Development of a Hodgkin disease tumor in the neck of a patient who previously had undergone complete excision of a hyaline-vascular Castleman disease neck mass.

Castleman disease is an uncommon cause of a neck mass. A benign lymphoproliferative disorder, it may be seen as a self-limited unicentric process or as a fulminant multicentric disease with systemic symptoms. The association between Hodgkin disease and Castleman disease has been debated extensively, but this association is rare. The associated Hodgkin disease frequently has been of the interfollicular subtype and typically has coexisted with the multicentric plasma-cell variant of Castleman disease. We report a case of mixed-cellularity Hodgkin disease of the neck in a patient previously diagnosed with hyaline-vascular-type Castleman disease who had undergone complete excision of a neck mass 2 years earlier.

Functional and aesthetic results obtained by modified Bernard reconstruction technique after tumour excision in lower lip cancers.

BACKGROUND: In this study, we investigated the functional and aesthetic results in new lip formation using modified Bernard reconstruction technique after tumour excision in lower lip cancers. MATERIAL AND METHODS: The study included 47 patients. All were operated due to lower labial squamous cell carcinoma and underwent defect reconstruction using modified Bernard technique. The patients were separated into two groups as: 50-70% and 70% total defect occurring after surgical excision. The functional and aesthetic assessments were done after at least 1 year had passed, and the results were compared statistically with a control group. RESULTS: Of the 18 patients with 50-70% defect, sensibility was normal in 16 (89%) and complete competence was determined in all (100%). In 17 patients (94%), complete and symmetric pouting and mouth-opening movements were ensured. Normal mouth opening was noted in all patients. Nasolabial asymmetry was detected in one patient (6%) and apparent mentolabial scar tissue was detected in two patients (11%). The new vermilion was of equal width to the upper lip vermilion in 15 patients (83%). Of the 29 patients with 70% total defect, sensibility was normal in 21 (72%) and complete competence was detected in 27 patients (93%). Sialorrhoea on fluid intake was detected in one patient (3.5%) and sialorrhoea at rest in one patient (3.5%). In 22 patients (76%), complete and symmetric pouting and mouth-opening movements were ensured. Normal mouth opening was noted in 27 (93%) of the 29 patients. Asymmetry in nasolabial fold was detected in one patient (3.5%), apparent scar tissue in nasolabial fold in one patient (3.5%) and commissure asymmetry in one patient (3.5%). In 25 patients (86%), the new vermilion was of equal width to the upper lip vermilion. No statistically significant difference was found (p>0.05) among the two patient groups and the control group in terms of functional and aesthetic results. CONCLUSION: Modified Bernard technique provides a good degree of lip mobility and sensation after excision of lower lip malignant tumour and produces acceptable results.

Evaluation of nasal symptoms and mucociliary function in patients with allergic rhinitis treated with chemosurgery using trichloroacetic acid.

PURPOSE: We treated allergic rhinitis with trichloroacetic acid (TCA) applied to the inferior turbinates. Further clinical evaluations were made to determine the effect of TCA application on symptoms of allergic rhinitis. We also report the results of measurement of the mucociliary transit time (saccharin time) and nasal airway resistance. MATERIALS AND METHODS: A group of 54 patients with perennial allergic rhinitis was treated with 80% TCA applied to the inferior turbinate. Further clinical evaluations were made to determine the effect of TCA application on symptom scores of allergic rhinitis. We also report the results of measurement of the mucociliary transit time (saccharin time) and nasal airway resistance in those cases. RESULTS: The most common complaint, nasal obstruction, improved effectively in 82% of cases, watery rhinorrhea in 86%, and sneezing in 86%, 1 year after treatment. A significant decrease in scoring was noted for subjective nasal obstruction, watery rhinorrhea, and sneezing. Nasal airway resistance was effectively reduced 1 year after treatment, and the difference was statically significant. In our study, saccharin time appeared to be shortened in the early and late periods after the TCA application. There was a statistical difference between the before- and after-treatment groups. CONCLUSIONS: We concluded that TCA treatment was quite effective for controlling nasal allergic symptoms and that it does not damage the mucociliary function.