Tinnitus affects the relative roles of semantics and prosody in the perception of emotions in spoken language.

Objective: Understanding communication difficulties related to tinnitus, by identifying tinnitus-related differences in the perception of spoken emotions, focussing on the roles of semantics (words), prosody (tone of speech) and their interaction.Study sample and design: Twenty-two people-with-tinnitus (PwT) and 24 people-without-tinnitus (PnT) listened to spoken sentences made of different combinations of four discrete emotions (anger, happiness, sadness, neutral) presented in the prosody and semantics (Test for Rating Emotions in Speech). In separate blocks, listeners were asked to attend to the sentence as a whole, integrating both speech channels (gauging integration), or to focus on one channel only (gauging identification and selective attention). Their task was to rate how much they agree the sentence conveys each of the predefined emotions.Results: Both groups identified emotions similarly, and performed with similar failures of selective attention. Group differences were found in the integration of channels. PnT showed a bias towards prosody, whereas PwT weighed both channels equally.Conclusions: Tinnitus appears to impact the integration of the prosodic and semantic channels. Three possible sources are suggested: (a) sensory: tinnitus may reduce prosodic cues. (b) Cognitive: tinnitus-related reduction in cognitive processing.

Adult supraglottitis: changing trends.

There is no clinical dynamic staging system which scores according to severity all the anatomical regions in adult supraglottitis. The objective of the study was to describe the demographics, clinical presentation, interventions and outcomes of adult patients diagnosed with acute supraglottitis (AS), and to study the correlation of a new AS classification with the need for airway intervention, in comparison with the current classification. This was a retrospective, cohort study conducted at a secondary medical care center. Adults diagnosed with AS from the years 1990-2013 were identified. Data were extracted for demographic and clinical information and there was no intervention. The main outcome and measures were the need for airway intervention. 288 eligible patients were enrolled. AS incidence rate was 4.3/100,000 patients/year. The mean age was 50 ± 16 years. Sore throat (94 %) and dysphagia (88 %) were the most common presenting symptoms. Patients were hospitalized either in the Otolaryngology Department (n = 255, 89 %) or in the Intensive Care Unit (n = 33, 11 %). Of the latter, 19 (58 %) had an airway securing intervention procedure. Our suggested classification was more sensitive than the current one for predicting the need for intubation (p = 0.03). Signs and symptoms of AS in adults are different from those in children. Adult patients presenting with oropharyngeal complaints should be suspected for AS and treated appropriately.

Augmented Reality-Guided Mastoidectomy Simulation: A Randomized Controlled Trial Assessing Surgical Proficiency.

OBJECTIVE: Mastoidectomy surgical training is challenging due to the complex nature of the anatomical structures involved. Traditional training methods based on direct patient care and cadaveric temporal bone training have practical shortcomings. 3D-printed temporal bone models and augmented reality (AR) have emerged as promising solutions, particularly for mastoidectomy surgery, which demands an understanding of intricate anatomical structures. Evidence is needed to explore the potential of AR technology in addressing these training challenges. METHODS: 21 medical students in their clinical clerkship were recruited for this prospective, randomized controlled trial assessing mastoidectomy skills. The participants were randomly assigned to the AR group, which received real-time guidance during drilling on 3D-printed temporal bone models, or to the control group, which received traditional training methods. Skills were assessed on a modified Welling scale and evaluated independently by two senior otologists. RESULTS: The AR group outperformed the control group, with a mean overall drilling score of 19.5 out of 25, compared with the control group's score of 12 (p < 0.01). The AR group was significantly better at defining mastoidectomy margins (p < 0.01), exposing the antrum, preserving the lateral semicircular canal (p < 0.05), sharpening the sinodural angle (p < 0.01), exposing the tegmen and attic, preserving the ossicles (p < 0.01), and thinning and preserving the external auditory canal (p < 0.05). CONCLUSION: AR simulation in mastoidectomy, even in a single session, improved the proficiency of novice surgeons compared with traditional methods. LEVEL OF EVIDENCE: NA Laryngoscope, 2024.

Intra-auricular sinus: first description of a variant of the pre-auricular cyst.

