The efficacy of polidocanol sclerotherapy in mucocele of the minor salivary gland.

OBJECTIVES: Mucocele of the minor salivary gland is usually caused when the duct is injured, mucus leaks into the tissue space and the mucous gland are obstructed, which lead to cystic lesion formation and dilatation. Currently, there are multiple therapeutic methods available with various outcomes. This study aims to provide clinical evidence of polidocanol sclerotherapy for the treatment of mucocele of the minor salivary gland. METHODS: In this study, we injected polidocanol into 112 patients who were diagnosed with mucocele of the minor salivary gland and evaluated the treatment efficacy and safety systematically. RESULTS: Of the 122 cases, 102 cases were cured, eight cases showed remarkable remission, and two cases had partial remission. No recurrence was found during follow-up, and none of the cases showed an invalid effect, resulting in a total cure rate of 91.07%. No severe side effects were observed during treatment or the follow-up period. No significant difference in efficacy between different genders was found (P = 0.490). Polidocanol sclerotherapy for mucocele on the lower lip was more effective compared to mucocele on the inferior surface of the lingual apex (P = 0.035). CONCLUSION: Polidocanol sclerotherapy showed satisfying curative effects for mucocele of the minor salivary gland without causing side effects of anesthesia, trauma, or severe pain.

Multiple superficial oral mucoceles after Mycoplasma-induced mucositis.

Oral mucoceles are lesions arising mainly from the minor salivary glands and are thought to occur after excretory duct trauma. We report a case of multiple superficial oral mucoceles on a child's labial mucosa after Mycoplasma pneumoniae mucositis. Mucoceles can mimic persistent or recurrent stomatitis and lead to potential errors in management.

The Application of Absolute Ethanol in the Treatment of Mucocele of the Glands of Blandin-Nuhn.

Mucocele of the anterior lingual salivary glands is a more common cystic lesion, especially in patients aged less than 20 years. The study is aimed to observe the effect of treatment by injection of absolute ethanol instead of surgery. Fourteen outpatients diagnosed as mucocele of the glands of Blandin-Nuhn were selected. These patients, after blood investigation, were treated by injection of absolute ethanol into a mucous cavity of lesion under superficial anesthesia with 2% lidocaine once a week and followed up from 3 months to 2 years. Mucocele of the glands of Blandin-Nuhn was extirpated in all patients after 1 to 3 injections. There were no other complications except slight distending pain occurred on the same day when the patients were treated. The recurrence was not observed during the follow-up period. In conclusion, the study suggests that injection of absolute ethanol may be an alternative means for treating mucocele of the glands of Blandin-Nuhn, because it is mininvasive, safe, effective, economic, and simply manipulated compared with surgical treatment.

Oral Mucoceles in Children--Analysis of 56 New Cases.

BACKGROUND: Mucoceles are common cystic lesions of the oral mucosa. Extravasation mucoceles (EMs) are mainly found in the lower lip of young patients, whereas retention mucoceles (RMs) are usually located in the cheek or palate of older patients. This study was undertaken to more fully characterize the clinicopathologic features of mucoceles in pediatric patients. METHODS: The records of 56 pediatric patients with mucoceles were included in the study. Age, sex, history of trauma, intraoral site, size, and method of treatment were evaluated. Histopathologically the lesions were classified as being EMs or RMs. RESULTS: The age range was 1.5 to 16 years (mean age 11.2 yrs). Of the 56 patients, 24 (43%) were males and 32 (57%) were females, with a male:female ratio of 1:1.33. A history of trauma was recorded in 32 (57%) patients of the lower lip. The intraoral sites were the lower lip (38 [68%]), tongue (10 [18%]), and floor of the mouth (8 [14%]). Of the 56 patients, 44 (79%) were EM and 12 (21%) were ranulas. No RMs were found. Mucoceles ranged from 0.3 to 3.8 cm in diameter (mean 0.9 cm). The treatment of EMs was surgical excision. Cryosurgey, electrosurgery, and carbon dioxide laser were also used. CONCLUSION: In contrast to adults, where EM and RM types can be found, among children all cases are of the EM type. The disparate site and age incidences of EMs and RMs of the oral mucosa suggest that these two types are not related and possibly have a different etiopathogenesis.

