Cirugía de desfuncionalización de glándulas salivales mayores en sialorrea masiva / Major salivary gland defunctionalization surgery in massive sialorrhea

Introducción: La sialorrea es la pérdida involuntaria de saliva de la boca, ya sea debido a la producción excesiva de saliva o disminución de la frecuencia de deglución. Se habla de sialorrea patológica cuando persiste más allá de los 4 años de edad. Además de las implicaciones sociales, cambios de ropa frecuentes, puede provocar neumonías por aspiración y deshidratación. El manejo de la sialorrea requiere una evaluación completa con un enfoque de equipo multidisciplinario para el tratamiento, que incluye terapias no farmacológicas, farmacológicas y quirúrgicas. Objetivo: Presentar resultados quirúrgicos y farmacológicos en el tratamiento de sialorrea masiva. Material y Método: Se realizó revisión de historias clínicas de 7 pacientes portadores de sialorrea masiva. Todos los pacientes incluidos fueron refractarios a tratamiento médico. El diagnóstico fue obtenido por un equipo multidisciplinario. Se les realizó desfuncionalización quirúrgica y farmacológica de glándulas salivales. Se les aplicó Escala de Severidad (DSS) y escala de frecuencia (DFS), previo a cirugía y posterior a procedimiento hasta el año. Resultados: Mejoría clínica subjetiva posterior a desfuncionalización quirúrgica con disminución de DSS y DFS. Disminución promedio de baberos a 10/día. Conclusión: Los resultados obtenidos son buenos, si se consideran las escalas DSS, DFS y el número de baberos al día, que son mediciones tanto subjetivas y objetivas respectivamente.

Introduction: Massive Sialorrhea is the involuntary loss of saliva from the mouth, either due to excessive saliva production or decreased swallowing frequency. We speak of pathological sialorrhea when it persists beyond 4 years old. In addition to the social implications and frequent clothing changes. It can cause aspiration pneumonia and dehydration. Treatment for sialorrhea requires a comprehensive evaluation with a multidisciplinary team approach. Including non-pharmacological, pharmacological, and surgical therapies. Aim: Presentation of the results of surgical defunctionalization of the salivary glands plus injection of Botulinum Toxin in the treatment of massive sialorrhea. Material and Method: A review of the clinical records of 7 patients with massive sialorrhea was carried out. All included patients were refractory to medical treatment. The diagnosis was obtained by a multidisciplinary team. Surgical and pharmacological dysfunctionalization of salivary glands was performed. Severity Scale (DSS) and Frequency Scale (DFS) were applied before surgery and after the procedure up to a year. Results: Subjective clinical improvement after surgical defunctionalization with decreased SHD and DFS. Average decrease in bibs to 10/day. Conclusion: The evaluated strategy presented similar benefits with respect to the literature. The SHD and DFS scales and the number of bibs per day are both subjective and objective measurements, respectively, and allow the clinical improvement and quality of life of patients undergoing surgery to be evaluated individually.

Clinical value of Ki-67 and human epidermal growth factor receptor 2 in stage Ⅲ-Ⅳ A salivary duct carcinoma / 中华放射医学与防护杂志

Objective:To explore the clinical value of Ki-67 and human epidermal growth factor receptor 2 (HER-2) in salivary duct carcinoma in stage Ⅲ-Ⅳ A. Methods:The data of 52 cases of locally advanced salivary duct carcinoma(SDC) diagnosed from January 2012 to December 2020 were retrospectively analyzed. All patients underwent radical surgery and postoperative radiotherapy. Among them, 15.4% of patients had local recurrence, 28.8% had distant metastasis, 17.3% had regional recurrence with distant metastasis. The relationship between clinical features, pathological features such as Ki-67 and HER-2 and prognosis such as local recurrence and distant metastasis was analyzed.Results:The average follow-up time was 37.6 months. The 1- and 2-year local recurrence free survival, distant metastasis free survival, progression free survival were 86.5%, 73.1%, 65.4% and 67.3%, 55.8%, 46.2% respectively. The 3-year progression free survival rate was 33.3%. Comparison between groups showed that age ≥ 65 years old, T stage, TNM stage, vascular tumor thrombus, radiotherapy dose <60 Gy, Ki-67 positive index and HER-2 positive were related to the prognosis of different stages. In multivariate analysis, only age, Ki-67 positive index ≥ 60% and HER-2 protein (3+ ) were independent poor prognostic factors for locally advanced SDC ( t =5.16, 9.84, 8.23, P<0.05). Conclusions:In stage Ⅲ-Ⅳ A SDC, only radical surgery and postoperative radiotherapy have a high rate of distant metastasis. Ki-67 positive index and HER-2 positive are independent adverse prognostic factors.