OBJECTIVE: The aim of this study was to describe a rare intra-auricular sinus. An otherwise healthy 15-year-old girl presented with recurrent infections in her right pinna from early infancy. Physical examination revealed a draining sinus which opened to the descending helical limb, while its cystic component was entrapped within the cartilaginous antitragus. Comprehensive surgical excision was performed after the tract and the more distal cyst was delineated. Surgical pathology revealed a true sinus, measuring 2 cm. Follow-up was unremarkable. DISCUSSION: In addition to the two previously described variants of pre-auricular cyst: the classic variant (the pit is anterior to the external auditory canal) and the postauricular variant (the pit is behind the ascending limb of the helix), we suggest a third variant which opens to the descending helical rim.

Head and neck manifestations of 22q11.2 deletion syndromes.

The allelic loss of 22q11.2 results in various developmental failures of pharyngeal pouch derivatives ("22q11.2 deletion syndromes", 22q.11DS), consequently affecting the anatomy and physiology of head and neck (H&N) organs. The objective of this paper was to describe those manifestations. Two 22q11.2DS patients with H&N manifestations were studied along with a comprehensive review of the English literature, from 1975 to 2010 regarding the associated H&N malformations among 22q11.2DS. A 24-year-old mentally disabled 22q11.2DS male presented with right hemithyroid enlargement, causing significant compressive signs. Sonography revealed a homogeneous 8 × 3 cm lesion, replacing almost the entire thyroid lobe. Fine needle aspiration revealed colloid material and abundant eosinophils. The hemithyroidectomy specimen confirmed follicular adenoma. A 19-year-old mentally disabled 22q11.2DS female underwent CT-angiography due to an upper GI bleeding. The study revealed a vascular malformation in the infratemporal fossa. Reviewing the reported data regarding 22q11.2DS-associated H&N malformations revealed abnormalities and malfunctions of the thyroid gland, parathyroid glands, thymus agenesis, cleft palate, carotid artery aberrations, malformations of the larynx and trachea and esophageal dysmotility. 22q11.DS patients may present with H&N anatomical abnormalities, along with hormonal dysfunctions, which require special awareness once treatment is offered, especially when concerning anesthetic and surgical aspects. In addition, hSNF5/INI1, a tumor suppressor gene, detected at location 22q11.2 was described to be "knocked out" in some patients. This may be associated with H&N tumors reported in these patients.

Effect of general anesthesia and intubation on parathyroid levels in normal patients and those with hyperparathyroidism.

BACKGROUND: Induction of general anesthesia and endotracheal intubation may precipitate parathyroid hormone (PTH) elevation in patients with primary hyperparathyroidism (HPT). The purposes of this study were to revisit this observation and to study its impact in healthy patients. METHODS: Patients with primary HPT who underwent parathyroidectomy were retrospectively studied. The PTH was sampled and compared: before, immediately after general anesthesia and endotracheal intubation, and 15 minutes after parathyroidectomy. Healthy adults who underwent elective operations were prospectively studied. The PTH was sampled before general anesthesia and endotracheal intubation, immediately after, and 15 minutes later. RESULTS: Thirty-one patients, aged 28-89 years (mean 60.1 ± 13 years), were retrospectively studied. The PTH was significantly elevated after general anesthesia and endotracheal intubation (P = .014). Fifty patients, aged 21-86 years (mean 54 ± 15 years), were prospectively studied. The PTH elevation after general anesthesia and endotracheal intubation was not significant. CONCLUSION: General anesthesia and endotracheal intubation causes an immediate, steep, and significant PTH elevation in patients with primary HPT but only a minor change in healthy adults. The difference may be attributed to an impaired adrenergic response in patients with primary HPT.

Tinnitus Perspectives among Israeli Ear, Nose and Throat Physicians: A Nationwide Survey.

OBJECTIVES: To study the compliance of ear, nose, and throat (ENT) physicians to the American Association Otolaryngology-Head - Neck Surgery (AAO-HNS) clinical practice guidelines (CPG) for tinnitus and to identify the disparity of both diagnosis and management options in the absence of a local protocol for the management of adult tinnitus. MATERIALS AND METHODS: A voluntary and anonymous questionnaire was emailed in a Google spread-out sheet format to all practicing ENT physicians across the country (n=370). Overall, 126 ENT physicians responded to the questionnaire (34% of the physicians to whom the questionnaire was sent). RESULTS: Medical history focuses on tinnitus characteristics and otological signs, and symptoms are often queried (80%-98%). Physicians routinely perform an otoscopic examination, whereas other relevant possible physical findings, such as temporomandibular joint disorders or neck trauma, are less frequently examined. Treating physicians have the most frequent recourse to sound therapy and cognitive behavioral therapy in accordance with AAO-HNS CPG. CONCLUSION: The publication of the AAO-HNS CPG for tinnitus is important, permitting a common approach for the diagnosis and management of primary tinnitus (PT). A diagnosis and management scheme that takes into consideration both the AAO-HNS CPG for tinnitus as well as physician diagnosis and management paradigms is suggested.

