Malignant Tumours of the Nose and Paranasal Sinuses

The aim of this paper is to give an overview of the most common malignant tumors of the nose and paranasal sinuses, histological types and new TNM classification and principles of oncological resection and methods of reconstruction defects based on experiences in single institutions. Patients treated at the Department of Maxillofacial and Oral Surgery of Dubrava University Hospital in Zagreb for a 20-year period are shown here. The frequency and distribution of certain types of malignant tumors of the nose and paranasal sinuses, indications and extent of surgical procedures for individual histological types, localizations and stages of the disease are presented in more detail. The principles of the nose and middle face defect reconstruction, advantages and disadvantages of individual methods are presented in detail as well. The conclusion outlines possible guidelines and algorithms for the surgical treatment and follow-up management of oncologic patients with nasal and paranasal sinus tumors

Malignant Tumours of the Nose and Paranasal Sinuses

The aim of this paper is to give an overview of the most common malignant tumors of the nose and paranasal sinuses, histological types and new TNM classification and principles of oncological resection and methods of reconstruction defects based on experiences in single institutions. Patients treated at the Department of Maxillofacial and Oral Surgery of Dubrava University Hospital in Zagreb for a 20-year period are shown here. The frequency and distribution of certain types of malignant tumors of the nose and paranasal sinuses, indications and extent of surgical procedures for individual histological types, localizations and stages of the disease are presented in more detail. The principles of the nose and middle face defect reconstruction, advantages and disadvantages of individual methods are presented in detail as well. The conclusion outlines possible guidelines and algorithms for the surgical treatment and follow-up management of oncologic patients with nasal and paranasal sinus tumors

Lymphatic drainage patterns of head and neck cutaneous melanoma: does primary melanoma site correlate with anatomic distribution of pathologically involved lymph nodes?

The aim of this study was to analyse patterns of metastatic spread from cutaneous head and neck melanoma, which are said to be highly variable. The medical records of 145 patients with pathologically proven metastatic melanoma were reviewed retrospectively. The location of pathologically positive lymph nodes was compared with clinically predicted spread, and patients with metastatic disease in areas outside of predicted drainage patterns were considered aberrant. There were 33 curative and 73 elective neck dissections. 21 of 77 patients undergoing parotidectomy had positive results for metastases. Clinical prediction proved to be correct in 33 of 45 cases (73.3%). Two patients with lateralized melanomas were initially seen with contralateral metastases. Six of 45 patients (13.3%) developed contralateral metastases after neck dissection. Patients with clinical involvement of the parotid gland were at high risk of occult neck disease (40%). Patients undergoing neck dissection for primaries originating in face, forehead, coronal scalp, periauricular area, and upper neck should be considered for parotidectomy. Patients with posterior scalp and posterior neck primaries should be considered for selective neck dissection in conjunction with posterior lymphadenectomy. In patients with coronal scalp and periauricular primaries, a complete neck dissection including parotidectomy is the recommended approach

Uvodna riječ

izuzetna nam je čast i zadovoljstvo pozdraviti vas u ime Organizacijskog odbora simpozija Iskustva i izazovi u liječenju oboljelih od COVID-19, koji se zbog pogoršanja epidemiološke situacije održava online 16. – 17. prosinca 2021. godine

Uvodna riječ

izuzetna nam je čast i zadovoljstvo pozdraviti vas u ime Organizacijskog odbora simpozija Iskustva i izazovi u liječenju oboljelih od COVID-19, koji se zbog pogoršanja epidemiološke situacije održava online 16. – 17. prosinca 2021. godine

Schwannoma of the tongue in a child

A schwannoma or neurilemmoma is a benign, slow growing, usually solitary and encapsulated tumour originating from Schwann cells of the nerve sheath. Approximately 25-40% of all schwannomas are seen in the soft tissues of the head and neck, often originate from the acoustic nerve. Intraoral schwannomas are rare and account for 1% of schwannomas of the head and neck region. We report the case of a 10-year-old boy diagnosed with a schwannoma of the tongue. The purpose of this report is to emphasize the possibility of diagnosing schwannoma among all other lingual lesions in children. The disease itself was diagnosed histologically after complete surgical excision. Five years after surgical treatment, the patient is without signs of recurrence. This paper highlights the importance of a multidisciplinary approach in the diagnosis and surgical treatment of this very rare entity

Calcifying Epithelial Odontogenic Tumor of the Maxilla (Pindborg Tumor)

Calcifying epithelial odontogenic tumor (CEOT), or the Pindborg tumor, is very rare neoplasm, which accounts up to 1% of all odontogenic tumors. These tumors involve mandible almost twice as common as the maxillary bone, mostly in the premolar and molar region and present at first with local swelling. There is no gender predilection and the tumor usually appears between 2nd and 6th decade of life. We report the case of a 36-year-old male patient with a Pindborg tumor in the maxillary region on the right side, also involving the adjacent maxillary sinus, with destroying of the local anatomical structures. Complete surgical excision of the tumor has been performed and four years after surgical treatment, there is no sign of recurrence

