Growth rates over time of unoperated parotid benign tumors.

INTRODUCTION: The treatment of parotid benign tumor is in principle surgery, but observation may be necessary in some cases. The purpose of this study was to investigate the growth rates over time of unoperated parotid benign tumors. METHODS: We retrospectively reviewed the medical records of 63 patients with unoperated parotid benign tumors diagnosed at our institution between January 2010 and December 2022. RESULTS: Forty-nine of the 63 patients had a Warthin tumor and 13 patients had a pleomorphic adenoma. On average, the unoperated parotid benign tumors grew 0.02 cm in length and 0.4 cm3 in volume per year. Compared to pleomorphic adenomas, Warthin tumors were more predominant in male patients and in those with a smoking history and a longer duration of smoking history; patients with Warthin tumors were also followed up longer (p < 0.05). However, the length and volume growth rates of unoperated Warthin tumors and pleomorphic adenomas did not significantly differ. CONCLUSION: Surgery is the standard treatment for parotid benign tumors. However, small benign parotid tumors identified during preoperative examination can be observed through close follow-up, taking into account the patient's medical and general condition.

Comparative analysis of benign and malignant parotid gland tumors: A retrospective study of 992 patients.

OBJECTIVE: We analyzed and compared the clinical characteristics of benign and malignant parotid gland tumors. PATIENTS AND METHODS: A total of 992 patients who underwent surgical treatment for parotid gland tumors from January 2010 to December 2020 were included in this study. This study population was subdivided into benign (n = 812, 81.9 %) and malignant parotid gland tumors (n = 180, 18.1 %). RESULTS: Pleomorphic adenoma is the most common benign tumor and mucoepidermoid carcinoma is the most common malignant tumor. The patients with malignant parotid gland tumors were older than the patients with benign lesions. The duration of symptoms was longer in patients with benign parotid gland tumors compared to those with malignant lesions. The size of the malignant tumors was larger than that of the benign lesions. Preoperative fine-needle aspiration cytology had a diagnostic sensitivity of 50.3 %, diagnostic specificity of 98.7 %, a positive predictive value of 89.5 %, a negative predictive value of 89.9 %, and accuracy of 89.9 % for diagnosing malignant parotid gland tumors. For benign parotid gland tumors, superficial parotidectomy was most frequently performed, and for malignant parotid gland tumors, total parotidectomy was most frequently performed. Facial palsy was observed in 19.4 % of the patients with malignant parotid gland tumors compared to 5.4 % of those with benign tumors. CONCLUSION: The clinical features of benign and malignant parotid gland tumors showed differences in age, symptoms, duration of symptoms, size and site of the parotid tumors, surgical procedures, and postoperative facial nerve palsy.

Delayed Pharyngocutaneous Fistula After Total Laryngectomy Caused by an Anterior Cervical Spine plate.

Pharyngocutaneous fistula (PCF) caused by a previous anterior cervical spine fixation plate more than a decade ago has not been reported yet. A 70-year-old man with dysphagia was diagnosed as supraglottic cancer. After partial laryngectomy and concurrent chemoradiation, due to increasing arytenoid lesion, total laryngectomy was followed. Pharyngocutaneous fistula occurred but resolved spontaneously. However, retropharyngeal granulation tissue emerging from the anterior cervical spine fixation plate caused delayed PCF. Dysphagia and PCF resolved after fixation plate removal.

Natural killer cells have a synergistic anti-tumor effect in combination with chemoradiotherapy against head and neck cancer.

BACKGROUND: The use of natural killer (NK) cells is a promising approach in the field of cancer immunotherapy; however, combination treatments are required to enhance the effects of NK cell immunotherapy. In this study, we assessed the potential of irradiation and cisplatin as a chemoradiotherapy (CRT) regimen to augment the effects of NK cell immunotherapy in head and neck squamous cell carcinoma (HNSCC). METHODS: NK cells were expanded using our recently established K562-OX40 ligand and membrane-bound interleukin (IL)-18 and IL-21 feeder cells in the presence of IL-2/IL-15 from peripheral blood of healthy donors. RESULTS: The results showed an increase in the purity of NK cells and expression of activation markers such as NKG2D and lymphocyte function-associated antigen 1 during the expansion process, which is positively correlated to the NK cell infiltration and overall survival in patients with HNSCC. CRT induced NK cell activation ligand (ULBP2) and adhesion molecules (ICAM-1, -2 and -3) on HNSCC, leading to enhanced cytotoxicity of NK cells against HNSCC. CONCLUSIONS: Our findings suggest that the NK cells have a potent anti-tumor effect in combination with CRT against HNSCC.

Carcinoma ex pleomorphic adenoma of the parotid gland.

