Anterior Oral Cavity Research Articles

High-speed, long-range and wide-field OCT for in vivo 3D imaging of the oral cavity achieved by a 600 kHz swept source laser.

We report a high-speed, long-range, and wide-field swept-source optical coherence tomography (SS-OCT) system aimed for imaging microstructures and microcirculations in the oral cavity. This system operates at a scan speed of 600 kHz, delivering a wide imaging field of view at 42 × 42 mm2 and a ranging distance of 36 mm. To simultaneously meet the requirements of high speed and long range, it is necessary for the k-clock trigger signal to be generated at its maximum speed, which may induce non-linear phase response in electronic devices due to the excessive k-clock frequency bandwidth, leading to phase errors. To address this challenge, we introduced a concept of electrical dispersion and a global k-clock compensation approach to improve overall performance of the imaging system. Additionally, image distortion in the wide-field imaging mode is also corrected using a method based on distortion vector maps. With this system, we demonstrate comprehensive structural and blood flow imaging of the anterior oral cavity in healthy individuals. The high-speed, long-range, and wide-field SS-OCT system opens new opportunities for comprehensive oral cavity examinations and holds promise as a reliable tool for assessing oral health conditions.

Diagnostic accuracy of combined optical- and radio-guided SNB for neck staging of oral squamous cell carcinoma lesions in the anterior oral cavity

PurposeThe purpose was to investigate the diagnostic performance of bimodal optical and radio-guided sentinel node biopsy (SNB) for oral squamous cell carcinoma (OSCC) sub-sites in the anterior oral cavity.MethodsProspective study of 50 consecutive patients with cN0 OSCC scheduled for SNB was injected with the tracer complex Tc99m:ICG:Nacocoll. A near-infrared camera was applied for optical SN detection. Endpoints were modality for intraoperative SN detection and false omission rate at follow-up.ResultsIn all patients, a SN could be detected. In 12/50 (24%) of cases, the SPECT/CT showed no focus in level 1, but intraoperatively a SN in level 1 was optically detected. In 22/50 cases (44%), an additional SN was identified only due to the optical imaging. At follow-up, the false omission rate was 0%.ConclusionOptical imaging appears to be an effective tool to allow real-time SN identification comprising level 1 unaffected by possible interference of radiation site from the injection.

Oral Cavity Movements of the Tongue During Large Interval Slurs in High-Level Horn Players: A Descriptive Study.

Recent publications describing lingual movement strategies within the oral cavity of brass players have established the existence of efficient and predictable movement patterns in healthy performers for a variety of performance tasks. In this study we extend the research to include the playing of large interval slurs in horn players. Real-time MRI films at 40-msec resolution were simultaneously obtained in the sagittal and coronal planes in 9 professional horn players as they performed 2 repetitions each of 3 slur sequences spanning 1 octave, 1 octave + 3rd, and 1 octave + 5th at a mezzo forte dynamic level. Nine profile lines were overlaid on the images allowing the measurement of dorsal tongue edge movement using a customized MATLAB toolkit. Movement along lines representing the anterior, middle, and posterior oral cavity in the sagittal plane, as well as the vertical height of an air channel observed in the coronal plane, are reported. Both sagittal and coronal views demonstrate patterned tongue movements that narrow and widen the air channel during ascending and descending slurs, respectively. The magnitude of these movements is greater during larger intervals, though not perfectly consistent within each slur sequence. Additionally, the tongue position during notes tends to drift in the direction of the subsequent note in each sequence. We suggest that the observed movements may help to modulate air speed through the lips, possible attenuating embouchure muscle tension changes by assisting changes in lip vibration frequency.

Measurement of Pharyngeal Air Pressure During Phonation Using High-Resolution Manometry.

