Management of Primary Spontaneous Pneumothorax: A Single-center Experience.

BACKGROUND: The prevalence of primary spontaneous pneumothorax is high in the Arab region. There is a lack of studies from the Eastern Province of Saudi Arabia highlighting the associated risk factors and demonstrating the effectiveness of surgical management. OBJECTIVES: To identify risk factors associated with primary spontaneous pneumothorax and to correlate the effectiveness of surgical management with the rate of disease recurrence. SUBJECTS AND METHODS: This retrospective chart review included adult patients who presented with primary spontaneous pneumothorax and were managed at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, from January 1, 2005, to December 31, 2014. The results are presented as arithmetic mean for quantitative data, and chi-square test was used for statistical analysis. P ≤0.05 was considered statistically significant. RESULTS: In total, 151 patients with primary spontaneous pneumothorax were included, with the majority being male (98.7%) and Saudis (88.7%). The mean age was 24 ± 6 years (range: 13-49 years), mean height 171 ± 8 cm (range: 144-193 cm) and mean body mass index 19.2 ± 3.8 kg/m2 (range: 13.3-39.0 kg/m2). About 62% of the patients were smokers. Ten patients had an ipsilateral recurrence of primary spontaneous pneumothorax after the first episode was successfully managed. Surgical exploration after the first episode itself was found to significantly reduce the recurrence rate. The study found that in the management of these patients, there was a shift from conventional open thoracotomy to the minimally invasive video-assisted thoracoscopic surgery method. CONCLUSIONS: The risk factors for primary spontaneous pneumothorax in this study were consistent with the current literature. Surgical exploration after the first episode of primary spontaneous pneumothorax significantly reduces the recurrence rate and there is a paradigm shift toward a less invasive surgical approach in managing these patients.

Sialolipoma of the Superficial Lobe of the Parotid Gland: A Case Report and Literature Review.

Sialolipoma of the parotid gland is very rare. We report a case of a 38-year-old woman who presented with a painless, slowly growing, mobile lump of the parotid gland. Computed tomography revealed lipoma of the superficial lobe of the parotid gland. Superficial parotidectomy was performed with uneventful postoperative course. The histology showed sialolipoma. Review of the 25 reported cases (including our case) of parotid sialolipoma shows that this tumor is more common in the fifth decade of life, on the left side and the superficial lobe. It has a slight preference for men. Its clinical presentation mimics the standard (pure) parotid lipoma and other more common benign parotid tumors particularly pleomorphic adenoma and Warthin's tumor. Surgical excision is curative with minor complications and small recurrence rate. Histological examination is necessary to establish the diagnosis and to exclude malignancy.