Concha Bullosa Mucopyocele: a Case Report.

Concha bullosa (CB) is among the most common anatomic variations of sinonasal anatomy. Although usually asymptomatic, CB can occasionally cause nasal obstruction or headache. Obstructions within the mucociliary transport system can develop into a mucocele or mucopyocele. A 48-year-old female, with a history of progressive headache and nasal obstruction, was referred to our department. Paranasal sinus tomography revealed a nasal mass in the left nasal cavity resembling a mucopyocele in the middle turbinate. Under general anesthesia, the purulent material was aspirated, and the lateral part of the left turbinate was resected. Mucopyoceles are common within the paranasal sinuses, but uncommon with CB; thus, they should be considered in patients with a large hyperemic nasal mass.

Sclerotherapy for the mucoceles of the anterior lingual salivary glands with pingyangmycin.

Recurrence is very common if the mucoceles of the anterior lingual salivary glands (ALSGs) are treated by surgery due to its anatomic characteristics. Therefore, more effective and less invasive treatment methods are urgently required to be applied instead of surgery. In this study, 40 patients with the mucocele of the ALSGs received the intralesional injections of pingyangmycin, and the median number of injections per patient was 2.075 (range, 1-3). All cases completely recovered with no recurrence after follow-up of more than 16 months. The complications included the local swelling, pain, and ulceration following injection, and all these symptoms resolved 7-10 days after the injection. Taken together, sclerotherapy with pingyangmycin is an effective and safe treatment method for the mucocele of the ALSGs and may be the primary treatment modality.

Comparison between ultrasonographic and clinical findings in 43 dogs with gallbladder mucoceles.

Cholecystectomy is the current standard recommended treatment for dogs with gallbladder mucoceles. However, medical management with monitoring has also been recommended for asymptomatic dogs. The purpose of this retrospective study was to compare ultrasonographic patterns of gallbladder mucoceles with clinical disease status in a group of dogs. For each included dog, the ultrasonographic pattern of the mucocele was classified into one of six types: type 1, immobile echogenic bile; type 2, incomplete stellate pattern; type 3, typical stellate pattern; type 4, kiwi like pattern and stellate combination; type 5, kiwi like pattern with residual central echogenic bile; and type 6, kiwi like pattern. A total of 43 dogs were included. Twenty-four dogs, including 11 dogs with gallbladder rupture, were symptomatic. Nineteen dogs were asymptomatic. Cholecystectomy (n = 19), medical therapy (n = 17), or monitoring (n = 6) treatments were applied according to clinical signs and owners' requests. One dog suspected of having gallbladder rupture was euthanized. Frequencies of gallbladder mucocele patterns were as follows: type 1 = 10 (23%), type 2 = 13 (30%), type 3 = 5 (12%), type 4 = 11 (26%), type 5 = 4 (9%), and type 6 = 0. In dogs with gallbladder rupture, type 2 (8/13) was the most common. No significant correlations were found between ultrasonographic patterns of gallbladder mucoceles and clinical disease status or gallbladder rupture. Findings indicated that ultrasonographic patterns of gallbladder mucoceles may not be valid bases for treatment recommendations in dogs.

Oral mucoceles - review of the literature.

