Lip cancer and pre-cancerous lesions harbor TP53 mutations, exhibit allelic loss at 9p, 9q, and 17p, but no BRAFV600E mutations.

Molecular mechanisms of lip squamous cell carcinoma (LSCC) and actinic cheilitis (AC) are unclear. We aimed at assessing loss of heterozygosity (LOH) and TP53 and BRAF V600E mutations in these lesions. Formalin-fixed paraffin-embedded (FFPE) samples of 17 LSCC and 16 AC were included, with additional 5 fresh LSCC genotyped for TP53 mutations. LOH was assessed by six polymorphic markers located at 9p22, 9q22, and 17p13 and correlated with cell proliferation (Ki-67) and P53 immunostaining. Direct sequencing of TP53 exons 2-11 (fresh samples), and exons 5-9 (FFPE samples) was carried out. BRAF V600E mutation was genotyped in eight LSCC. LOH occurred in at least one marker in 15/17 LSCC and in 9/16 AC. The marker exhibiting the highest frequency of allelic loss (FAL) in LSCC was D9S157 (8/12 informative cases) and D9S287 in AC (4/11 informative cases). Cell proliferation was not correlated with LOH or with the FAL and no correlation between P53 IHC and 17p LOH was observed. We found TP53 missense mutations in both lesions and nonsense in LSCC, including CC>TT transition, which is a marker of UV damage. BRAF V600E mutation was not detected. LOH and TP53 mutations detected in LSCC and AC may be associated with tumorigenesis, whereas BRAF V600E mutation does not seem to significantly contribute to LSCC pathogenesis.

Associação entre estadiamento clínico e patológico da metástase cervical do carcinoma de células escamosas de laringe e hipofaringe / The laryngeal squamous cell carcinoma and the association between clinical and hystopathlogical staging of cervical metastasis

Introdução: O carcinoma de células escamosas (CCE) de laringe, em nosso meio, é frequentemente diagnosticado em estadios avançados, encontrando-se metástases cervicais em até 50,0% dos pacientes. Considerando que a presença de metástases é importante fator na definição de proposta terapêutica e prognóstico, é da maior importância o estudo de métodos diagnósticos que permitam com segurança o estadiamento de metástases cervicais no pré- e per operatório. Objetivo: Avaliar a acurácia do exame clínico, em relação ao estadiamento das metástases cervicais, comparando-o ao estadiamento anatomopatológico em pacientes submetidos ao tratamento cirúrgico do CCE de laringe. Métodos: Foram avaliados 89 pacientes, com diagnóstico de CCE de laringe, submetidos à laringectomia total e esvaziamento cervical, entre os anos de 2009 e 2012. Comparamos o estadiamento cervical clínico (N) com o estadiamento patológico. Resultados: Foram encontradas metástases cervicais ao exame anatomopatológico em 55 dos 89 pacientes estudados (61,7%), sendo que em oito deles (8,9%) não foram detectados ao exame clínico. Em 18 pacientes (20,2%) o estadiamento anatomopatológico apontou doença mais avançada que o estadiamento clínico, que por sua vez apresentou sensibilidade de 76,0% e especificidade de 87,0%, sendo seu valor preditivo positivo de 89,5% e o valor preditivo negativo de 62,0%. Conclusão: O estadiamento clínico apresenta acurácia, valor preditivo positivo e especificidade para detectar metástases cervicais no CCE de laringe inferior, mas ainda assim comparáveis, aos métodos de imagem sendo a tomografia computadorizada cervical a principal delas. Entretanto, apresenta acurácia menor que o estadiamento anatomopatológico principalmente em pacientes submetidos a traqueostomia previamente ao exame clínico e cirurgia, e portanto, não deve ser o único norteador da proposta terapêutica.