Endoscopic surgery for sinonasal invasive aspergillosis in bone marrow transplantation patients.

OBJECTIVES/HYPOTHESIS: Sinonasal invasive aspergillosis (IA) is an aggressive fungal infection with high mortality rates. It commonly develops in immunocompromised patients, often after bone marrow transplantation (BMT). Aggressive surgical debridement by an external approach has been considered a central element of treatment. We describe our experience in endoscopic management of IA in BMT patients in a retrospective study. METHODS: Charts of BMT patients with IA in the past 5 years were reviewed. Demographic data, primary disease, comorbidities, signs and symptoms, blood test results, preparation for surgery, surgical technique, and outcome were recorded. RESULTS: Fourteen BMT patients, age ranging from 3 to 56 years, had sinonasal IA. The primary disease was acute myelogenous leukemia in 6, acute lymphoblastic leukemia in 3, chronic myeloblastic leukemia in one, severe combined immunodeficiency disease in 2, and myelodysplastic syndrome in 2 patients. Diagnosis was made by physical examination, biopsy, culture, and computed tomography scan. Treatment, including aggressive endoscopic debridement, a systemic antifungal medication, and local irrigations of amphotericin-B enabled eradication of IA in all patients. Seven patients required two or more operations. None required orbital exenteration or craniotomy. Six patients died of the primary illness or of comorbidities with no evidence of residual disease. Eight patients are alive. CONCLUSION: Early detection of IA in BMT patients enables aggressive treatment before the disease spreads into the orbit or brain. Proper preoperative preparation facilitates safe endoscopic surgery in patients with severe bleeding tendencies. Although sinonasal IA is lethal, endoscopic surgery is feasible and efficient, enabling excellent local control.

The Impact of Tobacco Smoking Upon Chronic/Recurrent Tonsillitis and Post Tonsillectomy Bleeding.

Introduction Smoking has many adverse effects on the oral and pharyngeal mucosa. Outcomes may be developing tonsillar infections and predisposing for post tonsillectomy bleeding (PTB). Objective The objective of our study was to determine whether smokers have more chronic/recurrent tonsillitis indicating for tonsillectomy or develop more PTB episodes. Methods We conducted a retrospective study on two groups of adults (age ≥18 years). Cohort 1: Smoking among patients who underwent tonsillectomy for recurrent/chronic tonsillitis. Cohort 2: Smoking among patients requiring control of PTB that were operated primarily for recurrent/chronic tonsillitis. Cohort 1 served as a population-reference for the second. We retrieved the data from medical records. Results Cohort 1: 206 adults aged 18-50 years (mean 26 ± 7.6). 28% (57 patients) were smokers, versus 24% and 20% in the general population (in the years 2000 and 2010; p = 0.5, p = 0.18, respectively). Cohort 2: 114 adults aged 18-73 years (mean 26 ± 7.6). 43% were smokers, double the incidence in the general population (p = 0.004, p = 0.0004, in 2000 and 2010, respectively), and 1.5 times cohort 1 (p = 0.02). Smoking rates among bleeders on post-operative days 8-10 and later than day 10 were 53% and 60% (p = 0.0005 and p < 0.0001, respectively). Five of ten patients presenting a second PTB were smokers. Timing of re-bleedings was similar to their first PTB and dated similarly as first PTB of the entire group, mean 5.6 days (SD ± 3.2). Conclusion Smokers may encounter more chronic/recurrent tonsillitis episodes, indicating tonsillectomy and significantly are more prone for PTB. Smoking cessation may perhaps diminish recurrent/chronic tonsillitis. Whether pre-operative abstinence or its length would reduce PTB incidence is yet to be determined.

The Middle Ear Cleft Status in a "Natural" Cohort With Eustachian Tube Dysfunction.

