A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population

Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Epidemiological survey of mucus extravasation phenomenon at an oral pathology referral center during a 43 year period / Levantamento epidemiológico de fenômeno de extravasamento de muco de um centro de referência em patologia oral por um período de 43 anos

ABSTRACT INTRODUCTION: Mucoceles are common benign pseudocystic lesions of the oral cavity; their main etiological factors are trauma and ductal obstruction. Two histological patterns are found: mucus retention phenomenon (MRP) and mucus extravasation phenomenon (MEP). Mucus extravasation phenomenon is the more common histological subtype and it mainly affects the lower lip. The knowledge of its main clinical features and management is important to assist health professionals in clinical practice. OBJECTIVE: This study aimed to determine the relative frequency and distribution of oral mucoceles in an oral pathology reference center. METHODS: Cross-sectional historical study that analyzed all cases pathologically diagnosed as mucus extravasation phenomenon by the department of anatomic pathology of an oral pathology referral center from June of 1970 to May of 2014, considering the clinical characteristics of the lesion and those relating to the patient. SPSS v. 20.0 software for Windows was used for descriptive analysis. RESULTS: During 43 years, 719 cases of mucus extravasation phenomenon (54.7% men and 45.3% women) were registered, with the lower lip as the most commonly affected site (n = 484; 67.3%). The average age of patients was 20.8 years (SD ± 14.4) with a peak occurrence in the second decade of life. Most professionals had oral mucocele/ranula (n = 606; 84.3%) as the initial clinical impression. CONCLUSION: Mucus extravasation phenomenon is a lesion that primarily affects young patients, affecting mainly the lower lip, and is commonly found in oral diagnostic services.

Resumo Introdução: Mucoceles são lesões pseudocísticas benignas comuns da cavidade oral, que possuem como principais fatores etiológicos trauma ou obstrução ductal. Dois padrões histopatológicos são encontrados: fenômeno de retenção de muco (FRM) e fenômeno de extravasamento de muco (FEM). O FEM é o subtipo histológico mais comum e tem como principal local de acometimento o lábio inferior. O conhecimento acerca de suas principais características clínicas e formas de tratamento se faz importante para auxiliar profissionais da saúde na prática clínica. Objetivo: Este trabalho objetivou determinar a frequência relativa e a distribuição das mucoceles orais em um centro de referência em patologia oral. Método: Estudo transversal de caráter histórico, no qual foram analisados os casos diagnosticados histopatologicamente como FEM pelo serviço de anatomia patológica de um centro de referência em patologia oral no período de junho de 1970 a maio de 2014, considerando-se variáveis clínicas da lesão e relativas ao paciente. O programa estatístico SPSS 20.0 for Windows foi utilizado para a análise descritiva dos dados. Resultados: Durante 43 anos foram observados 719 casos de FEM (54,7% homens e 45,3% mulheres), sendo o lábio inferior (n = 484; 67,3%) o local de principal acometimento. A média de idade dos pacientes foi de 20,8 anos (DP ± 14,4), com pico de ocorrência na segunda década de vida. A maioria dos profissionais teve mucocele oral/rânula (n = 606; 84,3%) como primeira hipótese clínica. Conclusão: O FEM é uma lesão que afeta principalmente pacientes jovens, acometendo preferencialmente o lábio inferior, sendo comumente encontrada nos serviços de diagnóstico oral.

Les mucoceles sinusiennes : etude epidemio-clinique et therapeutique de 25 cas colliges a Abidjan (Cote d'Ivoire)

