Necrotizing Sialometaplasia (NS) is a benign, self-limiting inflammatory disease of the mucus-secreting glands, and this illness mainly involves the minor salivary glands. The significance of NS resides in its clinical and histopathological resemblance to malignancy. We present here a case of necrotizing sialometaplasia on the soft palate, and this was accompanied by adenoid cystic carcinoma. We report here on this case to draw attention to the difficulty for deciding the extent of resecting a malignancy, and especially when the malignancy is simultaneously accompanied by necrotizing sialometaplasia.
Adenoids ; Carcinoma, Adenoid Cystic ; Palate, Soft ; Salivary Glands, Minor ; Sialometaplasia, Necrotizing

BACKGROUND AND OBJECTIVES: 5-Fluorouracil (5-FU) is a commonly used drug in carcinomas of the head and neck. Mucositis and bone marrow toxicity are the two major side effects. Some initial studies showed that the local use of allopurinol as a mouthwash may reduce the oral mucositis caused by the administration of 5-FU. The purposes of this study were to establish the stomatotoxicity of the chemotherapeutic agent in an animal model and to evaluate the effect of allopurinol mouthwashes in treating mucositis objectively. MATERIALS AND METHOD: Young male Golden Syrian hamsters were used. The combination of three intraperitoneal injection of 5-FU at five-day intervals and superficial mechanical mucosal irritation were applied and examined with a gross, light microscope, and a scanning electron microscope. The allopurinol oral mucosal paintings were applied three times everyday, starting with the treatment of 5-FU, only at the right buccal mucosa for one minute. RESULTS: Light microscopic changes were characterized by ulcer and inflammatory cells infiltration. The scanning electron microscopic examination showed irregular microridges and pits. Gross and histopathologic alterations were reliably reduced in the allopurinol mucosal painting group. CONCLUSION: This study suggests an effective animal model for stomatotoxicity of chemotherapeutic agents, and that allopurinol mouthwashes can be effective in treating or protecting the 5-FU induced stomatitis.
Allopurinol* ; Animals ; Bone Marrow ; Cricetinae* ; Fluorouracil* ; Head ; Humans ; Injections, Intraperitoneal ; Male ; Mesocricetus ; Models, Animal ; Mouth Mucosa ; Mouthwashes ; Mucositis ; Neck ; Paint* ; Paintings* ; Stomatitis* ; Ulcer

OBJECTIVES: To compare the velopharyngeal function, swallowing and speech of the conventional and modified radial forearm free flap (RFFF) for soft palate reconstruction. METHODS: Retrospective clinical study. Twenty-eight patients who underwent oropharyngeal reconstruction with RFFF were divided into two groups: 10 patients had conventional folded RFFF and 18 patients underwent modified method. RESULTS: The average speech intelligibility score in modified RFFF group was 8.0+/-2.4, and 6.2+/-2.2 in conventional RFFF group (P<0.05). The nasalance was 27.4+/-7.8% in modified group and 38.6+/-2.7% in conventional group during no nasal passage reading and 43.6+/-7.3% in modified group, 55.2+/-7.6% in conventional group during high nasal passage reading (P<0.05). The subjective swallowing functional score was 2.8 in modified group and 2.1 in conventional group. CONCLUSION: The speech assessment and nasalance demonstrate a more favorable outcome in modified group than conventional group.
Deglutition ; Forearm ; Free Tissue Flaps ; Humans ; Oropharyngeal Neoplasms ; Palate, Soft ; Retrospective Studies ; Speech Intelligibility

BACKGROUND AND OBJECTIVES: The accurate measure of salivary flow rate requires a variety of clinical and experimental protocols. Several methods have traditionally been used to collect and measure the whole mouth saliva. The objective of this study was to verify usefulness of a newly developed oral Schirmer test for detecting salivary gland hypofunction. SUBJECTS AND METHOD: The control group consisted of 85 healthy patients, while another group consisted of 30 patients with salivary grand resection or post-head and neck irradiation and a third group of 30 patients who suffered from subjective xerostomia caused by other pathologies. Oral Schirmer test was carried out in all subjects. The main outcome was the wetted length after 5 minutes. RESULTS: The mean saliva flow was 59.3+/-16.99 mm/5 min in the control group, 47.0+/-13.50 mm/5 min in the 2nd group and 39.9+/-11.65 mm/ 5 min in the third group. The differences between the control group and the other two groups were statistically different (p<0.001). A cut-off value 40 mm/5 min showed sensitivity of 83.7% and specificity of 62.5%. CONCLUSION: The oral Schirmer test is valid and reliable for identifying subjects with xerostomia.
Humans ; Mouth ; Neck ; Saliva ; Salivary Glands ; Sensitivity and Specificity ; Xerostomia

BACKGROUND AND OBJECTIVES: Although Gore-Tex is popularly used in nasal augmentation in human, studies about the histological changes have been carried out only in animal models. The purpose of this study is to investigate histological changes of Gore-Tex used in nasal augmentation in human. SUBJECTS AND METHODS: Gore-Tex of 24 patients who underwent nasal augmentation using Gore-Tex (non-reinforced sheets) 2-36 months ago and had re-operated for the sole cosmetic problems was obtained. Histologic examination was performed from specimens including Gore-Tex and the surrounding soft tissue with light microscope and electromicroscope. RESULTS: Histologically, connective tissue ingrowth was observed in all specimen. But the degree of foreign body reaction and collagen deposit varied from specimen to specimen and had no relationship with the duration. Neovascularization was observed from specimen whose duration was longer than 12 months and degenerative calcification was observed from 36 month old specimen. CONCLUSION: Unlike the findings of previous reports, individual differences and partial degenerative lesions in Gore-Tex were observed. Additional studies are required to confirm the stability of Gore-Tex as an implant to be used in human.
Child, Preschool ; Collagen ; Connective Tissue ; Foreign-Body Reaction ; Humans* ; Individuality ; Models, Animal ; Polytetrafluoroethylene ; Rhinoplasty