Anterior Margin Of Sternocleidomastoid Muscle Research Articles

Application of multi-slice spiral CT in the diagnosis of children's parotid cleft deformity

Objective:The aim of this study is to evaluate the value of multi-slice spiral CT （CT） and multi-planar reconstruction （MPR） in the diagnosis of children with parotid cleft deformity. Method:The CT images of 55 cases of branchial cleft deformity confirmed by surgery and pathology were retrospectively analyzed. Result:CT examination showed that 37 cases had strip-like, tubular fistula or cystic mass located in the anterior cervical triangle, anterior margin of sternocleidomastoid muscle, and 2 of them had bilateral fistula structure. In 16 casescystic mass and tubular fistula were found in the parotid gland or at the edge of the parotid gland. One case was accompanied by atresia of the lateral auditory meatus. After contrast enhancement, the cystic wall（tube wall） of 55 patients were enhanced. In 9 patients with infection, the boundary of the lesion was blurred, and the density of the cyst or lumen increased after contrast enhancement. MSCT diagnosed 6 cases of parotid cleft cyst with fistula, 35 cases of branchial cleft cyst, 13 cases of parotid fistula, and 1 case misdiagnosed as lymphadenitis. Among all the cases, 15 were type Ⅰ, 36 were type Ⅱand 4 were type Ⅲ. Compared with the results of pathological diagnosis and clinical operation, the accuracy of qualitative diagnosis and localization was 99.9% and 100.0%. Conclusion:Multi-slice spiral CT thin-slice images combined with MPR image post-processing technology can better display the location of branchial cyst and the course of branchial fistula.

LOW-LEVEL LASER THERAPY APPLICATION FOR ANALGESIA OF ODYNOPHAGIA CAUSED BY HEAD AND NECK RADIOTHERAPY

Head and neck radiotherapy causes many side effects, including hypopharyngeal mucositis (HPM), which makes feeding and swallowing difficult. Low-level laser therapy (LLLT) to treat oral mucositis is already consolidated in the literature. However, there are no reports of laser application in hypopharyngeal region. This study aimed to identify the best anatomic area of cervical region of corpses to propose an extraoral LLLT protocol for treating HPM, as well as to evaluate odynophagia in patients treated at a universitary hospital in southern Brazil. An anatomic study in corpses was performed selecting the best extraoral site to apply LLLT for treating HPM. Furthermore, statements about extraoral LLLT were reported by patients complaining of odynophagia. The carotid trigone showed to be the best site to perform LLLT. Laser protocol to treat HPM consisted in: infrared, 4 J, 100 mW, and 4 points along the anterior margin of sternocleidomastoid muscle. All patients related comfort and odynophagia relief after LLLT. This proposed extraoral LLLT protocol presented promising results.

A Second Branchial Cleft Cyst Presenting as a Dumbbell -Shaped Anterior Neck Mass

A Second Branchial Cleft Cyst Presenting as a Dumbbell -Shaped Anterior Neck Mass

A CASE OF LATERAL CERVICAL CYST

In a 23-year-old man, a sharply demarcated tumor with the size of an egg was palpated at the anterior margin of right sternocleidomastoid muscle. Cervical CT revealed a low density tumor with a relatively uniform internal structure. Extirpated specimen showed a smooth surface tumor with the size of 6×4×4cm filled with other pate-like content. Histopathologically the wall of the cyst was covered with stratified squamous epithelium and beneath the epithelium lymphatic tissues associated with embryonic center developed. This disease is diagnostically characterized by having a tumor located at the anterior cervical triangle particularly at the anterior margin of sternocleidomastoid muscle; having a dense mucus or pate-like content; and the existence of cholesterol crystal and lymphatic tissues in the cyst wall histopathologically. In this case cholesterol crystal was not tested, however, the other findings indicated a lateral cervical cyst. It is important for operation to confirm whether a patient has a fistula and/or fistulation.

TWO CASES OF VAGUS NEURINOMA OF THE NECK

We describe two cases of vagus neurinoma of the neck, together with a discussion of therapeutic problems arising from a review of 56 cases reported in Japan. Case 1 was a 27-year-old male who complained of a tumor on the left side of the neck. Palpation revealed a 5×3 cm, smooth surface, elastic-hard, and unmovable tumor at the anterior margin of sternocleidomastoid muscle of the neck. Under general anesthesia enucleation was carried out. During the operation, both upper and lower poles of the tumor were found to present with chordal structures and to be connected to the vagus nerve, and aftet by dividing the vagus nerve, the tumor was extripated. Histologically it was a neurinoma having Antoni type A and B. Immediately after surgery the patient became irreversively hoarse due to recurrent nerve paralysis. Case 2 was a 31-year-old male complaining of a right cervical tumor. Perioperatively, it was definitely diagnosed as vagus neurinoma. The tumor was very small and was presumed to have little possibility of malignancy. Accordingly only partial biopsy was carried out to avoid postopeative complications. In the treatment of vagus neurinoma of the neck, total or subcapsular extirpation should be applied as a rule. However, it may be appropriate for a case without malignancy to avoid extirpation and observe the course.