Cervicofacial Region Research Articles

Abdominal actinomycosis presenting as simple acute appendicitis

Actinomycosis is an uncommon chronic infection. It usually occurs in the cervicofacial, thoracic and abdominopelvic region. In abdominopelvic actinomycosis the ileum, ceacum and appendix is involved usually as a mass. In our case, there was no mass clinically or radiologically. He had tenderness right lower quadrant of abdomen, clinical diagnosis of acute appendicitis was made and appendicectomy done. Histopathological report showed bacterial colony or sulphur granules surrounded by acute and chronic inflammatory cells.

The comparison of efficacy of different imaging techniques (conventional radiography, ultrasonography, magnetic resonance) in assessment of wrist joints and metacarpophalangeal joints in patients with psoriatic arthritis

SummaryBackground:Vascular anomalies are usually diagnosed through their clinical picture and history. The purpose of this study was to assess the role of MR imaging in initial assessment of cervicofacial vascular anomalies in children.Material/Methods:Twenty pediatric patients with vascular anomalies located in the cervicofacial region underwent MRI examination in our department. Images were evaluated for lesion detectability and its signal characteristics (on T1w, T2w images with fat suppression and contrast enhanced T1w sequences); the extent of the lesions and surrounding tissue involvement were also assessed.Results:In the studied group MR images revealed all anomalies and provided information of their anatomic extent and invasion of surrounding anatomic structures. Nine hemangiomas and six venous malformations were found among studied patients. Two children had multiloculated lesions corresponding to lymphatic malformations. One examination visualized a lesion consisting mainly of dilated vascular channels with an apparent feeding artery, which was consistent with arteriovenous malformation. Two remaining lesions were mixed malformations. Nine patients had lesions limited to subcutaneous tissue. Two masses infiltrated bone structures. There was muscle involvement found in nine cases.Conclusions:MR imaging is a well-established method for detection and monitoring of vascular anomalies in children. With ultrasound used mostly for initial diagnosis and additional flow assessment, angiography viewed as an invasive therapeutic method and computed tomography used only in specific situations due to its high irradiation dose, magnetic resonance is the best imaging method used in differential diagnosis and topographical characterization of vascular malformations and tumors of cervicofacial area in pediatric patients. Noninvasively and without irradiation, it enables evaluation of the extent and characteristics of lesions and planning proper therapeutic strategy.

Lymphatic Malformations in Children and Adolescents

This article aimed to present a series of surgically treated lymphatic malformations of the cervicofacial region in a population of children and adolescents during a 13-year period. The medical records of all children and adolescents with cervicofacial lymphatic malformations, treated surgically at our department from 1998 to 2011, were reviewed retrospectively. Eighteen patients with 20 lymphatic malformations located within the soft tissues of the cervicofacial region were identified. All patients were submitted to surgical treatment (excision or resection with conventional scalpel or radiosurgery) to address complications (ulceration, bleeding, impaired mastication and feeding, airway obstruction) and/or aesthetic issues. Recurrence was noted in 2 of our patients. Accurate diagnosis based on history, clinical examination, and adequate imaging techniques is the key to the optimal treatment of cervicofacial lymphatic malformations; surgical intervention remains the treatment of choice for these lesions.

Necrotizing fasciitis of the cervico-facial region due to odontogenic infection

Necrotizing fasciitis (NF) of cervical region is an uncommon sequelae of odontogenic infection. It has been described in the past with different names such as hospital gangrene, necrotizing erysipelas, haemolytic streptococcal gangrene, suppurative fasciitis, bacterial synergistic gangrene and acute dermal gangrene [1,2].It is a highly aggressive infectious process characterized by spread along the fascial planes. It can rapidly involve overlying skin, subcutaneous tissues, muscle, and other adjacent soft tissue structures. The most frequently involved areas are the thorax, limbs, perineum, abdomen, and groin [3,4]. Occurrence in the head and neck region is relatively rare.The most common causes of cervical necrotizing fasciitis are odontogenic infection, blunt trauma, radiotherapy, and necrotizing fasciitis of unknown origin. It is a debilitating condition, with a high mortality rate and poor prognosis is aggravated with development of mediastinitis and septic shock.The predisposing factors include diabetes mellitus, steroid administration, arteriosclerosis, chronic renal failure, hypothyroidism, obesity, alcoholism, cancer, cirrhosis, drug abuse, and a poor nutritional state, as it involves suppression of host defence mechanism. We present two cases of NF, originating from odontogenic infection, successfully managed in our department.