Carcinoma del conducto salival: estudio clínico/patológico e inmunohistoquímico de 5 casos / Salivary duct carcinoma: a clinicopathologic and inmunohistochemical study of 5 cases

El carcinoma del conducto salival es un tumor epitelial maligno agresivo, que involucra principalmente a la glándula parótida, con características histológicas semejantes al carcinoma ductal de glándula mamaria. El propósito de este trabajo fue presentar los resultados clínico-patológicos de cinco casos de carcinoma del conducto salival primario de glándula parótida y evaluar la expresión de Ki67. Histológicamente, el carcinoma del conducto salival presentó nidos epiteliales con patrones papilar, sólido y cribiforme, comedonecrosis tanto en la lesión primaria como en los nodos linfoides metastásicos y, además, invasión perineural. Se demostró con Ki 67 una alta proliferación celular en cuatro (80 %) de los cinco casos estudiados. Se concluyó que: el carcinoma del conducto salival es una lesión maligna de mal pronóstico, raramente informado en la literatura odontológica, con características histológicas semejantes a las del carcinoma ductal de alto grado de la mama; la comedonecrosis es un signo específico de esta enfermedad; puede desarrollarse "de novo" o en un adenoma pleomórfico preexistente; su diagnóstico diferencial histopatológico es fundamental para planificar su tratamiento y determinar su pronóstico, a pesar de su tratamiento quirúrgico y radioterapia postoperatoria es un tumor agresivo con alta proliferación celular, infiltración perineural, recurrencias y metástasis.

Salivary duct carcinoma is an aggressive malignant epithelial tumor, primarily involving the parotid gland, with histologic features similar to ductal carcinoma of the breast. The purpose of this work was to report the clinicopathological results of five cases of primary salivary duct carcinoma of the parotid gland and evaluate the expression of Ki67. Histologically, salivary duct carcinoma presented epithelial nests with papillary, solid, and cribriform patterns, with comedonecrosis in both the primary lesion and the metastatic limph nodes, and perineural invasion. A high cell proliferation was demonstrated with Ki67 in four (80 %) of the five cases studied. We concluded that: salivary duct carcinoma is a malignant lesion with a poor prognosis, rarely reported in the dental literature, with histological characteristics similar to those of high-grade ductal carcinoma of the breast; comedonecrosis is a specific sign of this disease; may develop "de novo" or in a pre-existing pleomorphic adenoma; its differential histopathological diagnosis is essential to plan its treatment and determine its prognosis; despite its surgical treatment and postoperative radiotherapy, it is an aggressive tumor with high cell proliferation, perineural infiltration, recurrences and metastasis.

Clear cell-rich salivary duct carcinoma involving the palate / Carcinoma do ducto salivar rico em células claras envolvendo o palato

ABSTRACT Salivary duct carcinoma (SDC) is a rare and aggressive neoplasm arising from salivary glands. SDC occurs most frequently in major salivary glands, with isolated cases arising from the minor salivary glands. The occurrence of clear cells in salivary gland tumors is uncommon and is rarer in SDC cases. We report the case of a 51-year-old male diagnosed with a clear cell variant of SDC in the minor salivary gland, involving the left hard palate. Immunohistochemical analysis revealed positivity for HER2/neu and GATA-3. The patient was submitted to radical surgical excision, neck dissection, and radiotherapy. Unfortunately, he died 14 months after the cancer diagnosis.

RESUMEN El carcinoma ductal de las glándulas salivales (CDS) es un tumor raro y agresivo que surge de las glándulas salivales. El CDS ocurre con mayor frecuencia en las glándulas salivales mayores, sin embargo, existen casos aislados de afectación en las glándulas salivales menores. La aparición de células claras en los tumores de las glándulas salivales es infrecuente y más rara en los casos de CDS. Presentamos el caso de un varón de 51 años al que se le diagnosticó la variante de células claras del CDS en la glándula salival menor, que afecta al paladar duro izquierdo. El análisis inmunohistoquímica reveló positividad para HER2/neu y GATA-3. El paciente fue sometido a escisión local quirúrgica radical, disección del cuello y la radioterapia. Desafortunadamente, murió 14 meses después del diagnóstico de cáncer.