INTRODUCTION: Carcinoma ex pleomorphic adenoma (CXPA) is a rare malignant tumor of the parotid gland. We analyzed the clinical characteristics and treatment outcomes of CXPA of the parotid gland in patients managed for 11 years at this hospital. METHODS: The study included 17 cases of CXPA of the parotid gland from January 2010 to December 2020. RESULTS: Over 11 years, CXPA was the fourth most common parotid carcinoma, accounting for 9.4% of the 180 cases finally diagnosed as parotid carcinoma. Of the 17 cases of CXPA of the parotid gland, 12 lesions were removed by superficial parotidectomy, four lesions by total parotidectomy, and one lesion by radical parotidectomy. Four patients underwent neck dissection. The most common histopathology type was salivary duct carcinoma (n = 13, 76.5%). Postoperative radiation therapy (RT) was performed in 15 patients. Two patients (11.8%) experienced CXPA recurrence 14 and 19 months after surgery. CONCLUSION: CXPA of the parotid gland was treated without recurrence in about 90% of the patients through surgery and postoperative RT. In the case of frankly invasive or adverse factors in the histopathological examination, more attention is required because CXPA recurrence may occur more frequently.

Length of the Most Distal End of Head and Neck Defect to Axilla Affects Survival of Pedicled Latissimus Dorsi Flap.

OBJECTIVES: The objective of this study was to determine factors affecting the survival of pedicled latissimus dorsi (LD) flap. MATERIALS AND METHODS: Medical records of 20 pedicled LD flap patients for head and neck reconstruction by a single operator from 2015 to 2019 in a tertiary hospital were reviewed. Factors including flap size and pedicle's length from the most distal end of the flap to the axilla (Fp) and from the most distal end of the defect to the axilla (Dfp) were assessed. Partial flap loss requiring procedures and total loss were considered as failure. Descriptive statistics, the Pearson χ 2 test, and linear-by-linear association analysis were performed. RESULTS: Seventy percent of patients showed success. There was no significant difference in various factors including preoperative body mass index, underlying diseases such as hypertension and diabetes, preoperative treatment either radiation or chemotherapy, lab results, and operation time between the survival and the failure group. Rotation arc (Dfp/Fp) showed significant difference between 2 groups ( P =0.001). Unlike Fp, Dfp tend to be shorter on the success group ( P =0.053). CONCLUSIONS: Low rotation arc through shorter Dfp affects survival of pedicled LD flap significantly.

Surgical Treatment of Parapharyngeal Space Salivary Gland Tumor.

INTRODUCTION: Parapharyngeal space salivary gland tumors are very rare. The authors sought to examine the clinical features, treatment methods, and treatment results of parapharyngeal space salivary gland tumors in our hospital. METHODS: The authors retrospectively enrolled 15 patients who were finally diagnosed as having parapharyngeal space salivary gland tumors from January 2010 to January 2021. RESULTS: All parapharyngeal space salivary gland tumors arose from the prestyloid compartment. This study included 3 males and 12 females. The main symptoms were incidental diagnosis during imaging tests, followed by neck discomfort, oral mass, neck mass, and headache. Surgical methods for parapharyngeal space salivary gland tumors were performed in the following order: transcervical approach (n = 10), transcervical-parotid approach (n = 3), transoral approach (n = 1), and transparotid approach (n = 1). Pleomorphic adenoma was the most common tumor among parapharyngeal space salivary gland tumors. CONCLUSIONS: In the surgery of parapharyngeal space salivary gland tumors, a transcervical or transcervical-parotid approach was mainly used by predicting the origin site through radiologic examinations.

Facial nerve neurorrhaphy due to unexpected facial nerve injury during parotid gland tumor surgery.

BACKGROUND: Unexpected facial nerve damage can occur during parotid gland tumor surgery. We sought to determine the incidence and treatment outcomes of unexpected facial nerve injuries in patients with parotid gland tumor surgery. METHODS: We retrospectively enrolled in this study five patients, who underwent facial nerve neurorrhaphy due to unexpected facial nerve injury during parotid gland tumor surgery January 2012-August 2019. RESULTS: There were five patients (0.008%) with unexpected facial nerve injuries during the parotid gland tumor surgery of 577 patients in our hospital for approximately 8 years. The most common injury site of facial nerve was the marginal mandibular branch (n = 3), followed by the buccal branch (n = 1), and the cervicofacial division (n = 1). In the case of unexpected facial nerve damage, our treatment is immediate primary neurorrhaphy and steroid treatment. Three patients of five recovered and two did not worsen immediately after surgery. CONCLUSION: Unexpected facial nerve injury during parotid gland tumor surgery is extremely unfortunate. In this case, immediate primary neurorrhaphy and systemic steroids are recommended to restore facial function and reduce cosmetic deficits.