BACKGROUND: The Eustachian tube (ET) has a major role in the middle ear (ME) pressure homeostasis. ET dysfunction is the accepted paradigm for pressure-related ME disorders. We studied the ME status in patients with severely diminished ET opening abilities, and anticipated to find ME disorders in most of them. PATIENTS AND METHODS: ME status was evaluated in unconscious adults, who were hospitalized in a rehabilitation center with severe brain damage, requiring tracheotomy and gastrostomy. These patients were unable to swallow, produce valsalva, yawn, and needed oral suctioning. Examination included fiberoptic nasopharyngoscopy, gag reflex and soft palate assessments, otoscopy, and tympanometry. RESULTS: Nineteen patients (38 ears) were evaluated: 14 men and 5 women, aged 18 to 93 years (average 59). Duration of gastrostomy and tracheotomy were between 3 months and 18 years. All the patients lacked gag reflex, palatal movements, or supraglottic sensation. Eighteen ears (47%) had otitis media with effusion (OME) (versus ∼3% in the general population, p = 0.00001), none had significant tympanic membrane atelectasis, but 20 (53%) ears were normal. Twenty-two ears (59%) had tympanometry types B/C and 16 (41%) had type A. Cerumen impaction incidence (26 ears, 68%) was significantly higher than in normal adults (10%), mentally retarded (36%), and nursing homes residents (57%). CONCLUSIONS: A dysfunctional ET predisposed ME disorders. Yet, ∼50% of the ears were normal, in contrast to the current paradigm. This implies that ME pressure homeostasis is maintained by factors that can compensate for ET dysfunction. Treating cerumen impaction and OME may be beneficial for rehabilitation.

Cardiovascular Risk Factors Among Patients With Vestibular Neuritis.

OBJECTIVE: To investigate the correlation between cardiovascular risk factors (CVRFs) and vestibular neuritis (VN) in hospitalized adult patients. METHODS: A cross-sectional retrospective study was conducted in a tertiary hospital setting. The medical records of patients (aged over 18 years old) who were hospitalized between the years 2005 and 2014 with the diagnosis of VN were retrieved. Inclusion criteria were: (1) acute vertigo lasting for at least 24 hours, (2) absence of auditory complaints, (3) horizontal unidirectional nystagmus present during physical examination, and (4) absence of neurological symptoms or signs. The ratio of CVRFs among VN patients was compared to the ratio of those among the general Israeli population. RESULTS: A significantly higher prevalence of CVRFs was found among VN hospitalized patients in comparison to the general population ( P < .05). Furthermore, a significant correlation ( P < .001) was found between the patients' age and the number of CVRFs (r = .387). A positive correlation (r = .643) was found between the number of CVRFs and VN in each age group ( P = .119). CONCLUSION: There may be a possible interrelation between CVRFs and VN. This correlation can be caused by occlusion of small blood vessels leading to labyrinthine ischemia and apparition of symptoms of VN.

Impact of Pneumococcal Conjugate Vaccines on Selected Head and Neck Infections in Hospitalized Israeli Children.

BACKGROUND: Streptococcus pneumoniae is a major pathogen of pediatric head and neck infections (HNIs), for example, acute otitis media (AOM), acute mastoiditis, acute bacterial sinusitis and meningitis. The aim of this study was to characterize the epidemiology of pneumococcal HNIs (pHNIs) before, during and after the introduction of pneumococcal conjugate vaccines (PCVs). METHODS: Children 0-16 years of age, who were hospitalized with HNIs in the pediatrics department in a general hospital between January 1, 2007, and December 31, 2014, were retrospectively identified. Study years were categorized according to the PCV introduction timeline: 2007-2008: "pre-PCV years"; 2009-2011: "transition years" and 2012-2014: "post-PCV years." pHNIs episodes were defined if pneumococcal culture or urine antigen was positive. Children who received ≥2 doses of PCV7/PCV13 were considered as immunized. All other children were considered as unimmunized. RESULTS: HNIs accounted for 2.5%-4.7% of the total admissions; 3%-17% of them were pHNIs. Eighty-seven pHNI episodes were identified: AOM (n = 42), acute mastoiditis (n = 28) and meningitis (n = 17). There was a downward trend in the overall incidence of HNIs, and particularly of pHNIs, in the post-PCV years. The average age and hospitalization duration of children with HNIs/pHNIs remained stable during the study years. In 2009-2010, pHNIs incidence sharply decreased, from 7 to 1.74/1000 hospitalized children/year, due to ~55% reduction of pneumococcal AOM episodes. An additional decrease was observed in the post-PCV years (1.62/1000 hospitalized children/year). Immunized children were less likely to present with pHNIs (P = 0.001) but were more likely to undergo surgery (P = 0.042). CONCLUSION: We observed a reduction in pHNIs incidence after PCV program implementation.