Introduction: The laryngeal squamous cell carcinoma (SCC) is often diagnosed in advanced stages and hidden cervical metastasis are found in until 50% of the patients. As one of the most important factors related to its prognosis, cervical metastasis have been studied recently as well as the diagnostic methods related to their staging. Objective: This study aims to estimate the accuracy of the clinical findings to stage cervical metastasis in patients with laryngeal SCC in comparison to the histopathological staging. Methods: The survey included 89 patients diagnosed with laryngeal SCC, who were submitted to total laryngectomy and cervical lymph node dissection from 2009 until 2012. Their clinical cervical staging before surgery were compared to the histological staging as well as the factors which may be related to the different results between them. Results: In 55 of the 88 patients (61,7%), there were found cervical metastasis in the histological exam, in which 8 of them (8,9%) the clinical examination had not found metastasis. In 18 patients (20,2%), the hystopathological staging presented a more advanced stage then the one showed by the clinical examination. The sensibility of the clinical examination was 76,0% and the specificity, 87%. The positive predictive value was 89,5% and the negative predictive value was 62%. Conclusion: The clinical staging presents lower accuracy, positive predictive value and specificity than others diagnostic methods such as the Cervical Computed Tomography, but still comparable to them, what makes it important to the cervical metastasis staging. Although, due to its low accuracy if compared to the hystopathological staging mainly in patients submitted to tracheostomy before clinical exam and surgery, it cannot be the only leading factor to be considered to define treatment.

Effectiveness of unsedated transnasal endoscopy with white-light, flexible spectral imaging color enhancement, and lugol staining for esophageal cancer screening in high-risk patients.

BACKGROUND AND AIMS: Transnasal endoscopy (TNE) has been proposed to screen for esophageal squamous cell cancer (ESCC) in Asia. This study aimed to assess the feasibility and tolerance of Brazilian patients to undergo unsedated TNE for screening, the prevalence of ESCC in this population, and the effectiveness of white-light endoscopy (WLE) and digital chromoendoscopy [flexible spectral imaging color enhancement (FICE)] to diagnose esophageal neoplasia. PATIENTS AND METHODS: This was a diagnostic test study that enrolled patients with head and neck squamous cell cancer (HNSCC) referred to ESCC screening. Patients' tolerance was rated by a numeric pain intensity scale. Interventions included unsedated TNE with WLE and FICE examination of the esophagus, in a tandem manner with blinded operators, followed by lugol chromoscopy. Performance of WLE and FICE for neoplasia detection was compared with the reference standard (lugol chromoscopy plus histology). RESULTS: A total of 106 patients were recruited. TNE was feasible in 99.1%, and 92% of the patients rated the discomfort as absent or minimal. Thirteen ESCC were detected (12.3%), with 10 early cancers (77%). The tests showed an excellent performance and there was no difference between WLE (sensitivity 92.3%, specificity 98.9%, accuracy 98.1%, area under curve 0.995) and FICE (sensitivity 100%, specificity 98.9%, accuracy 99%, area under curve 0.956) for esophageal neoplasia detection. CONCLUSIONS: Unsedated TNE is a feasible, well accepted, and efficient diagnostic tool for the screening of ESCC. The elevated rate of esophageal neoplasia strengthens the recommendations to screen patients with HNSCC. The yields of WLE and FICE were similar for ESCC detection.

Fatores preditores para hipocalcemia pós-tireoidectomia / Predictors factors for post-thyroidectomy hypocalcaemia

OBJETIVO: Avaliar a incidência e os fatores preditores da hipocalcemia e hipoparatireodismo definitivo pós-tireoidectomia. MÉTODOS: Foi dosado cálcio iônico no pré e no pós-operatório (primeiro, segundo e 30ºdia) em 333 pacientes submetidos à tireoidectomia. Naqueles que apresentaram hipocalcemia, as dosagens foram feitas também aos 90 e 180 dias de pós-operatório, quando se dosou também o paratormônio. Os pacientes foram agrupados segundo a presença ou ausência de hipocalcemia e avaliados segundo idade, sexo, função tireoidiana, volume tireoidiano, número de paratireoides identificadas e necessidade de reimplante de paratireoides, tipo de operação, tempo operatório e diagnóstico histopatológico. RESULTADOS: A incidência de hipocalcemia temporária foi de 40,8% (136 pacientes), e hipoparatireoidismo definitivo de 4,2% (14 pacientes). Tireoidectomia total ou reoperação, esvaziamento cervical, hipertireoidismo, tempo operatório e idade acima de 50 anos foram fatores determinantes de incidência significativamente maior de hipocalcemia e hipoparatireodismo definitivo (p<0,05). CONCLUSÃO: os fatores preditores da hipocalcemia pós-operatória incluem idade (>50 anos), tireoidectomia total, reoperação, esvaziamento cervical e tempo operatório. Os fatores preditores do hipoparatireoidismo definitivo pós-tireoidectomia incluíram tipo de operação, diagnóstico histológico e hipertireoidismo.