RESUMO O carcinoma do ducto salivar (CDS) é um tumor raro e agressivo que se origina nas glândulas salivares. O CDS ocorre mais frequentemente nas glândulas salivares maiores, porém, há casos isolados de acometimento nas glândulas salivares menores. A ocorrência de células claras em tumores de glândulas salivares é incomum, sendo ainda mais rara nos casos de CDS. Relatamos o caso de um homem de 51 anos de idade que foi diagnosticado com a variante de células claras de CDS em glândula salivar menor, envolvendo o palato duro do lado esquerdo. A análise imuno-histoquímica revelou positividade para HER2/neu, GATA-3. O paciente foi submetido a excisão cirúrgica radical, esvaziamento cervical e radioterapia. Entretanto, ele faleceu 14 meses após o diagnóstico do câncer.

Carcinoma del conducto salival: presentación de un caso / Salivary duct carcinoma: report of a case

El carcinoma de conductos salivales (CCS) es una neoplasia maligna primaria clínica y patológicamente distinta de las glándulas salivales. Debido a su rareza existe una falta de documentación exhaustiva en la literatura con respecto a sus características, manejo y resultados clínicos. En la presente publicación se presenta un caso de un paciente de sexo masculino de 74 años, que acudió al servicio de odontología del Hospital Interzonal General de Agudos Presidente Perón de Avellaneda. El resultado ecográfico arrojó a nivel submaxilar derecho una imagen nodular de aspecto solido que mide 25 x 24 mm Se le realizó la intervención quirúrgica y el resultado anatomopatológico confirmó el diagnóstico de carcinoma de conductos salivales, una de las neoplasias salivales más agresivas. En la actualidad, la muerte ocurre en 60 a 80% de los pacientes, por lo general dentro de los 5 años; alrededor del 33% desarrolla recidiva local y más del 50% metástasis a distancia, en sitios que incluyen pulmones, huesos, hígado, cerebro y piel (AU)

Salivary duct carcinoma (SDC) is a clinically and pathologically distinct primary malignant neoplasm of the salivary glands. Due to its rarity, there is a lack of exhaustive documentation in the literature regarding its characteristics, management, and clinical results. This publication presents a case of a 74-year-old male patient who attended the dentistry service of the Interzonal General Acute Hospital President Perón by Avellaneda. The ultrasound result revealed a nodular image at the right submaxillary level solid aspect measuring 25 x 24 mm. Surgical intervention was performed, and the pathological result confirmed the diagnosis of salivary duct carcinoma, one of the most aggressive salivary neoplasms. Currently, death occurs in 60% to 80% of patients, usually within 5 years; about 33% develop local recurrence and more than 50% distant metastases, at sites including the lungs, bones, liver, brain, and skin (AU)

Sialolitiasis submandibular gigante, extracción quirúrgica y reparación ductal: reporte de caso / Giant submandibular sialolithiasis, surgical removal and ductal repair: case report

Introducción: la patología litiásica de las glándulas salivales forma parte de un grupo de afecciones que perjudica el sistema de drenaje normal de la saliva hacia la cavidad oral, ocasionando lesiones múltiples sobre la glándula afectada. Se realizó el reporte de un caso clínico con esta patología que, por el tamaño del lito, se considera extremadamente rara en nuestro medio. Método: se realizó el reporte de caso y revisión de la literatura (estudios radiológicos, historia clínica y hallazgos clínicos); además, el paciente firmó el consentimiento para esta publicación. Resultados: un paciente masculino de 38 años remitido de consulta externa con un cuadro clínico de 1 semana de dolor, edema y tumefacción en la región submandibular izquierda asociado con una secreción sialopurulenta por la cavidad oral. En la radiografía (Rx) oclusal estricta y en la tomografía axial computarizada (TAC) de cuello contrastado se evidenció una lesión litiásica de más o menos 4,5 x 1,8 cm de diámetro, de característica radiolúcida, a nivel del conducto de wharton. Se dio un manejo quirúrgico por otorrinolaringología maxilofacial, consistente en sialolitotomía y antibioticote- rapia por 10 días, con las cuales se obtuvieron buenos resultados. Conclusiones: la litiasis gigante a nivel del sistema salival (glándula, conductos) es una patología poco común en nuestro medio y está involucrada en el desarrollo de múltiples patología de tipo inflamatorio recurrente de la glándula involucrada, lo cual afecta la calidad de vida de los pacientes. Por esta razón, el diagnóstico y manejo debe ser oportuno para evitar complicaciones, como una infección profunda del cuello; en nuestro caso, el manejo fue oportuno con una extracción quirúrgica por la vía oral del cálculo y la reparación del conducto de wharton del lado izquierdo.

