Computed tomography (CT) is the current imaging standard for the evaluation of rhinosinusitis because of its exquisite ability to display and differentiate hypertrophic mucosa, bone, and air. Multi detector (multislice) computed tomography scanners are readily available in most imaging centers and provide a quick and comprehensive evaluation of rhinosinusitis. On the other hands flat-panel-based cone-beam computed tomography (CBCT) is a recently deployed technology that potentially decreases radiation dose approximately 50% to 70% compared with multi detector (multislice) CT. CBCT allows for relatively good resolution of bony structures in the maxillofacial area; however, it has poor soft tissue contrast. CBCT has limitation in soft tissue imaging but the fine imaging in bone structure as MDCT. In this paper the utility of CBCT in rhinosinusitis is described.
Traditionally, interrupted nylon sutures are used to close surgical wounds in ear surgery, however, 2-Octyl cyanoacrylate (2-OCA) tissue glue can be used as an alternative method to close a postauricular incision.
We prospectively reviewed the records of consecutive patients (11 patients given simple interrupted nylon sutures and 30 in which a topical skin adhesive was used) at our hospital who underwent tympanoplasty via a postauricular incision between February 2015 and March 2016.
The aim of our study was to compare ① the incidence of postoperative surgical site infection (SSI), ② the operative time until wound closure, and ③ the cost between the simple interrupted nylon suture and topical skin adhesive groups.
The incidence of SSI was 0% in both groups. The mean operative time until wound closure was significantly shorter in the 2-OCA group (11 min 43 sec) than in the suture group (8 min 54 sec). The operation cost was 2- to 5-fold higher in the 2-OCA group as compared to the simple interrupted nylon suture group. We consider the absence of need for dressing change or removal of stitches, and the possibility of granting patients permission to wash their hair and wear their glasses at an earlier stage as distinct advantages of the use of 2-OCT.
The use of 2-octyl cyanoacrylate topical skin adhesive for wound closure following middle ear surgery was safe and rapid, and was associated with a higher patient satisfaction as compared to the use of simple interrupted nylon sutures. I consider these advantages as being worth the additional expense of employing 2-OCT.
Salivary gland cancer accounts for approximately 1% of all cases of head and neck cancer. In particular, squamous cell carcinoma (SCC) of the submandibular glands is extremely rare. In the present paper, we present a case of SCC of the submandibular gland with mandibular invasion. The patient was a 71-year-old male, who presented with a 6-month history of a painless swelling in the left submandibular region. He was referred to our facility for further examination. Physical examination revealed a left submandibular induration with poor mobility and a suspicion of mandibular adhesion, and the imaging findings led to the suspicion of submandibular invasion. Preoperative aspiration biopsy cytology suggested class V, SCC; thus, the patient was diagnosed as having SCC of the submandibular gland and treated by surgery. Submandibular gland excision, mandibular segmental resection, left neck dissection, tracheotomy, free forearm flap reconstruction, free fibula flap reconstruction, and a full-thickness skin graft were performed, with a favorable postoperative course. The postoperative pathological findings were consistent with typical SCC.
Reports of SCC of the submandibular gland are rare, and to the best of our knowledge, there are no reports in the literature of SCC of the submandibular glands with mandibular invasion. When SCC is detected in a submandibular tumor, SCC of the submandibular gland should be considered in the differential diagnosis, along with metastatic lymph nodes and invasive tumors.
A reverse tooth is defined as a tooth that has been extracted at a site different from the normal dentition. Reverse teeth often present as rhinorrhea, nasal congestion or nasal bleeding, or are asymptomatic. They often occur in young people and half in teenagers, but rarely in children less than 10 years old.
We experienced the case of a girl in which a reverse tooth was incidentally detected at one year and eight-month old. Because she was young, she had been followed up on an outpatient basis, but she had excessive nasal discharge and increased granulation around the reverse periodontal tooth. At 2 years and 3 months she underwent endoscopic removal of the reverse tooth. Intranasal reverse teeth are often followed conservatively after diagnosis. However, although there are no symptoms at first, symptoms may appear as the affected patients grow up and opinion is strong that complete removal is desirable. Especially in the case of a very young patient as in the present study, it is important to treat reverse teeth at an earlier stage based on the parents' intention.