OBJECTIVE: To evaluate the incidence and predictors of post-thyroidectomy definitive hypocalcemia and hypoparathyroidism. METHODS: We assessed ionic calcium preoperatively and postoperatively (first, second and 30th day) in 333 patients undergoing thyroidectomy. In those presenting hypocalcemia, measurements were also made 90 and 180 days after surgery, when parathormone was also dosed. Patients were grouped according to the presence or absence of hypocalcemia and evaluated according to age, gender, thyroid function, thyroid volume, number of parathyroid glands identified and need to parathyroid reimplantation, type of operation, operative time, and histopathological diagnosis. RESULTS: The incidence of temporary hypocalcemia was 40.8% (136 patients), and of definitive hypoparathyroidism 4.2% (14 patients). Reoperation or total thyroidectomy, neck dissection, hyperthyroidism, operative time and age above 50 years were factors related to higher incidence of hypocalcemia and definitive hypoparathyroidism (p <0.05). CONCLUSION: predictors of postoperative hypocalcemia included age (> 50 years), total thyroidectomy, reoperation, neck dissection and operative time. The predictors of post-thyroidectomy definitive hypoparathyroidism included type of operation, histological diagnosis and hyperthyroidism.

Predictors factors for post-thyroidectomy hypocalcaemia.

OBJECTIVE: To evaluate the incidence and predictors of post-thyroidectomy definitive hypocalcemia and hypoparathyroidism. METHODS: We assessed ionic calcium preoperatively and postoperatively (first, second and 30th day) in 333 patients undergoing thyroidectomy. In those presenting hypocalcemia, measurements were also made 90 and 180 days after surgery, when parathormone was also dosed. Patients were grouped according to the presence or absence of hypocalcemia and evaluated according to age, gender, thyroid function, thyroid volume, number of parathyroid glands identified and need to parathyroid reimplantation, type of operation, operative time, and histopathological diagnosis. RESULTS: The incidence of temporary hypocalcemia was 40.8% (136 patients), and of definitive hypoparathyroidism 4.2% (14 patients). Reoperation or total thyroidectomy, neck dissection, hyperthyroidism, operative time and age above 50 years were factors related to higher incidence of hypocalcemia and definitive hypoparathyroidism (p <0.05). CONCLUSION: predictors of postoperative hypocalcemia included age (> 50 years), total thyroidectomy, reoperation, neck dissection and operative time. The predictors of post-thyroidectomy definitive hypoparathyroidism included type of operation, histological diagnosis and hyperthyroidism.

Linfoepitelioma de glândulas salivares maiores: relato de caso / Lymphoepithelioma of major salivary glands: case report

O linfoepitelioma de glândulas salivares maiores é um tumor maligno e raro, principalmente no ocidente. No presente artigo, descrevemos o caso de uma paciente do sexo feminino, com linfoepitelioma de parótida, que recidivou precocemente depois de cirurgia isolada e alcançou remissão depois de quimiorradiação. A paciente encontra-se no 19º mês de seguimento clínico, sem sinais de recidiva ou sequelas do tratamento. A literatura pertinente ao assunto foi revisada.

Lymphoepithelioma of major salivary glands is a rare malignant tumor, affecting mainly the population of Western countries. In the present paper, we report the case of a female patient with parotid lymphoepithelioma, which recurred early after surgery. The patient achieved remission after chemoradiation and has been followed up for 19 months with no evidence of relapse and sequelae of treatment. Additionally, we reviewed the relevant literature related to this topic.

Evolution of blood magnesium and phosphorus ion levels following thyroidectomy and correlation with total calcium values.

