Clear cell carcinoma: a comprehensive literature review of 254 cases.

This comprehensive literature review represents a summary of all cases of clear cell carcinoma (CCC) of the salivary glands that are documented in the literature. PubMed was used to collect available reports of CCC; 97 reports detailing 254 cases, published between 1983 and 2020, were retrieved. Clinically the tumor manifests most commonly as a painless mass or swelling on the palate, and the duration of symptoms prior to seeking care ranges from 1 week to 6 years. Metastasis, both local and distant, was reported in 13.9% of 202 total cases. Local tumor recurrence was present in 18.8% of the cases. By histopathology, CCC shows a mixture of growth patterns including solid (25.1%), nested (78.6%), sheet-like (23.5%), cords (46.1%), and trabeculae (42.4%). Immunohistochemical studies are positive for one or more cytokeratins (99.1%), PAS (95.1%), EMA (77.8%), and p63 (96.3%), but negative for S-100 (96.3%), PASD (91.1%), SMA (91.0%), and calponin (95.1%). Molecular features were reported in 115 cases; 96.0% were positive for an EWSR1 rearrangement by EWSR1 break apart FISH testing and 14.8% were positive for the rearrangement EWSR1-ATF1 tested by qPCR or targeted RNA sequencing. Clinical patterns and genetic studies imply that this tumor is the extraosseous counterpart of clear cell odontogenic carcinoma, an intraosseous odontogenic tumor of the jaws.

Clear cell odontogenic carcinoma: a rare jaw tumor. A summary of 107 reported cases.

The purpose of this study was to summarize the currently published cases of clear cell odontogenic carcinoma (CCOC). The PubMed and Springer databases were used to collect available reports, searching for 'clear cell odontogenic carcinoma', 'CCOC', or 'clear cell ameloblastoma'. The search resulted in 75 reports detailing 107 cases between 1985 and 2018. Clinically the tumor manifests as a swelling in the posterior mandible (n=46), anterior mandible (n=33), and maxilla (n=28). Radiological analysis of 85 cases typically showed a poorly defined expansive radiolucency (n=83). Of the 70 patients with symptoms reported, 44 specified a swelling, 11 tooth mobility, seven gingival/periodontal issues, five numbness, and three decreased jaw opening. One patient presented with a neck mass. The duration of symptoms prior to seeking care was specified for 52 patients: 2 months to 1 year for 34 patients, 1-2 years for seven, 2-4 years for two, 4-7 years for six, and 7-12 years for three. The incidence of recurrence appeared to be 38 of the 88 cases where recurrence was reported. CCOC can be distinguished from other oral cancers by its distinctive histology and immunohistochemical characteristics and less aggressive behavior. Currently, treatment should be early and aggressive resection with clear surgical margins and long-term follow-up. The overall goal is to collect a cohort of patients.

The surgical management of extra-articular ankylosis in noma patients.

Extraarticular ankylosis occurs frequently in children suffering from noma sequelae. Over 20years of operating on these patients, we observed high recurrence of mouth opening limitation. We therefore progressively changed our surgical strategy. This retrospective study compares the impact of different parameters (types of surgery, noma type, physiotherapy compliance, age and sex) on immediate and long-term mouth opening. It includes a series of 121 patients with extraarticular ankylosis operated on between 1990 and 2015. Soft tissue reconstruction evolved from local and pedicled flaps to large free flaps. Mouth opening was performed by bone-bridge excision, sometimes associated to contralateral coronoidectomy. Mouth opening technique including bilateral coronoidectomy with free flap reconstruction was the only independent factor for significantly better immediate mouth opening with a mean increase of 8.7mm [95% confidence interval (CI) 4.3-13.1, P<0.001) and this effect was maintained in the 3years of follow-up. Another positive factor related to long-term results was excellent physiotherapy, while noma type 4 was a negative factor. Recurrence remains problematic in the management of noma sequelae. If physiotherapy and long-term follow-up cannot be offered, patients should not be operated on, because if limitation of mouth opening recurs, oral feeding may become impossible when a facial defect has been reconstructed.

[Costal chondral grafting combined with mandibular distraction osteogenesis. A new approach to the correction of the temporomandibular joint ankylosis in an adult. A report of a case]. / Greffe chondrocostale et distraction mandibulaire simultanée. Une nouvelle approche dans le traitement de l'ankylose temporomandibulaire chez l'adulte. A propos d'un cas clinique.