Oral mucoceles are mucin filled cavities and lined by ductal epithelium or covered by granulation tissue in retention or extravasation type respectively. The extra-vasation type is very common in the minor salivary glands (particularly in the labial glands), but very infrequent in the major salivary glands, whilst most of the retention cyst affect the major salivary glands. Partial obstruction of duct and spillage of mucin following trauma are the chief etiological factors. Though the two lesions are clinically indistinguishable, the patients are typically older than in the case of extra-vasation type. The case history along with heedful clinical examination of the lesion is crucial for diagnosing mucoceles correctly, but to avoid recurrences histopathological examination is mandatory. The surgical approach to mucoceles is the most common mode of treatment amongst various other techniques including cryosurgery, laser and so on.

[Frontal sinusitis, mucocele and subperiosteal superolateral orbit abscess]. / Sinusite frontale, mucocèle et abcès orbitaire supérolatéral.

INTRODUCTION: Periorbital infection following pansinusitis is a rare complication which can lead to irreversible orbital and intracranial consequences. Chandler classified them in 1970. OBSERVATION: An eight-year-old child presented with a subperiosteal superolateral abscess. The initial flu-like syndrome developed into pansinusitis resisting to usual treatment. Palpebral edema and major exophthalmia then appeared requiring CT scan and MRI, which confirmed a subperiosteal abscess. DISCUSSION: A subperiosteal abscess is a serious condition requiring an early diagnosis and a medical or surgical treatment adapted to the severity. Chandler's classification gives the opportunity to adapt management to the infection's gravity. Ethmoiditis may be complicated by periorbital abscesses found usually in the superointernal quadrant. Medical imaging and surgical treatment confirmed a superolateral periorbital abscess and a frontal mucocele. This case illustrates the possibility of communication between frontal sinus and orbital cavity. During frontal sinus infection, pre-existing mucocele may become super-infected and induce a periorbital abscess.

Congenital nasolacrimal duct mucocele--a case report.

Congenital nasolacrimal duct mucocele (CNDM) is a very rare condition in newborns. Prolapse or expansion of the mucocele into the nose may lead to respiratory distress and difficulty in feeding. The triad of cystic medial canthal mass, dilatation of the nasolacrimal duct and a contiguous sub-mucosal nasal mass on computed tomography (CT) is indicative in the diagnosis of CNDM. The case of a five-week-old girl with infected CNDM is described. The authors aim to emphasize the very rare incidence of CNDM in Polish newborns, delayed diagnosis in the case described and the paramount importance of CT of the head for the correct diagnosis and treatment.

Overview of the Clinical Benefits Using the Different Diode Laser Wavelengths in Treatment of the Mucocele: Clinical Cases Report Review.

Objective: Diode laser has a wide range of wavelengths that may render the absorption effect and interaction with the tissue is different. Based on available evidences, the aim of this review is to critically evaluate the use of different diode laser wavelengths in the treatment of mucocele. Materials and methods: The literature of clinical case studies for the past 8 years has been considered. Literature search and selection, data extraction and methodological quality assessment, data analysis and interpretation, and drafting and revision have been performed. Both authors have read and approved the final article. Results: This review has aimed at detecting the experience on the background and at giving a critical summary of the clinical cases literature. Previous results of controlled clinical case reviews in this field as well as in basic research pointed to a potential of the diode laser in the surgical removal of mucocele. Initial clinical results showed that diode laser surgical therapy positively influences the post-surgical wound healing. All diode laser wavelengths do not show much difference in the acceleration in epithelial regeneration, and the healing of the wound takes some time by all wavelengths. They can reduce the need for anesthesia or wound care and therefore reduce the fear of the patient. Conclusions: The procedure in the most reviewed clinical cases took place within a few minutes and thus required no more time than a conventional surgical intervention with conventional surgical instruments. Since all surgical steps are carried out with the same instrument, there is no need for sutures and only one handpiece is sterilized. Due to the contactless preparation and the lack of vibrations as well as the elimination of the anesthesia, the entire process is much more pleasant for the patient and thus indirectly for the practitioner, because a relaxed patient can simply be better treated.

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study.