Laryngeal Hibernoma

Objective: Recognize hibernoma as an uncommon, benign tumor composed of brown adipose tissue that can occur in the head and neck. Learn the unique radiographic features of this rare tumor, and understand the principles of treatment. Method: A systematic review of the English literature was conducted. In addition, we present a series of 2 laryngeal hibernomas treated with transoral laser microsurgical resection at a tertiary referral center over a period of 18 years. Results: Nineteen cases of hibernoma in the cervicofacial region have been described in the literature. This includes only 2 cases of laryngeal hibernoma ever reported. We present a series of 2 laryngeal hibernomas encountered at our institution. In each case, preoperative imaging demonstrated a well-circumscribed neoplasm with fat density compatible with lipoma, but internal heterogeneity and vascularity seen in the context of liposarcoma. Transoral laser microsurgical resection was successfully completed in each case. Grossly, the tumors had the fatty appearance of a lipoma, however final pathology revealed myxoid hibernoma. Both patients healed well with normal speech and swallowing postoperatively. Conclusion: Hibernoma is a tumor composed of brown adipose tissue. There have been only 2 cases of para-glottic hibernoma reported to date. We report 2 additional cases of laryngeal hibernoma. In our experience, complete resection via transoral laser microsurgery is a safe and effective treatment modality with very little associated morbidity.

Resultados da ressecção de hemangiomas infantis nasais em fase proliferativa: abordagem segura para os tumores centrais da face

INTRODUÇÃO: O hemangioma infantil é o tumor benigno mais comum da infância, predominando na região cervicofacial. É caracterizado por apresentar 3 fases distintas, observando-se frequentemente regressão espontânea dessas lesões. No entanto, sequelas residuais ou deformidades das estruturas anatômicas em crescimento podem ocorrer. A abordagem cirúrgica precoce e definitiva é indicada, em decorrência da localização dos hemangiomas nasais e seu potencial desfigurante, visando à obtenção de bons resultados estéticos e preservação anatômica. O objetivo do presente estudo foi analisar os resultados da abordagem cirúrgica definitiva para hemangiomas proliferativos nasais, com base em uma avaliação objetiva. MÉTODO: No período de 1997 a 2009, 20 pacientes portadores de hemangiomas nasais em fase proliferativa foram submetidos a tratamento cirúrgico. As lesões foram avaliadas segundo local de acometimento e tratamento realizado. Foram analisados índices de complicações e necessidade de procedimentos adicionais. Os resultados estéticos foram avaliados por avaliadores independentes. RESULTADOS: As lesões estavam localizadas na ponta nasal em 50% dos pacientes; no dorso, em 20%; em todas as subunidades, em 15%; nas áreas paranasais, em 10%; e na unidade alar, em 5%. A ressecção foi total em 60% dos pacientes e subtotal em 40%. O período médio de acompanhamento foi de 42,6 meses. A média de procedimentos cirúrgicos por paciente foi de 1,3 + 0,7. Nenhuma complicação importante foi observada. Os resultados foram positivamente avaliados quanto a redução do volume da lesão e melhora do contorno facial, corroborando a conduta proposta. CONCLUSÕES: No manejo dos hemangiomas nasais, o tratamento cirúrgico definitivo pode ser considerado uma alternativa segura e eficaz, com baixas taxas de complicação.

Cutaneous Sinuses of Cervicofacial Region: A Clinical Study of 200 Cases

To evaluate the sinuses in the cervicofacial region and to identify the focus of infection. It is also to help the clinician in differentiating the sinuses' of odontogenic and nonodontogenic focus of infection. The study has been conducted in 200 patients, aged between 11 and 77years for a period of 6 and a half years at Narayana Dental College and Hospital, Nellore. History of present illness, clinical, radiological and laboratory examinations were carried out on all the patients. Majority of the cervical sinuses are of odontogenic origin (80%) and non-odontogenic being (20%) of the cases. The literature reveals that many cases have been misdiagnosed and inappropriately treated by many specialties of Medicine and Surgery wherein the odontogenic foci of infection is the main etiological factor for cervicofacial sinuses. A proper diagnosis is important and forms a key to the successful management of these sinuses in the head and neck region.