The authors present a thirty two years old women complaining of a temporomandibular joint ankylosis. History revealed a mandibular trauma sustained during the early infancy. The patient presented a typical bird face deformity with a maximal mouth opening of zero millimiter. Facing the squelettal deformation, the authors decide to combine a simultaneous costochondral graft with bilateral horizontal branch distraction. Good functional and aesthetic results allow the patient to return to a good social integration with no sign of recurrence at the medium term follow-up.

Clinical experience in the treatment of noma sequelae.

We report a cohort of 148 African children operated on between 1985 and 2000 for noma sequelae. A total of 440 operations were performed. Lesions included mouth constriction in 70 of 148 cases, and severe bone destruction in 69 of 148 cases. A large proportion of children was transferred to Switzerland for surgical treatment, whereas the others were operated on in local hospitals in Africa. Vascularized calvarium flap was mostly used for bone reconstruction (n = 36). Pedicled latissimus dorsi myocutaneous flap was the preferred strategy for cheek reconstruction (n = 40). Expanded frontal flap was used for nasal reconstruction (n = 18), and pedicled heterolabial flap for lip construction (n = 37). Given the elevated level of recurrence of mouth constriction (extraarticular ankylosis), a minimum of 2 years' follow-up after surgical treatment was considered mandatory. Follow-up was conducted by field nurses from the humanitarian organizations, and a third of the patients were seen directly by our surgical team during special missions to Africa.

[Treatment of recurrent luxation of the temporomandibular joint with botulinum toxin]. / Traitement de la luxation temporo-mandibulaire récidivante par toxine botulique.

We report the case of a 70-year-old man who suffered recurrent dislocations of the temporomandibular joint secondary to severe Parkinson syndrome. The patient was given repeated injections of botulinum toxin. After 3 injections over a 9-month period, no further dislocation occurred. Botulinum toxin may be an alternative to surgery.

Improvement of pain and function after arthroscopy and arthrocentesis of the temporomandibular joint: a comparative study.

In 1993 and 1994, 720 patients with pain in the temporo-mandibular joint area were examined and treated. The authors describe their therapeutic protocol. Sixty-two patients were not relieved by conservative nonsurgical therapy and were treated by arthroscopy or arthrocentesis. In both groups the differences in functional result and in pain control were analysed. Results show that both arthroscopy and lavage are useful in improving function and diminishing pain. Arthroscopy shows better results for functional treatment whereas arthrocentesis and arthroscopy show similar results in pain control.

Upper airway compression after arthroscopy of the temporomandibular joint.

An unusual complication is presented following a temporomandibular arthroscopy carried out under general anaesthesia. Severe cervicofacial oedema occurred immediately after surgery which required prolonged endotracheal intubation. Retrospective analysis revealed a massive fluid escape in the surrounding tissues leading to laryngeal oedema.

Cysts of the temporomandibular joint. Report of two cases.

Two patients with a cyst of the TMJ are presented. One had a synovial cyst, the other a ganglion cyst. The differential diagnosis of these lesions is discussed.

A destructive calcium pyrophosphate dihydrate deposition disease of the temporomandibular joint.

A case of calcium pyrophosphate dihydrate (CPPD) crystal deposition arthropathy of the temporomandibular joint is reported. The patient presented a 10-year history of swelling and pain of the left preauricular region. Magnetic resonance imaging showed a calcified mass filling the joint space and destroying the roof of the joint. Radiographs showed chondrocalcinosis of other joints. The authors discuss the diagnosis of this arthropathy and the reason why the temporomandibular joint is more affected than the other joints in the patient reported.

[Surgical treatment of salivary incontinence in cerebral palsy]. / Traitement chirurgical de l'incontinence salivaire chez l'infirme moteur cérébral.

For patients with cerebral palsy, chronic drooling is the result of an abnormality in the cerebral control of orofacial motor functions. Sialorrhea is a troublesome problem for these patients and their attendants. Among various surgical techniques, rerouting of the Stensen's ducts and bilateral excision of the submandibular salivary glands, as described by Wilkie, gives good results. Transposition of the submandibular gland ducts in the tonsillar fossae is an easier procedure but less favorable. We present 19 patients treated by these two methods.