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1.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 42(1): 126-134, 2024 Feb 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38475961

RESUMO

Oncocytoma is a benign tumor of the salivary gland. Its incidence is very low and very seldom documen-ted in literature. Clear-cell dominant oncocytoma is even less common. The tumor's clinical symptoms and imaging results are nonspecific, so distinguishing other salivary gland tumors (such as oncocytic carcinoma) from clear-cell renal carcinoma is difficult, possibly leading to misdiagnosis and maltreatment. Here, a case of clear-cell dominant oncocytoma was presented, and the relevant literature was evaluated to investigate the diagnosis and management of clear-cell dominant oncocytoma.


Assuntos
Adenoma Oxífilo , Neoplasias das Glândulas Salivares , Humanos , Glândula Parótida/patologia , Adenoma Oxífilo/diagnóstico , Adenoma Oxífilo/patologia , Neoplasias das Glândulas Salivares/diagnóstico , Diagnóstico Diferencial
2.
PLoS One ; 19(3): e0297387, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38470874

RESUMO

Head and neck cancer treatment often consists of surgical resection of the tumor followed by ionizing radiation (IR), which can damage surrounding tissues and cause adverse side effects. The underlying mechanisms of radiation-induced salivary gland dysfunction are not fully understood, and treatment options are scarce and ineffective. The wound healing process is a necessary response to tissue injury, and broadly consists of inflammatory, proliferative, and redifferentiation phases with immune cells playing key roles in all three phases. In this study, select immune cells were phenotyped and quantified, and certain cytokine and chemokine concentrations were measured in mouse parotid glands after IR. Further, we used a model where glandular function is restored to assess the immune phenotype in a regenerative response. These data suggest that irradiated parotid tissue does not progress through a typical inflammatory response observed in wounds that heal. Specifically, total immune cells (CD45+) decrease at days 2 and 5 following IR, macrophages (F4/80+CD11b+) decrease at day 2 and 5 and increase at day 30, while neutrophils (Ly6G+CD11b+) significantly increase at day 30 following IR. Additionally, radiation treatment reduces CD3- cells at all time points, significantly increases CD3+/CD4+CD8+ double positive cells, and significantly reduces CD3+/CD4-CD8- double negative cells at day 30 after IR. Previous data indicate that post-IR treatment with IGF-1 restores salivary gland function at day 30, and IGF-1 injections attenuate the increase in macrophages, neutrophils, and CD4+CD8+ T cells observed at day 30 following IR. Taken together, these data indicate that parotid salivary tissue exhibits a dysregulated immune response following radiation treatment which may contribute to chronic loss of function phenotype in head and neck cancer survivors.


Assuntos
Neoplasias de Cabeça e Pescoço , Glândula Parótida , Camundongos , Animais , Glândula Parótida/efeitos da radiação , Fator de Crescimento Insulin-Like I , Glândulas Salivares , Imunidade
3.
Sci Rep ; 14(1): 5303, 2024 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438461

RESUMO

Sjögren's syndrome (SS) is an autoimmune disease characterized by periductal lymphocytic infiltration of the salivary and lacrimal glands. SS also exhibits extra-glandular manifestations and specific autoantibodies. Salivary gland ultrasonography (SGUS) is a common procedure used to assess the severity of glandular involvement. However, the association between SGUS and extra-glandular lesions remains poorly understood. This study aimed to identify clinical indices, including disease activity, associated with glandular involvement using SGUS in patients with SS. We included 115 patients with SS and 90 without SS. Patients with SS had significantly higher ultrasonography (US) score than patients without SS. Multivariate analysis revealed focus score, Saxon test positivity, and anti-centromere antibody (ACA) positivity as independent variables associated with the US score in patients with SS. In addition, these results were similar to those obtained in patients with primary SS. Patients with SS and ACA positivity had higher US score and an increased prevalence of hyperechoic bands in the parotid glands and submandibular glands. In conclusion, this study indicated that ACA positivity is associated with the US score in patients with SS. These results suggest that US findings in patients with ACA positivity might show specific changes in the salivary glands, especially fibrosis.