Introduction: the lithiasic pathology of the salivary glands is part of a group of conditions that harms the normal drainage system of the saliva towards the oral cavity, causing multiple lesions on the affected gland, a report of a clinical case with this pathology was made. Due to the size of the stone it is considered extremely rare in our environment. Method: case report and review of the literature (radiological studies, clinical history, clinical findings) patient consent was signed for this publication. Results: a 38-year-old male patient referred from the outpatient clinic with a 1-week clinical picture of pain, swelling and edema in the left submandibular region associated with sialopurulent secretion from the oral cavity in the strict occlusal Rx and a contrast-enhanced neck CT revealed a lithiasic lesion with more or less 4.5 x 1.8 cm in diameter of radiolucent features at the level of the wharton duct, surgical management was given by maxillofacial ENT, consisting of sialolitotomy and antibiotic therapy for 10 days with good results. Conclusions: the giant lithiasis at the level of the salivary system (gland, ducts) is a rare pathology in our environment, is involved in the development of multiple pathologies of recurrent inflammatory type of the affected gland, affecting the quality of life of patients, so the diagnosis and management should be timely and avoid complications, such as deep neck infection; in our case, the management was timely with oral surgical removal of the calculus and repair of the wharton duct on the left side.

Analysis of PD-L1 expression in salivary duct carcinoma with its efficacy as a tumor marker / 대한두경부종양학회지

BACKGROUND/OBJECTIVES: Despite multiple approaches of treatments for salivary duct carcinoma, there has been a need for more successful treatment methods because of its poor prognosis. Treatment options like immunotherapy using new technologies have been attempted. Based on recent study results indicating that targeting programmed death receptors are effective in treating various cancers, this study aimed to identify the frequency of PD-L1 expression and its impact on survival rate in salivary duct carcinoma.MATERIALS #SPCHAR_X0026; METHODS: We studied 33 patients with salivary gland cancer who were available for histologic specimens. We examined the expression of PD-L1 in the tissues and analyzed the association with the survival rate and the association with various clinical parameters.RESULTS: According to this study and review of similar studies, we discovered that the expression of PD-L1 in salivary duct carcinoma was lower than other types of cancers. The impact of PD-L1 on survival rate also showed inconsistency in salivary duct carcinoma.CONCLUSION: Immunotherapy by PD-1/PD-L1 checkpoint blockade in salivary duct carcinoma needs further evaluation for clinical application.

Intraductal Carcinoma of Salivary Gland Originating from an Intraparotid Lymph Node: A Case Report

@#Introduction: Salivary gland intraductal carcinoma (IDC) is rare. We present the second case of IDC originating from an intraparotid lymph node (LN) with a more detailed description of the histogenesis, immunohistochemistry (IHC) and updated molecular information. Case Report: An 87-year-old male had a tumour nodule over the left parotid tail for about 20 years. Physical examinations revealed a 4.5 cm soft, non-tender and fixed mass. After the left parotidectomy, pathology confirmed the diagnosis of IDC arising within an intraparotid lymph node. The cystic component of the tumour was lined by single to multilayered ductal cells with micropapillary growth pattern. The solid part showed intraductal proliferation of neoplastic cells in solid, cribriform, micropapillary and Roman bridge-like structure. By immunohistochemistry (IHC), the tumour cells were positive for S-100, CK (AE1/AE3), mammaglobin, SOX10, and estrogen receptor (ER), with myoepithelial cell rimming highlighted by positive p63 and calponin IHC stains. The prognosis of this patient is excellent after complete excision. Discussion: The mechanism of salivary gland tumour arising in the intra-parotid gland LN was assumed to be related to salivary duct inclusion within the intraparotid gland LN which is a normal occurrence during embryology development. Although the terminology may raise some confusion about the relationship between IDC and conventional salivary duct carcinoma (SDA), they are different in immunophenotype and clinicopathologic features. IDC is characterised by S100 (+) ER (+) with predominant intraductal growth and excellent prognosis; while SDC features S100 (-) androgen receptor (+) with predominant invasive growth and aggressive behavior. Recent discovery of recurrent RET gene rearrangement in IDC but not SDC also supports that IDC is not precursor lesion of the SDC.

