EVALUATING THE OUTCOMES OF MINIMALLY INVASIVE THERAPY VS SURGERY FOR ORAL MUCOCELES: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: Oral mucoceles could be managed with minimally invasive therapy (MIT) or conventional surgery, and both modalities reportedly possess advantages and demerits. This review aims to investigate and compare the postoperative disease recurrence and complications of these interventions with each other. METHODS: Relevant studies were searched in 5 databases (PubMed, Embase, Scopus, Web of Science and Cochrane Library) from inception to December 17, 2022. The pooled relative risks (RRs) with 95% confidence intervals (CIs) of disease recurrence, overall complications, nerve injury and bleeding/hematoma in MIT vs conventional surgery were calculated in meta-analysis. Trial Sequential Analysis (TSA) was performed to confirm our conclusions and assess the need for future trials. RESULTS: Six studies (1 randomized controlled trial and 5 cohort studies) were included for systematic review and meta-analysis. The results showed no significant difference in recurrence between MIT and conventional surgery (RR=0.80; 95% CI, 0.39-1.64; P = .54; I2=17%), and the results of the subgroup analysis were consistent. The incidence of the overall complications (RR=0.15; 95% CI, 0.05-0.47; P = .001; I2=0%) and nerve injury (RR=0.22; 95% CI, 0.06-0.82; P = .02; I2=0%) was significantly lower in MIT than in conventional surgery, but the incidence of bleeding/hematoma presented no significant difference (RR=0.34; 95% CI, 0.06-2.07; P = .24; I2=0%). The results of TSA suggested that the conclusion of MIT significantly reducing the risk of overall complications was stable; and additional clinical trials were need in the future for confirming the conclusions regarding disease recurrence, nerve injury and bleeding/hematoma. CONCLUSIONS: For mucoceles in the oral cavity, MIT is less likely to induce complications (i.e., nerve injury) compared with surgical removal, and the control of disease recurrence is comparable to that of conventional surgery. Therefore, the application of MIT for mucoceles could be a promising alternative to conventional surgery when the latter is not applicable.

Orbitofrontal cholesterol granuloma masquerading as frontal sinus mucoceles: report of two cases.

BACKGROUND: Two cases of orbitofrontal cholesterol granuloma masquerading as frontal sinus mucoceles were reported to understand image findings, clinical and histopathologic features of orbitofrontal cholesterol granuloma to improve its diagnosis and treatment. CASE PRESENTATION: Two East Asian patients aged 41 and 27 without personal or familial medical or trauma history presented with the common complaint of proptosis and inferomedial displacement of the eyeballs. The computed tomography (CT) of both cases showed an irregularly shaped, well-defined lesion in the left frontal bone associated with bony erosion. The lesions resulted in the bone absorption of frontal bone and orbital roof, which extended into the superior orbital space. Anterior orbitotomy through subbrow incision by drainage and curettage resulted in a curative outcome. The histopathological examination revealed inflammatory granulation tissues, fibrous capsule wall, cholesterol clefts with altered blood pigments, and calcifications, consistent with the diagnosis of cholesterol granuloma. No recurrence was observed for one year after surgery in one case and three years in the other. CONCLUSIONS: When the following features are observed: orbital CT exhibits cystic lesion with irregular bone destruction in the superolateral orbit, magnetic resonance imaging (MRI) depicts lesions are hyperintense signals on T1 weighted images (T1WI), and T2 weighted images (T2WI), and the contrast-enhanced imaging reveals that the most of tumor is showed a non-significant enhancement, orbitofrontal cholesterol granuloma should be considered.

Mucoceles of Paranasal Sinuses: A Single Centre Experience.