Assuntos
Doenças Autoimunes , Síndrome de Sjogren , Humanos , Síndrome de Sjogren/diagnóstico por imagem , Glândulas Salivares/diagnóstico por imagem , Glândula Parótida/diagnóstico por imagem , Ultrassonografia
4.
BMJ Case Rep ; 17(3)2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38490709

RESUMO

Epidermoid cysts are benign lesions most commonly found in the skin but which can arise in many other locations including, very rarely the salivary glands. This rarity often leaves them off standard differential lists and can create a diagnostic dilemma. A patient with an incidentally detected parotid mass on MRI underwent core biopsy, which was unfortunately complicated by formation of a pseudoaneurysm and persistent arterial bleeding requiring coil embolisation. The histology showed only keratinous material and, in retrospect, the signal characteristics of the mass were entirely typical of an epidermoid cyst. Recognition of this common, benign entity in a very rare location can obviate the need for invasive tests and potential complications and direct management to more appropriate imaging follow-up.


Assuntos
Cisto Epidérmico , Humanos , Cisto Epidérmico/patologia , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/patologia , Biópsia/efeitos adversos , Glândulas Salivares/patologia , Pele/patologia
5.
BMC Neurol ; 24(1): 102, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38519935

RESUMO

BACKGROUND: Facial paralysis due to parotid sialolithiasis-induced parotitis is a unusual clinical phenomenon that has not been reported in prior literature. This scenario can present a diagnostic challenge due to its rarity and complex symptomatology, particularly if a patient has other potential contributing factors such as facial trauma or bilateral forehead botox injections as in this patient. This case report elucidates such a complex presentation, aiming to increase awareness and promote timely recognition among clinicians. CASE PRESENTATION: A 56-year-old male, with a medical history significant for hyperlipidemia, recurrent parotitis secondary to parotid sialolithiasis, and recent bilateral forehead cosmetic Botox injections presented to the emergency department with right lower facial drooping. This onset was about an hour after waking up and was of 4 h duration. The patient also had a history of a recent ground level fall four days prior that resulted in facial trauma to his right eyebrow without any evident neurological deficits in the region of the injury. A thorough neurological exam revealed sensory and motor deficits across the entirety of the right face, indicating a potential lesion affecting the buccal and marginal mandibular branches of the facial nerve (CN VII). Several differential diagnoses were considered for the lower motor neuron lesion, including soft tissue trauma or swelling from the recent fall, compression due to the known parotid stone, stroke, and complex migraines. An MRI of the brain was conducted to rule out a stroke, with no significant findings. A subsequent CT scan of the neck revealed an obstructed and dilated right Stensen's duct with a noticeably larger and anteriorly displaced sialolith and evidence of parotid gland inflammation. A final diagnosis of facial palsy due to parotitis secondary to sialolithiasis was made. The patient was discharged and later scheduled for a procedure to remove the sialolith which resolved his facial paralysis. CONCLUSIONS: This case emphasizes the need for a comprehensive approach to the differential diagnosis in presentations of facial palsy. It underscores the potential involvement of parotid sialolithiasis, particularly in patients with a history of recurrent parotitis or facial trauma. Prompt recognition of such uncommon presentations can prevent undue interventions, aid in timely appropriate management, and significantly contribute to the patient's recovery and prevention of long-term complications.


Assuntos
Paralisia de Bell , Toxinas Botulínicas Tipo A , Paralisia Facial , Parotidite , Cálculos das Glândulas Salivares , Acidente Vascular Cerebral , Masculino , Humanos , Pessoa de Meia-Idade , Glândula Parótida/diagnóstico por imagem , Cálculos das Glândulas Salivares/complicações , Parotidite/complicações , Parotidite/diagnóstico , Paralisia Facial/etiologia , Paralisia de Bell/complicações , Acidente Vascular Cerebral/complicações
6.
BMC Complement Med Ther ; 24(1): 111, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38448931