Objectif: Determiner les caracteristiques epidemio-cliniques et therapeutiques des mucoceles sinusiennes en Cote d'Ivoire. Materiel et Methode: Il s'est agit d'une etude multicentrique menee dans les services d'ORL des trois centres hospitaliers et universitaires et les polycliniques d'Abidjan de 1996 a 2012 (16 ans). Elle a concerne les patients chez qui il a ete diagnostique cliniquement et radiologiquement une mucocele sinusienne et qui ont beneficie d'une prise en charge chirurgicale. Resu(tats: Pendant la periode d'etude; 25 patients ont ete recrutes soit une incidence hospitaliere de 1.5 cas par an. Il y avait une predominance feminine avec 60% de femme et 40% d'homme soit un sex ratio de 0.67. Les patients consultaient pour des cephalees (68%); des tumefactions faciales (68%); une exophtalmie (28%). La rhinite allergique est l'antecedent rhinologique le plus retrouve (32%) suivi des sinusites (12%) et de la chirurgie naso-sinusienne (12%). La tomodensitometrie naso-sinusienne realisee chez tous nos patients; a pose le diagnostic de mucocele dans 100% des cas. L'exerese chirurgicale a ete faite par plusieurs voie d'abord dont les plus utilisees etaient la voie de JACQUES et la rhinotomie paralateronasale de MOURE. L'examen anatomopathologique des pieces operatoires a confirme le diagnostic de mucocele sinusienne. L'evolution a ete emaillee de complications a type de tumefaction palpebrale (1 cas); flou visuel (1 cas); cicatrice operatoire disgracieuse (1 cas). Conc(us ion : Les mucoceles naso-sinusiennes sont des lesions benignes pseudo-kystiques relativement rares; d'evolution insidieuse. Leur diagnostic soupconne par la clinique est confirme par le bilan radiologique. Leur traitement est essentiellement chirurgical

Mucoceles de cavidades paranasales: experiencia en el Hospital Barros Luco-Trudeau / Paranasal sinus mucoceles: the Barros Luco-Trudeau experience

Introducción: Los mucoceles son pseudotumores expansivos de las cavidades paranasales, cuyos síntomas están dados por su crecimiento expansivo. El tratamiento tradicional ha sido la extracción quirúrgica por vía externa, siendo desplazado en las últimas décadas por la resección endoscópica. Objetivo: Evaluar la experiencia en nuestro servicio sobre el diagnóstico y tratamiento de los mucoceles. Material y método: Revisión retrospectiva de pacientes tratados por mucocele en el Servicio de Otorrinolaringología, entre 2002y 2013. Se describen características clínico-demográficas, métodos diagnósticos, tratamiento y aparición de recidivas. Resultados: Se analizaron 45pacientes con seguimiento promedio de 24,93 meses. El 51,11% correspondió al sexo masculino. La edad promedio fue 49,68 años. El 46,6% fueron mucoceles fronto-etmoidales (6 frontales, 6 etmoidales y 9 fronto-etmoidales), el resto en seno maxilar, con un periodo de latencia de 7,33 meses. Los síntomas más frecuentes fueron oftalmológicos (55,5%) como proptosis y diplopía, mientras que el 51,1% de los pacientes tenía antecedentes de rinosinusitis crónica. El tratamiento fue mediante resección endoscópica en el 66,22%, por vía abierta 31,1% y manejo combinado en 6,66%. Hubo 8 casos recidivados, que representan el 17,7% de la serie. Discusión: Nuestra casuística resultó semejante a otras series publicadas. En los últimos años se ha preferido el abordaje endoscópico, sin embargo, el abordaje externo o combinado siguen siendo claves en el manejo de mucoceles extensos o para tratar recidivas. La aparición potencialmente tardía de recidivas requiere un tiempo de seguimiento largo para estos pacientes. Conclusiones: Los mucoceles representan un desafío diagnóstico y terapéutico y el manejo endoscópico parece una alternativa segura en el manejo de mucoceles que no comprometan órbita o tengan extensión craneal.

