Hybrid Treatment Protocol to manage a potentially Malignant Ulcer of Tongue
Narayan Memorial Hospital, Behala successfully treated 42-year-old man suffering from Potentially Malignant Ulcer of Tongue through Hybrid Treatment Protocol Management procedure. This path breaking treatment module creates a new ray of hope for the patients suffering from similar types of life-threatening mouth ulcers as derived from chewing of tobacco, betel nuts preparations. This present case was successfully handled by Lt. Col (Dr.) Indranil Mukhopadhyaya (Retd) and Dr. Camelia Saha at Narayan Memorial Hospital, Behala with the availability of state of art equipments and highly skilled team of the hospital.
A 42 year old male patient visited to Lt. Col. (Dr.) Indranil Mukhopadhyaya (Retd), senior consultant oral-dental surgeon, specially trained in stomatologist and Advance Laser Surgery at NMH-Behala, with a big sized white patch like ulcer on left lateral side of his tongue since 3-4 months (as the patient noticed), along with difficulty in chewing food, speaking due pain sensation from ulcer. He, before consulting Dr. Mukhopadhyaya, visited a few reputed health establishments of the city but he was neither satisfied about the treatment plan nor he was convinced with the answers as was replied to.
Patient was motivated by one of his distant relatives, who was offered curable treatment for his atypical mouth ulcer by Dr. Indranil Mukhopadhyaya after a long suffering. While examining the patient physically, it was noticed that he was too much anxious about the slowly progressing painful tongue ulcer, for which his food intake was also restricted. Patient gave history of considerable weight loss, probably related to anxiety.
Dr. Mukhopadhyaya, who was experienced to accept these types of challenges first decided to reduce the anxiety and fear psychosis of the patient while sharing the detailed information as much required by the patient to know about his sufferings after thorough examination. Col. Mukhopadhayaya first ensured the cessation of tobacco and betel nut chewing habits completely. A plan of biopsy followed by histopathological evaluation was chalked out for 3 cm x 2.5 cm large white, elevated non- scrapable ulcer of lateral border of tongue. Few essential blood tests and CT scan of head-neck area was carried out as a pre biopsy preparation and to rule out the possible metastatic spread of the potentially malignant ulcer.
The real problem started when the patient was reluctant to undergo excisional biopsy in hospital, as he feared of getting COVID-19 infection, as the time was in the middle of the second wave of the pandemic. So, the patient was put on some conservative treatment as modified effectively by Dr. Indranil Mukhopadhayaya and was reviewed after one month (after making the patient very much aware that this delay may complicate the present situation of his disease).
In the subsequent visit, the ulcer found to be reduced in size 1 cm x 1 cm from its larger original size, LASER excision was carried out (along with normal surrounding structure) without anesthesia bloodlessly and without any premedication, pre-operatively as well as post operatively to manage pain or infection. A LASER bandage was offered over the excision site to cover and protect the fresh wound from possible secondary infection and also to offer fast healing of the operation site.
Patient was reviewed post operatively, periodically and the complete healing was noticed without any anatomical or functional deficit.
The Team of Surgeons available 24/7 at the hospital aims to provide the residents of Behala and its adjoining areas a complete solution regarding health related queries, offering the very best of facilities close at hand. The advance facilities also help to save precious time for patients by minimizing the distance that one will otherwise have to travel for acquiring quality treatment, have a clear diagnosis and also provide inputs on prevention.
Narayan Memorial Hospital, Behala has the best facilities with the latest technologies and multi departmental support. The medical infrastructure includes 200-beds, multispecialty departments, 5 operation theatres with positive pressure, laminar flow, well equipped with all modern gadgets for safely conducting all complicated surgeries, 30-bedded intensive care unit, 15-bedded dialysis unit, 5 open care system of level III NICU, Isolated pressurized ICU with modern equipment, 6 super deluxe suits with attached guest room, sitting room and a small pantry, specialist doctors and technicians at your service. The ‘Patient First’ policy of NMH will redefine healthcare in the city.