Purpose The study of air pressure in the vocal tract is essential to understanding vocal function. Changes in vocal tract shape during different phonatory gestures are hypothesized to produce nonuniform air pressure across lower vocal tract locations. Current methods of air pressure measurement, however, are limited to a single location in the anterior oral cavity. The purposes of this study were (a) to assess the feasibility of a novel method of simultaneously measuring phonatory air pressure at multiple locations across the lower vocal tract using high-resolution pharyngeal manometry (HRM) and (b) to compare pressure across locations and among phonatory tasks. Method Two subjects underwent HRM while performing phonatory tasks. A catheter was passed transnasally and air pressure was measured simultaneously at five locations between the velopharyngeal port and the upper esophageal sphincter. Descriptive statistics were calculated for each location by task, and for each task averaged across locations. Results HRM was well tolerated, and air pressures from multiple locations in the lower vocal tract were able to be obtained simultaneously. During vocal tract semi-occlusion tasks, air pressures differed by location. Pressures averaged across locations demonstrated a pattern of increasing pressure with increasing semi-occlusion. Conclusions HRM is feasible for measuring air pressure simultaneously at multiple locations in the lower vocal tract during phonation with high spatial and temporal resolution, providing rich data to augment understanding of vocal function. The high spatial and temporal resolution yielded by this new method, paired with preliminary evidence that pressures change by location as a function of phonatory task, may be useful in future assays exploring differences in lower vocal tract air pressures between normal and disordered populations.

Noninvasive Measurement of Tongue Pressure and Its Correlation with Swallowing and Respiration.

Tongue pressure plays a critical role in the oral and pharyngeal stages of swallowing, contributing considerably to bolus formation and manipulation as well as to safe transporting of food from the mouth to the stomach. Smooth swallowing relies not only on effective coordination of respiration and pharynx motions but also on sufficient tongue pressure. Conventional methods of measuring tongue pressure involve attaching a pressure sheet to the hard palate to monitor the force exerted by the tongue tip against the hard palate. In this study, an air bulb was inserted in the anterior oral cavity to monitor the pressure exerted by the extrinsic and intrinsic muscles of the tongue. The air bulb was integrated into a noninvasive, multisensor approach to evaluate the correlation of the tongue pressure with other swallowing responses, such as respiratory nasal flow, submental muscle movement, and thyroid cartilage excursion. An autodetection program was implemented for the automatic identification of swallowing patterns and parameters from each sensor. The experimental results indicated that the proposed method is sensitive in measuring the tongue pressure, and the tongue pressure was found to have a strong positive correlation with the submental muscle movement during swallowing.

Clinical features of gingivostomatitis due to primary infection of herpes simplex virus in children

BackgroundPrimary herpetic gingivostomatitis (PHGS) in children, though usually self-limited, might mimic bacterial and enteroviral pharyngitis clinically. We conducted a study to define the clinical features of PHGS in children.MethodsBetween January 2012 and December 2016, 282 inpatients aged less than 19 years with cell culture-confirmed herpes simplex virus (HSV) infection in a medical center were identified from the virologic laboratory logbook. Clinical data were retrospectively collected.ResultsAmong the 282 inpatients, 185 cases were considered as PHGS and were included for analysis. Fever was present in 99.5%. The mean duration of fever was 5.11 days (±2.24) with the longest being 17 days. Common oral manifestations included oral ulcers (84.3%), which equally resided in the anterior and posterior part of the oral cavity (65.4% vs. 63.2%), gum swelling and/or bleeding (67.6%), and exudate coated tonsils (16.8%). Leukocytosis (WBC count > 15,000/uL3) was noted in 52 patients (28.1%) and a serum C-reactive protein level > 40 mg/L in 55 patients (29.7%). Fixty-five patients (35%) were diagnosed with PHGS on admission and were significantly more likely to have ulcers over the anterior oral cavity (76.1% vs. 26.7%) and gum swelling/bleeding (76.2% vs. 7.5%, p-value all < 0.001) on admission and were significantly less likely to receive antibiotic treatment (16.9 vs. 36.7%, p-value < 0.01) than others. Forty-six patients (25%) undiagnosed as PHGS on discharge were significantly more likely to have exudate coated on the tonsils, to receive antibiotic treatment and significantly less likely to have gum swelling/bleeding and oral ulcers (all p-values < 0.01).ConclusionsMeticulously identifying specific oral manifestations of gum swelling/bleeding and ulcers over the anterior oral cavity in children can help making the diagnosis of PHGS earlier and subsequently reduce unnecessary prescription of antibiotics.