Introduction: Mucoceles are expansive pseudotumors of the paranasal sinuses and clinical presentations of symptoms are given by expansive growth. Traditional treatment has been open surgical extraction, being shifted in recent decades by endoscopic resection. Aim: To evaluate our experience in diagnosis and treatment of mucoceles. Material and methods: Retrospective chart review of patients treated for mucocele in the Department of Otolaryngology, between 2002 and 2013. Clinical and demographic characteristics, diagnostic methods, treatment and recurrence are described. Results: 45 patients with average follow-up of 24.93 months were analyzed. 51.11% were male. The mean age was 49.68years. 46.6% were fronto-ethmoidal mucoceles (6 in frontal sinus, 6 in ethmoidal sinus and 9 fronto-ethmoidal), the rest in the maxillary sinus, with a latency period of 7.33 months. Most frequent symptoms were ophtalmologic (55.5%) as proptosis and diplopia, while 51.1% of patients had a history of chronic rhinosinusitis. Treatment was by endoscopic resection in 66.22%, 31.1% by open surgery and 6.66% in combined approach. There were 8 recurrent cases, accounting for 17.7% of the series. Discussion: Our series was similar to other published earlier. In recent years, endoscopic approach is preferred, however, combined external approach or keys remain in handling large mucoceles or to treat recurrences. The late onset of recurrences potentially requires a long follow-up time for these patients. Conclusions: Mucoceles represent a diagnostic and therapeutic challenge and endoscopic management seems a safe alternative in the management of orbital involvement or cranial extension mucoceles.

Mucocele - A study of 36 cases.

Background: Mucocele is one of the most common benign soft tissue tumor present in the oral cavity. They are of two types - one is extravasation and second one is retention type but the majority are extravasation type. Aims: The objective is to determine various factors related to mucocele such as role of trauma due to nearby teeth, recurrence, duration, and to find out whether there is any role of psychological stress which initiates trauma like lip or cheek biting. Materials and Methods: 36 cases of mucocele diagnosed at the Department of the Oral Pathology, Govt. Dental College and Hospital, Ahmedabad, between 2004 and 2008 were reviewed. The clinical data were recorded and histopathologic diagnosis was made. Statistical Analysis Used: Data analysis tool, Microsoft Office Excel 2007. Results: A diagnosis of mucocele was established in 36 cases with male-to-female ratio of 1.77:1. Most common type was extravasation in 30 (83.33%) cases. The peak age of occurrence was between 1st and 3rd decade. Lateral side of the lower labial mucosa was the most affected site in 34 (94.44%) cases. The history of trauma appeared the major etiological factor seen in 28 (77.77%) cases. Conclusion: We conclude that there was male predominance and they were more affected in 2nd and 3rd decade. The lateral side of lower labial mucosa was the commonest site and the trauma due to teeth or lip biting was the major etiological factor for the occurrence of the mucocele. The article highlights role of psychological stress in occurrence of mucocele. The reader should understand the importance of histopathology examination and should try to control the psychological stress in such mucocele patients.

A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan

OBJECTIVE: The aim of this retrospective analysis was to determine the age, gender, frequency and distribution of trauma-associated hard tissue and soft tissue lesions of the oral and maxillofacial region in a population from southern Taiwan. PATIENTS AND METHODS: Approximately 10 percent of the 27,995 biopsy records of patients with history of trauma resulting in lesions who were treated at our institution between 1991 and 2006 were examined for this study. RESULTS: In the included records, there were 2,762 soft tissue and 26 hard tissue lesions. Mucocele was the most frequent trauma-associated soft tissue lesion (955 cases). The youngest patients were those who presented with mucocele (mean age = 27.3 years), while the oldest patients were those with peripheral giant cell granuloma (58 years). The lower lip was the most frequent site of occurrence of mucocele (676, 64.5 percent) and was also the predominant site of occurrence of all soft tissue lesions (815, 29.5 percent), followed by the buccal mucosa (654, 23.4 percent) and the tongue (392, 14.2 percent). Trauma-associated hard tissue lesions included only osteoradionecrosis (24 cases) and traumatic bone cysts (2 cases). CONCLUSION: As little data of this nature have been reported from populations of Asian developing countries, the findings of this retrospective analysis is valuable for epidemiological documentation of type of traumatic oral lesions as well as for informing the professionals and the layman about the importance of this category of oral lesions.