Clinicopathological analysis of 40 cases of salivary duct carcinoma / 中华口腔医学杂志

Objective@#To investigate the clinical manifestations and pathological changes of salivary duct carcinoma (SDC) and the relationship between them, so as to provide reference for the diagnosis of SDC.@*Methods@#In this retrospective analysis 40 cases of SDC diagnosed from January 2012 to August 2018 in the Department of Pathology of the First Affiliated Hospital of Zhengzhou University were enrolled and the clinical and pathological characteristics were analyzed, 29 were male and 11 were female, the ratio of male to female was 2.64∶1, the median age was 59.0 years, the average course of disease was 3.5 years. The reported cases of SDC were reviewed and compared with patients of this study.@*Results@#Among the 40 patients, 24 cases occurred in parotid gland, 9 cases in submandibular gland and 7 cases in small salivary glands; 24 cases had cancer cell infiltration and invasion of adjacent tissues, 11 cases had lymph node metastasis and 9 cases had distant metastasis at the time of diagnosis. Pathological results showed that 27 cases belonged to primary salivary duct carcinoma, 13 cases belonged to malignant transformation of pleomorphic adenoma; 10 cases invaded local nerve, 22 cases invaded glandular lobules and ducts. Immunohistochemical results showed that 33 cases were positive for androgen receptor, 27 cases were positive for cytokeratin-7, 22 cases were positive for human epidermal growth factor receptor-2, 8 cases were positive for gross cyst disease fluid protein 15. The proliferation index of nuclear antigen Ki-67 ranged from 10% to 90%. Among them 18 cases were over 50% and 22 cases were below 50%.@*Conclusions@#Salivary duct carcinoma is a rare and highly malignant tumor of the salivary gland. Accurate pathological diagnosis is helpful to inhibit the early local recurrence, distant metastasis and improve survival rate of salivary duct carcinoma.

Endoscopy-assisted transoral removal of deep hilar and intraparenchymal stones in the Wharton′s duct / 中华口腔医学杂志

Objective@#To investigate the different surgical approaches and long-term outcomes of endoscopy-assisted transoral removal of deep hilar and intraparenchymal stones in the Wharton′s duct.@*Methods@#From January 2008 to March 2018, 481 consecutive patients with deep hilar and intraparenchymal calculi in the Wharton′s duct underwent endoscopy-assisted transoral removal at Deparment of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology. There were 250 males and 231 females. Their ages ranged from 9-86 years. We operated 476 patients under local anesthesia on an outpatient basis, and the remaining 5 were operated under general anesthesia. On the basis of ultrasonography, spiral CT, sialography and endoscopy, the calculi were classified into 4 types: hilum stones (located at the hilum or proximally with a distance <5 mm from the hilum), infra-hilum stones (intra-glandular stones with a distance of 5-10 mm from the hilum), intraparenchymal stones (with a distance ≥10 mm from the hilum), and multiple stones (concomitant hilum and intra-glandular stones). The treatment approaches included: hilum duct slitting, intraparenchymal duct slitting, submandibulotomy and intraductal retrieval. The success rate, immediate safety and effectiveness of different types of stones were evaluated. After surgery, the patients were followed up, and gland function was analyzed on the basis of clinical symptoms and signs.@*Results@#The calculi sizes varied from 3 to 25 mm, with a mean of 7.8 mm. The calculi were located in the right submandibular gland in 259 patients, in the left submandibular gland in 219 patients and in bilateral glands in 3 patients. The calculi were successfully removed in 446 glands, with a success rate of 92.1% (446/484). The success rate varied according to the stone sites: 97.8% (363/371) for hilum stones, 64.4% (29/45) for infra-hilum stones, 4/16 for intraparenchymal stones and 96.2% (50/52) for multiple stones. The main treatment methods applied included hilum duct slitting in 347 glands, intraparenchymal duct slitting in 13, submandibulotomy in 4, intraductal retrieval in 73, and hilum duct slitting accompanied by intraductal retrieval in 9. Ductal breakage occurred in 2 glands. All patients complained of mild to moderate pain with a duration of 3-7 days. Nine had temporal lingual nerve injury. During 3-120 months′ follow-up (mean 36 months) of the total 484 glands, 1.6% (7/446) developed ranula, 1.3% (6/446) experienced obturation of the main duct and 2.0% (9/446) had recurrent stones. The remaining 95.1% (424/446) glands were symptom-free with good function.@*Conclusions@#Endoscopy-assisted transoral removal of deep hilar and intraparenchymal submandibular calculi is a safe and effective gland-preserving procedure. According to the depth, size and number of the calculi, variant surgical approaches should be attempted to maximize the success rate and to minimize the side effects.