Transoral robotic surgery for hilo-parenchymal submandibular stones: step-by-step description and reasoned approach

The conservative transoral approach to hilo-parenchymal submandibular stones has been proposed as an alternative to traditional sialadenectomy. The main purpose is to preserve the gland and eliminate the risk of a cervical scar and damage to the marginal mandibular branch of the facial nerve. The spread of transoral robotic surgery has favoured its application not only in the oropharynx, but also in the anterior oral cavity. This article describes a transoral robotic approach for hilo-parenchymal submandibular stones. In January 2019, two patients with a right and a left hilo-parenchymal submandibular stone of 15mm and 8mm, respectively, underwent removal of the stone with transoral robotic surgery using the Si Da Vinci surgical robot. The procedure was performed successfully and tolerated well, with a one-night hospitalization. There were no complications such as lingual nerve damage, painful gland swelling, infection, or ranula. The patients were followed up clinically and ultrasonographically for the first 3 months to verify symptom relief and persistence of stones; no symptoms or stones were found. The transoral robotic surgical approach seems to be safe and adequate for the conservative management of large hilo-parenchymal submandibular stones. An adequate diagnosis together with proper docking and an appropriate approach to the oral floor is mandatory.

Tongue Position Variability During Sustained Notes in Healthy vs Dystonic Horn Players Using Real-Time MRI.

Embouchure dystonia (EmD) is a variant of focal task-specific dystonia in musicians characterized by the loss of control in facial and oral muscles while controlling airflow into the mouthpiece of a wind or brass instrument. We compared tongue position variability (TPV) during sustained notes between healthy, elite horn players and horn players affected by EmD. Real-time MRI films at 33.3 ms resolution were obtained from 8 healthy elite and 5 EmD horn players as they performed on a non-ferromagnetic horn at each of three different dynamic levels: pianissimo, mezzo forte, and fortissimo. Nine profile lines (3 from anterior, 3 from middle, and 3 from posterior oral cavity regions) were overlaid on each image using a customized MATLAB toolkit, and the variability of the dorsal tongue edge position was examined at each dynamic from temporal intensity profiles produced by MATLAB. Despite trends for more pronounced TPV (larger standard deviations) in the elite musicians (p=0.062), 2-way repeated measures ANOVA revealed no significant differences between groups. However, dynamic level significantly influenced TPV for all subjects, combined (p=0.048) and different regions of the oral cavity showed differing TPV (p<0.001). When only the most active region (anterior oral cavity) was included in the model, differences between groups reached statistical significance (elite > EmD, p<0.048), particularly at the fortissimo dynamic. We postulate that these differences may be due, in part, to a greater degree of generalized orofacial muscle tension in the EmD subjects that includes the tongue.

Prospective Evaluation of Surgical Outcome After Transoral CO2 Laser Resection of Potentially Malignant and Early Oral Malignancy.

A prospective observational study was done at the Regional Cancer Centre, Thiruvananthapuram, a tertiary referral center for cancer care in India with an aim to assess the surgical outcomes of CO2 laser resection of oral lesions in terms of operative time, blood loss, hospital stay, postoperative pain, time to re-epithelization, pathological margins achieved and the postoperative scar. The excision was performed in 30 patients with a diagnosis of either potentially malignant lesions (leucoplakia, erythroplakia) or early cancers, i.e., carcinoma in situ or T1/T2 squamous cell carcinoma of the anterior oral cavity (tongue, buccal mucosa), adhering to standard oncological principles, and the resultant defect was left for secondary healing.

In vivo imaging of human oral hard and soft tissues by polarization-sensitive optical coherence tomography.