Describe experience of managing paranasal sinus mucoceles, with either endoscopic endonasal approach (EESS) or combined external with EESS approach. Retrospective study done at SDMCMS&H, between 2007 and 2019, on patients undergoing surgical excision of mucocele. Results described as mean, median, mode, percentages. Twenty-one patients were included, with male to female ratio (0.75:1), mean age (42.95 years). Commonest presentation were facial pain (42.85%),visual symptoms (28.57%), headache (23.80%). Signs included, proptosis (52.38%), facial deformity (23.80%). Imaging: showed frontal mucoceles (42.85%), fronto-ethmoid (38.09%), ethmoid (14.28%), sphenoid (4.76%). Orbital extension in 42.85%, sinusitis (33.33%), skull base erosion (23.80%). EESS or combined external and EESS approach (61.90%, 38.09% respectively) were performed. Complete excision of mucocele wall done. Recurrence in two cases(average-2.5 years),revision surgery performed without further recurrences. Either EESS or combined external and EESS approach used based on site and extension of mucoceles. Complete peeling of mucocele wall without obliteration of the sinus cavity was the mode of surgical management in all cases.

An Unusual Case of Type 2 Fronto-Ethmoidal Mucopyocele.

Mucoceles of the paranasal sinuses are epithelium-lined cystic masses that develop when the sinus ostia get obstructed. They most frequently occur in the frontal and ethmoid sinuses. The paranasal sinus mucoceles' proximity to the orbit and skull base renders the patient at risk for substantial morbidity. Mucoceles have reactive bone growth, bleeding, fibrosis, and granulation tissue, which are histological traits of respiratory mucosa. The conventional therapy is surgical excision, with endoscopic procedures becoming more popular. A 60-year-old female patient reported to the ENT outpatient clinic complaining of swelling over the medial aspect of her left eye that had begun slowly and progressed over a year. Although there were no neurological, ocular, nasal, or facial symptoms clinically, radiological and cytological examinations aided us in arriving at the definitive diagnosis. The patient in this scenario had an infected mucocele and left medial canthal swelling with no visual impairment, which made it challenging to reach an accurate diagnosis. However, radiological evaluation and cytological examination focused on establishing a definitive diagnosis.

Clinical relationship between histopathological necrotic/partial necrotic findings and disease condition of gallbladder mucoceles in dogs.

Gallbladder mucocele (GM) is a common extrahepatic biliary disease recognized in dogs and is defined as the expansion and extension of the gallbladder by an accumulation of semi-solid bile or bile acid. Histopathological diagnosis of necrotizing cholecystitis and transmural coagulative necrosis of the gallbladder wall shows poor prognosis. Conversely, histopathological diagnosis with partial necrotic findings is often achieved. We hypothesized that histopathological partial necrosis of the gallbladder wall is the primary lesion of necrotic cholecystitis or transmural ischemic necrosis. Therefore, we investigated the relationship between histopathological necrosis/ partial necrosis findings and their clinical conditions. We retrospectively analyzed 55 dogs diagnosed with GM that had undergone cholecystectomy at the Yamaguchi University Animal Medical Center. The group with histopathological necrosis/partial necrosis of the gallbladder wall showed elevated levels of preoperative white blood cells, alanine transaminase, alkaline phosphatase, γ-glutamyltransferase, total bilirubin, and C-reactive protein compared to the non-necrotic group. Partial necrosis of the gallbladder wall may affect the progression of the disease and hematological abnormalities. Additionally, all death cases until 2 weeks were included in the histopathological necrosis/partial necrosis group. In this study, we found that poor prognosis factors were associated with partial necrosis of the gallbladder wall. Furthermore, these cases of partial necrosis showed elevated levels of blood test parameters. These results suggest that necrosis of the gallbladder wall is associated with poor prognosis and poor pathophysiological conditions.

Precision Endonasal Endoscopic Surgery of the Frontal Recess Cells and Frontal Sinus Guided by the Natural Sinus Drainage Pathway.

