Neuroepithelial Structures of the Oral Soft Tissues Including the Juxtaoral Organ of Chievitz: A Literature Review and Audit of Diagnosed Cases

Robert Kennedy

doi:10.1007/s12105-020-01131-5

Abstract

The juxtaoral organ of Chievitz (JOOC) is a part of microanatomy composed of bland epithelial islands closely associated with small nerves and usually described within the soft tissue on the lingual aspect of the posterior mandible. Similar structures are documented in the posterior tongue. There is a risk of misinterpretation as carcinoma showing perineural invasion. An audit was undertaken of diagnosed cases of the JOOC and similar neuroepithelial structures identified within the oral soft tissues of surgical specimens. Nineteen cases were identified. Epithelial islands ranged < 0.5–4 mm in maximum dimension and lay in close association with small nerves. Epithelial cells showed a squamoid appearance but were without keratinisation. There was no atypia and mitotic figures were not seen. In 53% of cases the epithelial cells showed cytoplasmic clearing, in 26% of cases there was brown pigment and in 11% of cases there were calcifications. In 53% of cases, these neuroepithelial structures lay within the soft tissue lingual to the mandible in the retromolar area, 26% of the structures were placed buccal to the mandible, 11% of the structures lay adjacent to the maxillary tuberosity and 11% of the structures were within the posterior tongue.

Highlights

Materials and MethodsThe juxtaoral organ of Chievitz (JOOC) is a part of normal microanatomy rarely encountered within resection specimens
The literature relating to neuroepithelial structures within the oral soft tissue is reviewed, and an audit of cases diagnosed at a single institute is presented
All the cases in the audit showed neuroepithelial structures with microscopic features consistent with descriptions in the literature including a size up to 4 mm and an shows positive staining of the epithelium, the calcified area has fallen from the section resulting the defect seen (b) association with small nerves together with an absence of atypia and keratinisation

Summary

Materials and Methods

The juxtaoral organ of Chievitz (JOOC) is a part of normal microanatomy rarely encountered within resection specimens. It is a neuroepithelial structure composed of bland islands of epithelium in intimate association with nerve fibres and is described as located lingual to the angle of the mandible. While the structure’s physiological function remains obscure, its clinical importance arises from the risk of misinterpretation as carcinoma showing perineural invasion. The literature relating to neuroepithelial structures within the oral soft tissue is reviewed, and an audit of cases diagnosed at a single institute is presented

Literature Review

Results

Discussion