Prise en charge diagnostique et thérapeutique du carcinome cutané basocellulaire – Analyse des recommandations

Basal cell carcinoma (BCC) is the most frequent skin cancer in France. BCC has above all a local evolution with an important locoregional morbidity. BCC are found in 80% in the cervicofacial region. Surgery is currently recognized to be the most reliable treatment. The surgeon needs to achieve an in sano excision and must recover the defect with the less aesthetic consequences. The aim of this work is to combine and to get-at-able the recommandations of the "Haute Autorité de santé" of 2004, and also to supply some details for the clinical practice of the plastic surgeon.

Angioma facial congénito no involutivo

The hemangioma is a benign vascular neoplasm frequently seen in early childhood, usually in females. Its location is common in the cervicofacial region in 60% of cases. This tumour represents a challenge for the health professional, as the major complications in these patients are bleeding disorders or obstructive airways. The clinical case presented is a 30 year old male patient with a diagnosis of a giant haemangioma arising from the orbicular muscle of the lip, treated with partial surgery and interferon, with no response or no real contribution. The volume of the haemangioma is currently increasing, causing a deformity on the left side of the face that exceeds the mandibular midline with subsequent oral alterations conditioned and aggravated by the disease itself, which is affecting his systemic health.

Subcutaneous emphysema and pneumomediastinum complicating a dental procedure

Cervicofacial emphysema and pneumomediastinum are rarely observed complications of dental interventions. The complications are associated with the use of a high-speed air-turbine dental drill. It is a potentially life-threatening condition, but the majority of cases are self-limiting and benign. We describe a patient with remarkable subcutaneous emphysema, pneumomediastinum, and partial pneumothorax after right second mandibular molar extraction. Dentists and physicians more often attribute the rapid onset of dyspnea in patients after a dental procedure to an allergic reaction to the anesthesia used during the procedure. Dentists and physicians should be aware that soft tissue emphysema can cause acute swelling of the cervicofacial region after dental procedures, which may mimic an allergic reaction.

Merkel Cell Carcinoma: A Presentation of 5 Cases and a Review of the Literature

Merkel cell carcinoma is an unusual, aggressive skin tumour, with a tendency to recur after its surgical extirpation. Five cases of tumours in the cervicofacial region seen at our Centre in the last 5 years are presented, along with a review of the literature, focusing on its etiopathogeneis, approach and treatment.

Carcinoma de células de Merkel: presentación de 5 casos y revisión de la literatura

Merkel cell carcinoma is an unusual, aggressive skin tumour, with a tendency to recurrence after its surgical extirpation. Five cases of tumours in the cervicofacial region seen at our Centre in the last five years are presented, along with a review of the literature, focusing on its etiopathogeneis, approach and treatment.

Primary Hydatid Cyst: An Unusual Cause of a Mass

Hydatid disease, also known as echinococcosis or hydatidosis, is an infectious disease caused by the cestode Echinococcus. Echinococcus granulosus is the most common Echinococcus species affecting human beings . It may affect any organ and tissue in the body, in particular the liver and lung . Musculoskeletal or soft tissue hydatidosis accounts for about 0.5% – 5% of all echinococcal infections in endemic areas, and is almost always secondary to the hepatic or pulmonary disease. Even in regions where echinococcosis is endemic, hydatidosis of cervicofacial region is extremely rare. Herein, we present exceptionally rare case with an unusual localization of primary hydatid cyst in the left supraclavicular region of the neck. doi:10.4021/jocmr495w

Cystic hygroma of unusual sites: Report of two cases

Cystic hygroma is the cystic variety of lymphangiomas. Its common site is cervico-facial region, followed by axilla, superior mediastinum, mesentery and retroperitoneal region. Its occurrence in upper extremity is rarely reported, whereas its location at sternum has not been reported before. We report two cases of cystic hygroma occurring at unusual sites.