Background: The endoscopic endonasal approach to removing lesions in the nasal cavity and sinuses has become the modern first choice. However, if endoscopic surgery is performed without proper knowledge of sinus anatomy, there is a risk of residual lesions, recurrence, and even serious complications. Therefore, this article illustrates the importance of precise sinus opening guided by the natural sinus drainage pathway, using the anatomy of the frontal sinus (FS) and the frontal recess (FR) cells as an example. Method: A total of 82 sides cadaveric heads were dissected and analyzed, and the natural drainage pathways of the FR cells and FS were observed at 0°and 70°nasal endoscopic views, and the findings were summarized. The data of 79 patients who accepted endonasal endoscopic surgery (EES) guided by natural sinus drainage pathways to remove mucoceles in our department from January 2015 to January 2021 were retrospectively analyzed. Results: Two natural drainage pathways of the FR cells were discovered, identified, and named the medial pathway of the FR (MPFR) and the lateral pathway of the FR (LPFR). The 79 patients who accepted EES to remove mucoceles through the natural drainage pathways of FR cells and the FS showed significant improvement in clinical symptoms, and none of them had recurrence after surgery without serious complications. Conclusion: The EES of the FR cells and FS through the natural drainage pathways to remove the mucoceles facilitates exposure of the cells without residual lesions and without serious complications.

Multiple oral mucoceles treated with evening primrose oil: a report of two cases.

Multiple mucoceles of the minor salivary glands are rare in the mouth. Typically, the minor salivary glands of the soft palate are affected. We report two cases that responded entirely following systemic therapy with evening primrose oil. No recurrence was reported over a two-year follow-up period. Evening primrose oil is postulated to have an effect on the composition and/or viscosity of minor salivary gland secretions.

Postoperative ethmoid sinus mucoceles: Late complication of endoscopic ethmoidectomy and MWA management in outpatient.

OBJECTIVE: The aim of this study was to investigate the feasibility of intranasal endoscopic microwave ablation (MWA) on the management of postoperative ethmoid sinus mucoceles. METHODS AND MATERIALS: The patients with postoperative ethmoid sinus mucoceles were ablated through intranasal endoscopic MWA. Postoperative pain intensity was measured via visual analogue scale (VAS), post-operative complications were recorded. RESULTS: Of the 26 patients with unilateral postoperative ethmoid sinus mucoceles, the mucoceles were diagnosed 3 to 11 years with average time of time of 6.9 ± 2.7 years after endoscopic ethmoidectomy. The ipsilateral middle turbinate was present and intact in 24 patients and partially resected during the original surgery in the remaining 2. There were adhesions in the middle meatus in one case. All 26 patients were successfully treated with the intranasal endoscopic ablation technique in outpatient. The ablation time was 6 to 11 min, with an average duration of 6.84 ± 1.27 min. The mean VAS pain score was 2.41 ± 1.22. There were no perioperative complications reported in this series. No evidence of recurrence was observed in any patients during follow-up periods. CONCLUSIONS: The present study demonstrates the safety and efficacy of intranasal endoscopic MWA in the office. The procedure is well tolerated by patients with low complication rates. Thus, it is alternative to conventional endonasal endoscopic marsupialization for treatment of postsurgical ethmoid sinus mucoceles.

The Investigation of 14 Appendiceal Mucocele Cases Encountered in 4850 Appendectomy Patients.

BACKGROUND: Appendiceal mucocele is a rarely seen disease which occurs when the appendix lumen is filled and obstructed by mucous. In our study, we aimed to reveal the surgical approach of our clinic, features of tumors, and clinical presentations in line with literature in cases of appendix mucocele. METHODS: Fourteen appendix mucocele patients who were admitted in our hospital between 2012 and 2019 were examined retrospectively in the electronic recording medium. Our patients were evaluated in terms of age, gender, clinical status, operation, imaging results, and pathology results. RESULTS: Of the fourteen patients, 12 applied to the emergency department and 2 to the general surgery clinic. All of our patients had abdominal pain at the time of admission. In the physical examination, 5 (35%) patients had defenses, 10 (71%) patients had rebound tenderness, and 12 (85%) patients had tenderness. In preoperative imaging studies, 11 patients were interpreted as having acute appendicitis and 3 patients were evaluated as having appendix mucocele. The pathological results were reported as 6 patients had appendiceal mucocele and 8 patients had appendiceal mucocele together with acute appendicitis. CONCLUSION: Appendiceal mucocele is a disease which generally causes similar clinical findings of acute appendicitis. Ultrasound and CT may be useful in preoperative diagnosis. Surgical treatment options of mucocele are open or laparoscopic appendectomy, cecum resection, and right hemicolectomy. Although its incidence is low, due to pseudomyxoma peritonei, it is a pathology that requires careful surgery.

