Nasolabial flap and its modifications are a group of versatile flaps used in reconstructive surgeries of face and oral cavity providing a source of pliable skin with good colour match! However, scar on the face is a serious limitation and therefore, needs careful planning.

Full thickness defects of ala of nose can be reconstructed by local flaps or composite graft. Pinna provides an excellent source of composite graft. The present case already had an oblique facial scar near the nasolabial fold, therefore the incision for flap was modified to keep the same scar line.

An emergency procedure every Maxillofacial Surgeon should be well versed with, is Tracheostomy. A procedure to gain access to airway in both elective and emergency situations, tracheostomy can be done under local anesthesia. Horzontal Incision gives more esthetic result and vertical incision allows faster surgery. After sharply dissecting through skin and superficial fascia, the key to a good tracheostomy is to remain in the midline. Midline provides a relatively avascular plane and prevents potentially life threatening complications like false intubation, injury to oesophagus and Neurovascular complications

Excision defects of mucosa may result after surgical treatment of lesions like Leukoplakia, Erythroplakia, Erosive Lichen Planus. If small, they may be closed primarily, otherwise the options include Collagen membrane dressing, Plancental membrane dressing, Split thickness skin graft and local flaps.

Anterior surface, medial surface, lateral surface of Thigh are good donor sites for Split thickness Sking Graft. Since the cheek mucosa is mobile, quilting is recommended. An alternative (not prefered by us) is to use a bolus dressing tied over the the graft securely.

Internal derangements of TMJ frequently reach a point where the articular disc cannot be salvaged due to advanced degenerative changes and require Disectomy with or without condylar shave. TMJ can be approached through various incision like preauricular and its modifications, endauricular, postauricular, retromandibular, Rhytidectomy etc. Protecting the facial nerve is the prime consideration. Incision through the capsule close to the lateral lip of artcular fossa reveals the superior joint space. The disc can be reconstructed with temporalis muslce/fascia, cartilage graft or alloplasts. Temporalis muscle/fascia is a reliable donor source and doesn’t have the problem of extrusion as is sometimes seen with alloplastic materials

Eagle’s syndrome is primarily managed surgically by styloidectomy. Intraoral Styloidectomy is preferred as it avoids a submandibular scar. However, when it has to be combined with submandibular gland resection, an extraoral approach is preferred. A submandibular incision 2 cm below lower border of mandible through skin and platysma is given. Marginal mandibular nerve must be preserved. Anterior belly of digastric is identified and traced back to posterior belly. Retracting the posterior belly down reveals styloid process.

Submandibular gland can be removed with or without ligating the facial artery. Hypoglossal nerve and Lingual nerve must be preserved.

Oral Squammous Cell Carcinoma Primarily spread to Neck lymph nodes, therefore, their management frequently requires neck dissection along with wide excision of the tumor. Neck dissection can range from Supraomohyoid Neck dissection to Radical Neck Dissection. However, current research is more in favour of Modified Radical Neck Dissection which preserves Spinal Accessory Nerve, Internal Jugular Vein and Sternocleidomastoid. Some of the factos that affect the decision are the tumor size, location, histological variant, possibility of followup, possibility of multimodal therapy etc. Mc Fee incision gives a good exposure combined with safety of cover on the carotid furcation.

Eminectomy is one of the surgical modalities of treatment of Recurrent or Long standing TMJ Dislocations. The joint is accessed through Preauricular or Endauricular or Post auricular approach. The incision is made through skin and superficial fascia The superficial layer of deep temporal fascia is incised. Disssecting between the two layers of deep temporal fascia saves the facial nerve branches. A periosteal incision exposed the articular eminence. A slightly inferiorly directed eminence osteotomy completes the eminectomy. Layered closure of the wound is necessary.

Orthognathic surgeries aim to correct the deformities of the face. Bilateral Sagitttal Split Osteotomy (BSSO) is one of the most frequently employed procedures to correct mandibular deformities.

Dental Implants have become the mainstay of management of edentulism with many advantages over the conventional prosthesis. An implant supported prosthesis may take various forms like implant supported bridge, implant and tissue supported overdenture, implant supported overdenture and the All-on-four concept.

Calverial grafts are harvested from the parietal bone to reconstruct various bony deformities of face. The presented case involved reconstructing a post-traumatic deformity of frontal bone with Calverial Bone Graft. Exposure of the site was done through bicoronal flap.