Is extracapsular dissection for pleomorphic adenoma rather a euphemism for enucleation that jeopardises the intactness of the capsule?

The aim of this study was to compare several surgical modalities with respect to the incidence of positive margins and focal capsular exposure of pleomorphic adenoma of the parotid gland. The clinical records and histopathological findings of all patients who underwent parotidectomy for pleomorphic adenoma between 2006 and 2020 were retrospectively evaluated (n = 845). The lesion was removed by extracapsular dissection in 577 cases (68%) and facial nerve dissection in 268 (32%). Our analysis did not reveal a statistically significant difference between the examined modalities regarding positive margins (p=0.648) or capsular exposure (p=0.112). Recurrences were detected in 7/845 cases (0.82%) with a mean (range) follow-up time of 82.3 (6-183) months. The choice of surgical method does not seem to have a significant effect on the incidence of positive margins, or on the capsular exposure of a pleomorphic adenoma.

[Acupuncture as after care following injuries of the upper extremities]. / Die Akupunktur als Nachbehandlung nach Verletzugen der oberen Extremitäten.

Acupuncture is able to improve restriction of motion in general and in the smaller joints of the upper extremity, disturbances in circulation, posttraumatic swelling, reversible nerve lesions and ulcers following burns or pressure of a plaster. Localisation of the points for acupuncture in the different conditions and the possibilities of their combinations are described. Acupuncture is performed bilaterally at symmetrical points, unilaterally in pareses, contralaterally in amputees and in cases with dressings. During ear acupuncture the analgesic effect occurs more quickly, but has a shorter duration of action; in paralyses it was without success. The course of the treatment was controlled by clinical examination and measurement of the range of motion.