Since optical coherence tomography (OCT) provides three-dimensional high-resolution images of biological tissue, the benefit of polarization contrast in the field of dentistry is highlighted in this study. Polarization-sensitive OCT (PS OCT) with phase-sensitive recording is used for imaging dental and mucosal tissues in the human oral cavity in vivo. An enhanced polarization contrast of oral structures is reached by analyzing the signals of the co- and crosspolarized channels of the swept source PS OCT system quantitatively with respect to reflectivity, retardation, optic axis orientation, and depolarization. The calculation of these polarization parameters enables a high tissue-specific contrast imaging for the detailed physical interpretation of human oral hard and soft tissues. For the proof-of-principle, imaging of composite restorations and mineralization defects at premolars as well as gingival, lingual, and labial oral mucosa was performed in vivo within the anterior oral cavity. The achieved contrast-enhanced results of the investigated human oral tissues by means of polarization-sensitive imaging are evaluated by the comparison with conventional intensity-based OCT.

Place de la protonthérapie en cancérologie ORL

The absence of exit dose and the sharp lateral penumbra are key assets for proton therapy, which are responsible for its dosimetric superiority over advanced photon radiotherapy. Dosimetric comparisons have consistently shown a reduction of the integral dose and the dose to organs at risk favouring intensity-modulated proton therapy (IMPT) over intensity-modulated radiotherapy (IMRT). The structures that benefit the most of these dosimetric improvements in head and neck cancers are the anterior oral cavity, the posterior fossa, the visual apparatus and swallowing structures. A number of publications have concluded that these dosimetric differences actually translate into reduced toxicities with IMPT, for example with regards to reduced weight loss or need for feeding tube. Patient survival is usually similar to IMRT series, except in base of skull or sinonasal malignancies, where a survival advantage of IMPT could exist. The goals of the present review is to describe the major characteristics of proton therapy, to analyse the clinical data with regards to head and neck cancer patients, and to highlight the issue of patient selection and physical and biological uncertainties.

Deformable image registration and interobserver variation in contour propagation for radiation therapy planning.

Deformable image registration (DIR) and interobserver variation inevitably introduce uncertainty into the treatment planning process. The purpose of the current work was to measure deformable image registration (DIR) errors and interobserver variability for regions of interest (ROIs) in the head and neck and pelvic regions. Measured uncertainties were combined to examine planning margin adequacy for contours propagated for adaptive therapy and to assess the trade‐off of DIR and interobserver uncertainty in atlas‐based automatic segmentation. Two experienced dosimetrists retrospectively contoured brainstem, spinal cord, anterior oral cavity, larynx, right and left parotids, optic nerves, and eyes on the planning CT (CT1) and attenuation‐correction CT of diagnostic PET/CT (CT2) for 30 patients who received radiation therapy for head and neck cancer. Two senior radiation oncology residents retrospectively contoured prostate, bladder, and rectum on the postseed‐implant CT (CT1) and planning CT (CT2) for 20 patients who received radiation therapy for prostate cancer. Interobserver variation was measured by calculating mean Hausdorff distances between the two observers' contours. CT2 was deformably registered to CT1 via commercially available multipass B‐spline DIR. CT2 contours were propagated and compared with CT1 contours via mean Hausdorff distances. These values were summed in quadrature with interobserver variation for margin analysis and compared with interobserver variation for statistical significance using two‐tailed t‐tests for independent samples (α=0.05). Combined uncertainty ranged from 1.5‐5.8 mm for head and neck structures and 3.1‐3.7 mm for pelvic structures. Conventional 5 mm margins may not be adequate to cover this additional uncertainty. DIR uncertainty was significantly less than interobserver variation for four head and neck and one pelvic ROI. DIR uncertainty was not significantly different than interobserver variation for four head and neck and one pelvic ROI. DIR uncertainty was significantly greater than interobserver variation for two head and neck and one pelvic ROI. The introduction of DIR errors may offset any reduction in interobserver variation by using atlas‐based automatic segmentation.PACS number(s): 87.57.nj, 87.55.D‐

P2X2 Receptor Terminal Field Demarcates a "Transition Zone" for Gustatory and Mechanosensory Processing in the Mouse Nucleus Tractus Solitarius.

