Parotid Gland Duct Research Articles

Parotid Ductal Carcinoma with skin metastasis

Introduction: ductal carcinoma of the parotid salivary gland, have an epithelial origin. The behavior of this disease is aggressive, so a correct and early diagnosis is vital. Objective: to present a case with a diagnosis of parotid ductal carcinoma with metastatic skin lesions.Case presentation: 60-year-old male patient with a history of high blood pressure who for approximately 3 months has been experiencing discomfort in the pre-auricular region, lower third of the right side of the face, and exophytic lesions in the skin of that area. An oral examination revealed poor oral hygiene, the presence of root remains, an increase in the volume of the excretory duct of the right parotid gland, and changes in the integrity of the buccal mucosa. Complementary and imaging tests are indicated (imaging, biopsy, computed axial tomography and immunohistochemistry). The diagnosis was confirmed with a T4N2M1 staging and total surgical treatment was determined immediately. Conclusions: patients with ductal carcinoma, despite treatment with parotidectomy, cervical dissection and postoperative radiotherapy, a large proportion of patients develop local and distant recurrence, so a timely diagnosis can guarantee greater survival for the patient.

Unveiling the Mechanisms of Fluid Secretion in Parotid Gland Ducts: CFTR Dependency, Cellular Contributors, and Signaling Pathways

Compelling evidence indicates that salivary gland ducts mediate fluid secretion, yet the specific cell types responsible for this process remain unclear. Our study aimed to elucidate the fundamental mechanisms governing fluid secretion within ducts and to determine their significance within the context of parotid gland function.Consistent with previous research in exocrine gland ducts, fluid secretion in parotid gland ducts is enhanced when both calcium and cAMP signaling pathways are simultaneously stimulated. Furthermore, we found that duct fluid secretion depends on the activities of CFTR, NKCC1, and the cAMP-activated kinase PKA.To further investigate the cellular contributors to duct-mediated fluid secretion, we generated a mouse model lacking ionocytes in salivary gland ducts using a diphtheria toxin-based approach. Our findings showed that ionocytes play a key role in the process of duct fluid secretion, as their absence resulted in impaired fluid secretion.Overall, our results underscore the significance of ionocytes in facilitating duct fluid secretion, highlighting the essential interplay between calcium and cAMP signaling pathways to achieve optimal secretion. Moreover, our research identified specific basolateral and apical ion-transporting proteins involved in the fluid secretion process. The pharmacological activation of ionocytes may offer a viable alternative secretory pathway when the function of secretory acinar cells is compromised, as observed in pathological conditions that lead to xerostomia. Fondecyt 1211838. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The anterior lobe of the parotid gland：A CT sialographic study.

To investigate the imaging and anatomic features of the anterior lobe (AL) of the superficial parotid gland. Computed tomographic sialography examinations were undertaken for 142 parotid glands in 77 patients. Whole computer tomography (CT) data were analyzed using multi-planar reformation and maximum intensity projection to generate sialographic CT images. The tributary ducts of the superficial parotid gland were analyzed to classify the parotid morphology. Three-dimensional analyses were used to investigate the AL and its relationship with adjacent anatomic landmarks. Four major types (I-IV) and two minor types (V-VI) of the AL and the superficial parotid gland were observed. Type I AL (83/142) was contiguous and not separated from the retromandibular parotid gland. Type II AL (16/142) was detached from the retromandibular parotid gland with one to four tributary ducts. Type III AL (12/142) showed a small isolated lobe above the Stensen's duct around the anterior edge of the masseter. Type IV (28/142) showed the absence of the AL. Type V (3/142) shows the absence of the retromandibular parotid gland. Type VI (3/142) showed the presence of ectopic salivary gland beneath the Stensen's duct anterior to the retromandibular parotid gland. The AL gives rise to the morphological variations of the superficial parotid gland. AL also gives rise to the accessory parotid gland when it is detached from the retromandibular parotid gland.