Paying attention to the protection of the function organ of submandibular gland / 中华口腔医学杂志

Submandibular gland is an important human function organ. With the wide application of sialoendoscope and new understanding of IgG4 related sialadenitis, a lot of submandibular glands which were previously considered to be removed are preserved. However, some submandibular glands which might be preserved are still unfortunately sacrificed. Therefore, we advocate the popularization and promotion of new knowledge and techniques and should pay more attention to the protection of the function organ of submandibular gland.

Submandibular sialolithiasis with CT and scintigraphy: CT values and salivary gland excretion in the submandibular glands

PURPOSE: Sialolithiasis is one of the most prevalent large obstructive disorders of the submandibular glands. The aim of this study was to investigate submandibular sialolithiasis with computed tomography (CT) and scintigraphy, with a particular focus on the relationship between CT values of the submandibular glands and their excretion rate. MATERIALS AND METHODS: Fifteen patients with submandibular sialolithiasis who underwent CT and salivary gland scintigraphy were included in this study. The relationship between the CT values of submandibular glands with and without sialoliths and salivary gland excretion measured using salivary gland scintigraphy was statistically analyzed. Dynamic images were recorded on the computer at 1 frame per 20 seconds. The salivary gland excretion fraction was defined as A (before stimulation test [counts/frame]) / B(after stimulation test [counts/frame]) using time-activity curves. RESULTS: The CT values in the submandibular glands with and without sialoliths was 9.9±44.9 Hounsfield units (HU) and 34.2±21.8 HU, respectively (P=.233). Regarding the salivary gland excretion fraction using scintigraphy, the A/B value in the submandibular glands with sialoliths (1.09±0.23) was significantly lower than in the submandibular glands without sialoliths (1.99±0.57, P=.000). CONCLUSION: Assessments of the CT values and the salivary gland excretion fraction using scintigraphy in the submandibular glands seem to be useful tools evaluating submandibular sialolithiasis.

Gland excision in submandibular sialolithiasis: a case report / Escisión glandular en sialolitiasis submandibular: reporte de un Caso

It has been shown that about 1 percent of the population suffers from calculi of the salivary glands; 80 percent of them occur in the submandibular gland. The aim of this paper is to present a clinical case of a 34-year-old patient, who was diagnosed with submandibular sialolithiasis and treated surgically for the total removal of the lesion and of the salivary gland, removing the swelling and acute pain. The diagnosis and treatment protocol for sialolithiasis of submandibular gland was carried out according to the latest guidelines, resulting in complete remission of the disease, without functional sequelae during the three months of postoperative follow-up...

Se ha demostrado que alrededor del 1 por ciento de la población padece de cálculos de las glándulas salivales, donde el 80 por ciento de ellos ocurren en la glándula submaxilar. El objetivo de este artículo es dar a conocer un caso clínico de una paciente de 34 años de edad, quien fue diagnosticada de sialolitiasis submandibular y tratada quirúrgicamente para la remoción total de la lesión, junto con la glándula salival, en donde se obtuvo como resultado la eliminación del aumento de volumen y el dolor agudo. El protocolo de diagnóstico y tratamiento para la sialolitiasis de la glándula submandibular fue llevado a cabo de acuerdo a los últimos lineamientos, obteniendo la remisión total de la patología, sin presentar secuelas funcionales durante los tres meses de seguimiento postoperatorio...