Chromosomal mapping and phenotypic characterization of hereditary otosclerosis linked to the OTSC4 locus.

OBJECTIVE: To perform chromosomal mapping and clinical analysis of hereditary otosclerosis linked to the fourth locus for otosclerosis (OTSC4) in an Israeli family. DESIGN: Pedigree study. SETTING: A genetics of hearing loss research laboratory, a clinical genetics laboratory, a center for speech and hearing, and an otolaryngology department at a university and medical centers in Israel. SUBJECTS: An Israeli family of which 24 members were ascertained and a pedigree was constructed; 12 members had otosclerosis. INTERVENTIONS: Confirmation of otosclerosis by surgery (3 subjects) and by audiologic evaluation, medical history, and family history (9 subjects), and whole-genome scanning to identify the chromosomal region of the mutant locus. MAIN OUTCOME MEASURES: Chromosomal location of the otosclerosis locus. RESULTS: Linkage to the 16q21-23.2 interval was identified and confirmed with a logarithm of odds (LOD) score of 3.97 at theta = 0. The new locus for otosclerosis was designated OTSC4. The OTSC4 interval of 9 to 10 megabase includes several genes involved in the immune system and bone homeostasis that may be good candidates for genes otosclerosis. CONCLUSION: The elucidation of the OTSC4 gene may disclose the etiology of the disorder, and the functional and structural analysis of the protein may open new options for diagnosis, treatment, and prevention of otosclerosis.

Acute Mastoiditis in Children: Necessity and Timing of Imaging.

BACKGROUND: Acute mastoiditis (AM) can be clinically diagnosed, with an option for supplemental imaging: computed tomography (CT) scan and magnetic resonance imaging (MRI). Debate widely exists whether clinical diagnosis alone is sufficient, in view of the risk of missing undetected complications. We sought to study the reasons leading to the performance of an imaging study during AM course. METHODS: Medical records of children younger than 8 years who were admitted from 2005 to 2014 with AM were retrospectively reviewed. Data included medical history, signs and symptoms, laboratory results, imaging studies, treatment methods and final outcomes. RESULTS: Eighty-six children were diagnosed with 88 AM episodes. Of the AM episodes, 55 (63%) were in boys and 46 (52%) were in children younger than 2 years. All children were treated with parenteral antibiotics, and 82 (95%) underwent myringotomy on admission. Only 20 (23%) children underwent imaging studies, on the 6th median day. Of those, 20 (100%) children underwent CT scans, and 3 (15%) underwent additional MRI studies. The reasons for imaging studies included suspected subperiosteal abscess (9 of 20, 45%), lack of improvement despite adequate medical therapy (7, 35%) and focal neurological signs (4, 20%). Sixteen (16%) children underwent surgery for these pathologies: subperiosteal abscesses (n = 12,), jugular vein thrombosis (n = 2), perisinus empyema (n = 2), epidural abscess (n = 2) and Luc abscess (n = 1). CONCLUSIONS: Most children presenting with AM can be diagnosed clinically and do well with intravenous antibiotics and myringotomy. CT and MRI imaging should be reserved for children with suspected AM-related intracranial complications.

Purulent chondritis of the laryngeal framework cartilages.

This manuscript reports on our experience with purulent chondritis of the laryngeal cartilages (PCLC), an entity that has not yet been described. Three patients had a diagnosis of PCLC. The probable causes were relapsing polychondritis, a previous prolonged intubation, and an idiopathic cause. The patients suffered from hoarseness and inspiratory stridor for 1 to 3 months before diagnosis. None complained of pain in the neck. Laryngoscopy showed supraglottic edema. A computed tomography scan revealed abscess formation between the intact inner and outer perichondria of the thyroid cartilage. The treatment included rigid endoscopy, external incision and drainage, and prolonged medical therapy. The culture results were Staphylococcus aureus in the first 2 cases and Aspergillus fumigatus in the third. The second patient (in whom the cricoid cartilage was also affected) required emergency tracheotomy. The other 2 patients did not require airway intervention. The rarity of PCLC and the relatively mild symptoms require a high index of suspicion for its diagnosis.

Deep neck infections in cervical injection drug users.

