
Background:
The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal
impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of
the most common complications after the primary cleft palate repair is velopharyngeal insufficiency,
which leads to the subsequent surgery. The velopharyngeal function assessment characterizes
speech development in children. Researches noted that velopharyngeal insufficiency causes in
5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary
surgical method for each particular type of cleft palate.
Objective:
To compare velopharyngeal function using nasopharyngoscopy after primary CP repair
Materials and Methods:
The patients who with congenital cleft palate and, underwent primary cleft palate repair in the
Department of Maxillo-facial surgery of the National Centre for Maternal and Child Health and had
velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence
and oronasal fistula postoperatively were excluded from the study.
Cleft palate was classified according to the Veau system and Golding-Kushner scale of
nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with
cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact
test were used for statistical analysis.
Results:
A total of 335 patients were included in the study. The mean age at primary palate repair was
22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III
type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow
technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von
Langenbeck technique.
Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow”
technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in
48.1% and Von Langenbeck technique in 47.1% cases.
Conclusion
The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after
primary palatoplasty.
6. EPIDEMIOLOGIC STUDY OF ORAL AND MAXILLOFACIAL SURGERY PATIENTS IN MONGOLIA
Davaadorj P ; Otgonbileg E ; Bold M ; Odkhuu J ; Purevdorj G ; Denis S ; Ayanga G ; Khuderchuluun CH ; Batbayar B ; Baasanjav N ; Oyunaa CH ; Budmaa S ; Khentii L
Innovation 2015;9(Dentistry):16-20
The purpose of this study was to analyze the epidemiology of oral and maxillofacial surgery patients in Mongolia and advocate guidelines and programs to promote optimal oral health care. A fact-finding epidemiologic study on the patients who visited at Departments of Oral and Maxillofacial Surgery, at National Hospitals at Ulaanbaatar city and Province and other Central hospitals of Mongolian, from Jan to Dec, 2013.Total 12957 patients treated at inpatients care center at the above mentioned national hospitals. From Ulaanbaatar city were 4284 (36%) and from province were 7673 (64%). Patients from province were treated at FCH 69%, NTORC 6.4%, NCC 11.3%, NCMCH 27% and CMAFH 1.8%. Zero to 16 years, 17 to 36 years, 37 to 56 years and 57 or more years old patients were3072 (27.1%), 4224 (34.2%), 3218 (26.9%) and 1412 (11.8%), respectively. Males and females were 6841 (53%), 6090 (47%). Cases of the inpatients were as follows: infectious disease 5971 (49.88), benign tumor 1039 (8.01%), trauma & injury 1799 (15%), salivary gland disease 2.41%, TMJ disease 2.8%, neuralgia and muscle pain 0.8% and others. 5 provinces have no Oral and Maxillofacial Surgeon and patients were referred to other central hospitals or to the Ulaanbaatar city. This study gives a topic of conversation about undergraduate dental education, continuing education and enough specialists in the region.