Arteria labial de calibre persistente / Caliber-persistent labial artery

La arteria labial de calibre persistente (ALCP) es una entidad poco común, que se caracteriza por una arteria labial cuyo calibre permanece invariable tras su penetración en la submucosa. El diagnóstico diferencial debe apoyarse en pruebas de imagen pues la biopsia puede ocasionar sangrados importantes. El tratamiento varía desde el seguimiento clínico hasta la escisión quirúrgica. Presentamos el caso de una mujer de 40 años que acude a nuestra consulta por una tumoración lineal submucosa en labio superior, que le ocasionaba problemas estéticos y funcionales. (AU)

Caliber-persistent labial artery is an uncommon lesion of the lip, which consists of a labial arteriy that penetrates into the submucosal tissue of the lip, without a loss of caliber. The differential diagnosis must be supported by image tests, since the surgical biopsy can cause significant bleeding. Treatment varies from clinical follow-up to surgical excision. We present the case of a 40-year-old woman who attends to our consultation for a lineal submucosal lesion that caused her aesthetical and functional compromise. (AU)

The Intraoral Ultrasonography in Dentistry.

Ultrasonography (USG) is a diagnostic method that the ultrasonic image is created by ultrahigh-frequency sound waves, which have an acoustic frequency above the threshold of human hearing. Compared to other medical imaging methods, USG has several advantages of being real time, portable, inexpensive, radiation free, and noninvasive. In the medicine, most of the USG applications are transcutaneous. However, intraoral USG has been a relatively rare application, it has recently been drawing more interest. Intraoral USG is also used in dentistry for examining the salivary glands and ducts, as well as the mouth floor, the buccal, labial, and palatal mucosa, the tongue, periodontal tissues, and periapical lesions. The main purpose of this review is to provide detailed information about intraoral USG applications in dentistry.

Necrotizing Lip Infection Causing Septic Thrombophlebitis of the Neck: A Rare Variant of Lemierre Syndrome.

Lemierre syndrome is an uncommon condition in which internal jugular vein thrombosis presents after recent oropharyngeal infection. Frequently, this is accompanied by septic emboli. This report outlines a variant of this disease process, with septic thrombophlebitis of the neck associated with a necrotizing skin infection of the lower lip and chin. A 25-year-old man with lower lip and chin swelling, initially managed with intravenous antibiotics, progressed to the development of a left facial vein thrombus, septic emboli to the lungs, and a necrotizing lower lip and chin infection that was managed with debridement, thrombectomy, and prolonged hemodynamic and pulmonary support. A necrotizing skin infection with thrombus of the jugular system and septic emboli is a very rare variant of Lemierre syndrome. Early recognition of an infection with septic emboli and/or necrotizing pathobiological findings allows for prompt antibiotic and surgical therapy, minimizing the mortality of these potentially lethal infections.

Oral mass revealing Chédiak-Higashi syndrome.

This case report describes common oral inflammatory findings leading to the identification of Chédiak-Higashi syndrome (CHS). A 15-year-old girl presented with an enlarging and painful mass on the upper lip. Two weeks after the initial visit, the mass showed further protrusion in the absence of fever. Magnetic resonance imaging revealed a well-circumscribed cystic lesion with a thick capsule, and suggested an abscess derived from the mucous cyst in the upper lip. Inflammation indices were not elevated; however neutrophils were significantly lower than the normal level. Giant cytoplasmic granules in neutrophils, eosinophils, and lymphocytes, which are pathognomonic of CHS, were noted. The patient displayed brownish-red hair with some grey hair, and partial oculocutaneous albinism. Hepatosplenomegaly was evident on ultrasonography. The final diagnosis was of an oral infection facilitated by the adolescent form of CHS (gene CHS1/LYST at 1q42.1-2). This report offers a reminder that lip swelling may represent the initial manifestation of the inflammatory response in a patient with loss of immunocompetence due to pathologies such as CHS, and may rarely present as the patient's main complaint.

Mucoceles of minor salivary glands in children. Own clinical observations.