OBJECTIVES/HYPOTHESIS: To characterize deep neck infections (DNI) in adult intravenous drug users (IDUs) who injected illicit substances to their neck, in comparison to DNI in non-IDUs. STUDY DESIGN: Retrospective, cohort study. METHODS: Data were retrieved from medical charts of adult DNI patients in a secondary hospital during 2000-2013. Clinical, radiologic, and microbial data were extracted and tabulated following categorization into 2 patient groups: IDUs and non-IDUs. RESULTS: Of the 136 patients identified with DNI, 20 (15%) were IDUs; of them 80% were males. IDUs were significantly younger than non-IDUs (mean age, 35 ± 10 vs. 44 ± 16 years, P = .01). All IDUs had multiple comorbidities. IDUs presented for medical examination and hospitalization later in the course of their disease, and the most common involved neck spaces were consistent with areas where cervical injections are commonly performed. Abscess formation was more common in IDUs than non-IDUs (16 [80%] vs. 79 [68%], respectively, P = .04). Despite later presentation of IDUs and their higher rate of comorbidities, laboratory data, microbiology cultures, and disease course were similar to non-IDUs. CONCLUSIONS: Although IDU and non-IDU differ in DNI presentation, both groups had good outcomes. DNI in IDUs frequently evolved into abscesses, and most were found in the anterior triangle deep to sternocleidomastoid (SCM), posterior triangle, and anterior triangle superficial to SCM, in concordance with the injection sites. LEVEL OF EVIDENCE: 4.

Changing trends of acute otitis media bacteriology in central Israel in the pneumococcal conjugate vaccines era.

BACKGROUND: The widespread use of 7-valent pneumococcal conjugate vaccine (PCV7) has changed acute otitis media (AOM) bacteriology. Only scattered data with regard to this effect of PCV13 have been published so far. METHODS: We retrospectively identified children <6 years of age who presented to our hospital with AOM, and had middle ear fluid (MEF) cultures obtained during tympanocentesis or from spontaneous otorrhea during 2008-2013, when PCV7 (2009) and PCV13 (2010) were gradually introduced in the Israeli National Immunization Program. Data were extracted for demographics, clinical and microbiologic parameters, according to vaccination status. RESULTS: Of the 295 eligible AOM episodes reported in 279 children, 224 (76%) had MEF cultures from tympanocentesis and 71 (24%) from spontaneous otorrhea. Boys and children <2 years of age contributed 178 (60%) and 219 (74%) AOM episodes, respectively. Acute mastoiditis complicated 58 (20%) of these episodes. None of the children were PCV immunized in 2008, but >90% had received ≥1 PCV dose(s) by 2011 or later. Of the 106 (36%) MEF cultures which tested positive for otopathogens, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and multiple bacteria grew in 60 (57%), 39 (37%), 2 (2%) and 5 (5%) episodes, respectively. S. pneumonia-positive MEF culture rate in unimmunized children (31, 69%) was significantly higher than in PCV7-immunized children (22, 59%) or PCV13-immunized children (12, 50%), P = 0.04 and P = 0.02, respectively. CONCLUSION: PCV7 and PCV13 implementations in the Israeli National Immunization Program were associated with a rapid reduction of "severe" pneumococcal AOM episodes.

Pneumolabyrinth: an unusual finding in a temporal bone fracture.

Pneumolabyrinth or pneumocochlea are rarely found in temporal bone fractures. The presence of air in the inner ear is evidence of a pathological connection between the inner ear and the air-filled mastoid or middle ear cavities. A case of a pneumolabyrinth in a 2-years-old child is presented here. Diagnosis was made by means of a high resolution, thin sections computed tomography (CT) scan of the temporal bones, which is the imaging modality of choice in cases of otologic complaints after head trauma.

Basal cell adenocarcinoma in a buccal minor salivary gland.

Basal cell adenocarcinoma (BCAC) is an extremely rare neoplasm in salivary glands, particularly minor glands. BCAC is a low-grade malignant tumor which has cytologic features of basal cell adenoma, together with infiltrative growth and perineural invasion. We describe the case of a 55-year-old man with a 3 x 3 cm2 right buccal BCAC, which was treated by means of transoral resection and postoperative adjuvant radiotherapy. The histologic features of this tumor demonstrate the differential diagnosis of basal cell tumors. It is necessary to differentiate BCAC from other basaloid cell tumors of the salivary glands due to differences in treatment and prognosis.