Contemporary management of primary parapharyngeal space tumors

The parapharyngeal space is a complex anatomical area. Primary parapharyngeal tumors are rare tumors and 80% of them are benign. A variety of tumor types can develop in this location; most common are salivary gland neoplasm and neurogenic tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques, surgery, and radiotherapy. Most tumors can be removed with a low rate of complications and recurrence. The transcervical approach is the most frequently used. In some cases, minimally invasive approaches may be used alone or in combination with a limited transcervical route, allowing large tumors to be removed by reducing morbidity of expanded approaches. An adequate knowledge of the anatomy and a careful surgical plan is essential to tailor management according to the patient and the tumor. The purpose of the present review was to update current aspects of knowledge related to this more challenging area of tumor occurrence.Peer reviewe

Polymorphous adenocarcinoma of the salivary glands : reappraisal and update

Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.Peer reviewe

Partial superficial parotidectomy as the method of choice for treating pleomorphic adenomas of the parotid gland

We present our experience of 156 patients with parotid pleomorphic adenomas who were treated from 1995 to 2009 by partial superficial parotidectomy. In each case the main trunk of the facial nerve was identified and dissected. Only the division of the nerve adjacent to the tumour was dissected, and only the parotid tissue surrounding the tumour was excised. The results were satisfactory, as no patient developed permanent partial or total facial nerve paralysis, and transient paresis was noticed in only 23 patients (15%). Only one tumour recurred, and Frey syndrome developed in only 6 patients (4%). Enucleation was required in 55 patients (35%) because the tumour was so close to the branches of the facial nerve. Partial superficial parotidectomy is a safe treatment for parotid pleomorphic adenomas with relatively few postoperative complications. When it is done by experienced surgeons no permanent deficits are likely, it has low rates of recurrence, and gives excellent aesthetic results. © 2010 British Association of Oral and Maxillofacial Surgeons

Surgical treatment of plunging ranula: Report of three cases and review of literature

Introduction: Plunging ranulas arise when a simple ranula extends beyond the floor of the mouth into the neck. These cysts usually arise from the sublingual salivary gland and rarely from the submandibular gland. They are either the result of mucus retention or they represent a mucus escape reaction occurring from disruption of the sublingual duct because of local trauma. Two variants have been described in the literature: a simple oral ranula and the deep diving or plunging ranula. A number of different modalities have been described for the treatment of ranulas and especially for plunging ranula. Purpose: The aim of this study is to present the experience of surgical management in three cases of patients with plunging ranula using an extra-oral extension. In addition, clinical and radiographic findings of the patients along with the relevant review of the literature also refered. Cases reports: Three cases of patients with specific diagnosis of plunging ranulas were treated by a cervical approach and excision of the cyst without any intraoral extension. Data of patients were recorded including gender and age, location of lesion and possible treatment. Results: All cysts were ranulas and the cases presented indicate that this lesion can be managed by a less invasive procedure without complications and recurrence. At the first patient ranula grow to a large size and the treatment became by removal of the ipsilateral sublingual and submandibular glands, while at second and third patient by removal of sublingual gland only. Conclusion: There is a consensus about the appropriate treatment of ranula. The best treatment for a plunging ranula is excision of the lesion along with the involved gland (usually sublingual gland). © 201

A modified anterior maxillary osteotomy: 15 years experience

A modified technique of anterior maxillary osteotomy is described, based mainly on the Wassmund (buccal aspect) and the Wunderer (palatal aspect) methods. Experience of 148 cases operated on during 15 years is presented. © 1991

Spindle cell lipoma of the oral cavity

A case of intraoral spindle cell lipoma in the left cheek of a 55-year-old man is reported. © 1995 Munksgaard International Publishers Ltd

The use of titanium mesh in sinus Augmentation

Sinus floor elevation is a clinical procedure to allow implantation in the posterior maxillary areas, in cases of reduced alveolar height. Numerous techniques and materials have been described during the last 2 decades. The aim of this article is to present an innovative technique for sinus lifting procedure. The use of a titanium mesh allows better stability of grafted materials and a more predictable result. Copyright © 2010 by Lippincott Williams & Wilkins

A method for marking histopathological specimens of neck - technical note

The authors present a technical note for marking the location of lymph nodes of the neck for histopathological examination. A more precise histopathological report permits more effective overall management of patients with neoplastic disease of the head and neck. © 2009 International Association of Oral and Maxillofacial Surgeons