INTRODUCTION: Mucoceles are benign lesions associated with the pathology of the oral mucosa of minor salivary glands. Two types of cysts are distinguished depending on their pathogenesis. Most often they occur as a result of mechanical trauma and mucus extravasation into tissues or obstruction of the gland ducts. AIM: The aim of the study was to present our own experiences regarding mucoceles of minor salivary glands in the oral cavity taking into account how frequently the individual types of cysts occur in children. MATERIAL AND METHODS: The research was carried out based on medical files from the years 2005-2015. These were: medical case records, operating books and the medical registry of patients treated at the Clinic of Maxillofacial Surgery, Frederic Chopin Clinical Regional Hospital in Rzeszow. In that period 64 children and teenagers, 28 girls and 36 boys were treated. What was considered was the age and gender of the patients, the reason for their appointment with a doctor, the location, size and histopathological type of the cysts, as well as the course and results of the diagnostic and therapeutic process. RESULTS: In the group analyzed, the reasons for referral to the Clinic were: in 25 patients accidental ascertainment of a non-symptomatic tumor in the oral cavity during examination by a dentist, pediatrician or laryngologist which had not caused any discomfort to the children; in 13 patients concern had been raised by a gradually increasing tumor; in 18 cases there was an increased tissue tension surrounding the tumor, while in 3 children red oedema was observed in the oral cavity (suspicion of abscess). The most frequent mucocele location was the lower lip (34 children). The most frequent size was 2.1-3 cm (28 children). The most frequent histological type was MEP. All the patients were treated at the Clinic in the one-day surgery mode, with good outcome. CONCLUSIONS: Mucocele ascertainment in children's oral cavity could be made accidentally in routine pediatric examination, therefore it is necessary to extend pediatricians' knowledge about small salivary gland mucoceles. The most frequent type of MEP could be related to different types of trauma in the oral mucose.

Nasolabial cyst mimicking inflammatory cyst.

The nasolabial cyst is an uncommon non-odontogenic soft tissue cyst. It arises as an ectodermal developmental swelling and is classified as a fissural cyst, found outside the bone, in the region corresponding to the nasolabial furrow and alar nose. A case of nasolabial cyst with classic clinical and histopathological features, along with few features mimicking those of an inflammatory cyst in a 32-year-old woman is reported.

Intraoral ultrasonography: development of a specific high-frequency probe and clinical pilot study.

Although ultrasonography is a non-invasive, inexpensive and painless diagnostic tool for soft tissue imaging, this technique is not currently used for oral exploration. Therefore, we developed a 25-MHz high-frequency ultrasound probe, specially designed for intraoral applications. This paper aims to present clinical intraoral ultrasound images actually interpretable, in order to identify the relevant applications of this novel tool and to design future oral studies. Two independent radiologists performed ultrasound examinations on three healthy volunteers. All the teeth were explored on the lingual and buccal sides (162 samples) to evaluate the ergonomics of the system and the visualisation of anatomic structures. Osseointegrated dental implants and a mucocele were also scanned. At the gingivodental junction of the maxillary and mandibular teeth, the device clearly identifies the tooth surfaces, the alveolar bone reflection with its surrounding subepithelial connective tissue of the gingiva and the gingival epithelia. The bone level and the thickness of soft tissue around the implant are measurable on the buccal and lingual sides. Therefore, intraoral ultrasonography provides additional morphological information that is not accessible by conventional dental x-rays. We propose a novel diagnostic tool that explores the biological width and is able to define the thin or thick nature of the gums. Moreover, intraoral ultrasonography may help to monitor precancerous lesions. This promising device requires large-scale clinical studies to determine whether it should remain a research tool or be used as a diagnostic tool for daily dental practice.

Diagnosis and surgical treatment of a nasolabial cyst.

Nasolabial cysts are uncommonly diagnosed nonodontogenic soft tissue lesions located close to the nasal alar region of the face, presenting as extraosseous swelling in the region of the nasolabial fold. Nasolabial cysts are likely to remain undetected unless and until they become infected or are associated with facial deformity. Histologically, it is lined with nonkeratinized squamous epithelium or, more frequently, with respiratory-type cylindrical epithelium with goblet cells. The aim of this article was to present and discuss the surgical management of a case of nasolabial cyst and to briefly review the literature.

Nasolabial cyst: case report with CT and MRI findings.

Nasolabial cysts are uncommon primarily unilateral soft tissue lesions located adjacent to the alveolar process above the apices of the maxillary incisors. Clinical features of the nasolabial cysts are smooth fluctuant soft tissue swelling between the upper lip and nasal aperture with obliteration of the nasolabial fold and elevation of the nasal ala. A nasolabial cyst is described including its features on CT and MRI exams.

High-resolution color Doppler ultrasound of a caliber-persistent artery of the lip, a simulator variant of dermatologic disease: case report and sonographic findings.

