Salivary gland choristoma of the middle ear

Choristoma is a mass of tissue histologically normal for an organ or part of the body other than the site at which it is located. A rare case of ectopic salivary gland choristoma in the middle ear is described in a 14-year-old girl whose only symptom was a 55 dB conductive hearing loss. The left middle ear mass appeared whitish and was located behind the intact tympanic membrane. We first suspected it to be congenital middle ear cholesteatoma. Exploratory tympanotomy, however, revealed a salivary gland choristoma that adhered tightly to the facial nerve. Differential diagnosis and treatment of this rare condition are discussed

Case Report - Lingual schwannoma

Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannoma accounts for 1% of head and neck region and are commonly seen at the base region of tongue. Most of the few such reports in the literature, have described schwannomas that occurred in the tongue. In this article, we report a rare case of lingual schwannoma involving the anterior of tongue, in a young individual, in whom the lesion was completely excised via an intra oral approach

Case Report - Lingual schwannoma

Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannoma accounts for 1% of head and neck region and are commonly seen at the base region of tongue. Most of the few such reports in the literature, have described schwannomas that occurred in the tongue. In this article, we report a rare case of lingual schwannoma involving the anterior of tongue, in a young individual, in whom the lesion was completely excised via an intra oral approach

Analysis of the hMSH2 Gene Variants in Head and Neck Cancer

The hMSH2 (human MutS homolog 2) gene plays a central role in DNA mismatch repair. Structural variations in the gene may lead to protein instability and deficient mismatch repair. However, the role of polymorphic variants of the hMSH2 gene have not been defined in head and neck cancer. In this study, the roles of three polymorphic variants in the functional domains of the gene were investigated in 166 patients with head and neck cancer by allele-specific PCR, electronical array addressing, and PCR/RFLP (restriction fragment length polymorphism). This is the first study to investigate the gIVS12-6T -> C polymorphism in head and neck cancer. A significant association between the CC genotype and reduced risk of disease suggests that the gIVS12-6T -> C substitution at the splice-acceptor site may affect the risk of head and neck cancer. We did not observe an association between the Asn127Ser and Gly322Asp polymorphisms and cancer risk. A possible role of the gIVS12-6T -> C substitution warrants further validation in larger cohorts because of low allele frequency

Autologous fat augmentation for voice and swallow improvement after cordectomy

Surgery for the treatment of early-stage glottic carcinoma still remains a valid option. In most patients, newly formed neocord tissue preserves glottic functions, but in some patients an important glottic gap leading to glottic insufficiency may occur. In our study, 11 patients who had serious glottic insufficiency after endoscopic laser and laryngofissure cordectomy were treated with autologous fat injection (AFI) into the neocord tissue for voice and swallowing rehabilitation. One patient did not attend the first control visit and was excluded from the study. The remaining 10 patients were evaluated in the preoperative and postoperative periods for phonatory functions and efficacy of AFI by videolaryngostroboscopy and computerized acoustic analysis. Phonatory functions showed statistically significant improvement in the shimmer, noise-to-harmonic ratio, maximum phonation time and fundamental frequency. Perceptual ratings (GRBAS scale) also showed statistically significant improvement in all 5 parameters. Despite improvement in glottic closure, the mucosal wave deteriorated. Due to recurrence of symptoms of glottic insufficiency, AFI was repeated in 2 patients at the third and fifth months, respectively. One year later, the AFI resulted in successful rehabilitation of swallowing in all patients. The probability of resorption of autologous fat and the deterioration of the mucosal wave after AFI remain a problem, but re-injection can be done easily. As AFI is an easy, safe and cheap method, we concluded that it is a promising alternative procedure for managing voice problems after laser or laryngofissure cordectomy defects. Copyright (c) 2006 S. Karger AG, Basel

COMPARISON OF LATERALIZATION THYROPLASTY AND LASER CORD WEDGE RESECTION IN TERMS OF VOICE QUALITY IN PATIENTS WITH BILATERAL ABDUCTOR VOCAL CORD PARALYSIS

AbstractBackground/Aims: It was aimed to compare lateralization thyroplasty with laser cord wedge resection in terms of postoperative voice analysis, duration of hospital stay, tracheotomy rate, and decannulation time in patients with bilateral abductor vocal cord paralysis. Methods: A total of 37 patients who presented to our department with bilateral abductor vocal cord paralysis between February 2005 and February 2009 were enrolled in this prospective study. External arytenoid lateralization (lateralization thyroplasty) was randomly performed in 22 patients and laser posterior cordotomy was performed in 15 patients. Fifteen healthy volunteers were assigned to the control group. Postoperative 6th month maximum phonation time (MPT), S/Z ratio, and the results of objective voice analysis [mean frequency perturbation (jitter), mean amplitude perturbation (shimmer), mean fundamental frequency (fo), and NHR (noise to harmonic ratio)] were compared between the two groups and the control group. Decannulation time, patient tracheotomy status, and duration of hospital stay were also recorded.Results: The mean postoperative MPT decreased but S/Z ratio increased in both patient groups compared to the control group. The mean MPT was shorter in the external arytenoid lateralization group versus the laser posterior cordotomy group (p= 0.011). There was no statistically significant difference between the external arytenoid lateralization and laser posterior cordotomy groups in terms of mean S/Z ratio (p= 0.306). It was observed that jitter, shimmer, and NHR values were increased, i.e. voice quality impaired, in both patient groups. Jitter (p= 0.004), shimmer (p<0.001), and NHR (p= 0.052) values were significantly increased in the laser posterior cordotomy group as compared with the external arytenoid lateralization group. No statistically significant difference was found between the external arytenoid lateralization group and the laser posterior cordotomy group in terms of the mean postoperative f(o) (p= 0.417), as well as for decannulation time (p= 0.076) and duration of hospital stay (p= 2.30).Conclusions: External arytenoid lateralization is a more preferable technique than laser posterior cordotomy because it preserves mucosal integrity and cord mass, which results in better voice quality