Peroxisomes Are Highly Abundant and Heterogeneous in Human Parotid Glands

The parotid gland is one of the major salivary glands producing a serous secretion, and it plays an essential role in the digestive and immune systems. Knowledge of peroxisomes in the human parotid gland is minimal; furthermore, the peroxisomal compartment and its enzyme composition in the different cell types of the human parotid gland have never been subjected to a detailed investigation. Therefore, we performed a comprehensive analysis of peroxisomes in the human parotid gland's striated duct and acinar cells. We combined biochemical techniques with various light and electron microscopy techniques to determine the localization of parotid secretory proteins and different peroxisomal marker proteins in parotid gland tissue. Moreover, we analyzed the mRNA of numerous gene encoding proteins localized in peroxisomes using real-time quantitative PCR. The results confirm the presence of peroxisomes in all striated duct and acinar cells of the human parotid gland. Immunofluorescence analyses for various peroxisomal proteins showed a higher abundance and more intense staining in striated duct cells compared to acinar cells. Moreover, human parotid glands comprise high quantities of catalase and other antioxidative enzymes in discrete subcellular regions, suggesting their role in protection against oxidative stress. This study provides the first thorough description of parotid peroxisomes in different parotid cell types of healthy human tissue.

What are the complications of oral lipectomies?

Oral Lipectomy is a medical-dental procedure that aims to correct the volume of the adipose body of the cheek that is somehow generating unfavorable clinical implications for the stomatognathic system, being for facial aesthetic reasons, cause of trauma to the judgmental mucosa, occurrence of traumatic herniation. fat content into the oral cavity, or as a result of pathologies such as lipomas. Thus, this surgical procedure can be performed aiming at removing part of the fat content in the region indicated for the surgical procedure. However, in many cases this procedure can be accompanied by intraoperative complications such as hemorrhages or trauma to the parotid gland duct or nervous structures; as well as, postoperative complications such as: edema, trismus, emphysema, seroma, hematoma and infections may occur. Thus, the surgeon must be familiar with the surgical technique used and these procedures must be performed and followed with extreme caution to minimize possible complications and optimize their treatments.

SIALODOCHITIS FIBRINOSA OF KUSSMAUL: A CASE PRESENTATION

<h3>Objective</h3> Sialodochitis fibrinosa of Kussmaul is a rare phenomenon that was first reported in 1879. It is characterized by recurrent major salivary gland swelling in patients with atopic background. Treatment includes antihistamines, systemic glucocorticoids, massage, mucolytic agents, sialendoscopy, and surgery. To date, less than 70 cases have been reported in the literature. <h3>Case Summary</h3> A 42-year-old woman was referred from the emergency room to the Oral Medicine unit at Sheba Medical Center with the chief complaint of severe xerostomia and asphyxia due to submandibular swelling. Her medical history was significant only for asthma. The patient reported facial and submandibular swelling accompanied by severe pain, 3 weeks before her presentation. Two months earlier, she had developed urticaria, which was treated with antihistamines. The patient denied any symptoms associated with xerophthalmia. Complete blood count as well as lipase, IgG4, and angiotensin converting enzyme (ACE) levels were within normal limits. Blood levels of amylase and C-reactive protein were elevated. Virology (hepatitis B virus, cytomegalovirus, hepatitis C virus, human immunodeficiency virus [HIV], measles, mumps) and autoimmune panel were negative. Salivary glands ultrasound failed to demonstrate any pathologic findings. Clinical examination revealed enlarged cervical lymph nodes, bilateral mild swelling posterior to angle of mandible, perioral rash, dry tongue covered with white coating, erythema around the orifices of parotid ducts, and labial minor salivary glands enlargement. There was no secretion upon milking of major salivary glands. After stimulation with citric acid, foamy saliva secretion was noted, and on milking a mucous plug was released followed by clear saliva secretion. Sialography demonstrated dilated parotid gland ducts. No focal lymphocytic infiltration was noticed on minor salivary gland biopsy. Cytology of the mucous plugs demonstrated the presence of eosinophils. In the light of salivary glands swelling, dilated parotid ducts, the presence of eosinophils within the mucous plugs, and atopic background, the diagnosis of sialodochitis fibrinosa of Kussmaul was made. <h3>Conclusions</h3> Sialodochitis fibrinosa should be included in the differential diagnosis of patients presenting with sialadenitis, recurrent swelling of major salivary glands, and atopic background.