CONTEXT AND OBJECTIVE: magnesium ion concentration is directly related and phosphorus ion concentration is inversely related to calcemia. The aim of this study was to evaluate the evolution of magnesium and phosphorus ion levels in patients undergoing thyroidectomy and correlate these with changes to calcium concentration. DESIGN AND SETTING: prospective study at the Alpha Institute of Gastroenterology, Hospital das Clínicas, Universidade Federal de Minas Gerais. METHODS: the study included 333 patients, of both genders and mean age 45 ± 15 years, who underwent thyroidectomy between 2000 and 2005. Total calcium, phosphorus and magnesium were measured in the blood preoperatively and 24 and 48 hours postoperatively. Ionic changes were evaluated according to the presence or absence of postoperative hypocalcemia. RESULTS: there were statistically significant drops in blood phosphorus levels 24 and 48 hours after thyroidectomy, compared with preoperative values, in the patients without hypocalcemia. In the patients who developed hypocalcemia, there was a significant drop in plasma phosphorus on the first postoperative day and an increase (also statistically significant) on the second day, in relation to preoperative phosphorus levels. A significant drop in postoperative magnesium was also observed on the first and second days after thyroidectomy in the patients with hypocalcemia, in relation to preoperative levels. In the patients without hypocalcemia, the drop in magnesium was significant on the first day, but there was no difference on the second day. CONCLUSION: despite the postoperative changes, neither magnesium nor phosphorus ion levels had any role in post-thyroidectomy calcemia.

Kikuchi-Fujimoto disease: three case reports.

CONTEXT: Kikuchi-Fujimoto disease (KFD) manifests in most cases as unilateral cervical lymphadenomegaly, with or without accompanying fever. The disease mainly affects young women and has a self-limited course. It is more common in oriental countries, with few reports of its occurrence in Brazil. KFD should be included in the differential diagnosis of suspected cases of viral infections, tuberculosis, reactive lymphadenitis, systemic lupus erythematosus and metastatic diseases. It can be histologically confused with lymphoma. The disease is benign and self-limiting and an excisional biopsy of an affected lymph node is necessary for diagnosis. There is no specific therapy. CASE REPORTS: This study reports on three cases of non-Asian female patients with KFD who were attended at our service between 2003 and 2006. A review of the literature was carried out, with a systematic search on this topic, with the aim of informing physicians about this entity that is manifested by cervical masses and fever.

Reconstrução de hipofaringe com retalho miocutâneo peitoral maior após faringolaringetomia total / Hypopharyngeal reconstruction using pectoralis major myocutaneous flap after total pharyngolaryngectomy

O câncer de hipofaringe representa 5 a 10% das neoplasiasdas vias aerodigestivas superiores e frequentemente édiagnosticado em sua forma avançada, com invasão da laringee metástases cervicais. A série é constituída por três pacientesportadores de tumores avançados de hipofaringe com invasãolaríngea. O tratamento cirúrgico, em todos os casos, consistiuem faringolaringectomia circular. A reconstrução foi realizadaconforme a técnica de Fabian modificada por Spriano. Em todosos pacientes ocorreu restabelecimento satisfatório da alimentaçãopor via oral. As técnicas de reconstrução consideradas comopadrão-ouro são o retalho livre vascularizado de alça de jejuno e atransposição gástrica. Uma alternativa às técnicas apresentadasseria a reconstrução com retalho miocutâneo peitoral.

Hypopharyngeal carcinomas of hipofaringe represent 5 to10% of upper aerodigestive tract and is often diagnosed in itsadvanced form, with invasion of the larynx and neck metastases.The series is constituted by three patients with advancedhypopharyngeal tumors. The surgical treatment of all the casesconsisted of total pharyngolaryngectomy. The reconstruction wascarried in agreement with the technique of Fabian modified forSpriano. In all the patients occurred satisfactory reestablishmentof the oral feeding. The considered gold standard techniquesof reconstruction are free jejune interposition and the gastrictransposition. An alternative to the presented techniques would bereconstructions using major pectoralis myocutaneous flap.

Kikuchi-Fujimoto disease: three case reports / Doença de Kikuchi-Fujimoto: relato de três casos

CONTEXT: Kikuchi-Fujimoto disease (KFD) manifests in most cases as unilateral cervical lymphadenomegaly, with or without accompanying fever. The disease mainly affects young women and has a self-limited course. It is more common in oriental countries, with few reports of its occurrence in Brazil. KFD should be included in the differential diagnosis of suspected cases of viral infections, tuberculosis, reactive lymphadenitis, systemic lupus erythematosus and metastatic diseases. It can be histologically confused with lymphoma. The disease is benign and self-limiting and an excisional biopsy of an affected lymph node is necessary for diagnosis. There is no specific therapy. CASE REPORTS: This study reports on three cases of non-Asian female patients with KFD who were attended at our service between 2003 and 2006. A review of the literature was carried out, with a systematic search on this topic, with the aim of informing physicians about this entity that is manifested by cervical masses and fever.