Peripheral gustatory neurons express P2X2 purinergic receptors and terminate in the rostral portion of the nucleus tractus solitarius (rNTS), but a relationship between the P2X2 terminal field and taste evoked activity has not been established. Additionally, a portion of somatosensory neurons from the trigeminal nerve, which are devoid of P2X2 expression, also terminate in the lateral rNTS. We hypothesized that P2X2 receptor expression on afferent nerve endings could be used as an anatomical tool for segregating gustatory from mechanosensory responsive regions in the mouse rNTS. C57BL/6 mice were used to record extracellular activity from neurons within the rNTS and the laterally adjacent reticular formation and trigeminal nucleus. Histological reconstruction of electrolytic lesions indicated that gustatory activity coincided with electrode tracks that traversed through P2X2 terminal fields. Gustatory recordings made more rostral in the rNTS had receptive fields located in the anterior oral cavity (AO), whereas gustatory recordings made more caudal in the rNTS had receptive fields located in the posterior oral cavity (PO). Mechanosensory neurons with AO receptive fields were recorded near the lateral border of the P2X2 terminal field and became numerous on electrode tracks made lateral to the P2X2 terminal field. In contrast, mechanosensory responses with PO receptive fields were recorded within the P2X2 terminal field along with gustatory activity and transitioned to mechanosensory only outside the P2X2 terminal field. Collectively, our results indicate that the lateral border of the P2X2 terminal field, demarcates a faithful "transition zone," where AO responses transition from gustatory to mechanosensory.

Relationships Between Formant Frequencies of Sustained Vowels and Tongue Contours Measured by Ultrasonography.

The purpose of this study was to explore the formant-articulation relationships in corner vowels by acoustic analysis of speech signals and measuring tongue contour using ultrasonography. Eighteen healthy adults (8 men, 10 women), aged between 20 and 40 years, were enrolled. Speech signals of sustained vowels /ɑ/, /i/, and /u/ were recorded to obtain the first 2 formant frequencies. Tongue height, tongue advancement, and lengths of posterior tongue surface (LPTS) and anterior oral cavity (LAOC) were obtained using ultrasound image processing technique in order to examine the resonance mechanism of the oral vocal tract. LPTS and LAOC, as well as mean frequencies of the first and second formants, showed significant differences between sexes and among vowels. The first formant significantly and better correlated with LPTS than with tongue height (r = -.78, p < .001, Pearson's correlation). The correlation of the second formant with LAOC (r = -.85, p < .001) was also significant and better than the correlation with tongue advancement. Sex, however, did not show significant correlation with the formant frequencies. Ultrasonographic measurements of tongue contour correlated well to the formant frequencies. The results stressed the importance of tongue shaping in articulation. Although more studies are necessary in clinical implications, disorders associated with abnormal tongue shaping may be the target applications in the future.

Relationships Among Rheological, Sensory Texture, and Swallowing Pressure Measurements of Hydrocolloid-Thickened Fluids.

The objective of this study was to examine the relationships among three categories of measurements (rheological, sensory texture, and swallowing pressure) from fluids thickened to two different viscosities with 15 different hydrocolloids. Fluids at viscosities of 300 and 1500cP (at 30s(-1)) were targeted because these are the viscosities corresponding to the barium standards used in radiographic dysphagia diagnosis. Within the low viscosity (nectar) fluids (300cP), the sensory properties thickness, stickiness, adhesiveness, mouth coating, and number of swallows were highly positively correlated with each other and highly positively correlated with the flow behavior index, n value (an indicator of shear-thinning behavior). Within the higher viscosity (thin honey) fluids (1500cP), the sensory textures of adhesiveness, stickiness, mouth coating, and number of swallows correlated positively with rheological measures of n value. Swallowing pressures measured in the anterior oral cavity correlated negatively with the consistency coefficient k [shear stress/(shear rate) (n) ]. Samples that were more shear thinning (lower n values, higher k values) were generally perceived as less thick, with less adhesive properties (stickiness, adhesiveness, mouthcoating, and number of swallows). This information can be useful for selecting thickeners for people with dysphagia. A desirable thickener for many dysphagic patients would be one that allowed for a safe swallow by being viscous enough to reduce airway penetration, yet pleasant to drink, having the minimal perceived thickness and mouthcoating associated with greater shear thinning.