Oral acute graft versus host disease after donor lymphocyte infusions: Clinicopathological characterization in a monocenter cohort.

Donor lymphocyte infusions (DLI) are used after hematopoietic stem cell transplant (HSCT) in order to boost the graft-versus-tumor effect. The most significant toxicity is acute or chronic graft-versus-host disease (GVHD), whose clinical symptoms mirror those occurring after HSCT. By contrast, oral acute GVHD lesions have been exceptionally described post-DLI. We report on a monocenter cohort of 12 adult patients that developed oral acute GVHD after DLI. The majority was treated for acute myeloid leukemia. A total of 29 DLI treatments were applied and the median time between the last DLI and the oral mucosal lesions was 42 days. Most patients presented these oral lesions concomitant with skin lesions and none of them had exclusive oral involvement. Oral lichenoid changes were observed in 11 patients, including plaque-like lesions and/or reticulated white streaks consistent with Wickham's striae, affecting mainly the buccal mucosa and dorsal or lateral aspects of the tongue. Mucosal histopathological findings showed a patchy-to-florid lichenoid interface dermatitis for 3 biopsied patients. Eight patients also experienced salivary gland changes. The treatment of oral lesions included high- to very high-potency topical corticosteroids in the majority of patients. Oral GVHD lesions have seldom been described after DLI, and only exceptionally in an acute setting. Our results are not consistent with those reported in the literature evaluating GVHD after DLI. In fact, oral acute GVHD lesions post-DLI appeared very common and similar to the oral lichenoid reactions of chronic GVHD following HSCT. The main limitations of this work are its retrospective design and the relatively small sample size.

Sinus Floor Augmentation in Presence of Mucocele Eroding Maxillary Sinus Wall: A Case Report With 3 Years Follow-Up.

INTRODUCTION: The maxillary mucocele is a slow-growing aggressive lesion and a mucous-containing sac lined with epithelium that occurs due to ductal obstruction and self-limiting injury. Rarely, it may be associated with non-specific symptoms. It is characterized by bone resorption due to its expanding behavior. Reduced height of bone and sinus pneumatization associated with pathologic lesions located in the floor of maxillary sinus may impede sinus augmentation. Therefore, careful diagnosis and management of pathology before sinus floor elevation is important in determining its recurrence and prognosis. CASE PRESENTATION: We reported a case with small mucocele on right pneumatized antrum with insufficient residual bone height for implant placement. Radiograph in the region of teeth #3 and #4 revealed a homogeneous solitary radiopaque mass. Cone-beam computed tomography revealed irregular osteolysis of the lateral wall of the sinus. It was excised through Caldwell-Luc technique and simultaneous sinus augmentation was performed. Later, delayed implant restoration was performed. No complication or recurrence was reported during 36 months of follow-up. CONCLUSIONS: The excision of mucocele on sinus floor and simultaneous sinus augmentation obviates the need for the extended treatment period. The clinician must be habituated with the anatomy and pathology of the maxillary sinus to evade any non-essential complications following lateral sinus floor augmentation procedure. A diminutive mucocele should not be regarded as a contraindication for sinus augmentation; sometimes it manifests with bone erosion. The prompt diagnosis and careful evaluation are needed to avoid future complications during implant therapy.

The role of imaging in the management of sinonasal mucoceles.