RESUMO

BACKGROUND: Radiation plays an essential role in treating malignancies. Radiation exposure of salivary glands often results in permanent loss of their functions; therefore, their protection against radiation is crucial. Nigella sativa oil (NSO) is a useful antioxidant against free radicals. The purpose of this study was to investigate the radio-protective effect of NSO on oxidative injury of parotid glands of gamma-irradiated rats. METHODS: Twenty-eight male albino rats were divided into four groups (n = 7): Group 1: Neither NSO nor radiation, Group 2: Rats received NSO 400 mg/kg, Group 3: Rats received 15 Gy cranium gamma irradiation & Group 4: Rats received gamma irradiation and NSO. Rats were sacrificed two weeks after the last NSO dose. Histological sections of parotid glands were stained with H&E, Masson's trichrome and anti-TGF-ß antibodies. Area percentage of Masson's trichrome and TGF-ß expression was morphometrically examined. RESULTS: Parotid glands of control and NSO groups revealed normal morphology. Gamma-irradiated glands showed loss of normal acinar architecture and slight acinar shrinkage. NSO treatment of gamma-irradiated glands preserved acinar outline and architecture. Masson's trichrome stained samples revealed trace amounts of collagen fibers in control and NSO groups, and excessive amounts of collagen fibers in gamma-irradiated group, in addition to few collagen fibers for gamma-irradiated glands treated with NSO. Additionally, control and NSO groups showed negative TGF-ß expression. Gamma-irradiated group showed high TGF-ß expression, while NSO treated gamma-irradiated group showed moderate TGF-ß expression. CONCLUSIONS: Gamma-irradiation adversely affected parotid glands, and in contrast, NSO seemed to positively counteract this adverse effect.


Assuntos
Nigella sativa , Glândula Parótida , Óleos de Plantas , Crânio , Masculino , Animais , Ratos , Fator de Crescimento Transformador beta , Colágeno
7.
Head Neck Pathol ; 18(1): 4, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38334835

RESUMO

Dysgenetic polycystic disease, also known just as polycystic disease, is a very rare developmental abnormality affecting the salivary gland duct system. This entity has been reported in only 21 patients previously, although a careful review suggests only 16 patients have histological evidence of the disease. In previously reported cases, this lesion most commonly presents as either an incidental finding or as a swelling affecting the parotid glands bilaterally, or rarely the submandibular glands bilaterally. This case report details the first time dysgenetic polycystic disease is found affecting the minor salivary glands of the tongue in a 55-year-old male. Histochemical and immunohistochemical stains are presented and include positivity for AE1/AE3 and p63, and negativity for progesterone receptor, androgen receptor, mammaglobin, S100 and BRAF V600E. PAS-D and Congo Red highlight special microamyloid spheroliths structures intraluminally.


Assuntos
Cistos , Glândulas Salivares Menores , Masculino , Humanos , Pessoa de Meia-Idade , Glândulas Salivares Menores/patologia , Cistos/patologia , Glândula Parótida/patologia , Glândula Submandibular/patologia , Língua/patologia
8.
NeuroRehabilitation ; 54(2): 259-273, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38306064

RESUMO

BACKGROUND: Facial nerve dysfunction can be a devastating trouble for post-parotidectomy patients. OBJECTIVE: To assess rehabilitation outcomes concerning patients with post-parotidectomy facial nerve dysfunction, comparing benign versus malignant neoplasms. METHODS: Prospective study enrolling adults who underwent parotidectomy with facial nerve sparing between 2016 and 2020. The Modified Sunnybrook System (mS-FGS) was used for facial assessments. Physiotherapy began on the first post-operative day with a tailored program of facial exercises based on Neuromuscular Retraining, to be performed at home 3 times/day. From the first outpatient consultation, Proprioceptive Neuromuscular Facilitation was added to the treatment of cases with moderate or severe facial dysfunctions. RESULTS: Benign and malignant groups had a statistically significant improvement in mS-FGS (p < 0.001 and p = 0.005, respectively). There was no significant difference between groups regarding treatment duration or number of physiotherapy sessions performed. The history of previous parotidectomy resulted in more severe initial dysfunctions and worse outcome. Age over 60 years and initially more severe dysfunctions impacted the outcome. CONCLUSION: Patients with benign and malignant parotid neoplasms had significant and equivalent improvement in postoperative facial dysfunction following an early tailored physiotherapy program, with no significant difference in the final facial score, treatment duration, or number of sessions required.