Clinical difference between benign and malignant tumors of the hard palate.

OBJECTIVE: To determine the clinical characteristics and treatment results of benign and malignant tumors of the hard palate in our hospital. PATIENTS AND METHODS: A total of 25 patients who underwent surgical treatment for hard palate tumors between 2008 and 2018 were included in this study. Their demographic characteristics, smoking status, alcohol consumption, symptoms, duration of symptoms, size and localization of hard palate tumor, status of mucosal surface, radiologic examinations, surgery, reconstruction method, histopathologic results, treatment outcomes, oral intake start time, adjuvant treatment, postoperative complications, and recurrence were reviewed. RESULTS: Of the 25 patients with hard palate tumors, 15 (60.0%) had benign tumors and 10 (40.0%) had malignant tumors. Both benign and malignant tumors of the hard palate occurred more frequently in females than in the males. The most common symptom of hard palate tumor was palate mass. The most common benign tumor was pleomorphic adenoma (n = 13). The most common malignant tumors were squamous cell carcinoma and carcinoma ex pleomorphic adenoma (n = 3 for each). All patients were operated via transoral approach without external incision. We did not experience any recurrence in this study. The oral intake start time was late in malignant hard palate tumors (p < 0.05). CONCLUSION: The comparison of clinical features of benign and malignant hard palate tumors showed a statistical significance only for oral intake start time. Transoral surgical removal with clear margin is a safe and effective procedure for benign and malignant hard palate tumors.

Gelatin Sponge Induced Maxillary Sinusitis After Transsphenoidal Pituitary Surgery.

Transsphenoidal pituitary surgery is a safe, well-established treatment method, but it is associated with several postoperative nasal complications. However, gelatin sponge induced maxillary sinusitis after transsphenoidal pituitary surgery has not been reported. In this study, we present an unusual case of gelatin sponge induced maxillary sinusitis after transsphenoidal pituitary surgery. Therefore, it should be recognized that gelatin sponge induced maxillary sinusitis may occur as a complication after transsphenoidal pituitary surgery.

Nasal Septum Actinomycosis Mimicking Mucocele.

Actinomycosis commonly occurs in the cervicofacial region, but rarely in the paranasal sinus. The authors report an unusual case of nasal septum actinomycosis that was mistaken for a mucocele. The patient was treated accordingly using antibiotic therapy after endoscopic sinus surgery was performed. It is noteworthy that actinomycosis of the nasal septum could appear as a mucocele without central calcification or bony destruction in imaging studies.

External Jugular Vein Aneurysm in a Child With Hemophilia A.

An external jugular vein (EJV) aneurysm is an extremely rare disease. Ultrasonography with color doppler methods is considered the criterion standard for diagnosis of a venous aneurysm. The treatment of choice for an EJV aneurysm is surgical excision. Herein, we report an unusual case of an EJV aneurysm in a child with hemophilia A. Because the incidence of an EJV aneurysm is low, it is important to distinguish it from other neck lesions, including congenital disease. In addition, it should be noted that in hemophilia patients, an EJV aneurysm may occur in a spontaneous or small trauma.

Coexistence of Antrochoanal Polyp and Fibrous Dysplasia in the Maxilla.

The authors report an unusual case of coexistence of antrochoanal polyp (ACP) and fibrous dysplasia (FD) in the maxilla. To the best of our knowledge, this condition has never been reported in the literature. The complete removal of the ACP through endoscopic sinus surgery was attained and FD was ultimately diagnosed by histopathological examination. It is hypothesized that chronic inflammation or irritation due to FD has an effect on the occurrence of ACP.

Cavernous Lymphangioma in the Maxillary Sinus.

Lymphangioma in the maxillary sinus is rare. Herein, the authors report an unusual case of cavernous lymphangioma, in the maxillary sinus, with imaging examinations. Clinicians should be aware of the possibility of lymphangioma in the maxillary sinus, and be capable of distinguishing it, from other benign cystic lesions.

Clinical Study of Second Branchial Cleft Anomalies.