Mucoceles are slow-growing paranasal sinus cystic masses whose clinical presentation varies according to the affected sinus. Diagnosis is often radiological, based essentially on CT scan. The aim of this work was to study the radiologic characteristics of mucoceles on CT scan and MRI. We conducted a retrospective study of patients with mucoceles explored by imaging and operated on in our department. In our series, fronto-ethmoidal sinuses were the most frequently affected (81%). Facial scan confirmed the diagnosis in the majority of cases. Magnetic resonance imaging (MRI) was performed in 4 cases. Eleven patients were operated on by endonasal approach, three by external approach and one by combined surgical approach. Recurrence was observed in two patients after an average delay of 24 months. CT scan is considered the method of choice in the investigation of mucoceles. MRI is indicated in some cases to assess any orbital or intracranial extension.

Benign non-carcinoid neoplasms of the cecal appendix: presentation of 36 cases during the last 17 years in a third level hospital.

BACKGROUND: The tumors of the cecal appendix are a rare and heterogeneous group of neoplasms with variable prognosis and evolution, its incidence is very low. Mucinous tumors are defined as a dilated cecal appendix due to an abnormal accumulation of mucin, which may be benign or malign. Within these we find the mucoceles, which according to the latest consensus and classifications no longer include them. In this article we describe our experience in these tumors, we also propose a group to include the mucoceles and we review the literature. METHOD: Descriptive and retrospective study, analyzing all the surgical pieces of cecal appendix during the last 17 years. RESULTS: We analyzed 4910 surgical pieces. 36 were included in the group of non-carcinoid benign epithelial neoplasms (NEBNC), in this group 16 were low-grade mucinous neoplasms, 14 mucoceles and 6 tubular adenomas. The most frequent presentation's form was simulating an acute appendicitis. Surgical treatment was performed by open approach in 22 cases and by laparoscopic approach in 14 cases. CONCLUSIONS: Symptomatic NEBNC can simulate acute appendicitis but in people with a higher mean age, so this diagnostic should be considered in older patients with nonspecific imaging tests. The recommended treatment is always surgical and it can be possible by laparoscopic approach.

ANTECEDENTES: Las tumoraciones del apéndice cecal son un grupo raro y heterogéneo de neoplasias con evolución y pronóstico variables, y tienen una incidencia muy baja. Las tumoraciones mucinosas se definen como aquellas con un apéndice cecal dilatado debido a una acumulación anormal de mucina en su interior; pueden ser benignas o malignas. Dentro de ellas se encuentran los mucoceles, que según los últimos consensos y clasificaciones ya no los incluyen. En este artículo se describe la experiencia de los autores en estas tumoraciones y se propone un grupo en el que incluir los mucoceles; además, se hace una revisión de la literatura. MÉTODO: Estudio descriptivo y retrospectivo en el que se analizan todas las piezas quirúrgicas de apéndice cecal durante los últimos 17 años. RESULTADOS: Se analizaron 4910 piezas quirúrgicas. De ellas, 36 fueron incluidas en el grupo de neoplasias epiteliales benignas no carcinoides (NEBNC): 16 fueron neoplasias mucinosas de bajo grado, 14 mucoceles y 6 adenomas tubulares. La forma de presentación más frecuente fue simulando una apendicitis aguda. El tratamiento quirúrgico fue mediante abordaje abierto en 22 casos y laparoscópico en 14. CONCLUSIONES: Las NEBNC sintomáticas pueden simular cuadros de apendicitis aguda, pero en personas con una mayor edad media, por lo que hay que considerar esta posibilidad diagnóstica en pacientes mayores con pruebas de imagen inespecíficas. El tratamiento recomendable es siempre quirúrgico, y resulta viable su realización mediante abordaje laparoscópico.

Modified endoscopic inferior meatal fenestration with mucosal flap for maxillary sinus diseases.