BACKGROUND: Caliber-persistent labial artery (CPLA) is a vascular anomaly in which a primary artery penetrates the submucosa without caliber loss. It presents as an asymptomatic papular lesion, usually on the lower lip, which may be misdiagnosed as a malignant skin tumor and can cause severe bleeding during biopsy or surgery. Development of new high-resolution ultrasound equipment has improved its observation. AIM: This study was undertaken to assess the scope of ultrasound for the diagnosis of CPLA. METHODS: We report a case of a 65-year-old woman with a nodule involving the lower lip, initially misdiagnosed as a malignant skin tumor. Diagnosis was confirmed by high-resolution color Doppler ultrasound using a compact linear probe that generates frequencies of 7-15 MHz. RESULTS: The clinical presentation of the lesion, ultrasound technique, and sonographic findings are described. A current literature review of CPLA diagnosis was performed. Clinical and sonographic images are given as examples. CONCLUSIONS: High-resolution color Doppler ultrasound is a reliable noninvasive technique for CPLA diagnosis. It allows direct visualization of this vascular variant in real time without the use of an intravenous contrast agent. It may avoid surgical complications and help in the differential diagnosis. Newer high-resolution equipment allows a clear definition of the cutaneous and muscular layers, as well as the vascularity of the lips.

Calibre persistent labial artery: clinical features and noninvasive radiological diagnosis.

Calibre persistent labial artery (CPLA) is defined as a primary arterial branch that penetrates into the submucosal tissue without division or decrease in diameter. It usually presents as an asymptomatic papule on the lower lip and can be easily misdiagnosed as a varix, haemangioma, venous lake, mucocele or fibroma. When it is ulcerated, squamous cell carcinoma is the most usual differential diagnosis. The most frequently used method to confirm the diagnosis of CPLA has been excisional biopsy, which carries the risk of profuse bleeding. Angiography, another invasive method, has also been used. Here, we report a case of a 20-year-old woman with a 5-year history of multiple CPLA lesions involving both upper and lower lips. In this case, the diagnosis was made clinically and confirmed by Doppler ultrasonography, which is a noninvasive and simple diagnostic tool.

Ultrasonography: a noninvasive tool to diagnose a caliber-persistent labial artery, an enlarged artery of the lip.

OBJECTIVE: Currently, practitioners use clinical and histopathologic examination to diagnose a caliber-persistent labial artery (CPLA). We illustrate the use of ultrasonography as a noninvasive diagnostic tool to visualize this enlarged artery of the lip. METHODS: We examined the lips of 3 patients with a suspected CPLA. We localized and determined the extension of the intralabial artery with ultrasonography, including pulsed and color Doppler analysis. We compared the sonograms to the clinical and histopathologic findings. RESULTS: Sonograms showed clear enlargement of the labial artery in the 3 cases. The course of the constant-diameter artery was either vertical or oblique from the depth of the lip to the surface of the mucosa. This vascular abnormality was confirmed by histopathologic examination. CONCLUSIONS: Ultrasonography and color Doppler imaging may be useful noninvasive tools for the diagnosis and preoperative evaluation, as well as the follow-up, of labial lesions related to a CPLA, thus eliminating the need for diagnostic surgery in typical pulsatile nodules. Ultrasonography may help distinguish a CPLA from other vascular lesions of the lip such as an aneurysm. Atypical cases or chronic ulcerations mimicking a cancer should undergo biopsy so that a malignant process is not missed.

Traumatic arteriovenous fistula of the upper lip.

Traumatic arteriovenous fistulas can present days to years following penetrating trauma and are often challenging to diagnose and manage. Patients may present to the dermatologist with unilateral varicose veins or a pulsatile mass. Our case illustrates the value of palpation in a careful systematic approach to any new lesion, especially in the context of previous penetrating trauma. We also discuss the nomenclature of arteriovenous communications and review their current management.

Case report: bilateral nasoalveolar cysts.

Nasoalveolar cysts are rare developmental cysts arising in the region of the upper lip, just below the ala nasi. We present a case where a woman was suspected of having a local abscess. The microscopic features of this abscess were consistent with nasoalveolar cysts.

Ultrasonographic appearance of dermoid and epidermoid cysts in the head and neck.

The ultrasonographic features of 6 histologically proven dermoid and epidermoid cysts in the head and neck are reported. All 6 cysts had internal echoes, with a solid appearance. Five of the 6 were echogenic, with only slight or no posterior echo enhancement. Amorphous keratinous debris from keratinizing stratified squamous epithelium filled the lumen of each cyst, producing the internal echoes. Most of the true solid tumors examined were generally of lower echogenicity, and could be differentiated from dermoid and epidermoid cysts ultrasonographically, although lipomas were indistinguishable from these cysts.