Use of PerClot® in head and neck surgery: a Scottish centre experience.

OBJECTIVE: PerClot® is a biocompatible, polysaccharide haemostatic system recommended for surgical procedures. It is an absorbable modified polymer that is non-pyrogenic and is derived from purified plant starch. Our goal was to evaluate the safety, efficacy and usefulness of PerClot® in head and neck surgery (H&N) in our department. METHODS: All patients who received PerClot® after their neck operation over 1-year period (2019-2020) were prospectively investigated. The information collected included demographics, admission and discharge dates, type of operation, operative details, postoperative complications and their management. The data were collected and analysed using Excel. RESULTS: A total of 57 patients (males = 26, females = 31) with mean age of 51 (range 19-83) were identified. None of the patients developed primary or secondary haemorrhage. Ten patients suffered from post-operative wound complications (18%). Wound infection was noticed in 9/57 (16%) of patients. 1/57 patients had seroma. CONCLUSIONS: PerClot® is safe, effective in reducing the postoperative bleeding and would appear to be useful in head and neck surgery with minimal adverse effects.

The diagnostic value of cytology in parotid Warthin's tumors: international multicenter series.

INTRODUCTION: Warthin's tumor (WT) is a common benign salivary gland neoplasm with a negligible risk of malignant transformation. However, there is a risk of malignant tumors being misdiagnosed as WT on cytology and inappropriately managed conservatively. METHODS: Patients from nine centers in Italy and the United Kingdom undergoing parotid surgery for cytologically diagnosed WT were included in this multicenter retrospective series. Definitive histology was compared with preoperative cytological diagnoses. Surgical complications were recorded. RESULTS: A total of 496 tumors were identified. In 88.9%, the final histological diagnosis was WT. In 21 cases (4.2%) a malignant neoplasm was diagnosed, which had been incorrectly labeled as WT on cytology. CONCLUSIONS: The risk of undiagnosed malignancy should be balanced against surgical risks when considering the management of WT. Although nonsurgical management remains an appropriate option, there may be a rationale for serial clinical or radiological evaluation if surgical excision is not performed.

Surveillance of HPV-Positive Head and Neck Squamous Cell Carcinoma with Circulating and Salivary DNA Biomarkers.

Head and neck squamous cell carcinoma (HNSCC) manifests in the mucosal epithelial lining of the oral cavity, oropharynx, hypopharynx, nasopharynx or larynx and has a tremendous disease burden worldwide. Smoking and alcohol consumption were once major risk factors, but HPV-associated infection has emerged as the major contributor to HNSCC occurrence in developed countries. Circulating biomarker evaluations in biofluids, also known as liquid biopsy, are an attractive alternative for cancer screening as they are minimally invasive, potentially low cost, and easily repeatable on a serial basis. This review summarizes the current knowledge and potential of assessing circulating blood and salivary HPV DNA and HPV antibodies for the surveillance of HPV-positive HNSCC. Additionally, the biological underpinnings of the presence and relevance of circulating HPV DNA is discussed.

Mantle Cell Lymphoma of the Palatine Tonsil: A Rare Case Report.

INTRODUCTION: Primary mantle cell lymphoma (MCL) of the palatine tonsil without involvement of the regional lymph nodes is rarely reported. CASE REPORT: A 52-year-old male presented with complaints of a change in his voice over 3 months, with neither sore throat nor fever. Physical examination revealed right-sided grade IV and left-sided grade III tonsillar enlargement with prominent vessels. The patient underwent bilateral tonsillectomy. An initial histopathological report revealed chronic tonsillitis on the left side and suspicion of atypical lymphoproliferative disorder on the right. Immunohistochemically, the neoplastic cells were positive for Bcl2, CD20, CD5 and Cyclin D1 and negative for CD10, Bcl6 and CD3; thus a diagnosis of MCL was confirmed. CONCLUSION: MCL of the tonsil is rare. The microscopic diagnosis is challenging as the picture is very similar compared with other types of small cell lymphomas. A detailed immunohistochemistry panel is required for an accurate diagnosis.

Rhinosporidiosis: A Chronic Tropical Disease in Lateral Pharyngeal Wall.

Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. It predominantly affects the mucous membranes of the nose and the nasopharynx. Clinically the lesion presents as a pink or red pedunculated polyp in one or both nostrils. Diagnosis can be made by aspiration cytology and examination with May-Grunwald-Giemsa, hematoxylin and eosin, Periodic acid-Schiff and mucicarmine staining. Definitive diagnosis is by histopathology of the specimen. We report a case of Rhinosporidiosis at the lateral pharyngeal wall which is a very rare site for Rhinosporidiosis to occur; was treated by diathermy excision of the mass and cauterization of the base and oral Dapsone to prevent recurrence of the disease.

Soft tissue myxoma- a rare differential diagnosis of localized oral cavity lesions.

Myxomas have a common histologic appearance of myxoid ground substance and are classified in group of soft tissue tumors. According to literature myxomas occurring in every decade of life have been reported. Very often intraoral soft tissue myxoma can be misinterpreted as malignant and are difficult to differentiate from the other tumours with myxoid stroma. Of the different variants of soft tissue myxoma, intraoral is extremely rare, slow growing, benign mesenchymal tumour. We report a case of a 22-year-old male who presented with swelling in the right cheek and mass in the right buccal mucosa that appeared gradually over two year. No history of pain over the lesion or bleeding on touch. On intraoral examination a lesion measuring 3 X 3 cm was seen in the right buccal mucosa. Biopsy of the lesion revealed oral soft tissue myxoma. Wide excision with clinically clear margins was done under general anaesthesia. Histopathological report revealed the diagnosis as to be oral soft tissue myxoma. A case of oral soft tissue myxoma is presented for its rarity and for differential diagnosis of localized oral cavity lesions.