A Case of Salivary Duct Cyst in Oral Mucosa / 대한피부과학회지

No abstract available.

Rigid swelling of sublingual caruncle area due to the salivary gland duct obstruction by a sialolith

Sialolithiasis is the presence of calculus within the ductal system of a salivary gland. Among the diagnostic methods are inspection, palpation, checking the amount of saliva secreted and the identification of a sialolith. The authors present the case of a 37-year-old female patient with edema of the submandibular area and a bulging sublingual caruncle due to a calculus that obstructed the salivary gland ostium.

Penetração espontânea de objeto metálico em glândula submandibular: relato de caso / Spontaneous penetration of a metalic object in the submandibular gland: case report

Introdução: A obstrução de um ducto salivar por corpo estranho, em que ocorre inflamação crônica e fibrose de glândulas salivares, é de denominada sialoadenite. A obstrução de um ducto salivar por passagem retrógrada acidental de um corpo estranho é muito rara. Revisão de Literatura com Diagnóstico Diferencial: Alguns tipos de corpos estranhos em glândulas salivares já relatados na literatura: cerdas de escova de dente, fios de cabelo, espinha de peixe, semente de girassol, palha e até mesmo lascas de unhas. Esses corpos estranhos se alojam nas glândulas passando pelos ductos salivares gerando o quadro de sialoadenite cujos principais sintomas são: dor, edema e endurecimento da glândula acometida, além de diminuição da secreção salivar. Alguns dos diagnósticos diferenciais que devem ser considerados diante desses sintomas são: síndrome de Sjögren, sialolitíase, sialoadenite aguda e neoplasias de glândulas salivares. Apresentação de Caso Clínico: J.C.S., 32 anos, masculino, procurou atendimento médico com queixa de dor e abaulamento em região submandibular direita há 7 dias, depois de “chupar” um grampo aberto que “desapareceu” no assolho de sua boca. Discussão: O caso foi analisado sob alguns aspectos, para compara-lo com outros casos já relatados na literatura, como: idade, sexo, exames realizados, tratamento adotado, hábitos incomuns como “chupar grampos”. Comentários Finais: Para fazer o diagnóstico de sialadenite por corpo estranho é essencial fazer uma boa anamnese e inspeção da glândula e, assim, conseguir excluir outras hipóteses.

Introduction: The obstruction of a gland duct due to a foreign body, associated with chronic inflammation and fibrosis of the gland, is named sialadenitis. The obstruction of the salivary duct by retrograde passage of an accidental foreign body is pretty rare. Literature Review with Differential Diagnosis: Some types of foreign bodies in the salivary glands already reported in the literature: toothbrush bristles, hairs, fishbone, sunflower seed, straw and even splinters nail. These foreign bodies are lodged in the glands by passing through salivary ducts causing sialoadenitis, whose main symptoms are pain, swelling and hardening of the affected gland, and decreased salivary secretion. Some of the differential diagnosis to be considered due to such symptoms are: Sjögren’s syndrome, sialolithiasis, acute sialadenitis and salivary gland neoplasms. Clinical Case Report: J.C.S, 32 years old, male, complains of pain and swelling of the submandibular region since he “sucked” an opened clip and it “disappeared” in his mouth seven days ago. Discussion: Some aspects of the case were analyzed and compared with others studies of the literature, such as: age, gender, exams that are usually used, chosen treatment, besides unusual habits like “suck clips”. Final Comments: The diagnosis of sialadenitis due to foreign body needs a careful inspection of the gland and also a good anamnesis, to be able to exclude other hypotheses.

