RESUMO
Mucosal preservation is paramount to achieving successful outcomes after endoscopic sinus surgery (ESS). Despite best surgical practices and implementation of evidenced-based postoperative care, patients in rare cases might exhibit persistent demucosalization that is recalcitrant to conservative therapies. We retrospectively reviewed the records of 3 patients-a 63-year-old woman, a 67-year-old woman, and a 43-year-old man-who experienced clinically significant local demucosalization after uncomplicated ESS despite routine surgical and postoperative management. We collected data on the characteristics of presentation, wound management strategies, and postoperative care practices. Two patients achieved remucosalization with mechanical debridement, gelatin sponge placement, and intensive moisturization therapy. Our experience suggests that surgical debridement of these chronic, persistent demucosalized wounds may be an effective management strategy for patients who develop this unusual and rare postoperative complication. Biopsy and culture of the persistently demucosalized wound bed may be useful in recognizing the presence of worrisome disease processes and identifying any tenacious infectious agents so that more appropriate therapy can be initiated if necessary.
RESUMO
Acinic cell carcinoma is a rare tumor of the head and neck that mainly affects the parotid gland but occasionally involves the minor salivary glands of the upper aerodigestive tract. The authors present a case report of an occurrence of a low-grade acinic cell carcinoma of the true vocal fold, which they believe to be the first reported case of this type of carcinoma in this location. Laryngoscopy and laser excision was completed for what was initially thought to be a granuloma, and pathology confirmed low-grade acinic cell carcinoma of the right true vocal fold. The mass was well circumscribed and did not invade adjacent structures. After complete excision, postoperative radiation therapy was used to reduce local recurrence.
