Stafne bone defects radiographic features in panoramic radiographs: Assessment of 91 cases

Background: To evaluate 91 cases of Stafne bone defect (SBD) in panoramic radiographs (PR) to determine the prevalence of different SBD variants, considering age, gender, and side. Additionally, to assess the most frequent imaging features of SBD. Material and Methods: Participant data were collected from 91 SBD cases with PR imaging. First, SBDs were classified according to their location, as anterior, posterior, or ramus variant. SBD imaging features were classified according to radiographic imaging findings, assessing margins, degree of internal radiolucency, shape, topographic relationship between the defect and mandibular border, location of the defect according to mandibular teeth, and locularity. The topographic relationship between the SBD and the mandibular canal was described for the inferior variant only. Mean sizes were also described. Results: A total of 92 SBD cases were evaluated from 91 radiographs. One case presented multiple defects. Mean patient age was 60.80 years. Men were more affected than women. The most frequent SBD variant was the posterior variant, and the least frequent was the ramus variant. The most observed radiographic features were thick sclerotic bone margin in the entire contour of the defect, partially radiolucent internal content, oval shape, continuity with mandible base without discontinuity of mandible border, third molar region location, and unilocular shape. With the posterior variant only, the most common topographic relationship between the defect and the upper wall of the mandibular canal was the defect located below the upper wall and continuous with the inferior wall of the mandibular canal. Conclusions: The knowledge of common SBD radiographic imaging features in PR can help dental practitioners with the differential diagnosis of SBD

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Nerve innervations in the human adult and fetal parotid duct

The human adult parotid duct is the longest of all major salivary gland ducts, approximately 6-8 cm in length. Its unique structure extends over the masseter muscle, penetrates through the buccinator muscle and opens into the oral cavity. Salivary secretion is under basic control of the sympathetic and parasympathetic divisions of the autonomic nervous system. Scarce reporting on the parotid duct nerve distribution led us to this study; to investigate the nervous distribution in the human adult and fetal parotid ducts using an antibody against protein gene product 9.5 (PGP9.5), a molecular marker for nerve cells and fibers. In order to identify the nerve fibers distributed throughout the parotid duct and confirm them to be part of the autonomic nervous system, we stained adult parotid ducts with tyrosine hydroxylase (TH) and choline acetyltransferase (ChAT) for observation. PGP9.5 staining of the parotid duct’s inside wall where it traverses over the masseter prior to penetrating the buccinator revealed a dense concentration of nerve fibers in the area. Staining revealed both sympathetic and parasympathetic nerve fibers in the same area, with the majority of the sympathetic nerve fibers surrounding blood vessels. However, the section of the duct penetrating the buccinator showed less concentration of nerve fibers in both adult and fetal specimens. The difference in the nerve distribution of the parotid duct suggests its direct association with the salivary transport function of the duct. PGP9.5 expression in fetuses over five months of age further suggests that the nerve distribution in the human parotid duct is fully established at six months of gestation

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Unilateral absence of submandibular gland secondary to stones. Aplasia versus early atrophy

Major salivary gland absence is a rare disorder. The cause of congenital absence of the salivary glands has not been determined, but it may be associated with ectodermal defects of the first and second branchial arches. Isolated absence of a unilateral submandibular gland is an unusual entity with less than ten cases reported in the literature.The etiopathogenesis of isolated absence of a major salivary gland without other developmental anomaliesis still unclear. The formation of a sialolith within the remaining Wharton’s duct, associated with isolated aplasia(versus atrophy) of a unilateral submandibular gland has been recently reported. We describe in this work two cases of sialolithiasis within the ipsilateral remaining Wharton´s duct in patients with isolated absence of a unilateral submandibular gland. In the cases reported, absence of the submandibular gland may have been the result ofthe complete acinar atrophy secondary to an early obstruction of Wharton´s duct (AU)

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Sialoectasia crónica del conducto de Stenon: a propósito de un caso / Chronic sialoectasis of Stenon’s duct: report of a case

