Objectives: The aim of this study is to review salivary tumors arising from heterotopic salivary inclusions in the periparotid and cervical lymph nodal tissues over a 25-year span.Methods: A retrospective chart review revealed 24 patients with asymptomatic neck masses treated between 1976 and 2001, whose pathology demonstrated heterotopic salivary tissue or neoplasms arising from heterotopic salivary tissue.Results: Nine cases were benign periparotid lymph nodes with heterotopic salivary inclusions, 3 of which had multimodal involvement. Fifteen cases of heterotopic salivary tumors were identified. The benign tumors were predominantly Warthin's tumor (8) with 1 pleomorphic adenoma. Malignant tumors included mucoepidermoid (3), acinic cell (2), and adenocarcinoma (1). Patients were treated by a superficial parotidectomy, neck dissection, or simple excision depending on site and preoperative workup. Adjuvant radiation therapy was included for high-grade malignancies. Among the 15 tumor patients, follow-up ranged from 1 month to 17 years. Nine patients are alive and disease-free, 5 are deceased, and 1 was lost to follow-up.Conclusions: Heterotopic salivary tissue in periparotid and upper cervical nodes is a more common occurrence than historically recognized. Tumorigenic changes arise from heterotopic nodal inclusions, and although infrequent, should be considered in the differential diagnosis for isolated neck/periparotid masses and parotid Warthin's tumor. Suggested management, after a thorough clinical exam/needle aspiration biopsy, includes an imaging survey of the parotid gland and neck lymphatics with an appropriate resection to include a simple excision, parotidectomy, neck dissection, and/or irradiation as indicated. Isolated low-grade malignant lesions/benign lesions are adequately managed by excision or parotidectomy alone. High-grade malignant lesions require more extended surgery with possible irradiation. (c) 2005 Elsevier Inc. All rights reserved.
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OBJECTIVE. The study goals were to evaluate the use of titanium condylar prostheses in the setting of tumor resection and to discuss the techniques used to minimize complications.STUDY DESIGN AND SETTING: We conducted a retrospective review of a case series in a tertiary care hospital. Six patients underwent mandibulectomy, including the condyle, with primary reconstruction using titanium condylar prostheses. Charts were reviewed for operative technique, pathology, and complications.RESULTS: Pathology included squamous cell carcinoma, Ewing's sarcoma, embryonic rhabdomyosarcoma, giant cell granuloma, and adenocarcinoma. Three patients are alive without disease. Follow-up spanned 6.4 years with premorbid occlusion established in all cases, and there were no prosthesis extrusions or erosions. The condylar head was wrapped in preserved joint capsule or adjacent temporalis muscle/fascia and secured with permanent purse-string sutures; careful duplication of the length, and angulation of the native mandible from the angle to the superior extent of the condylar head.CONCLUSION: Titanium condylar prostheses are a viable choice in the setting of tumor resection and reconstruction, with appropriate technical precautions.
Otolaryngology–Head and Neck SurgeryVolume 129, Issue 2 p. P239-P239 Scientific Posters P084: Cervical Heterotopic Salivary Tissue and Neoplasms: A Ten-Year Experience Elena Daniel presenter MD, Elena Daniel presenter MD Winston Salem, NCSearch for more papers by this authorWilliam Frederick McGuirt Sr MD, William Frederick McGuirt Sr MD Winston Salem, NCSearch for more papers by this author Elena Daniel presenter MD, Elena Daniel presenter MD Winston Salem, NCSearch for more papers by this authorWilliam Frederick McGuirt Sr MD, William Frederick McGuirt Sr MD Winston Salem, NCSearch for more papers by this author First published: 17 May 2016 https://doi.org/10.1016/S0194-59980300959-8Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume129, Issue2August 2003Pages P239-P239 RelatedInformation
Objective: To report the prevalence of esophagitis in patients with pH-documented laryngopharyngeal reflux. Study Design: Prospective study of 58 consecutive patients with documented laryngopharyngeal reflux, all of whom underwent transnasal esophagoscopy as part of their reflux evaluations. Methods: All patients with a diagnosis of laryngopharyngeal reflux confirmed by abnormal pharyngeal pH monitoring over a 5-month period were included, and all subjects completed a self-administered reflux symptom index and underwent transnasal esophagoscopy with directed biopsy. Results: Of the 58 study patients with pH-documented laryngopharyngeal reflux, the mean age was 49 years (+/- 13 y), and 53% (31 of 58) were women. Of the study group, 40% (23 of 58) had heartburn and 48% (28 of 58) had abnormal esophageal reflux (by pH monitoring criteria); by transnasal esophagoscopy with biopsy, 12% (7 of 58) had esophagitis and another 7% (4 of 58) had Barrett's metaplasia. Thus, 60% of the study cohort had no heartburn, and 81% (47 of 58) had normal esophageal epithelium (i.e., no esophagitis or Barrett's metaplasia). Conclusions: In the present series of patients with documented laryngopharyngeal reflux the prevalence of esophagitis and Barrett's metaplasia was only 19%. These data confirm the clinical impression that the patterns, mechanisms, and manifestations of laryngopharyngeal reflux differ from those of classic gastroesophageal reflux disease. Unlike gastroesophageal reflux disease, patients with laryngopharyngeal reflux uncommonly have esophagitis. Thus, although esophagoscopy may be an excellent method for screening the esophagus, it is not the method of choice for diagnosing laryngopharyngeal reflux.
Objective To present the otolaryngologic manifestations and management of 12 patients with the rare presentation of ectodermal dysplasia.