OBJECTIVE: The objective of this study was to review the clinical characteristics and surgical treatment outcomes of second branchial cleft anomalies, and to evaluate the usefulness and accuracy of preoperative fine-needle aspiration cytology (FNAC) in the diagnosis of branchial cleft cysts. METHODS: A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2010 to December 2016. RESULTS: Among 25 patients with second branchial cleft anomalies, in 23 patients (92.0%), these anomalies presented as cysts, and in the remaining 2 patients (8.0%), these anomalies presented as fistulas. Fine-needle aspiration cytology had a diagnostic sensitivity of 100%, a positive-predictive value of 100%, and accuracy of 100% for diagnosing second branchial cleft cyst. All patients of second branchial cleft anomalies were treated surgically under general anesthesia. No recurrence of second branchial cleft anomalies was observed. CONCLUSION: Branchial cleft cysts were the most common type of second branchial cleft anomalies. Preoperative FNAC is a useful and accurate method for preoperative evaluation of branchial cleft cysts. Surgical excision of second branchial cleft anomalies is the treatment of choice without any complications and with no recurrence.

Surgical Treatment Outcomes of Vocal Process Granuloma After Endotracheal Intubation.

INTRODUCTION: The objective of this study was to review the clinical characteristics and surgical treatment outcomes of the vocal process granuloma after the endotracheal intubation. METHODS: A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2008 to December 2015. RESULTS: Twenty-one vocal process granulomas after endotracheal intubation were diagnosed in 13 patients. The most common symptom was hoarseness. Among 13 patients, bilateral vocal process granulomas were in 8 patients. For the remaining 5 patients, their unilateral vocal process granulomas were all left-sided. All the cases of vocal process granulomas after the endotracheal intubation were treated by laryngoscope microsurgery under general anesthesia. Recurrence of vocal process granulomas was identified in 1 lesion. CONCLUSION: This study suggests that surgery for vocal process granuloma after endotracheal intubation is a good treatment option for a rapid resolution of lesions and the associated symptoms, along with having low recurrence rates.

Sphenoid Sinus Mucocele Caused by Complications After Transsphenoidal Pituitary Surgery.

OBJECTIVE: The purpose of this study was to review the clinical characteristics, treatment methods, and surgical outcomes of sphenoid sinus mucocele after transsphenoidal pituitary surgery. PATIENTS AND METHODS: A total of 404 patients who underwent transsphenoidal pituitary surgery between January 2010 and December 2016 were identified. Among them, 5 patients with sphenoid sinus mucocele were included in this study. In our hospital, a single-nostril endonasal endoscopic wide sphenoidotomy is routinely used for pituitary tumor surgery. RESULTS: The occurrence rate of sphenoid sinus mucocele was 1.2% (5/404). Of the 5 patients, 2 were males and 3 were females. Four lesions (80.0%) were located in the right sphenoid sinus and 1 lesion (20.0%) was located in the left sphenoid sinus. Endoscopic marsupialization for sphenoid sinus mucocele was performed under local anesthesia in all patients. There were no major complications resulting from the surgical intervention, and there was no recurrence at the time of the last follow-up. CONCLUSION: Sphenoid sinus mucocele after endonasal transsphenoidal pituitary surgery is an extremely rare complication. Nasal endoscopy and MRI are useful for diagnosing this lesion. Endoscopic marsupialization is a safe and effective procedure for sphenoid sinus mucocele after endonasal transsphenoidal pituitary surgery.

Double Thyroglossal Duct Cysts in an Adult.

Double thyroglossal duct cysts (TDCs) are a very rare congenital malformation. Herein, we report a rare case of double TDCs, one below the hyoid bone and the other at the base of the tongue. Clinicians should be aware that TDCs can occur as multiple cystic lesions. Preoperative radiological examinations should be performed for an accurate diagnosis of double TDCs.

Congenital Salivary Fistula From Parotid Main Gland.

Congenital parotid fistulas are extremely rare diseases. Herein, the authors report a patient with congenital salivary fistula from parotid main gland in a 15-year-old boy. Therefore, clinicians should consider the possibility of congenital parotid fistula form parotid main gland. Surgical excision of the fistula and parotid gland can be effective treatment option of congenital parotid fistula.

Bronchogenic Cyst in the Head and Neck Region.

OBJECTIVE: The objective of this study was to review the clinical characteristics and surgical treatment outcomes of patients with bronchogenic cysts in the head and neck region. METHODS: A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2006 to May 2016. RESULTS: Eight patients with a final diagnosis of bronchogenic cyst in the head and neck region were identified based on their medical records. The most common location for the head and neck lymphatic malformations was the neck (4 patients), followed by the soft palate (1 patient), the posterior pharyngeal wall (1 patient), the floor of mouth (1 patient), and the arytenoid (1 patient). The size of the lymphatic malformations ranged from 1 to 6 cm. Bronchogenic cysts recurred in 2 patients. Both these patients were disease-free after the revision operation. No major complications resulting from the surgical intervention were observed. CONCLUSION: Bronchogenic cysts are rare congenital malformations and they can occur at various sites in the head and neck region. Bronchogenic cyst should be considered in the differential diagnosis of midline and lateral neck masses or intraoral cysts.