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Diferencias estructurales entre las sialosis parotidea de etiología diabética y alcohólica / Structural differences between alcoholic and diabetic parotid sialosis

Entre los agentes etiológicos de la sialosis se citan el alcoholismo crónico y la diabetes. Ambas entidades nosológicas se describen con un cuadro histopatológico similar.Objetivos: El objetivo de este trabajo fue analizar y comparar las modificaciones estructurales de la sialosis diabética con las de etiología alcohólica.Diseño del estudio: Se analizaron 7 biopsias de glándula parótida de individuos diabéticos y 4 de pacientes no diabéticos (controles), con patología oncológica en regiones vecinas. El estudio comparativo se efectuó con muestras de archivo que comprendieron 12 biopsias parotídeas de pacientes con diagnóstico clínico de cirrosis hepática alcohólica y 6 autopsias de individuos que fallecieron por cirrosis hepática alcohólica. El material fijado en formol e incluído en parafina, se coloreó con técnicas de rutina y se marcó con anticuerpos para citoqueratinas EA/1 y EA/3.Resultados: En los diabéticos, la parótida se caracterizó por presentar acinos de tamaño más reducido, mayor cantidad de inclusiones lipídicas intracitoplasmáticas en las células acinares y ductales e infiltración grasa abundante en el estroma, comparado con los alcohólicos. Se observó que la expresión de citoqueratinas fue heterogénea a nivel de los acinos e intensamente positiva en los ductos hiperplásicos, comparada con los grupos alcohólico y control.Conclusion: Estas valoraciones cualitativas indican diferencias en el cuadro histopatológico entre estas sialosis de distinto origen

Between the sialosis’ etiologic agents, we can find the chronic alcoholism and diabetes. Both nosologic entities are descirbed using a similar histopathologic pattern. ;;Objectives: The purpose of this work has been analyzing and comparing the histopathological differences between the diabetic and alcoholic sialosis.Study design: We studied 7 parotid glands samples of diabetic patients and 4 samples of normal glands obtained from surgical material were used as a control. For the comparative study, we used 12 parotid glands from chronic alcoholic patients with clinical diagnosis of cirrhosis and 6 autopsies on individuals who had died from alcoholic hepatic cirrhosis. This material was fixed in formaline, processed for embedding in paraffin, standart coloration techniques and immunotechnique for cytokeratin EA/1 y EA/3. ;;Results: In the cases of diabetics, the parotid gland was characterised by the presence of small acini, a bigger number of lipid intracytoplasmic droplets in the acinar and ductal cells, as well as an abundant adipose infiltration in the stroma when compared to the alcoholics. We observed that the cytoqueratins’ expression was heterogeneous at the acinar level, and very positive in the hyperplasic ducts, compared to the alcoholic and control groups. ;;Conclusions: These qualitative valorations indicate the differences between the histopathologic pattern of sialosis with different origins

Tratamiento quirúrgico dé una hiperplasia fibrosa localizada en la desembocadura del conducto de Estenon. Descripción de la técnica / Surgical treatmen of a fibrous hyperplasia located in the cauncula of opening of Estenon´duct

La hiperplasia fibrosa es una lesión exofítica circunscrita y formada por tejido conectivo fibroso denso, cubierto por un epitelio escamoso estratificado. Se localiza con más frecuencia en la mucosa yugal, encía, lengua y paladar blando, generalmente zonas donde se produce mayor roce, ya que su etiopatogenia parece estar relacionada con factores irritativos crónicos o traumáticos repetidos. El tratamiento consiste en la extirpación quirúrgica y la eliminación de los factores irritantes locales. Presentamos un caso de tumoración unilateral de aspecto fibroso de diez años de evolución localizada en mucosa yugal izquierda, que incluía la carúncula de desembocadura del conducto de Estenon. El tratamiento consistió en la canalización del conducto para preservar su integridad, extirpación quirúrgica de la lesión con bisturí frío y colocación de un drenaje activo intraoral. El estudio histopatológico de la muestra confirmó el diagnóstico de hiperplasia fibrosa. Tras un año de seguimiento, el paciente no ha presentado ninguna recidiva, y el drenaje de la glándula parótida izquierda se mantiene normal (AU)

