Publication

Abstract :

Background: Gingivobuccal carcinoma is one amoung the squamous cell carcinoma found in the oral cavity. The lip, tongue, buccal mucosa, gingivobuccal (GB) sulcus tumours are more common. This is because of the extensive usage of quid of tobacco with lime which is kept in GB sulcus. Management will depend upon the stage of disease as early stages treated by surgery alone and advanced stages require multimodality treatment which involves chemoradiation in addition to surgery.

Case history: The patient complaining of non-healing ulcer in oral cavity, halitosis, odynophagia and trismus was heated. This case report discuss the effective management with Jalukavacharana (local application of leech) on a case diagnosed as gingivobuccal carcinoma measuring 5.5 × 3.7 cm in axial dimension and 4.5cm supero-inferiorly with multiple rounded lymph nodes in submandibular region and who underwent ultrafast multislice multiplanar pre and post IV contrast CT scan of neck. Jalukavacharana was done externally over the large mass in right buccal wall for a period of 1 month i.e.; weekly once with four sittings.

Results: Progression of symptoms in Gingivobuccal carcinoma especially odynophagia and trismus is effectively managed by Jalukavacharana modality which is one among Raktamokshana (bloodletting) procedure. This is because the leech saliva contains numerous bioactive constituent which possess anti-inflammatory, analgesic, thrombolytic, antioxidant, vasodilator, anti-coagulant and blood circulation enhancing factors.

Conclusion: This case reveals that the Gingivobuccal Carcinoma can be effectively managed by Jalukavacharana modality which is one among the Raktamokshana Marga (route of bloodletting). Due to its proximity to mandible and posteriorly infratemporal fossa, extent of surgery remains critical to provide cure with satisfactory functional and esthetic outcomes. On this principle, studies must be conducted to validate the management of this condition. Further studies are needed to assess the sustained results.