Intraductal pressure during sialendoscopy.

BACKGROUND: Sialendoscopy can be followed by swelling and infection of the salivary gland. A possible pathomechanism is damage of the deeper salivary duct system by intraductal pressure generated by the irrigation fluid. METHOD: After measuring the physiological intraductal pressures which arise during sialendoscopy, these pressures were simulated in freshly excised salivary glands and the tissue was analysed histologically. RESULTS: Normal intraductal filling pressure during sialendoscopy is 100-250 daPa, and pressure peaks can be up to 2000 daPa during flushing. A filling pressure of more than 400 daPa results in dilatation of the salivary ducts and acinar area. No direct damage to any duct structures could be observed histologically. CONCLUSION: Irrigation fluid should be administered intermittently rather than continuously during sialendoscopy. The intraductal filling pressure should not exceed 400 daPa to minimise the trauma to the salivary duct system and reduce the risk of developing oedema and inflammation.

Primary tuberculosis of submandibular gland.

Salivary gland tuberculosis is a rare pathology and does not always have the diagnostic guidelines led by previous tubercular localizations. Tubercular bacillus can reach the salivary gland in different ways, but the condition that most frequently causes a tubercular infection is the decay of the human organism defensive capacity toward the germ.A 15-year-old Romanian boy presented with a swelling in the left submandibular region. Normal extraoral, intraoral examination, and routine diagnostic examinations were performed. In order to make a final diagnosis, we performed a surgical left submandibular gland sialo-adenectomy operation to enable a histologic examination of the withdrawn tissue. Microscopic examination of the gland and lymph nodes showed a chronic necrotizing phlogosis of tubercular type. Previous routine examinations have been important only after final diagnosis to confirm that the submandibular tubercular localization was a primary infection. Diagnosis of this kind of disease is extremely difficult and is made with certainty only with the histologic examination, as happened in our case.

[Tuberculosis of the submandibular gland: a case report]. / Tuberculose de la glande sous-mandibulaire: un piège diagnostique.

INTRODUCTION: Tuberculosis remains an important public health problem in France. After a certain decline, its incidence has remained unchanged since 1990. 30% of tuberculosis cases are extra-pulmonary form, most of them concern nodes especially in cervical areas. CASE REPORT: This case of submandibular tuberculosis illustrates diagnostic and therapeutic difficulties. DISCUSSION: There are few clinical signs or laboratory clues suggestive of tuberculosis, however a surgery cannot be avoided and must be performed in combination with antituberculosis chemotherapy.

[Tuberculosis of the parotid gland]. / Tuberculose de la glande parotide.

INTRODUCTION: The aim of this study is to emphasize the difficulties of diagnosing parotid gland tuberculosis because of its non specific symptoms and to incite the physician to seek it more frequently. MATERIAL AND METHOD: Six cases of parotid gland tuberculosis were diagnosed within a 4-year period and included in a retrospective study. RESULTS: There were two men and four women, mean age 45 years. Four patients underwent superficial parotidectomy with frozen section analysis which enabled us to rectify the diagnosis. Medical treatment was based on a 6-month course of bactericidal chemotherapy. Outcome was favorable in all the cases with nine months average follow. DISCUSSION: Symptoms of parotid gland are misleading, pathologic findings are of increasing importance for diagnosis, which with the new serology techniques may improve further.

Parotid TB.

TB of the parotid is rare and only about 100 cases have been reported in the world literature. Often the diagnosis is made only after the surgery performed for a suspected neoplasm. We describe three patients with diffuse form of parotidTB without any evidence of tubercular focus elsewhere. Fine needle aspiration cytology confirmed the diagnosis in two cases, while the third case was diagnosed only after surgery.

Tuberculous otitis media: report of 2 cases on Long Island, N.Y., and a review of all cases reported in the United States from 1990 through 2003.

We report 2 cases of tuberculous otitis media that were diagnosed at Stony Brook University Hospital in New York since 1999. Both patients were women, aged 30 and 31 years. One patient had grown up in Russia, the other was a native-born American who had never left the East Coast region of the United States. Both patients had been symptomaticfor many months; one complainedof chronic otorrhea, and the other reported otorrhea, hearing loss, and discomfort. Neither patient responded to medical management, and both ultimately underwent surgery. One was diagnosed after surgical pathology revealed acid-fast bacilli on frozen-section analysis. In the other, pathology revealed chronic inflammation and granulomata, butstains were negative and her diagnosis was delayed for almost 2 years. We also review 9 other cases of tuberculous otitis media in the United States that have been reported in the literature since 1990. Our review suggests that the number of cases is rising in areas where tuberculosis is most common--that is, in major U.S. cities. Although 3 of these 9 cases occurred as reactivation disease in immigrants, most might have occurred as a result of local transmission. Clinicians should maintain a high degree of suspicion for tuberculosis in patients with chronic otitis symptoms, particularly those who are at higher risk of exposure to tuberculosis.