INTRODUCTION: This is a novel minimally invasive surgical method for maxillary sinus mucoceles and antrochoanal polyps. AIM: To describe a modified technique of inferior meatal fenestration with a mucosal flap for maxillary sinus diseases and to present a case series of subjects who underwent this procedure. The novel surgical technique and indications for this approach are also discussed. MATERIAL AND METHODS: The authors analyzed data from 32 cases involving patients who underwent resection of maxillary sinus mucoceles and antrochoanal polyps via modified endoscopic inferior meatal fenestration with a mucosal flap in the period from January, 2011 to January, 2016. The group included 19 men and 13 women, and the patients' mean age was 36.2 years (range: 11-56 years). Preoperative and postoperative imaging studies were available in all cases and were reviewed. RESULTS: Thirty-two cases are included in this study. The appearance of nasal and (or) maxillary sinus mucosa was observed in the follow-up at 1 month, 3 months and 6 months using endoscopes. Postoperative computed tomography was performed for only 9 patients in this study. The mean follow-up period was 56 (range: 10-82) months in these cases. All patients had an uneventful post-operative period. Postoperative symptoms were relieved gradually for 1 to 2 weeks after the operation. No patients experienced recurrent symptoms related to the mucocele. Mucocele and polyps recurrence was not observed. No patient showed re-stenosis and obstruction of the nasal cavity, facial pain or numbness during follow-up. CONCLUSIONS: Maxillary sinus mucoceles and antrochoanal polyps are completely excised via modified endoscopic inferior meatal fenestration with a mucosal flap. It could keep the nasal lateral wall intact.

Técnica de Shira utilizada no tratamento de mucocele: Quando indicar? Como realizar? / Shira's technique used in mucocele treatment: when indicate? How to perform?

O termo mucocele é empregado clinicamente como um termo genérico, para se referir aos fenômenos de retenção e extravasamento de muco, sendo essa lesão um pseudocisto de etiologia traumática, decorrente do rompimento do ducto de uma glândula salivar menor. Clinicamente, esse tipo de lesão pode se apresentar como uma tumefação ou bolha, macia à palpação, de coloração azulada ou, mesmo, normocrômica, dependendo da sua profundidade nos tecidos, assintomática, de superfície lisa e de tamanho variado, sendo o lábio inferior a região mais acometida. Com relação ao seu tratamento, a enucleação é a técnica mais preconizada. Entretanto, algumas técnicas alternativas têm sido propostas na literatura para esse fim, como o uso do laser de dióxido de carbono, marsupialização e a técnica de Shira, sendo esta realizada com a injeção prévia de um hidrocoloide irreversível no interior da lesão, para evitar o extravasamento do conteúdo mucoso no momento da divulsão cirúrgica. O objetivo deste trabalho é mudar o caso clínico da paciente encaminhada à Clínica de Cirurgia Oral menor da Universidade Federal Fluminense, lhe apresentou, ao exame clínico, uma mucocele em lábio inferior do lado direito, com 14 dias de evolução e cerca de 2,0 cm em seu maior diâmetro, tendo sido realizado remoção completa da lesão por meio da técnica de Shira. A paciente evoluiu sem complicações e recidiva da lesão... (AU)

The mucocele term is used clinically as a generic term to refer to retention phenomenon and mucus extravasation, which is a pseudocyst injury of traumatic etiology, due to the rupture of the duct of a minor salivary gland. Clinically this type of injury may present as a swelling or blister, soft palpation, bluish or even normochromic coloring, depending on their depth in the tissues, asymptomatic smooth surface and varying size, with the lower lip the most affected region. Regarding treatment, enucleation is the recommended technique. However, some alternative techniques have been proposed in the literature for this purpose, such as using carbon dioxide laser, Marsupialization and Shira's technique, which is performed with the previous injection of an irreversible hydrocolloid inside the lesion to avoid extravasation the mucous content at the time of surgical divulsion. The aim of this paper is to present a case of C.R.F. patient, 18-year-old female was referred to minor oral surgery clinic of the Federal Fluminense University, with clinical examination mucoceles in lower right lip 14 days of evolution and about 2.0 cm in its largest diameter, where complete removal of the lesion was performed using the Shira's technique. The same progressed without complications and recurrence of injury... (AU)

Office-based 532-Nanometer pulsed potassium-titanyl-phosphate laser for marsupialization of laryngeal and vallecular mucoceles.

