Osteochondroma is an osseous protuberance with cartilaginous growth potential that usually forms at the ends of long bones such as knee, hip, shoulder and joints(1). Osteochondromas are one of the most common benign tumours of bone, approximately 35% to 50% of all benign tumors and 8% to 15% of all primary bone tumors (2). Only about 1% of these occur within the head and neck region (1). The most common sites of occurrence is coronoid process of the MANDIBLE and the mandibular condyle(3-5). Trauma and inflammation have been implicated as predisposing factors (6, 7). Clinical Feather of condylar osteochondroma include facial asymmetry, vertical elongation of the face on the affected side, malocclusion with cross-bite on the contralateral side and lateral open bite on the affected side, TMJ dysfunction symptoms such as pain Which may resemble those seen in patients with temporomandibular joint disorders (TMD) (2-8). Differential diagnosis of slow-growing tumors of the mandibular condyle include giant cell tumor, condylar hyperplasia, vascular malformation, osteoma and chondroma (9, 10). these lesions are radiopaque and are easily identified on computed tomography (CT)(11). Pre operative computed tomography scans (CT) are essential in the treatment planning of these tumours(12). Cone beam computed tomography (CBCT) is a good alternative modality for evaluation of mandibular condyle. in comparison to CT scans, CBCT provides geometrically accurate images and excellent spatial resolution with lower dose(13). These condylar tumors have been variably treated. Partial or total condylectomy, vertical ramus osteotomy and adjuvant orthognathic surgery are possible modes of treatment depending on cosmetic defect. Reconstruction plan depends on the case to case situation and can be performed by upward placement of sagittally or vertically splited ramus, locally available bone graft with attached medial pterygoid muscle, costochondral graft or a custom-made titanium plate(14). The aim of this case report is to describe clinical, radiographic features, differential diagnosis, histopathologic feater and treatment of condylar osteochondroma.

Fibrosarcomas is an uncommon connective tissue growth that rises from the proliferation of malignant fibroblasts. Local recurrence is frequent, but metastasis is rare. About 0. 05% of cases are affected in the head and neck. We report a case of mandibular fibrosarcoma in a 30-year-old man who presented with intraoral swelling in the ridge of the left mandibular alveolus. Histopathology showed the proliferation of malignant fibroblast cells arranged in a classic herringbone pattern.

Objectives: This study is aimed at analysing the accuracy and reliability of the cone beam CT (CBCT) measurements and direct physical measurements of the posterior MANDIBLE. Materials and Methods: Eighteen cadaveric hemi-MANDIBLEs were dissected from the soft tissues and the CBCT images of the MANDIBLEs were taken. Direct physical and cone beam CT measurements of six landmarks which includes height of ramus (R), distance of lingula to sigmoid notch (LS), distance of lingula to inferior border (LI), position of lingula in relation to occlusal plane (L-OP), ramus thickness at crestal level (RT-C), and ramus thickness at midway between sigmoid notch and lingula (RT-M) were determined. Accuracy and reliability of the measurements were tested. Results: Four landmarks showed high accuracy when measuring the posterior MANDIBLE, while two landmarks, LI and RT-M, showed statistically significant weaker accuracy (p<0. 05). Inter-reliability were good for all landmarks when measured directly physically on MANDIBLEs (ICC>0. 7 and p>0. 05), but were low on two landmarks, LI and RT-C, on CBCT measurement (ICC<0. 5 and p<0. 05). Conclusion: A generally strong accuracy between direct physical and CBCT measurements for most landmarks on posterior MANDIBLE were found. Reliability between two researchers were high on direct physical measurements. Meanwhile, two landmarks on CBCT which include LI and RT-C showed low inter-reliability. Hence, CBCT measurements proved to be a good tool for pre-operative assessment, since high inter-reliability and strong accuracy corresponding to direct physical were recorded.

Langerhans cell histiocytosis is a relatively rare unique disease process characterized by an abnormal proliferation of immature dendritic cells usually affecting children and young adults. Jaws are involved in less than 10% of children with the disease while mandibular involvement in young children is uncommon and bilateral affection is very rare. The purpose of this report is to describe a unique and very rare case of simultaneous and bilateral occurrence of Langerhans cell histiocytosis in both the jaws of a four-year-old boy.

Introduction: Chondrosarcomas (CS) are malignant mesenchymal tumours with cartilaginous differentiation that rarely affects the maxillofacial region. It accounts for approximately 10-20% of malignant bone tumours. The CS is rare in occurrence with aggressive course with high malignant potential, and poor prognosis. Case Report: Here we report a rare case of a 37year old female presenting tumoral mass in the lower jaw, for the past 3 years, which was gradually progressive in nature with an area of skin ulceration. The CT revealed a well-defined lesion with soft tissue component measuring 15x12x10 cm in size infiltrating both right and left masseter. Biopsy confirmed the diagnosis of grade IIICS. Considering the size and aggressive nature of the lesion, surgical resection was done. The reconstruction of the MANDIBLE was done with vascularised fibula pedicle flap to achieve acceptable cosmesis. The patient was discharged uneventfully. Though few cases of high grade CS have been reported in literature but CS of this enormous size has not been reported yet. Conclusion: In this case report we documented the management of a relatively rare but challenging reconstructive maxillofacial surgery. Since in this case the CS was enormous in size and aggressive surgery was required, the cosmetic and functional outcomes were challenging. In our case report we have found that a vascularised fibula pedicle flap gives a good functional and cosmetic outcome and can be used for reconstruction of complete MANDIBLE.

Dear Editor: Salivary gland tumors consist of about 3% of all head and neck tumors. Benign tumors (mainly pleomorphic adenoma) are the most common type. About 80% of them occur in the parotid glands. Carcinomas are rare and more common in the smaller salivary glands. Benign salivary gland tumors rarely develop in the jaw bones. They arise from either the ectopic salivary tissue or minor salivary glands that are implanted in the bones. Ex pleomorphic adenomas within the MANDIBLE are extremely rare and only a few cases have been reported to date.