Primary tuberculosis of tongue.

A case of a 55 years old lady with tuberculosis of the tongue is reported. Patient presented with non-healing ulcer in dorsum of the tongue for one year. Initial biopsy and histopathological examination revealed non-specific inflammation. After surgery, biopsy report proved primary tuberculosis of tongue. Anti-tubercular therapy for nine months showed uneventful recovery of the patient.

Tuberculosis de la glándula submaxilar: aportación de dos casos clínicos / Tuberculosis of the submandibular gland: report of two clinical cases

Exponemos dos casos diagnosticados primariamente como sialoadenitis y que, posteriormente, resultaron ser una tuberculosis de la glándula submaxilar. Esta afeccón se presentea con una semiología inespecífica similar a una sialolitiasis. Aunque es más frecuente en nuestro medio la Tbc ganglionar que la glandular, debemos tener siempre presente que ante una adenopatía cervical habrá que descartar esta patología y que el diagnóstico definitivo lo vamos a realizar, tras la cirugía, con el examen anatomopatológico y bacteriológico. La PAAF junto con el test de Mantoux pueden ayudarnos en el diagnóstico prequirúrgico de la enfermedad

Tuberculosis de la glándula submaxilar: aportación de dos casos clínicos / Tuberculosis of the submandibular gland: report of two clinical cases

Exponemos dos casos diagnosticados primariamente como sialoadenitis y que, posteriormente, resultaron ser una tuberculosis de la glándula submaxilar. Esta afeccón se presentea con una semiología inespecífica similar a una sialolitiasis. Aunque es más frecuente en nuestro medio la Tbc ganglionar que la glandular, debemos tener siempre presente que ante una adenopatía cervical habrá que descartar esta patología y que el diagnóstico definitivo lo vamos a realizar, tras la cirugía, con el examen anatomopatológico y bacteriológico. La PAAF junto con el test de Mantoux pueden ayudarnos en el diagnóstico prequirúrgico de la enfermedad (AU)

Parotid tuberculosis simulating malignancy.

An interesting case of parotid tumour simulating malignancy is reported. The rarity of this lesion and the associated clinical and diagnostic problems are emphasized together with the relevant literature.

Tuberculosis of the parotid gland.

The presentation of tuberculosis as an isolated parotid lump is rare. In this paper, six cases with tuberculous parotitis are reported which were evaluated as a benign parotid neoplasm in 216 specimens pre-operatively. All but one of them had no previous history of tuberculosis and all had a parotid lump as a sole symptom for at least one year. The diagnosis of tuberculosis was made, after superficial parotidectomy, by histopathology. Parenchymal involvement and intraparotid lymph node involvement with tuberculosis were seen in five and three patients, respectively. Two of the patients had lymph node involvement outside the parotid area. One of six patients had a coincidental Warthin tumour. A surgical approach is not only therapeutic but also diagnostic when other diagnostic tools fail.

Primary mycobacterial infection of the uvula.

Tuberculosis, and non-tuberculous mycobacterial infections are becoming more common thus it is more likely that otolaryngologists will encounter these conditions. We describe an otherwise well patient, with symptoms and signs from chronic uvular inflammation, who proved to have a primary mycobacterial infection. This is an unique presentation in the literature and reminds clinicians of the need, where uncertainty exists in diagnosis, to consider mycobacterial infections.

Primary tonsillar tuberculosis: a case report.

A 67-year-old man with an enlarged left tonsil underwent a tonsillectomy for the suspicion of malignancy. He had had a dental extraction six months earlier. Clinical and histopathological investigations established the diagnosis of primary tonsillar tuberculosis.

Primary tuberculosis of the parotid gland.

A very unusual presentation of Mycobacterium tuberculosis in the parotid gland substance is described to suggest reexamination of the place of tuberculosis in the differential diagnosis of a parotid mass. In this patient, diagnosis was made postoperatively only by histologic examination of the excised specimen. When M. tuberculosis etiology is suspected, either clinically or at operation, culture confirmation should be tried, and a Mantoux test should be performed to complete the investigation.

Tuberculosis of the parotid gland: a case report.

A case of tuberculosis of the parotid gland, which involved the intraparotid lymph nodes of a 39-year-old Thai man is reported. The histologic characteristics of caseating granulomas with presence of acid and alcohol fast bacilli were criteria for diagnosis. This case is thought to be the first report of tuberculosis of the parotid gland in Thailand.