Assuntos
Paralisia Facial , Neoplasias Parotídeas , Adulto , Humanos , Pessoa de Meia-Idade , Nervo Facial/cirurgia , Glândula Parótida/cirurgia , Estudos Prospectivos , Complicações Pós-Operatórias , Neoplasias Parotídeas/cirurgia , Estudos Retrospectivos
9.
Radiother Oncol ; 193: 110112, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38309587

RESUMO

OBJECTIVES: We sought to describe outcomes for locally advanced cutaneous squamous cell carcinoma (SCC) involving the parotid treated with volumetric modulated arc therapy (VMAT) versus pencil beam scanning proton beam therapy (PBT). MATERIALS AND METHODS: Patients were gathered from 2016 to 2022 from 5 sites of a large academic RT department; included patients were treated with RT and had parotid involvement by: direct extension of a cutaneous primary, parotid regional spread from a previously or contemporaneously resected but geographically separate cutaneous primary, or else primary parotid SCC (with a cutaneous primary ostensibly occult). Acute toxicities were provider-reported (CTCAE v5.0) and graded at each on treatment visit. Statistical analyses were conducted. RESULTS: Median follow-up was 12.9 months (1.3 - 72.8); 67 patients were included. Positive margins/extranodal extension were present in 34 cases; gross disease in 17. RT types: 39 (58.2 %) VMAT and 28 (41.8 %) PBT. Concurrent systemic therapy was delivered in 10 (14.9 %) patients. There were 17 treatment failures (25.4 %), median time of 168 days. Pathologically positive neck nodes were associated with locoregional recurrence (p = 0.015). Oral cavity, pharyngeal constrictor, and contralateral parotid doses were all significantly lower for PBT. Median weight change was -3.8 kg (-14.1 - 5.1) for VMAT and -3 kg (-16.8 - 3) for PBT (p = 0.013). Lower rates of ≥ grade 1 xerostomia (p = 0.002) and ≥ grade 1 dysguesia (p < 0.001) were demonstrated with PBT. CONCLUSIONS: Cutaneous SCC involving the parotid can be an aggressive clinical entity despite modern multimodal therapy. PBT offers significantly lower dose to organs at risk compared to VMAT, which seemingly yields diminished acute toxicities.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Parotídeas , Terapia com Prótons , Radioterapia de Intensidade Modulada , Neoplasias Cutâneas , Humanos , Carcinoma de Células Escamosas/patologia , Glândula Parótida/patologia , Radioterapia de Intensidade Modulada/efeitos adversos , Terapia com Prótons/efeitos adversos , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/patologia , Recidiva Local de Neoplasia , Neoplasias Parotídeas/radioterapia , Neoplasias Parotídeas/patologia
10.
Radiother Oncol ; 193: 110116, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38316193

RESUMO

BACKGROUND AND PURPOSE: We performed a cost-effectiveness analysis (CEA) comparing an adaptive radiotherapy (ART) strategy, based on weekly replanning, aiming to correct the parotid gland overdose during treatment and expecting therefore to decrease xerostomia, when compared to a standard IMRT. MATERIALS AND METHODS: We conducted the ARTIX trial, a randomized, parallel-group, multicentric study comparing a systematic weekly replanning ART to a standard IMRT. The primary endpoint was the frequency of xerostomia at 12 months, measured by stimulating salivary flow with paraffin. The CEA was designed alongside the ARTIX trial which was linked to the French national health data system (SNDS). For each patient, healthcare consumptions and costs were provided by the SNDS. The reference case analysis was based on the primary endpoint of the trial. Sensitivity and scenario analyses were performed. RESULTS: Of the 129 patients randomly assigned between 2013 and 2018, only 2 records were not linked to the SNDS, which provides a linkage proportion of 98.4%. All of the other 127 records were linked with good to very good robustness. On the intent-to-treat population at 12 months, mean total costs per patient were €41,564 (SD 23,624) and €33,063 (SD 16,886) for ART and standard IMRT arms, respectively (p = 0.033). Incremental cost effectiveness ratio (ICER) was €162,444 per xerostomia avoided. At 24 months, ICER was €194,521 per xerostomia avoided. For both progression-free and overall survival, ART was dominated by standard IMRT. CONCLUSION: The ART strategy was deemed to be not cost-effective compared with standard IMRT for patients with locally advanced oropharyngeal cancer.


