Journal of Case Reports in Medical Science

Comparative Analysis of Scalpel and Diode Laser Surgical Methods in Management of Traumatic Fibroma

2026-01-06T11:54:16+00:00

Aims: To compare the clinical outcomes of conventional scalpel excision and diode laser ablation in the management of traumatic fibroma.

Presentation of Case: This report presents two cases of traumatic fibroma treated using different surgical modalities. In Case 1, a traumatic fibroma was excised using a conventional scalpel technique, resulting in complete lesion removal with satisfactory healing at 15 days and no recurrence at one-month follow-up. In Case 2, excision was performed using an 880-nm diode laser, which provided excellent intraoperative haemostasis, minimal patient discomfort, and rapid postoperative healing without scarring within eight days. Histopathological examination in both cases confirmed the diagnosis of traumatic fibroma.

Discussion: Both treatment modalities were effective in achieving complete lesion removal. However, diode laser excision demonstrated superior clinical advantages, including better haemostasis, reduced postoperative discomfort, and faster wound healing compared to conventional scalpel excision.

Conclusion: While both scalpel and diode laser techniques are effective for the management of traumatic fibroma, diode laser excision offers enhanced clinical efficiency and patient comfort, making it a valuable alternative for soft-tissue lesion management.

Resolution of Neck Pain and Recovery of Drug-associated Erectile Dysfunction Following Conservative Management in Cervical Spondylosis: A Case Report

2026-02-27T10:38:28+00:00

Cervical spondylosis is a degenerative disorder of the cervical spine that commonly causes chronic neck pain and functional limitations in older adults. Although pharmacologic therapy, including neuropathic pain agents, is usually the first line of management, it can cause adverse effects such as erectile dysfunction, which may limit its usefulness and necessitate conservative management like physiotherapy.

A 67-year-old male civil servant presented with a six-month history of right-sided neck pain and a burning sensation that began after abrupt neck rotation during exercise. Radiographs showed osteophyte formation and straightening of the cervical lordosis. Medical management included Amlodipine, Neurovite, and the neuropathic pain agent Gabapentin, which provided minimal relief but triggered erectile dysfunction shortly after initiation, prompting discontinuation and referral for physiotherapy.

The patient underwent eight physiotherapy sessions over four weeks, consisting of cervical mobilization (Grades II and III), soft-tissue mobilization, cryotherapy, progressive neck stabilization exercises, strengthening exercises, and ergonomic counseling.

Following treatment, pain reduced (NPRS: 8/10 to 2/10), disability decreased (NDI: 27% to 8%), and the drug-induced erectile dysfunction completely resolved (IIEF-5: 10/25 to 25/25). Cervical range of motion improved across all planes, and no radicular signs were observed.

This case highlights the role of structured physiotherapy in improving pain and function in cervical spondylosis and was associated with recovery of drug-related erectile dysfunction after medication cessation, although causality cannot be definitively established.

Venous Malformation of the Buccal Mucosa in a 65-Year-Old Female: A Case Report

2026-03-12T05:42:16+00:00

Aim: To present a case of venous malformation of the buccal mucosa in an elderly patient and to emphasize the role of clinical and radiologic evaluation in establishing an accurate diagnosis.

Case Presentation: A 65-year-old female reported a painless swelling on the left buccal mucosa that had been present for three months. Clinical examination revealed a localized, soft, bluish lesion that was compressible and demonstrated blanching on diascopy, indicating a vascular origin. Based on initial findings, hemangioma was considered provisionally. To further assess the lesion, Doppler ultrasonography was performed, which revealed a low-flow vascular pattern consistent with a venous malformation.

Discussion: Accurate distinction between vascular tumors and vascular malformations is essential, as their biological behavior and treatment approaches differ. Sole reliance on clinical appearance may lead to misdiagnosis, particularly in older patients. Doppler imaging provides valuable information regarding flow characteristics, enabling precise classification and appropriate treatment planning.

Conclusion: Comprehensive evaluation combining clinical examination and imaging is crucial for correct diagnosis and rational management of oral vascular lesions.

Black Hairy Tongue in an Elderly Patient: A Case Report

2026-06-23T10:33:12+00:00

Aims: Black hairy tongue is a benign acquired disorder characterised by elongation, defective desquamation, and discolouration of the filiform papillae on the dorsal surface of the tongue. Although it is commonly associated with poor oral hygiene, tobacco use, staining beverages, xerostomia, and selected medications, it may also occur without these factors. This case report presents an elderly patient with black hairy tongue and highlights the value of clinical recognition and conservative management.

Case Presentation: A 72-year-old male patient presented with persistent dark discolouration of the tongue for the previous 2–3 years. He had no pain, burning sensation, altered taste, or halitosis, and his main concern was the aesthetic appearance. His medical and drug history was non-contributory, and he reported no tobacco use, alcohol consumption, or deleterious oral habits. He had used complete dentures for 7 years. Intraoral examination showed diffuse blackish-brown discolouration over the posterior two-thirds of the dorsal tongue, with a hairy, carpet-like appearance and elongated filiform papillae. The lateral borders and tip of the tongue were relatively normal. The diagnosis of black hairy tongue was made clinically, and no additional laboratory investigations were performed.

Management and Outcome: The patient was managed conservatively with gentle brushing of the dorsal tongue, use of a tongue cleaner, reinforcement of oral hygiene, once-daily antiseptic mouthwash, adequate hydration, denture cleaning, night-time denture removal, and reassurance. Follow-up showed a marked reduction in pigmentation and improvement in tongue texture, with gradual resolution of the hairy appearance.

Conclusion: Black hairy tongue is a benign and reversible condition. Careful clinical assessment, patient education, oral and denture hygiene, and mechanical debridement can support favourable outcomes while avoiding unnecessary interventions.