A rare case of long-standing mucoepidermoid carcinoma of minor salivary glands of the palate.

Salivary gland carcinomas are the uncommon and clinically diverse group of neoplasms with mucoepidermoid carcinoma (MEC) being the most common among them. MEC accounts for 5% of all salivary gland tumors. As the name implies, the tumor is composed of both mucus secreting cells and epidermoid type cells in varying proportions. Most patients are aware of the lesion for 1 year or less. We report clinical, radiographic and histological features of a long-standing case of mucoepidermoid carcinoma of minor salivary glands of the palate in a 35-year-old male patient. The patient reported with a slow growing swelling on the palate which began 15 years ago. The patient was treated with hemi-maxillectomy and is currently under follow up.

A Rare Clinical Presentation of an Osteochondroma of Coronoid Process of Mandible.

Osteochondroma (osteocartilaginous exostosis) is one of the most common benign tumors of bone but is rare in the craniofacial region. Only a few cases of osteochondroma of the coronoid process have been reported in the literature, since the time of its discovery (osteochondroma of a coronoid process) by Jacob in 1899. We present a case of osteochondroma of the left coronoid process in a 16-year-old female patient. Contrary to the literature, our patient had no limited mouth opening despite a close approximation of left hyperplastic coronoid process with zygomatic arch, making it a unique case among similar cases. Plain radiography can be used for this hyperplastic condition but due to its inherent distortion and being only two-dimensional (2D) it has a limited diagnostic advantage. Cone beam computed tomography (CBCT) was employed for necessary diagnostic information. We managed our patient with an intraoral coronoidectomy.

Clinical and radiographic features of parry-romberg syndrome.

Parry-Romberg syndrome or progressive hemifacial atrophy is a craniofacial disorder characterized by slow and progressive atrophy, generally unilateral, of facial tissues including muscles, bones and skin. The coup de sabre is a clear line of demarcation seen between the normal and abnormal structures. The severity of the facial deformity is dependent on the age of onset of the disease. Cosmetic management is the only available treatment and has to be delayed until facial growth is completed. The present case report deals with a 43-year-old woman with progressive hemifacial atrophy which started from the age of 10 months. Despite almost complete involvement of the right paramedian area and the early age of onset, she had neither eye changes nor any dental malformations.

Rare features associated with Mobius syndrome: Report of two cases.

Mobius syndrome is a rare congenital disorder with the preliminary diagnostic criteria of congenital facial and abducent nerve palsy. Involvement of other cranial nerves, too, is common. Prevalence rate of this syndrome is approximately 1 in 100,000 neonates. It is of unknown etiology with sporadic occurrence. However, data regarding the occurrence rate in India is limited. Features such as orofacial malformations, limb defects, and musculoskeletal, behavioral, and cognitive abnormalities might be associated. A thorough evaluation to identify the condition and establishing an adequate treatment plan is of utmost important in this condition. We are reporting clinical and radiographic features of Mobius syndrome in two cases along with unusual findings of limb and neck deformity.

Evaluation of effect of transcutaneous electrical nerve stimulation on salivary flow rate in radiation induced xerostomia patients: a pilot study.

CONTEXT: Xerostomia is a common sequel in patients undergoing irradiation of malignant tumors of the head and neck. Palliative treatments of xerostomia like topical agents such as ice-chips, saliva substitutes, systemic sialogogues like pilocarpine and cevimeline work well for some patients. Electrostimulation was studied in the past and showed moderate promise but never became part of the mainstream therapy for better management of xerostomia patients. AIMS: The aim of the following study is to evaluate the effectiveness of a transcutaneous electrical nerve stimulation (TENS) unit in stimulating the whole salivary flow rate in radiation induced xerostomia patients. MATERIALS AND METHODS: A total of 40 subjects were included in the study. The study group consisted of 30 individuals and was divided into Group S1 (n = 20), which was further subdivided into Group S1A (n = 10) subjects complaining of dry mouth who were undergoing head and neck radiotherapy with TENS stimulation during the commencement of radiotherapy, on the 3 rd , 6 th week and after a month of completion of radiotherapy and Group S1B (n = 10) with TENS stimulation daily during the full course of radiotherapy and Group S2 (n = 10) subjects complaining of dry mouth who had undergone head and neck radiotherapy that ended 1 month prior to their entry into the study. The control group (n = 10) consisted of healthy individuals not complaining of dry mouth and who have not undergone head and neck radiotherapy. Whole saliva was collected without stimulation for 10 min and after electrostimulation with TENS unit for additional 10 min in a graduated test tube. The results were statistically analyzed using Mann-Whitney U-test and Kruskal-Wallis's test. RESULTS: The data analysis revealed that control and S1B group showed increased salivary flow rate after stimulation by TENS therapy compared with the unstimulated salivary flow, whereas in S1A and S2 group it was found to be statistically non-significant. CONCLUSION: The present study gave us an insight about the effectiveness of TENS therapy in stimulating salivary flow in healthy subjects and it is very effective when used in conjunction with radiation therapy by reducing the side-effects of radiation therapy. Hence, TENS therapy can be used as an adjunctive method for the treatment of xerostomia along with other treatment modalities.

Congenital infiltrating lipomatosis of the face: A case report with review of literature.

Congenital infiltrating lipomatosis of the face (CIL-F) has been described as a disorder in which mature lipocytes invade adjacent tissues in the facial region. Its etiology and pathogenesis is unknown. The tumor is congenital in origin and occurs in infancy or early childhood. It is unencapsulated and characterized by diffuse infiltration of mature adipose tissue over normal muscle fibers, rapid growth, associated osseous hyperplasia, and a high recurrence rate postsurgical intervention. Due to its diffuse infiltration and involvement of important facial structures, complete surgical excision is often impossible. CIL-F is rare and there are only a few cases reported in the available literature. We present the case of a 17-year-old female, who reported with the complaint of recurrent unilateral facial swelling, with a history of two previous resections.

Imaging and histopathological features of Jacob's disease: a case study.

A pathologically elongated coronoid process forming a joint with the zygomatic arch and bone is termed as "Jacob's disease." Herein, we present a case of Jacob's disease, which has rarely been reported in the literature. Moreover, very few cases have been reported from the Indian subcontinent. A 28 years-old male reported to us with progressive restriction of mouth opening. After detailed imaging, coronoidectomy was performed through an intraoral approach. A mushroom-shaped gross specimen was obtained. Osteochondroma of the coronoid process was diagnosed based on the histopathologic examination of the excised tissue. Although Jacob's disease is seldom considered in the list of differential diagnoses for restricted mouth opening, our case highlights the need for evaluation of the coronoid process, which is usually ignored during routine radiographic examination. The report also highlights the miniscule incidence of this condition in the available literature.

Oromandibular-limb Hypogenesis Syndrome Type II C: A Rare Case.

The oromandibular-limb hypogenesis syndrome comprises a group of anomalies which simultaneously affect the mandible, tongue, and maxilla with or without reductive limb anomalies. It is characterized by failure of development of the intraoral region and distal extremities. Multiple and variable deformities of the mandible, maxilla and tongue may occur in combination with a variety of limb defects. The wide range of presentation and combination of anomalies make classification difficult. They usually feature primarily in sporadic case reports because of their low incidence. The genetic origin of this syndrome is uncertain. It is congenital and there seems to be no sex predilection. The key radiographic features are retruded mandible, impacted teeth and malformed phalanges. When compared to available literature, frequently reported features like hypodontia, hypoglossia, microstomia, protruded maxilla and limb anomalies were present in our case. The case presented here is one of the rarest subtypes of this rare syndrome.