Assuntos
Neoplasias de Cabeça e Pescoço , Radioterapia de Intensidade Modulada , Xerostomia , Humanos , Análise de Custo-Efetividade , Radioterapia de Intensidade Modulada/efeitos adversos , Análise Custo-Benefício , Neoplasias de Cabeça e Pescoço/radioterapia , Xerostomia/etiologia , Xerostomia/prevenção & controle , Xerostomia/epidemiologia , Glândula Parótida , Dosagem Radioterapêutica
11.
Ann Anat ; 253: 152226, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38331006

RESUMO

BACKGROUND: The external carotid artery (ECA) is a major artery of the head and neck. Although numerous studies describe the variability of ECA branches, the course variation of the ECA was seemingly overlooked. It was aimed to study the morphological possibilities of the retromandibular segment of the ECA. METHOD: A retrospective study was performed on 60 computed tomography angiograms of 26 male and 31 female adult patients. Three types of retromandibular ECA were defined: type 1 - the ECA has a straight course deep to the anatomical plane of the ramus of the mandible; type 2 - the ECA makes a retromandibular loop directed laterally, extending externally to the anatomical plane of the ramus of the mandible; and type 3 - the retromandibular loop directed laterally reaches just behind the posterior margin of the ramus of the mandible. RESULTS: Type 1 was found in just 43.33%, type 2 in 18.33%, and type 3 in 38.33% of 120 sides cases. On the right, type 1 was significantly associated with the male gender, and type 3 with the female gender (Pearson Chi2=10.9, p=0.004). On the left, there were no statistically significant associations (Pearson Chi2=3.5, p=0.153). In 20 cases, the retromandibular course of the ECA was asymmetrical; in 21 cases, type 1 was recorded bilaterally; in 5 cases, type 2 was bilaterally symmetrical; and in 14 cases, type 3 was found bilaterally. CONCLUSION: These previously undocumented types of ECA are relevant during parotid surgery and should be investigated preoperatively on a case-by-case basis.


Assuntos
Artéria Carótida Externa , Pescoço , Adulto , Humanos , Masculino , Feminino , Artéria Carótida Externa/diagnóstico por imagem , Artéria Carótida Externa/anatomia & histologia , Artéria Carótida Externa/cirurgia , Estudos Retrospectivos , Glândula Parótida , Cabeça
12.
J Am Anim Hosp Assoc ; 60(2): 68-73, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38394695

RESUMO

A 3 yr old female spayed Labrador retriever was referred for the treatment of a chronic oropharyngeal stick injury. After computed tomography scan evaluation, the cervical area was explored surgically and a right-sided cervical abscess that contained a wooden stick was identified adjacent to the vagosympathetic trunk and carotid artery. The ipsilateral mandibular salivary gland was resected concurrently given its abnormal appearance, and histology confirmed inflammation and necrosis of the gland, which was suspected to be due to direct trauma from the foreign body. The clinical signs initially improved but then recurred, and a follow-up computed tomography scan was suggestive of sialadenosis or sialadenitis in the right parotid, zygomatic, and molar salivary glands. A presumptive diagnosis of sialadenosis was made and a course of phenobarbital was initiated. The clinical signs resolved completely within a few days, and there was no recurrence several months after termination of the phenobarbital treatment. This is the first case report of presumptive sialadenosis in a dog as a suspected complication of an oropharyngeal stick injury. Informed consent was obtained from the owner of the dog and the patient was managed according to contemporary standards of care.


Assuntos
Doenças do Cão , Sialadenite , Cães , Feminino , Animais , Doenças do Cão/tratamento farmacológico , Sialadenite/diagnóstico , Sialadenite/veterinária , Sialadenite/patologia , Orofaringe/lesões , Orofaringe/patologia , Fenobarbital , Glândula Parótida/patologia
13.
Clin Oral Investig ; 28(2): 154, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38366095