CONTEXTO: A doença de Kikuchi-Fujimoto (DKF) se manifesta na maioria das vezes como linfadenomegalia cervical unilateral, que pode ser acompanhada de febre. Afeta principalmente mulheres jovens, com evolução autolimitada. A prevalência desta doença é mais comum no oriente, havendo poucos relatos de sua ocorrência em nosso meio. DKF deve ser incluída no diagnóstico diferencial de casos suspeitos de infecções por vírus, tuberculose, linfadenite reacional, lúpus eritematoso sistêmico e doença metastática. Histologicamente pode ser confundida com linfoma. A doença é de caráter benigno, auto-limitada, a biópsia excisional do linfonodo acometido é necessária para o diagnóstico e não há tratamento específico. RELATO DE CASOS: Este trabalho relata três casos de pacientes não asiáticas do sexo feminino com DKF, atendidas em nosso serviço entre 2003 e 2006, e faz revisão da literatura com uma busca sistematizada sobre o assunto, com o objetivo de informar os médicos sobre essa entidade que se manifesta com massa cervical e febre.

Course of ionized calcium after thyroidectomy.

BACKGROUND: The goal of the present study was to investigate the course of ionized calcium after thyroidectomy and to define a cut-off value that indicates symptoms of hypocalcemia. METHODS: The sample included 333 patients undergoing thyroidectomy at the University Hospital of UFMG between September 2000 and December 2005. Ionized calcium was determined before and after surgery (days 1, 2, and 30) in all patients and on postoperative days 90 and 180 in those with hypocalcemia. Asymptomatic patients received no calcium replacement therapy, irrespective of calcium concentration. Patients with clinical manifestation of hypocalcemia were treated after laboratory confirmation. The presence or absence of postoperative hypocalcemia was associated with ionized calcium concentration measured on the reported days. RESULTS: Ionized calcium declined on the first two days after surgery in all patients when compared to preoperative levels (P = 0.000). Forty-seven (34.6%) of the 136 (40.8%) patients with postoperative hypocalcemia had symptoms. Patients with symptomatic hypocalcemia had significantly lower ionized calcium levels than those with asymptomatic hypocalcemia (P = 0.001). Fourteen (4.2%) patients progressed to definitive hypoparathyroidism by the end of 6 months. CONCLUSIONS: Measurement of ionized calcium on postoperative days 1 and 2 is sufficient for the evaluation of post-thyroidectomy hypocalcemia. Ionized calcium concentrations <1.03 mmol/l on postoperative day 1 are indicative of the presence of symptoms and the need for treatment.

Evolution of blood magnesium and phosphorus ion levels following thyroidectomy and correlation with total calcium values / Evolução dos níveis dos íons fósforo e magnésio séricos e sua correlação com valores de cálcio total após tireoidectomia

CONTEXT AND OBJECTIVE: Magnesium ion concentration is directly related and phosphorus ion concentration is inversely related to calcemia. The aim of this study was to evaluate the evolution of magnesium and phosphorus ion levels in patients undergoing thyroidectomy and correlate these with changes to calcium concentration. DESIGN AND SETTING: Prospective study at the Alpha Institute of Gastroenterology, Hospital das Clínicas, Universidade Federal de Minas Gerais. METHODS: The study included 333 patients, of both genders and mean age 45 ± 15 years, who underwent thyroidectomy between 2000 and 2005. Total calcium, phosphorus and magnesium were measured in the blood preoperatively and 24 and 48 hours postoperatively. Ionic changes were evaluated according to the presence or absence of postoperative hypocalcemia. RESULTS: There were statistically significant drops in blood phosphorus levels 24 and 48 hours after thyroidectomy, compared with preoperative values, in the patients without hypocalcemia. In the patients who developed hypocalcemia, there was a significant drop in plasma phosphorus on the first postoperative day and an increase (also statistically significant) on the second day, in relation to preoperative phosphorus levels. A significant drop in postoperative magnesium was also observed on the first and second days after thyroidectomy in the patients with hypocalcemia, in relation to preoperative levels. In the patients without hypocalcemia, the drop in magnesium was significant on the first day, but there was no difference on the second day. CONCLUSION: Despite the postoperative changes, neither magnesium nor phosphorus ion levels had any role in post-thyroidectomy calcemia.

