Various lesions of the oral cavity have always been a challenge to Radiologists., delineating the extent of a mass in the oral cavity can prove to be difficult owing to the close relation of adjacent mucosa. Very Small tumours of the oral cavity are not always visible on conventional CT studies. Even though Large tumours can be well made out on CT, it may not be always possible to determine the surface of origin of the tumour. Dynamic manoeuvres tend to distend the oral cavity and widen the window available for the radiologists. Aims & Objectives: Determining the diagnostic efficacy of Dynamic Maneuvers in Computed Tomography in better delineation of Oral Cavity lesions as compared to conventional CT Materials & Methods: 40 patients referred to Department of Radio-diagnosis, J.J.M Medical College Hospital; Davangere were selected for the study. These patients were mostly referred by the department of dental sciences for CT evaluation. The study was a hospital based prospective cross sectional study conducted over a period of of one year from june 2015-june 2016 Initially conventional CECT were performed which was later followed up with a dynamic maneouvre .later the images obtained by both were compared and the results computed. Results: Puffed cheek manoeuvre was highly useful in 73.3% of cases and was not much helpful in 26.7% in evaluation of oral lesions. Puffed Cheek CT has a sensitivity of 80% and a specificity of 28 % in accurately staging oral malignancies. Puffed cheek CT had a positive predictive value of 33.3% and a negative predictive value of 75% and an Accuracy rate of 51% compared to conventional CT in staging oral malignancies. The size of the lesion measured using puffed cheek CT technique correlates well with the actual size of the lesion seen during surgery. Thus Puffed Cheek CT scan is better than conventional CT scan for delineating the extend of the tumour and for accurate assessment of lesion size. Almost 77% of the cases included in the study were able to perform the puffed cheek maneuver with ease. Conclusion: We were able to conclude from our study that Puffed-cheek CT scans provide a clearer and more detailed evaluation of mucosal surfaces of the oral cavity than do conventional images. While standard CT can be insufficient for tumour localisation, imaging during distension may contribute to a more exact localisation. In selected patients, like those with lesions of retromolar trigone, the puffed-cheek technique may serve as a worthy supplement to conventional CT in evaluation of bony invasion and proper delineation of tumour extend. Radiological staging using cross sectional imaging is far superior to clinical staging and in assessment of metastatic neck nodes.
