Conservative Lateral Approach for Pleomorphic Adenomas of Parotid Gland Involving the Parapharyngeal Space-A Case Series.

The aim of this paper is to present and discuss the symptoms, clinical signs, diagnostic methods and a conservative surgical approach to large parotid pleomorphic adenomas arising from deep lobe and extending to the parapharyngeal space. In this case series we are describing four such cases which presented with painless swelling of different sizes in the parotid region along with intraoral swelling. Detailed diagnostic workup which included computed tomography scan, fine needle aspiration biopsy and magnetic resonance imaging was undretaken for confirming the diagnosis. Complete excision of the tumour via transcervical and transparotid approach without mandibulotomy and after securing local neurovascular structures was performed in all cases. This conservative lateral approach reduces the likelihood of complications. All the four patients were discharged without any complications and a proper follow up was done.

Comparative evaluation of genotoxicity by micronucleus assay in the buccal mucosa over comet assay in peripheral blood in oral precancer and cancer patients.

Early detection and quantification of DNA damage in oral premalignancy or malignancy may help in management of the disease and improve survival rates. The comet assay has been successfully utilised to detect DNA damage in oral premalignant or malignancy. However, due to the invasive nature of collecting blood, it may be painful for many unwilling patients. This study compares the micronucleus (MN) assay in oral buccal mucosa cells with the comet assay in peripheral blood cells in a subset of oral habit-induced precancer and cancer patients. For this, MN assay of exfoliated epithelial cells was compared with comet assay of peripheral blood leucocytes among 260 participants, including those with oral lichen planus (OLP; n = 52), leukoplakia (LPK; n = 51), oral submucous fibrosis (OSF; n = 51), oral squamous cell carcinoma (OSCC; n = 54) and normal volunteers (n = 52). Among the precancer groups, LPK patients showed significantly higher levels of DNA damage as reflected by both comet tail length (P < 0.0001) and micronuclei (MNi) frequency (P = 0.0009). The DNA damage pattern in precancer and cancer patients was OLP < OSF < LPK < OSCC, and with respective oral habits, it was multiple habits > cigarette + khaini > cigarette smokers > areca + khaini > areca. There was no significant difference in the comet length and MNi frequency between males and females who had oral chewing habits. An overall significant correlation was observed between MNi frequency and comet tail length with r = 0.844 and P < 0.0001. Thus, the extent of DNA damage evaluation by the comet assay in peripheral blood cells is perfectly reflected by the MN assay on oral exfoliated epithelial cells, and MNi frequency can be used with the same effectiveness and greater efficiency in early detection of oral premalignant conditions.

Pleomorphic adenoma of hard palate: an experience.

INTRODUCTION: Pleomorphic adenoma of minor salivary glands of hard palate is a rare benign tumour. It usually presents as slow growing submucosal mass on hard palate. The purpose of this study was to collect observational data regarding age, size, symptoms, CT findings and treatment of pleomorphic adenoma of hard palate. MATERIAL AND METHODS: The prospective observational study was done in the Department of ENT, Department of Oral and maxillofacial surgery at SKIMS Medical College and at Peoples Care Polyclinic for a period of 2 years. Twenty cases were enrolled in the study. After clinical suspicion, computed tomography, FNAC and core needle biopsy was done in all twenty cases before any surgical intervention was done. RESULTS: Most common age group seen to be involved was 16-30 years. Most common symptom was submucosal slow growing mass. Core biopsy was diagnostic with 100 % efficacy. On CT scan twelve patients (60 %) were seen to have intact hard palate even without minor erosions while four patients had full thickness erosion of hard palate. Surgical wide excision was done in all cases and one patient needed total maxillectomy. All treated patients were followed for one year and none showed signs of recurrence. CONCLUSION: Pleomorphic adenoma of hard palate is usually seen in adults. Definitive diagnosis lies on histopathological examination. CT is necessary for ruling out any bony erosion. Treatment is by wide local excision.

Clinical characteristics and comparative study of different modalities of treatment of pseudocyst pinna.

The aims of the article were to study the clinical characteristic of patients with pseudocysts and to compare different common modalities of treatment and introduce the concept of observation in pseudocyst management. Twenty-eight patients were diagnosed with pseudocyst of the auricle between June 2009 and June 2011 in a medical college hospital. The patients were divided into four groups each of seven patients on the basis of primary treatment offered. Four primary treatments offered were simple aspiration, aspiration with intralesional steroid, incision and drainage with removal of anterior cartilage leaflet with buttoning, and lastly, simple observation and reassurance. All 28 patients were male with involvement of right side more than left and no one had bilateral involvement. Adults in the age group of 30-40 were commonly affected. Most of the patients had history of significant trauma by security forces. Most common site of involvement was scaphoid and triangular fossa. The best form of treatment with minimum recurrence was incision and drainage with removal of anterior cartilage leaflet with buttoning. Simple observation as a treatment option was found to be as good as intralesional steroids. Pseudocyst of the pinna is a benign condition of unknown etiology affecting the pinna, commonly encountered in middle-aged men. It is a rare condition and is hardly encountered in routine ENT practice. Bilateral diseases are uncommon. Most common site of occurrence is triangular and scaphoid fossa. Many modalities of treatment have been recommended in literature with varied recurrence and failure rates. The best treatment is surgical deroofing followed by buttoning with minimum recurrences. An option of simple observation for 2-3 months should be discussed with each patient and was found to be as good as intralesional steroids.

Characterization of antacid compounds containing both aluminum and magnesium. II. Codried powders.

The composition and antacid properties of six samples of codried antacids containing both aluminum and magnesium were determined. Aluminum hydroxide-magnesium carbonate codried gel and aluminum hydroxide-magnesium hydroxide codried gel were non-homogeneous, as the samples contained combinations of hydrotalcite, amorphous aluminum hydroxide, magnesium hydroxide, magnesium hydroxycarbonate, and magnesium carbonate. All samples passed the preliminary antacid test and had high acid neutralizing capacities. However, the rate of acid neutralization varied between samples. In some cases the rate of acid neutralization at a dose of 400 mg was too slow to raise the pH to 3.0 as required by the Rossett-Rice test.

Characterization of antacid compounds containing both aluminum and magnesium. I. Crystalline powders.

The composition and antacid properties of 10 samples of crystalline antacids containing both aluminum and magnesium were determined. The composition was found to vary significantly, even within the same type of antacid. For example, three of four hydrotalcite samples exhibit evidence of the presence of a minor phase of amorphous aluminum hydroxide. Almagate and almagcit, which are claimed to be unique compounds, were found to be composed of hydrotalcite, magnesium hydroxycarbonate, and/or magnesium carbonate and amorphous aluminum hydroxide. All three magaldrate samples examined contained a minor phase of amorphous aluminum hydroxide. All 10 samples passed the preliminary antacid test and had high acid neutralizing capacities. However, the rate of acid neutralization varied between samples. In some cases the rate of acid neutralization at a dose of 400 mg was too slow to raise the pH to 3.0 as required by the Rossett-Rice test.