CONTEXTO E OBJETIVO: A concentração do íon magnésio está diretamente e a do íon fósforo inversamente relacionada à calcemia. O objetivo foi avaliar a evolução das concentrações dos íons magnésio e fósforo nos pacientes submetidos a tireoidectomia, e relacioná-los com as alterações da concentração do cálcio. TIPO DE ESTUDO E LOCAL: Estudo prospectivo realizado no Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais. MÉTODOS: O estudo incluiu 333 pacientes de ambos os sexos, com média de idade de 45 ± 15 anos, submetidos a tireoidectomia no período de 2000 a 2005. Cálcio total, fósforo e magnésio foram dosados no pré-operatório e com 24 e 48 horas de pós-operatório. As alterações dos íons foram avaliadas de acordo com a presença ou ausência de hipocalcemia pós-operatória. RESULTADOS: Houve queda estatisticamente significativa dos níveis sanguíneos de fósforo 24 horas e 48 horas após a tireoidectomia em relação ao pré-operatório nos pacientes que não tiveram hipocalcemia. Quanto aos pacientes que evoluíram com hipocalcemia, houve queda significativa do fósforo plasmático no primeiro dia de pós-operatório e elevação, também estatisticamente significativa, no segundo dia em relação ao fósforo pré-operatório. Foi também observada queda significativa do magnésio pós-operatório em relação ao pré-operatório no primeiro e no segundo dia após a tireoidectomia nos pacientes com hipocalcemia. Naqueles sem hipocalcemia, a queda do magnésio foi significativa no primeiro dia, mas não houve diferença no segundo dia. CONCLUSÃO: Embora alterados no pós-operatório, as concentrações dos íons magnésio e fósforo não apresentaram papel na calcemia pós-tireoidectomia.

Identificação das mudanças na mastigação e deglutição de indivíduos submetidos à glossectoma parcial / Identification of chewing and swallowing changes in individuals submitted to partial glossectomy

OBJETIVO: Identificar as alterações de mastigação e deglutição decorrentes da cirurgia curativa do câncer de língua, com extensão inferior a 50 por cento da dimensão da língua e sem comprometimento do soalho da boca e da base da língua. MÉTODOS: Foram realizadas avaliações das funções de mastigação e deglutição em nove pacientes, seis homens e três mulheres, no período pré-operatório, aplicando-se um protocolo específico. No pós-operatório mediato, três semanas após a cirurgia, cinco pacientes foram reavaliados, quatro homens e uma mulher, seguindo o mesmo protocolo. Para verificar a significância dos resultados foi utilizado o teste não paramétrico de Kruskall Wallis (Teste H). RESULTADOS: Comparando-se os achados do pré-operatório com os achados do pós-operatório encontramos, de forma significativa (p<0,05), mudança da via de alimentação, que passou de uma alimentação exclusivamente oral, para uma alimentação exclusivamente enteral. Também houve mudança significativa na eficiência mastigatória, que passou a ser ineficiente em todos os pacientes. Percebeu-se, de forma significativa, a dificuldade dos pacientes em manipular o bolo alimentar durante o processo de mastigação, gerando dificuldade na formação de um bolo coeso. Isso demonstra que a cirurgia influencia na realização desta função, ou seja, a perda de parte da língua compromete o processo de mastigação. A deglutição também foi prejudicada pela cirurgia, uma vez que o teste demonstrou de forma significativa a presença de estase oral, após a deglutição e movimentos compensatórios de cabeça para a deglutição de alimentos sólidos. CONCLUSÃO: Os pacientes submetidos à glossectomia parcial apresentam mudanças na mastigação e deglutição decorrentes do tratamento cirúrgico.