The fibrous hyperplasia is an exofitic injury circumscribed and formed by dense fibrous conective weave, covered by epithelio squamous stratified. lt is located with more frequency in the buccal mucosa, gingiva, tongue and soft palate, generally zones where greater rubbing takes place, since his etiopathogenia seems to be related to chronic irritatives or traumatic repeated factors. The treatment is based in the surgical extirpation and the elimination of the local irritating factors. We present a case of unilateral tumor of fibrous aspect of ten years of evolution located in left buccal mucosa, that included caruncula of opening of Estenon's duct. The treatment consisted of the canalization of the duct to preserve its integrity, surgical extirpation of the injury with cold scalpel and positioning of an active intraoral drainage. The histopathologic study of the sample confirmed the diagnosis of fibrous hyperplasia. After one year follow-up, the patient has not presented any recurrence, and the drainage of the left parotid gland is functioning normally (AU)

Carcinoma de conducto de Stenon o Stensen / Stenon's or Stensen's duct carcinoma

El conducto de Stenon es un lugar de raro asiento de carcinomas, y así, sólo se han referenciado 28 casos en la literatura desde que en 1927 se publicó el primero. De todos los publicados, solamente dos corresponden a carcinoma adenoide quístico como el caso que presentamos. Se trata de un varón de 83 años con tumoración poco dolorosa en mucosa yugal izquierda; el tumor fue extirpado, sin lesión facial mediante una incisión ampliada de parotidectomía y previa lobectomía superficial (AU)

Carcinomas arising from the Stensen's duct are extremely rare, and only 28 cases have been reported since 1927. Only two cases of the whole were adenoid cystic carcinoma like our case. A 83-year-old man with painless tumour of the left cheek is reported. The tumour was removed without facial nerve injury via extended parotidectomy incision and after superficial lobectomy (AU)

Estudio comparativo de los cambios relacionados con la edad en las glándulas salivales palatinas y labiales / A comparative study of age-related changes between palatal and labial salivary glands

Objetivos: El proposito de este artículo es comparar los cambios histomorfométricos relacionados con la edad entre glandulas salivales palatinas y labiales (GSP y GSL respectivamente).Diseño del estudio: Se realizó un análisis del volumen proporcional medio (VPM) del componente acinar (CA), del componente ductal (CD) y del componente inflamatorio (CI) de 120 muestras de GSP y GSL, obtenidas de sujetos sin historia previa conocida de patología o tumores de glándulas salivales. Las muestras se dividieron en grupos de edad: jovenes (n=30, =30 años), adultos (n=45, 31-60 años) y ancianos (n=45, >60 años).Resultados: En GSP, se apreció una disminución significativa del VPM del CA (p<0,0001) y concomitantemente un aumento significativo del VPM del CD (p<0,0001), para todos los grupos de edad. En GSL, se apreció una disminución significativa del VPM del CA (p=0,002) y concomitantemente, un aumento del VPM del CD (p=0,002), entre los grupos de edad adultos y ancianos. Se observó un aumento significativo del VPM del CI en GSP entre los grupos de edad jóvenes y adultos (p<0,0001), mientras que en GSL esta diferencia se hizo evidente entre los grupos adultos y ancianos (p<0,0001). Los componentes ductal e inflamatorio demostratron el mismo patrón de cambios relacionados con la edad tanto en GSP como en GSL. Conclusiones: A la vista de estos resultados, se sugiere que los cambios prematuros y continuos en GSP, en comparación con GSL, pueden explicar parcialmente su implicación más frecuente en los procesos patológicos (AU)