RESUMO

OBJECTIVES: The objective was to evaluate the effects of experimental apical periodontitis on the inflammatory, functional, biochemical, and redox parameters of the parotid and submandibular glands in rats. MATERIALS AND METHODS: Twenty 12-week-old male Wistar rats were randomly divided into two groups (n = 10): a control group and apical periodontitis group. After 28 days, the saliva was collected for salivary flow rate and biochemistry composition. Both glands were sampled for quantification of the tumor necrosis factor-alpha (TNF-α) and biochemical analyses of redox state. RESULTS: TNF-α concentrations were higher in both salivary glands adjacent to the periapical lesions in animals with apical periodontitis and also compared to the control group. The apical periodontitis group increased the salivary amylase, chloride, potassium, calcium, and phosphate. The total oxidant capacity increased in the parotid gland adjacent to the periapical lesions in the same rat and compared to the control group. Conversely, the total antioxidant capacity of the parotid glands on both sides in the apical periodontitis group was lower than that in the control group. Furthermore, glutathione peroxidase activity increased in the submandibular gland adjacent to the apical periodontitis group compared to the control group. CONCLUSIONS: Experimental apical periodontitis alters salivary biochemical composition, in addition to increasing inflammatory marker and inducing local disturbances in the redox state in the parotid and submandibular glands of male rats. CLINICAL RELEVANCE: Apical periodontitis could exacerbate the decline in oral health by triggering dysfunction in the salivary glands.


Assuntos
Periodontite Periapical , Fator de Necrose Tumoral alfa , Ratos , Masculino , Animais , Ratos Wistar , Fator de Necrose Tumoral alfa/metabolismo , Glândulas Salivares , Glândula Submandibular , Glândula Parótida , Saliva/química , Oxirredução , Antioxidantes/metabolismo , Periodontite Periapical/metabolismo
14.
BMC Oral Health ; 24(1): 245, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38365725

RESUMO

BACKGROUND: This study aimed to investigate the homogeneity of the major salivary glands in multiple sclerosis (MS) patients using ultrasonography (USG), assess DMFT indices, measure resting salivary flow rates, and compare these values with healthy individuals. METHODS: In this study, 20 individuals diagnosed with Relapsing-Remitting Multiple Sclerosis (RRMS) (mean age 36.15 ± 8.51) and 20 systemically healthy individuals (mean age 35.7 ± 9.22) were included. Oral and radiologic examinations were performed in all individuals. The parotid and submandibular salivary glands were examined using USG, and their homogeneity was assessed based on the scoring system recommended by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) study group. Resting salivary flow rates and DMFT indices were measured, and the obtained data were subjected to statistical analysis. RESULTS: The parotid glands exhibited more heterogeneity on USG within the MS patient group than the control group, with a statistically significant difference between the two groups (p = 0.015). A statistically significant correlation was observed in total homogeneity values between the patient and control groups (p = 0.021). Furthermore, the MS patient group exhibited higher DMFT indices and lower salivary flow rates than the control group. The difference between the DMFT indices and salivary flow rate between the patient groups was statistically significant (p = 0.004 and p = 0.002 respectively). CONCLUSIONS: The parenchyma of the major salivary glands in MS patients exhibited decreased homogeneity than the healthy controls. Additionally, the MS group showed a decrease in salivary flow rate and an increase in the DMFT index. Autonomic dysfunction and medications used for MS are thought to cause salivary gland hypofunction and dry mouth. It can be interpreted that hyposalivation and motor skill losses in MS patients lead to an increase in DMFT index.


Assuntos
Esclerose Múltipla , Síndrome de Sjogren , Xerostomia , Humanos , Adulto , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/complicações , Glândulas Salivares/diagnóstico por imagem , Xerostomia/diagnóstico por imagem , Xerostomia/etiologia , Glândula Parótida/diagnóstico por imagem , Ultrassonografia/efeitos adversos , Síndrome de Sjogren/complicações
15.
Nucl Med Commun ; 45(4): 312-320, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38312062

RESUMO

OBJECTIVE: This study aimed to evaluate the effects of three antioxidants, selenium yeast capsule, vitamin E and vitamin C, alone or in combination, on the salivary glands of patients with differentiated thyroid cancer (DTC) treated with iodine-131 ( 131 I). METHODS: A total of 69 postoperative DTC patients were randomly divided into three groups: vitamin E combined with vitamin C group (21 cases); selenium yeast group (23 cases); and selenium yeast combined with vitamin C group (25 cases). Salivary gland functional changes were assessed by salivary gland dynamic imaging functional parameters in the enrolled patients before and 1 month after 131 I treatment. RESULTS: Comparison of salivary gland function parameters before and after 131 I treatment in the three groups were evaluated. In the vitamin E combined with the vitamin C group, the left parotid gland excretion fraction (EF) value was significantly higher than that before treatment. In the selenium yeast group, the left parotid gland excretion part, bilateral parotid gland excretion ratio (ER), left submandibular gland maximum uptake ratio within 20 min (UR20), and the right submandibular gland ER values were significantly higher than that before treatment, while in the selenium yeast combined with vitamin C group, the bilateral parotid gland EF, bilateral submandibular gland UR20, EF, and left submandibular gland ER values were significantly higher than that before treatment (all P < 0.05). CONCLUSION: During high-dose 131 I treatment, vitamin E combined with vitamin C improved the excretory function of parotid glands in DTC patients; selenium supplementation had a protective effect on salivary glands; and the combination of selenium and vitamin C had a better effect.