BACKGROUND: Diagnosis of maxillary sinus pathology must include the clinical radiological study (CRS) and histopathological analysis. The aim of this study is 1) to describe the clinicopathological features of maxillary sinus lesions, obtained successively in a single medical centre over the last 10 years and 2) to determine the sensitivity and specificity for the diagnosis of malignant lesions based exclusively on the CRS. METHODS: It is a single-centre observational retrospective clinical study on patients who attended the University Hospital Complex of Santiago de Compostela (CHUS) with sinus pathologies during the period of 2009-2019. RESULTS: The sample consisted of 133 men (62.1%) and 81 women (37.9%), with an average age of 46.9 years (SD = 18.8). In terms of frequency, the most frequent pathology was the unspecified sinusitis (44.4%), followed by polyps (18.2%), malignant tumours (9.8%), inverting papilloma (7.5%), fungal sinusitis (4.7%), cysts (3.7%), benign tumours (2.3%), mucocele (2.3%) and other lesions (1.9%). Cysts and benign tumours were diagnosed earliest Vs malignant tumours (65.2 years (SD = 16.1)) were diagnosed the latest (p < 0.001). Based only on the CRS for malignancies, diagnostic indexes were 71.4% sensitivity and 97.9% specificity, with a Kappa value of 0.68 with (p < 0.001). CONCLUSION: Maxillary sinus pathology is very varied with therapeutic and prognostic repercussions. CRS is sometimes insufficient and histopathological confirmation is essential.

Postoperative maxillary sinus mucocoele: risk factors for restenosis after surgery and preventive effects of mytomycin-C.

OBJECTIVE: To evaluate the clinical factors associated with restenosis after the surgery for treating postoperative maxillary sinus mucocoele and the preventive effect of topically applied mytomycin-C (MMC) on the restenosis. METHODS: This double-blinded randomized controlled prospective study included 38 cases of postoperative maxillary sinus mucocoeles. The patients underwent inferior meatal antrostomy with or without Caldwell-Luc operation, and cotton-pledgets soaked with MMC or normal saline were applied to the antrostomy sites for 5 minutes. The degree of narrowing of the opening and its correlation with the preoperative characteristics, including age, gender, allergy, presence of polyps, interval between previous surgery and computed tomography findings were evaluated. RESULTS: Three months after the surgery, the openings were patent in 24 cases, narrowed in 5 cases and stenotic in 9 cases. MMC application, septation of mucocoele and concurrent inflammation at the lesion side all had a significant effect on stenosis of the antrostomy site at 3 months after the surgery (p < 0.05, Chi-square test). CONCLUSIONS: MMC has a favorable effect in preventing narrowing of the opening after surgery for maxillary sinus mucocoeles. The presence of septa in the mucocoeles or concurrent inflammation in the ipsilateral sinuses has an effect to promote restenosis.

Oral mucoceles; extravasation cysts and retention cysts. A study of 298 cases.

Oral mucoceles can be divided in two different forms, extravasation and retention cysts. The aim of this study was to identify the frequency of each form, sex- and age distribution, location, recurrences, referent and the differences between the two forms. A total of three-hundred-five cases were retrieved from the Department of Oral Pathology at the Institution of Odontology, The Sahlgrenska Academy at Göteborg University between 1993 and 2003. Seven referrals were disregarded because there was insufficient information, leaving 298 cases for this study. In relation to other studies, our study investigated a larger number of cases. Extravasation cysts were the most common type (258 cases). There was a slight predominance among women (55%) and the most frequent location was the lower lip (71%). 84% occurred between the ages of 0 and 40 years with peak incidence in the second decade (34%). 62% of the referrals came from specialists, 28% from general practitioners, and 10% from the Department of Oral Medicine. Retention cysts were not found as frequently as extravasation cysts (40 cases) and the occurrence in women was also a bit higher (58%). We found a more even distribution regarding age and location. The most common locations were floor of the mouth (25%), cheek (20%), and lower lip (18%). They occurred more often between the ages of 11 and 30 (31%), and between 50 and 80 (50%). 75% of the referrals came from specialists, 15% from general practitioners,and 10% from the Department of Oral Medicine. Recurrences were unusual for both cyst types. 17 cases of extravasation cysts were reported as recurrences and one case of retention cyst.