PURPOSE: To identify the commonest changes in chewing and swallowing as a result from curative tongue cancer surgery, with less than 50 percent of tongue resection and preservation of both mouth floor and tongue base. METHOSD: Nine patients - six men and three women - were assessed during the pre-surgical period, using a specific protocol. During the mediate postsurgical period, five patients - four men and one woman - were reassessed using the same protocol. The Kruskall Wallis non-parametric test (Test H) was used to analyze the significance of the results. RESULTS: The comparison between pre and postoperative results showed significant (p<0,05) changes from oral to enteral feeding. There was also a significant change in chewing efficiency, which became ineffective in all patients. It was significantly observed the patients' difficulty in handling the food bolus during the chewing process, causing difficulty in forming a cohesive bolus. This demonstrates that surgery influences this function, that is, the partial loss of the tongue undermines the chewing process. The swallowing process was also impaired by the surgery: the protocol demonstrated significant presence of oral stasis after swallowing, and compensatory head movements for swallowing solids. CONCLUSION: The patients submitted to partial glossectomy presented significant alterations in chewing and swallowing as a result from surgical cancer treatment.

Solitary fibrous tumour of the buccal mucosa: case report and review of the literature.

Solitary fibrous tumours are spindle-cell neoplasms that usually occur in the pleura and peritoneum, and rarely involve the oral mucosa. We report a 30-year-old man with a large solitary fibrous tumour on the buccal mucosa that resembled a salivary gland neoplasm. The lesion was excised and has not recurred.

Manifestações da amiloidose em otorrinolaringologia / Otorhinolaryngologic manifestations of amyloidosis

A amiloidose caracteriza-se pela deposição de fibrilas protéicas com características microscópicas especificas que podem acometer diversas partes do organismo. Esses depósitos podem ser localizados, ou disseminados, definindo as formas localizadas ou sistêmicas da doença. Na região da cabeça e do pescoço pode apresentar-se como doença localizada, sistêmica ou associar-se com discrasias de células plasmáticas. Devido à gravidade da forma sistêmica e à associação em 20% dos plasmocitomas com a amiloidose, é de suma importância a distinção entre essas manifestações e a forma localizada. A eletroforese de proteínas séricas e a biópsia por aspiração de gordura abdominal ou de mucosa de lábio são exames de simples realização, que devem ser feitos em todos os pacientes. O objetivo deste trabalho é mostrar revisão da literatura sobre o tema e apresentar três casos, sendo dois com acometimento laríngeo e um em cavidade nasossinusal, enfatizando a fisiopatologia da doença, sua classificação e associação com outras patologias.

Amyloidosis represents a group of disorders characterized by the deposition of protein fibrils with typical microscopic features. Head and neck amyloidosis may represent a local or systemic disease and also can be associated with plasma cell dyscrasias. Because of the severity of the systemic diseases and the 20% of association of the plasmocytomas with amyloidosis, it is very important to distinguish these two from local disease. Protein eletrophoresis and abdominal fat aspiration or mucosal lip biopsy Must be performed in all patients. The aim of this study is to review the literature and to present three cases of amyloidosis, two of them involving the larynx and the other involving the nasal cavity and the paranasal sinuses. The authors discuss the pathophysiology, its classification and the relation to other pathologies.

Hemangiomas múltiplos da mandíbula, maxila e osso frontal / Hemangiomas of the mandible, maxilla and frontal bone

Bone hemangiomas are histologically benign neoplasms, especially those in the skull. They are relatively rare when compared to all bone tumors and occur more frequently in females during the second decade of life. The predominant symptoms are bone expansion, regional displacements and bleeding. A case of multiple hemangiomas of mandible, maxilla and frontal bones is described. The tumor largely involved the face and oral cavity, with massive fatal bleeding as a complication of surgery. The clinical and radiological difficulties in diagnosing and treating these lesions are discussed, emphasizing the complexity of the surgical treatment and the possible life threatening uncontrolled bleeding that may occur

Carcinoma adenóide cístico do seio frontal: apresentaçäo de um caso / Adenoid cystic carcinoma of the frontal sinus: a case report

Apresenta-se um caso de carcinoma adenóide cístico primitivo do seio frontal, tratado por cirurgia radical, sendo que a paciente foi acompanhada por 9,5 anos sem que apresentasse sinais de recidiva ou metástase. Embora o tempo de acompanhadamento possa ser considerado relativamente curto, para esse tipo de neoplasia, considera-se que a radicalidade cirúrgica tenha sido essencial no controle local da doença