Diagnosis and Treatment of Multiple Primary Cancers of the Cervicofacial and Esophageal Regions

Diagnosis and Treatment of Multiple Primary Cancers of the Cervicofacial and Esophageal Regions

Primary Hydatid Cyst: An Unusual Cause of a Mass

Hydatid disease, also known as echinococcosis or hydatidosis, is an infectious disease caused by the cestode Echinococcus. Echinococcus granulosus is the most common Echinococcus species affecting human beings. It may affect any organ and tissue in the body, in particular the liver and lung. Musculoskeletal or soft tissue hydatidosis accounts for about 0.5% 5% of all echinococcal infections in endemic areas, and is almost always secondary to the hepatic or pulmonary disease. Even in regions where echinococcosis is endemic, hydatidosis of cervicofacial region is extremely rare. Herein, we present exceptionally rare case with an unusual localization of primary hydatid cyst in the left supraclavicular region of the neck.KeywordsHydatid cyst; Supraclavicular region; Neck; Unusual localization

Necrotising fasciitis of the cervicofacial region: a bizarre presentation

The following paper presents the case of a middle-aged woman, who presented with a necrotising soft tissue infection of the cervicofacial region with maggots in situ. She was managed with aggressive surgical debridement, but eventually succumbed to the disease because of erosion of the great vessels of the neck by the maggots. The purpose of this case report is to emphasise the severity of this disease and also to present an unusual case, which had a fatal outcome.

Hin mörgu andlit geislagerlabólgu: Faraldsfræðileg rannsókn á Íslandi 1984-2007

Actinomycosis is a rare infection caused by Actinomyces spp. which are part of the oral, intestinal and vaginal bacterial flora. It can invade tissue through mucosal disruption and form abscesses which tend to be difficult to treat and diagnose. This population-based study explores the epidemiology and manifestations of actinomycosis in Iceland. All diagnosed cases of actinomycosis in Iceland 1984-2007 were identified by a computerised search using ICD and SNOMED codes. Clinical information was collected by chart review. The subjects were included in the study if they fulfilled two out of five diagnostic criteria. 41 women and 25 men (mean age 45 years) met the diagnostic criteria. The incidence rate during the first half of the period was 0.86/year/100.000 and 1.17 during the second half.The cervicofacial region (42%) was most commonly affected, then the pelvis (32%), lacrimal duct (14%), abdomen (11%) and thorax (2%). Diagnostic delay was common. The longest delay from first symptoms to diagnosis was 8-9 years (median 5 months) and it was significantly shorter among patients with abdominal or pelvic infections compared to infections of the lacrimal duct (p=0.012). No significant difference was noted in diagnostic delay between other groups and no patients died from the infection. This is the first population-based study of actinomycosis. The incidence rate increases with age and the time passing from first symptoms to diagnosis tends to be long.

A Case of Hemangiopericytoma Occurring in the Infratemporal Fossa

Hemangiopericytoma is an uncommon vascular tumor in the head and neck region that origin- ates from Zimmerman's pericytes, the small, spindle-shaped pericapillary cells. Clinical diagno- sis of such a lesion is an extremely challenging task because there are very few detailed reports of such lesions and one would hardly think of a diagnosis such as hemangiopericytoma while examining a lesion. Only 15% of hemangiopericytomas are localized in the cervicofacial region, with occurrence in the infratemporal fossa is particularly exceptional. In this article, we report an unusual case of hemangiopericytoma originating from the right infratemporal area and ex- tending into the pterygomaxillary fissure, the buccal fat pad, and the hard palate. We present a case of infratemporal fossa hemangiopericytoma that was treated by resection of the transantral approach. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:511-4 Key WordsZZHemangiopericytoma·Infratemporal fossa.

Cystic hygroma: An overview

Cystic hygromas are the cystic variety of lymphangioma, common locations being cervico-facial regions and axilla. Respiratory distress, recurrent infections or cosmetic reasons are the main indications of the treatment. The ideal treatment is complete surgical excision; however, there is a gradual conversion towards sclerosant therapy. This article reviews the current literature and discusses the various problems encountered during the management of these lesions.