OBJECTIVES/HYPOTHESIS: Many laryngopharyngeal disorders are effectively managed in the office. Herein, an in-office method utilizing the 532-nm potassium-titanyl-phosphate (KTP) laser for the treatment of benign laryngeal and vallecular mucoceles is described. STUDY DESIGN: Retrospective case review. METHODS: A review was performed of patients who had their vallecular or laryngeal mucoceles marsupialized in the office using KTP laser. RESULTS: Outcomes included long-term follow-up laryngoscopy for evidence of recurrence, significant intraprocedural complications, tolerance of the procedure, final pathology of the specimen, and resolution of symptoms. CONCLUSIONS: In-office KTP marsupialization of laryngeal and vallecular mucoceles is effective and well tolerated, with no episodes of recurrence to date. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1116-1118, 2017.

[Experience in the surgical treatment of paranasal sinus mucoceles in a university hospital]. / Experiencia en el tratamiento quirúrgico de mucoceles de senos paranasales en un hospital universitario.

BACKGROUND: Mucoceles are benign cystic lesions of the paranasal sinuses. Endoscopic marsupialisation is considered the first choice of treatment, due to its low morbidity and recurrence rates. OBJECTIVE: To establish the number of patients with recurrence, who were diagnosed clinically or by computed tomography, and who were submitted to surgery in the Ear, Nose and Throat Unit in a tertiary university hospital. MATERIAL AND METHODS: A clinical, cross-sectional, descriptive, observational and retrospective study was conducted on patients with a mucocele diagnosis operated on in the period from January 2006 to December 2013. A descriptive statistical analysis was performed to obtain the frequencies, ratios and proportions. Measures of central tendency and dispersion were obtained. The recurrence rates of each surgical technique were compared using the Chi-squared test. RESULTS: Of the 59 patients included in the study, 39 were female and 20 were men. The most common location was in the maxillary sinus (22 patients) followed by frontoethmoidal (20 patients). There was a recurrence of 9% in those submitted to a surgical procedure. The endoscopic approach was used in 51 patients, 8 cases were combined (open plus endoscopic), and there was no open approach. There was a recurrence in 7 of 51 of patients with endoscopic surgery, and one out of 8 patients had a recurrence with a combined technique. CONCLUSIONS: No statistically significant relationship was found between the type of surgery and recurrence, or between the presence or absence of a predisposing factor and recurrence.

Mucoceles of minor salivary glands in children. Own clinical observations.

INTRODUCTION: Mucoceles are benign lesions associated with the pathology of the oral mucosa of minor salivary glands. Two types of cysts are distinguished depending on their pathogenesis. Most often they occur as a result of mechanical trauma and mucus extravasation into tissues or obstruction of the gland ducts. AIM: The aim of the study was to present our own experiences regarding mucoceles of minor salivary glands in the oral cavity taking into account how frequently the individual types of cysts occur in children. MATERIAL AND METHODS: The research was carried out based on medical files from the years 2005-2015. These were: medical case records, operating books and the medical registry of patients treated at the Clinic of Maxillofacial Surgery, Frederic Chopin Clinical Regional Hospital in Rzeszow. In that period 64 children and teenagers, 28 girls and 36 boys were treated. What was considered was the age and gender of the patients, the reason for their appointment with a doctor, the location, size and histopathological type of the cysts, as well as the course and results of the diagnostic and therapeutic process. RESULTS: In the group analyzed, the reasons for referral to the Clinic were: in 25 patients accidental ascertainment of a non-symptomatic tumor in the oral cavity during examination by a dentist, pediatrician or laryngologist which had not caused any discomfort to the children; in 13 patients concern had been raised by a gradually increasing tumor; in 18 cases there was an increased tissue tension surrounding the tumor, while in 3 children red oedema was observed in the oral cavity (suspicion of abscess). The most frequent mucocele location was the lower lip (34 children). The most frequent size was 2.1-3 cm (28 children). The most frequent histological type was MEP. All the patients were treated at the Clinic in the one-day surgery mode, with good outcome. CONCLUSIONS: Mucocele ascertainment in children's oral cavity could be made accidentally in routine pediatric examination, therefore it is necessary to extend pediatricians' knowledge about small salivary gland mucoceles. The most frequent type of MEP could be related to different types of trauma in the oral mucose.