Sialolito de grandes dimensões no ducto da glândula submandibular / Large sialolith in the submandibular gland duct

O objetivo deste trabalho é descrever o caso de um sialolito de grandes dimensões em glândula submandibular. Paciente do sexo feminino, leucoderma, 53 anos, procurou o cirurgião-dentista queixando-se de xerostomia, dor e inchaço na região de assoalho bucal, principalmente observado durante as refeições. O exame físico revelou uma tumefação em região submandibular esquerda, sensível a palpação, além de aumento de volume intra-oral firme, na região sublingual esquerda. Ao ordenhar a glândula submandibular, houve saída de pus. A radiografia oclusal inferior evidenciou extensa imagem radiopaca extensa, bem delimitada, cilíndrica e alongada. A associação dos exames clínicos e radiográficos levou ao diagnóstico de cálculo salivar. Foi realizada excisão cirúrgica da lesão sob anestesia local, com preservação da glândula submandibular. O exame anatomopatológico do cálculo revelou, na macroscopia, uma peça cirúrgica de consistência dura e cor amarela medindo 2,2 cm de diâmetro e, na microscopia, a presença de laminações concêntricas de material calcificado. A paciente encontra-se em acompanhamento há 2 anos e 8 meses, sem queixas de função glandular ou fluxo salivar, sem aumento de volume e exame radiográfico sem alterações. Apesar das grandes dimensões do sialolito, sua localização próxima à saída do dueto permitiu um tratamento conservador com bons resultados para a paciente.

This paper aims to describe a case of a large submandibular sialolith. A 53-year-old Caucasian female looked for for her dentist complaining of xerostomia, pain and swelling in the floor of the mouth, mainly observed during meals. The physical exam revealed a tender swelling on palpation in the left submandibular region, and also a firm intraoral swelling was detected in the left sublingual region. It was possible to draw pus from the submandibular gland. Mandibular occlusal radiography showed an extensive cylindrical and elongated, well-defined radiopaque image in the floor of the mouth. The association of clinical and radiographic findings led to the diagnosis of salivary calculus. The lesion was submitted to surgical excision under local anesthesia and the submandibular gland was maintened. Macroscopic analysis revealed a yellow and hard in consistency specimen, measuring 2.2 cm in length, and microscopic analysis revealed the presence of concentric laminations of calcified material associated with . The patient is being followed up for 2 years and 8 months, with no complaints of salivary flow or gland dysfunction, without gland swelling and no radiographic changes. Despite it being a large sialolith, its location near the exit of the duct allowed a conservative treatment with satisfactory aesthetic and functional results for the patient.

A Simple, Safe, and Effective Surgical Technique for The Treatment of Post-Traumatic Parotid Sialocoele

Post-traumatic parotid sialocoele is a subcutaneous extravasation of saliva from the parotid gland secondary to traumatic disruption of its duct or parenchyma. Currently, there is no consensus regarding the best therapy for parotid sialocoele, as it is resistant to conservative management. The present paper puts forward a relatively simple, safe and effective technique for the treatment of parotid sialocoele, specifically a peroral drainage technique. The results justify our recommendation to use this approach for the treatment of sialocoele.

Salivary duct cyst in the upper lip: Case report and review of the literature.

Salivary duct cyst (SDC) in an uncommon lesion of the minor salivary glands, with etiology related to obstruction of the salivary duct. It presents with a color similar to that of the mucosa, is mobile, measures between 3 and 10 mm and affects preferentially the bottom lip, fl oor of the mouth and the jugal mucosa. SDC have a predilection for the male and individual in elderly groups. The pathogenesis of SDC is associated with the formation of a mucous plug that causes partial or total obstruction of the salivary gland system duct, resulting in the dilation of the duct and increase in intraluminal pressure. They present clinical-pathological characteristics similar to those of salivary gland tumors, making diagnosis diffi cult and subject to errors in treatment. It is important for the dentist to include SDC in the differential diagnosis of lesions that affect the upper lip, although it is relatively rarely found in this anatomic site.

Parotid sialolithiasis in a two-year-old boy / 소아과

Sialolithiasis is caused by the obstruction of a salivary gland or its excretory duct by the formation of calcareous concretions or sialoliths; this results in salivary ectasia and provokes subsequent dilation of the salivary gland. Sialolithiasis is relatively common, accounting for 30% of salivary diseases; however, it is rarely observed in childhood. This case report describes a 2-year-old male patient who complained of a painful swelling over the right cheek, and presented with palpable stones and pus discharge from the orifice of the right Stensen's duct. Computerized tomography of the neck confirmed the diagnosis, and the patient received intravenous empiric antibiotics combined with intraoral sialolithotomy. We also provide a review of the spectrum of concepts regarding the pathogenesis, diagnosis, and treatment of sialolithiasis.