Long-term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both.

BACKGROUND: Gallbladder mucoceles (GBM) typically are treated by cholecystectomy. Medical management rarely has been reported and medical and surgical management have not been compared. HYPOTHESIS/OBJECTIVES: To compare survival of dogs treated for GBM by medical management or cholecystectomy or both. ANIMALS: Eighty-nine client-owned dogs diagnosed with GBM that received cholecystectomy or medical treatment or both from 2011 to 2017. METHODS: Potential cases were identified by searching the medical records database. Data collected included signalment, clinicopathologic results, treatments, and ultrasonographic images and reports. Dogs were grouped according to the treatment received (medical management, surgical treatment, or both) that was chosen at the discretion of the attending veterinarian. Survival analysis was performed and prognostic variables identified and compared between treatment groups. RESULTS: Of dogs surviving at least 14 days after diagnosis, median survival times were 1802 (95% confidence interval [CI], 855-not reached) days, 1340 (95% CI, 444-1340) days, and 203 (95% CI, 18-525) days, for the surgical, medical, and medical then surgical treatment groups, respectively, and differed significantly (P < .0001). Gallbladder mucocele type (P = .05), serum alkaline phosphatase activity (P = .0001), and serum creatinine (P = .002) and phosphorus (P = .04) concentrations were associated with decreased survival across groups. Suspicion of biliary rupture on abdominal ultrasound (AUS) examination was correlated with increased survival in the surgical group (P = .02). CONCLUSIONS AND CLINICAL IMPORTANCE: Cholecystectomy for the treatment of GBM results in the best long-term survival in dogs surviving the immediate postoperative period (14 days) compared to medical management. Although medical management is associated with shorter survival compared to surgical treatment, it is a reasonable alternative when surgery cannot be pursued.

Congenital bilateral dacryocystocele.

INTRODUCTION: Newborns are obligatory nasal breathers. Therefore, nasal obstruction can lead to cyanosis and desaturation. In spite of being very rare, congenital bilateral dacryocystocele is a possible etiology for neonatal respiratory distress. CASE SUMMARY: Case report of a male newborn with respiratory distress caused by a bilateral polypoid and bluish lesion occupying almost the entire inferior nasal meatus. Imaging confirmed bilateral dacryocystocele. Treatment was conservative. There was spontaneous drainage, with relief of respiratory distress. Discussion The diagnosis of congenital dacryocystocele is clinical, although imaging exams may be requested to confirm it. Treatment is controversial, because the natural history is variable. An initial conservative management may be recommended, but, if there is a permanent respiratory obstruction without improvement, surgical management is mandatory.

Soft Tissue Disorders of the Mouth.

Soft tissue disorders of the mouth encompass a wide expanse of pathophysiology. This article focuses on the identification, etiology, management, and complications of common infectious processes (candidiasis, dental caries, and herpes labialis), inflammatory lesions (sialolithiasis, oral lichen planus, and aphthous ulcer), and benign entities (bony tori and mucocele).

Adult nasolacrimal sac mucocele.

Adult nasolacrimal sac mucocele is an uncommon mass arising in the medial canthal region of the orbit. Twenty-one cases with lacrimal sac mucocele were reviewed retrospectively. We gathered information about the clinical characteristics, natural history, mechanism for mucocele formation and optimal management of this disorder. The results show that the medial canthal mass was confirmed to be dacryo-cystocele-associated with distal nasolacrimal duct obstruction and proximal obstruction at the junction of the common canaliculus and sac. The interventional procedure of polyurethane stent placement is a practicable and simplified treatment for lacrimal sac mucocele.