CONSERVATIVE MANAGEMENT OF PAROTID SIALOCELE :- A CASE REPORT

The collection of the saliva in the soft tissue plane is termed as sialocele. When this communicates with the skin and drains it is known as parotid fistula. Sialocele occurs due to injury to the parotid gland parenchyma or duct, this result in accumulation of saliva in periglandular and glandular tissues or in subcutaneous cavity. In this article we report a case of Parotid sialocele formation following inadvertant incison given for space infection in parotid region. We followed conservative treatment and got excellent result.

Rekürren aftöz stomatitli hastalarda serum ve tükürükte dermcidin düzeylerinin araştırılması ve tükürük bezinde dermcidin analizi

Objective Recurrent aphthous stomatitis (RAS) is a common self-limiting oral mucosa disease. In this study, it was aimed to determine the dermcidin level in the serum and saliva of patients with RAS, the presence of dermcidin in the salivary gland and its role in the pathogenesis of RAS. Methods Thirty-one patients presenting with RAS and 30 control subjects participated in this study. Dermcidin levels in serum and saliva of patients and control group were studied in accordance with the working procedures specified in the catalogs of the human dermcidin ELISA kit. The presence of dermcidin in salivary glands was assessed by immunohistochemical analysis. Results A statistically significant difference was found when the mean salivary dermcidin levels (105.80 ± 80.14 ng/mL) of the RAS patients were compared with the mean salivary dermcidin levels (456.13 ± 354.59 ng/mL) of the control group (P=0.000). There was no statistically significant difference between the mean serum dermcidin levels (316.41 ± 784.55 ng/mL) of the RAS patient and those of (130.65 ± 179.75 ng/mL) the control group. Dermcidin immunoreactivity was observed in the parotid gland, submandibular gland and interlobular striated ducts. Conclusion The findings in this study showed that striated cells in salivary gland synthesized dermcidin. Low levels of dermcidin with antimicrobial properties in saliva were considered as a predisposing factor for RAS.

The use of Schirmer strips to measure salivary and lacrimal flow in non-Sj\xf6gren patients

IntroductionOral and ocular dryness are the most common symptoms reported during ophthalmological and dental examinations. It is becoming a serious and growing problem due to the huge variety of affecting factors and with population aging.ObjectivesThe purpose was to demonstrate an application of the Schirmer test for xerostomia. Subsequently, to compare and correlate the results achieved from the lacrimal Schirmer test and salivary Schirmer test in non-Sjögren patients.MethodsStudy group consisted of 642 patients with/without subjective or/and objective symptoms of dry eye or mouth who did not fulfill the criteria for diagnosis of Sjögren syndrome. The lacrimal Schirmer test (lST) and the salivary Schirmer tests (sST) were performed (sSTm was put on the floor of the mouth, sSTp in front of the parotid gland duct). The results were recorded after 1 min (sSTm), 3 min (sSTp), and 5 min (lST).ResultsThe lST and sST test scores were considerably higher in the healthy group than in others, p < 0.001. The results of sST1 and sST2 decreased with the appearance of subjective and objective symptoms, p < 0.001. There were positive correlations between lST and sSTm outcomes between the groups, p < 0.001.ConclusionsWe present the Schirmer test adapted to measure salivary gland hypofunction that is a time-saving tool in our daily practice. Results of this study reveal an excellent correlation between the eye Schirmer test and the salivary Schirmer tests.Clinical relevanceThe salivary Schirmer tests seem to be rapid, convenient, and reliable objective screening tools for salivary gland hypofunction in non-Sjögren patients.