Histopathogenesis of non-HPV-related differentiated oral squamous intraepithelial neoplasia.

A study of immunohistopathologic and cytohistopathologic changes of the parabasal/basal layers in the differentiated squamous intraepithelial neoplasia (DSIN) may elucidate the histopathogenesis and reveal changes aiding early diagnosis and grading of the lesion. A total of 55 consecutive resection specimens of nonbasaloid squamous cell carcinoma of the anterior oral cavity and 8 biopsies before resections displaying DSIN in the overlying squamous epithelium were examined. Squamous epithelium that is continuous/immediately adjacent to invasive squamous cell carcinoma (type 1) and the more peripheral (type 2) epithelium of resection specimens displayed consistent changes in the parabasal/basal layers: (A) cytologic atypia with proliferation of parabasal cells with downward expansion causing reactive proliferation of the basal cell layer in the early stage, invading the basal layer in the late stage; (B) disordered nuclear/cytoplasmic arrangement; (C) "Cobblestone" appearance. Immunoreactivity for TP53 and Ki67 was helpful in the diagnosis. The epithelial spectrum of changes decreased as one moved from type 1 to type 2 lesions. Five out of 8 biopsies showed type 1 lesions (followed by resection in a period of 11±6 mo) and 3 showed type 2 lesions (followed by resection in a period of 55±20 mo). In addition, resections were margin positive for type 2 lesions in 5 cases associated with recurrence at the site of resection during a period of 69±9 months. DSIN is characterized by a proliferation of neoplastic parabasal cells with dyskeratosis, downward expansion/pushing of the basal layer with elongation of rete ridges. We proposed grading of DSIN based on the changes of the parabasal/basal layers.

Stage I intraoral food transport: Effects of food consistency and initial bolus size

ObjectiveWe examined the temporospatial characteristics of stage I oral food transport, in which a piece of solid food is moved from the anterior oral cavity to the postcanine region for chewing. Anteroposterior transport is accomplished by carrying food posteriorly on the surface of the tongue, in contrast to the squeeze-back mechanism of stage II transport from the oral cavity to the pharynx. DesignThere were two experiments (Exp1 and Exp2): In Exp1, Twelve healthy young adults ate 2g, 4g, 6g, 8g 12g initial bolus sizes of banana and cookie; in Exp2, fourteen similar subjects ate 6g of banana and cookie with and without radiopaque tongue surface makers. Motions were recorded with videofluorography in lateral projection. ResultsStage I transport duration was longer for cookie than banana (P≤.025), but there were no significant durational differences among initial bolus sizes. With cookie, tongue pullback was more frequent for small (2g and 4g) than large (12g) bolus sizes (P≤.048). With banana, however, the frequency of pullback was independent of initial bolus size. Kinematic analysis of tongue pullback revealed that the lower jaw opened as the tongue and hyoid bone moved both posteriorly and inferiorly; the magnitude of these displacements did not vary significantly between banana and cookie. ConclusionsWe conclude that stage I transport is a complex behaviour involving posterior and inferior displacement of the tongue, jaw and hyoid bone. Its frequency of occurrence is related to initial bolus size and consistency, but the magnitude of displacement is relatively constant.

Squamous Cell Carcinomas of the Anterior Oral Cavity Are Commonly Associated With Simplex (or Differentiated) Oral Intraepithelial Neoplasia

We investigated the occurrence of differentiated oral intraepithelial neoplasia (DOIN) that met the criteria for differentiated intravulvar neoplasia, associated with invasive squamous cell carcinoma (SCC) of the anterior oral cavity, and its clinicopathologic significance. Sixty-nine consecutive cases of SCC of the anterior oral cavity were categorized into 2 groups: group A comprised SCC associated with DOIN; Group B consisted of cases associated with classical SCC in situ. Fifty-five cases (80%) were classified as group A, or DOIN lesions, with only 14 (20%) as group B. All cases were associated with invasive SCC, except 2 cases in group B. Squamous epithelium continuous or adjacent to invasive SCC displayed consistent changes in the parabasal and basal layers with (1) cytologic atypia with proliferation of parabasal cells in downward expansion causing reactive proliferation of the basal cell layer in early stage and invading the basal layer in late stage, (2) disordered nuclear/cytoplasmic arrangement, and (3) a "cobblestone" appearance characterized by prominent intercellular spaces and cytoplasmic density involving the entire cell (dyskeratosis) of the parabasal layer. p53 and Ki67 immunostaining revealed linear reactivity mainly in the parabasal layer. DOIN lesions are frequently associated with invasive SCC of anterior oral cavity. Due to the subtle histopathologic changes, DOIN lesions pose potential diagnostic difficulty with differentiation from mild dysplasia or reactive atypia.