Assuntos
Selênio , Neoplasias da Glândula Tireoide , Humanos , Radioisótopos do Iodo/uso terapêutico , Antioxidantes/uso terapêutico , Antioxidantes/farmacologia , Selênio/farmacologia , Selênio/uso terapêutico , Saccharomyces cerevisiae , Neoplasias da Glândula Tireoide/radioterapia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/tratamento farmacológico , Glândulas Salivares , Glândula Parótida , Vitamina E/farmacologia , Vitamina E/uso terapêutico , Ácido Ascórbico/farmacologia , Ácido Ascórbico/uso terapêutico
17.
Int J Clin Pract ; 2024: 5525741, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38410673

RESUMO

Cutaneous squamous cell carcinomas (cSCC) are malignant tumours with excellent prognosis unless nodal metastases develop. The aim of our study is to determine the prognostic significance of the clinical stage of parotid gland metastases and the incidence of occult cervical lymph node involvement in cSCC of the head. Our retrospective analysis includes 39 patients with cSCC parotid gland metastases, 15 of whom had concurrent cervical node involvement. In 32 patients, the lymph nodes manifested at stage N3b. A total of 26 patients were treated with parotidectomy, 9 patients received radiotherapy alone, and 4 received symptomatic therapy. The surgical treatment included either total conservative (21 cases) or superficial parotidectomy (5 cases) and neck dissection (therapeutic neck dissections in 11 cases and elective in 14 cases). In all cases, surgery was performed with sufficient tumour-free resection margins. Adjuvant radiotherapy was administered postoperatively in 16 patients. Occult metastases were present in 21% of cases after an elective neck dissection, but not in any case in the deep lobe of the parotid gland. The five-year overall survival and recurrence-free interval were 52% and 55%, respectively. Patients with the cN3b stage and G3 histological grade tend to have a worse prognosis, but not at a statistically significant level. The prognosis was not worse in patients with concurrent parotid and cervical metastases compared to those with metastases limited to the parotid gland only. The addition of adjuvant irradiation, in comparison to a single modality surgical treatment, was the only statistically significant prognostic factor that reduced the risk of death from this diagnosis (p=0.013). The extent of parotidectomy (partial vs. total) had no impact on either the risk of recurrence or patient prognosis. The combination of surgery with irradiation provides the best results and should be applied to all patients who tolerate the treatment. A partial superficial parotidectomy should be sufficient, with a minimum risk of occult metastasis in the deep lobe. Conversely, the relatively high incidence of occult neck metastases indicates that patients could likely benefit from elective neck dissection.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Parotídeas , Neoplasias Cutâneas , Humanos , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Glândula Parótida/cirurgia , Glândula Parótida/patologia , Estudos Retrospectivos , Neoplasias Parotídeas/cirurgia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/secundário , Estadiamento de Neoplasias
18.
Dev Biol ; 509: 1-10, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38311164

RESUMO

Saliva is vital to oral health, fulfilling multiple functions in the oral cavity. Three pairs of major salivary glands and hundreds of minor salivary glands contribute to saliva production. The secretory acinar cells within these glands include two distinct populations. Serous acinar cells secrete a watery saliva containing enzymes, while mucous acinar cells secrete a more viscous fluid containing highly glycosylated mucins. Despite their shared developmental origins, the parotid gland (PG) is comprised of only serous acinar cells, while the sublingual gland (SLG) contains predominantly mucous acinar cells. The instructive signals that govern the identity of serous versus mucous acinar cell phenotypes are not yet known. The homeobox transcription factor Nkx2.3 is uniquely expressed in the SLG. Disruption of the Nkx2.3 gene was reported to delay the maturation of SLG mucous acinar cells. To examine whether Nkx2.3 plays a role in directing the mucous cell phenotype, we analyzed SLG from Nkx2.3-/- mice using RNAseq, immunostaining and proteomic analysis of saliva. Our results indicate that Nkx2.3, most likely in concert with other transcription factors uniquely expressed in the SLG, is a key regulator of the molecular program that specifies the identity of mucous acinar cells.