A survey of oral and maxillofacial biopsies in children: a single-center retrospective study of 20 years in Pelotas-Brazil

Despite the large number of published cases about oral and maxillofacial pediatric lesions, the literature is scarce on epidemiological studies regarding the prevalence of these entities. This study retrieved oral and maxillofacial pediatric lesions from the Center of Diagnosis of Oral Diseases (CDDB) at the Dental School of the Federal University of Pelotas (UFPEL), comprising a 20-year period (1983-2002). From the total of 9,465 biopsies received in this period, 625 (6.6%) were from children aged 0 to 14 years. Regardless of the histopathological diagnosis, patient data referring to lesion location, sex and age were collected. Diagnoses were grouped in 13 categories. As much as 89 percent of the cases occurred in patients aged 7 to 14 years (53% in females and 47 percent in males). Mucocele (17.2%) was the most common type of lesion, followed by dentigerous cyst (8.6%). In the category of odontogenic tumors, odontoma was the most frequent lesion (64.2%). Malignant lesions were observed in a small section of the sample (1.2%). Generally, the results of the present study are in line with those reported in the literature concerning the most prevalent lesions in the pediatric population. Most lesions were benign, and malignant lesions were diagnosed in a very small part of the sample.

Presencia de quistes de retención mucoso del seno maxilar detectados por radiografías panorámicas en pacientes de la ciudad de Temuco, Chile / Presence of mucus retention cysts in maxillary sinus detected by panoramic radiographs on patients of Temuco, Chile

Los quistes de retención mucoso son una patología muy poco frecuente en el seno maxilar, pero de fácil detección en radiografías panorámicas. El propósito de este estudio fue cuantificar los casos de mucoceles en senos maxilares durante un periodo de 5 meses, observando su frecuencia por edad y sexo. Se encontró una prevalencia de 2.06 por ciento en 339 radiografías revisadas, observándose mayor frecuencia en el género masculino y a una edad promedio de 30 años. Todos los casos no manifestaron sintomatología alguna.

Mucus retention cyst are a pathology with very low frequency in maxillary sinus, but easy to detect in panoramic radiographs. The aim of this study was quantify mucocele cases in maxillary sinus along five months, detecting their frequency by age and sex. It was found a prevalence of 2.06 percent, noting more frequently in male sex and with an average age of 30. All cases were presented without previous symptomatology.

Mucocele: prevalência de 10 anos no Hospital Universitário Antônio Pedro/UFF / Mucocele: 10 years' prevalence at Antonio Pedro University Hospital-UFF

Realizou-se estudo retrospectivo para verificar a prevalência das lesões distintas da mucocele - cisto de retenção e fenômeno de extravasamento mucoso - bem como sexo, a idade e o local de maior incidência. A prevalência de mucocele foi de 158 (6,6%) em 2.379 exames, sendo 139 (88%) casos de fenômeno de extravasamento. Verificou-se o diagnóstico inicial das requisições, onde 9% apresentavam outras hipóteses como hiperplasia fibrosa, lipoma e tumores de glândulas salivares. Este estudo mostra a importância do encaminhamento de biópsias desta lesão, tida como comum e de fácil diagnóstico clínico, para a histopatologia, investigando a possibilidade de neoplasias e proporcionando tratamento correto para o paciente.

Prevalencia de lesiones histopatológicas bucales en la zona del Bajío (agosto del 90 a diciembre del 96) / Prevalence of histopathological oral lesions in the Bajio zone (August 90 trough December 96)

Objetivo: establecer la prevalencia de las lesiones histopatológicas bucales definiendo sus características clínicas, de pacientes en la región del Bajío, México, durante un período de seis años (agosto de 1990 a diciembre de 1996). Material y métodos. Se revisaron los registros de diagnósticos histopatológicos efectuados por el autor, de las lesiones diagnosticadas en el CUERPO, con el propósito de obtener la información epidemiológica correspondiente. Resultados. Durante el lapso del estudio, se efectuaron un total de 1.047 biopsias, predominando el sexo femenino y los pacientes de la década de los 20-29 años; participaron 18 instituciones canalizando sus biopsias para el diagnóstico histopatológico correspondiente, donde las universidades de la región aportaron el 53 por ciento de los mismos. Se diagnosticaron 300 lesiones diferentes, el granuloma periapical crónico infectado fue la lesión más frecuente. Las lesiones odontológicas prevalecieron. Las lesiones malignas representaron el 3.63 por ciento del total de las biopsias, siendo el carcinoma epidermoide la lesión maligna más frecuente