Micro-marsupialization versus surgical excision for the treatment of mucoceles.

BACKGROUND: Mucocele is a common disorder of minor salivary glands which arises due to mucous accumulation resulting from their alteration. Several techniques have been described for the treatment. However, most of them are invasive or require costly armamentarium. PURPOSE: The present study was conducted to evaluate the efficacy of micro-marsupialization technique as an alternative to surgical excision for the treatment of mucoceles. MATERIALS AND METHODS: A prospective study was conducted. A total of twenty patients were selected based on clinical diagnosis of mucoceles and were randomly divided into two groups comprising ten patients each. Micro-marsupialization was done in Group 1 patients and surgical excision in Group 2. Patient's gender, age, size, location, duration, complications, and recurrences were evaluated during various visits. Data between the two groups were analyzed by descriptive and analytical (Chi-square tests) statistics. RESULTS: The mean age of the patients in Group 1 was 19.6 ± 9.6 years while in Group 2 was 21.9 ± 11 years. The most common location for mucocele in Group 1 as well as Group 2 patients was lower lip (60% and 80%, respectively). In Group 1, two patients had recurrence while in Group 2, one patient had a recurrence. All recurrent cases were subsequently treated by surgical excision. No statistically significant difference was found between the two methods. CONCLUSION: Micro-marsupialization technique is as efficacious as surgical excision for the treatment of mucocele. It is advantageous over surgical excision as it is simple to perform, is less invasive therefore not associated with complications associated with invasive procedure, and is well tolerated by patients.

[Benign proliferative breast disease with and without atypia]. / Prise en charge des proliférations épithéliales du sein avec et sans atypies : hyperplasie canalaire atypique, métaplasie cylindrique avec atypie, néoplasies lobulaires, proliférations épithéliales sans atypie, mastopathie fibrokystique, adénose, cicatrices radiaires, mucocèles, lésions prolifératives apocrines : recommandations pour la pratique clinique.

In the last few years, diagnostics of high-risk breast lesions (atypical ductal hyperplasia [ADH], flat epithelial atypia [FEA], lobular neoplasia: atypical lobular hyperplasia [ALH], lobular carcinoma in situ [LCIS], radial scar [RS], usual ductal hyperplasia [UDH], adenosis, sclerosing adenosis [SA], papillary breast lesions, mucocele-like lesion [MLL]) have increased with the growing number of breast percutaneous biopsies. The management of these lesions is highly conditioned by the enlarged risk of breast cancer combined with either an increased probability of finding cancer after surgery, either a possible malignant transformation (in situ or invasive cancer), or an increased probability of developing cancer on the long range. An overview of the literature reports grade C recommendations concerning the management and follow-up of these lesions: in case of ADH, FEA, ALH, LCIS, RS, MLL with atypia, diagnosed on percutaneous biopsies: surgical excision is recommended; in case of a diagnostic based on vacuum-assisted core biopsy with complete disappearance of radiological signal for FEA or RS without atypia: surgical abstention is a valid alternative approved by multidisciplinary meeting. In case of ALH (incidental finding) associated with benign lesion responsible of radiological signal: abstention may be proposed; in case of UDH, adenosis, MLL without atypia, diagnosed on percutaneous biopsies: the concordance of radiology and histopathology findings must be ensured. No data is available to recommend surgery; in case of non-in sano resection for ADH, FEA, ALH, LCIS (except pleomorphic type), RS, MLL: surgery does not seem to be necessary; in case of previous ADH, ALH, LCIS: a specific follow-up is recommended in accordance with HAS's recommendations. In case of FEA and RS or MLL combined with atypia, little data are yet available to differ the management from others lesions with atypia; in case of UDH, usual sclerosing adenosis, RS without atypia, fibro cystic disease: no specific follow-up is recommended in agreement with HAS's recommendations.