Assuntos
Proteômica , Fatores de Transcrição , Camundongos , Animais , Fatores de Transcrição/genética , Glândulas Salivares , Glândula Sublingual , Glândula Parótida , Proteínas de Homeodomínio/genética
19.
Artigo em Inglês | MEDLINE | ID: mdl-38195353

RESUMO

OBJECTIVE: To investigate the value of magnetic resonance imaging (MRI) signal intensity ratios (SIRs) based on fat-suppressed T2-weighted imaging (FS-T2WI), together with demographic features, MRI anatomical characteristics, and SIRs of histopathological patterns of the tumors, in the differentiation of parotid pleomorphic adenoma (PA) from Warthin tumor (WT). STUDY DESIGN: In total, 90 patients with PA and 56 patients with WT were enrolled in the study. SIRs of tumor to normal parotid gland (SIR-T/P), spinal cord (SIR-T/S), and muscle (SIR-T/M) were calculated. Demographic and radiological features of the 2-patient groups were compared with univariate analysis and multivariate logistic regression analysis. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were analyzed to evaluate the utility of SIRs in distinguishing between PA and WT. RESULTS: SIR-T/P exhibited outstanding discriminating ability (AUC = 0.934), SIR-T/S had excellent discrimination (AUC = 0.839), and SIR-T/M showed acceptable discrimination (AUC = 0.728). When SIR-T/P of 1.96 was selected as the cutoff value, sensitivity and specificity were 0.756 and 0.982, respectively. SIR-T/P, age, sex, and number of lesions were identified as independent predictors by multivariate logistic regression analysis. Differences in SIRs between histopathological patterns were significant. CONCLUSION: SIR-T/P based on FS-T2WI is an effective discriminator in the differential diagnosis between PA and WT. Age, sex, and number of lesions provided additional value in differentiation.


Assuntos
Adenolinfoma , Adenoma Pleomorfo , Neoplasias das Glândulas Salivares , Humanos , Adenoma Pleomorfo/patologia , Adenolinfoma/diagnóstico por imagem , Adenolinfoma/patologia , Imageamento por Ressonância Magnética/métodos , Glândula Parótida/patologia
20.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 59(2): 173-177, 2024 Feb 09.
Artigo em Chinês | MEDLINE | ID: mdl-38280737

RESUMO

To investigate the safety and feasibility of gasless total endoscopic resection of deep lobe parotid gland tumors via a postauricular hairline plus temporal approach. The approach was designed as: a 4 to 5 cm main incision was designed at the postauricular hairline, and a 0.5 cm auxiliary incision was designed in the temporal hairline. The operating cavity was established with the assistance of a special retractor. "Anterograde" dissection of the facial nerve was performed throughout the procedure, along with partial or total gland removal of the tumor. All 16 operations were successfully completed without conversion to open surgery. During the operation, the trunk and branches of the facial nerve were completely preserved, the tumor was completely removed, and the incision healed. Six patients had mild facial paralysis after operation, and recovered completely after 3 to 6 months. There was no salivary fistula, Frey syndrome, infection, or other complications. The postoperative incision was concealed and the aesthetic effect was good. The postauricular hairline plus temporal approach gasless total endoscopic parotidectomy is safe and feasible. This technique can achieve the complete dissection of the total trunk to the branches of the facial nerve, and has good access to the tumors located in any part of the parotid gland region. On the basis of radical resection of the tumor, it achieves minimally invasive and aesthetic improvement.


Assuntos
Paralisia Facial , Neoplasias Parotídeas , Humanos , Glândula Parótida/cirurgia , Estética Dentária , Neoplasias Parotídeas/cirurgia , Endoscopia/métodos , Paralisia Facial/etiologia , Complicações Pós-Operatórias
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