Use of Cone Beam Computed Tomography for Studying Temporomandibular Joint Morphology

The aim of the present study was to investigate morphology of temporomandibular joint using cone beam computer tomography. Study included 45 adults (32 females and 13 males). Articular eminence inclination, glenoid fossa width, glenoid fossa depth, condylar mediolateral distance, condylar anteroposterior distance and condylar type were determined for each temporomandibular joint. Since independent samples t-test did not show significant differences between left and right sides for all of observed parameters (p≥0.05), left and right side values were treated as one sample. The determined glenoid fossa depth was 7.11±2.23, glenoid fossa width 19.22±2.58, condylar anteroposterior distance 7.54±1.59, condylar mediolateral distance 17.95±2.81 and articular eminence inclination was 34.59±7.35 degrees. Most of condyles were classified as convex type (32.5%), followed by flattened (23.8%), rounded (11.3%) and angled (10%). Undefined (other type) were classified 22.5% of condyles. Cone beam computer tomography measurements of temporomandibular joint bone structures in present study showed similarities to most of previous research (with different populations studied). Still, the prevalence of different condylar types differs from those obtained by most of previous studies. Interindividual differences in temporomandibular joint morphology are expected

The Importance of Team Work of Cytologist and Surgeon in Preoperative Diagnosis of Intraoral Minor Salivary Gland Tumours

Tumours arising from oral minor salivary glands may exhibit an overlap of clinical and morphological features that may produce diagnostic and therapeutic dilemmas. The aim of this study is to asses the value of fine needle aspiration cytology (FNAC) in differentiation of benign and malignant tumours and to render a specific diagnosis.We evaluated the team work of surgeon and cytologist to improve diagnostic accuracy. Two steps are important for accuracy: sampling aspirate that should be done together by surgeon and cytologist and cytological microscopic analysis of the smears that should be performed by an experienced cytologist. The study included 132 patients with intraoral minor salivary gland tumours between 2002 and 2011. Adequate material was obtained from 121 (91.7%) patients. FNAC was usually performed by cytologist in a team with maxillofacial surgeon at cytology department that is more convenient for preparing the samples and especially for ROSE procedure (rapid-on site evaluation) of smears. In such a way the cytologist checked the adequacy of samples and decided whether some ancillary techniques should be used and therefore repeat FNAC. A total of 82 patients underwent surgery, 40 with malignant and 42 with benign tumours. Preoperative cytological diagnoses were compared with histopathological ones using histopathology as a gold standard. The most common benign tumour was pleomorphic adenoma and among malignant tumours adenoid cystic carcinoma. The most commonly affected site was the palate. The team work of surgeon and cytologist achieved specificity of 95.1%, sensitivity of 97.6% and diagnostic accuracy of 96.3%. We can conclude that although subclassification of some tumour types of salivary glands remains poor, FNAC is invaluable in patient triage and therefore should be considered in the first line investigations of these lesions by the cytologist and surgeon

The Importance of Team Work of Cytologist and Surgeon in Preoperative Diagnosis of Intraoral Minor Salivary Gland Tumours

Tumours arising from oral minor salivary glands may exhibit an overlap of clinical and morphological features that may produce diagnostic and therapeutic dilemmas. The aim of this study is to asses the value of fine needle aspiration cytology (FNAC) in differentiation of benign and malignant tumours and to render a specific diagnosis.We evaluated the team work of surgeon and cytologist to improve diagnostic accuracy. Two steps are important for accuracy: sampling aspirate that should be done together by surgeon and cytologist and cytological microscopic analysis of the smears that should be performed by an experienced cytologist. The study included 132 patients with intraoral minor salivary gland tumours between 2002 and 2011. Adequate material was obtained from 121 (91.7%) patients. FNAC was usually performed by cytologist in a team with maxillofacial surgeon at cytology department that is more convenient for preparing the samples and especially for ROSE procedure (rapid-on site evaluation) of smears. In such a way the cytologist checked the adequacy of samples and decided whether some ancillary techniques should be used and therefore repeat FNAC. A total of 82 patients underwent surgery, 40 with malignant and 42 with benign tumours. Preoperative cytological diagnoses were compared with histopathological ones using histopathology as a gold standard. The most common benign tumour was pleomorphic adenoma and among malignant tumours adenoid cystic carcinoma. The most commonly affected site was the palate. The team work of surgeon and cytologist achieved specificity of 95.1%, sensitivity of 97.6% and diagnostic accuracy of 96.3%. We can conclude that although subclassification of some tumour types of salivary glands remains poor, FNAC is invaluable in patient triage and therefore should be considered in the first line investigations of these lesions by the cytologist and surgeon