Anatomia da cavidade bucofaringeana de Sorubim trigonocephalus (Siluriformes, Osteichthyes)

Sorubim trigonocephalus Miranda et Ribeiro, 1920 conhecido popularmente como chinelo, é uma espécie migratória, de importância econômica. Bastante apreciado na gastronomia por apresentar sabor agradável e sem ossos intermusculares (espinhos). Os exemplares foram coletados em um trecho no Rio Teles Pires, localizado no município de Alta Floresta/MT. Anestesiados e sacrificados em solução aquosa de benzocaína, fixados com solução de formoldeído a 10%, transferidos para o Laboratório de Anatomia Animal/Unemat para descrição das características da cavidade bucofaringeana. Esta espécie apresentou uma pré-maxila bem desenvolvida e cabeça achatada dorsoventralmente, boca localizada na porção ventral média da cabeça, com fenda bucal ampla. Os lábios superiores apresentaram pigmentação cinza escuro com pequenas áreas claras, sendo mais largos que os inferiores e não apresentaram pigmentação. Foram identificadas quatro regiões dentígeras na porção anterior da cavidade bucal e duas na região da faringe, todas com dentes viliformes. A porção posterior da cavidade bucal era limitada lateralmente por quatro pares de arcos branquiais que decresciam em tamanho do primeiro ao último par, crânio-caudal, formados por dois ramos: o superior, mais curto, e o inferior, mais longo. A cavidade bucofaringeana de S. trigonocephalus se mostrou semelhante à de outros teleósteos descritos na literatura, estando adaptado ao hábito alimentar com dieta carnívoro-ictiofágica e diferindo apenas pela ausência de língua estrutural com pré maxila bem desenvolvida apresentando dentes viliformes.

Human papillomavirus-associated oral intraepithelial neoplasia

This study evaluated an unusual subset of oral epithelial dysplasia for the presence of transcriptionally active high-risk HPV subtypes and to further characterize the histological criteria for this condition. There were 20 cases diagnosed as epithelial dysplasia with marked apoptosis of the anterior oral cavity. Clinical and follow-up data were collected and histopathological features were documented. Immunoperoxidase studies were performed for p16 and in situ hybridization studies were performed for low- and high-risk HPV sub-types. Gender- and site-matched controls of conventional moderate-to-severe oral epithelial dysplasia were similarly evaluated using immunoperoxidase studies for p16 and in situ hybridization; the number of apoptotic cells for study and control cases was counted at two different tissue sites. There were 17 men and 3 women with a median age of 56 years. Seventeen lesions were described as white and five were described as rough or papillary. Thirteen were located on the lateral or ventral tongue, some extending onto the floor of the mouth. Epithelial hyperplasia with marked karyorrhexis and apoptosis were present in all the cases, along with features of conventional oral epithelial dysplasia. A statistically significant number of apoptotic cells were identified in the study cases when compared with controls (P>0.0001). Twenty cases were positive for high-risk HPV by in situ hybridization and all 19 nineteen cases evaluated for p16 demonstrated overexpression. Two patients were diagnosed with squamous cell carcinomas and one patient developed recurrent disease. We report a subset of oral epithelial dysplasia that occurs mostly in adult men on the ventral or lateral tongue and is positive for high-risk HPV and for p16. We propose use of the term ‘HPV-associated Oral Intraepithelial Neoplasia’ to characterize these lesions of the oral cavity for consistency in nomenclature with HPV-associated lesions of the lower anogenital tract. One case recurred and one developed invasive cancer.