An Orthodontic Spring Coil and Soft Tissue Complication

This case report describes a scenario where a 14-year-old patient during orthodontic treatment at Solihull Hospital, West Midlands, presented with a rare soft tissue orthodontic complication. On routine examination, the spring coil from the orthodontic appliance was found to be located in the parotid gland duct. This was extracted by the oral and maxillofacial team at Solihull Hospital. The patient was followed post-operatively for any signs of sialadenitis, sialolithiasis and strictures. After 3 years of follow up, no post-operative complications were noted. CPD/Clinical Relevance: Soft tissue and orthodontic complications are common, usually due to trauma from sharp components. Clinicians should be aware of complications that can also occur.

Comparison of circulating tumor cells and cell-free DNA in the molecular characterization of patients with head and neck cancer.

e18521 Background: The role of liquid biopsy in diagnosis and therapy monitoring in patients with head and neck cancer has been much less studied compared to other cancers. Our aim was to evaluate the perfomance in the isolation and recovery for molecular characterization of circulating tumour cells (CTC) of a new immunoafinity-based method and to compare it with the molecular diagnostic yield of plasma cell-free DNA. Methods: Patients with recurrent/metastatic (RM) head and neck cancer (HNC) were enrolled prospectively. Forty mililiters (ml) of plasma were collected at one or several time-points. First blood draw was always collected before starting a new therapeutic intervention or at the time of radiologic progression. For CTC detection and isolation, either anti-EpCAM or both anti-EpCAM + anti-EGFR antibodies were used. Digital PCR and castPCR were used to study KRAS and PI3KCA mutations in non-squamous HNC. A 15-gene customized NGS panel was used to characterized both CTC and cfDNA in patients with squamous HNC. Results: Between February 2016 and October 2018, 14 patients with R/M HNC were included (n = 1 local-only disease, n = 10 local and distant disease, n = 3 distant-only disease). Squamous histology (S): n = 9. Non-squamous (NS): n = 5 (1 naso-ethmoidal intestinal-type adenocarcinoma, 1 parotid gland exadenoma pleomorfic carcinoma, 2 parotid-gland salivary duct carcinomas (SDC), 1 parotid-gland high-grade neuroendocrine carcinoma). Twenty-five CTC determinations were performed. In 5 patients serial CTC determinations were performed. Median CTC was 4 (min-max: 0-49). Median CTC among 11 CTC determinations in S-HNC was 4 (min-max: 0-49). Median CTC was 3 CTC (min-max: 0-26) among the 14 determinations performed in NS-HNC. Digital PCR unveiled mutations in CTC and in cfDNA in 2 of 4 patients tested with NS histology (KRAS, PIK3CA), with one of them being concordant for the specific mutation. NGS unveiled mutations in CTC in 7/9 patients and in cfDNA in 6/9 patients, with only one loci-concordant case between CTC and plasma. Conclusions: IsoFlux detected CTC in the majority of patients with R/M HNC, regardless of the histologic type, and allowed for molecular characterization of CTC using different techniques for mutational analysis. Both NGS and digital PCR allowed for the detection in cell-free DNA of commonly mutated genes in HNC. Liquid biopsy should be more actively studied in this disease in order to better define its role in diagnosis and therapeutic monitoring.

The value of 3D-iMSDE MR neurography in the determination of the anatomical relationship between intraparotid facial nerve and parotid ducts and parotid tumors

Objective To investigate the spatial relationship between intraparotid facial nerve and parotid ducts in different types of parotid neoplasms with 3D improved motion-sensitized driven-equilibrium pulse (3D-iMSDE) MR neurography, and to guide the operation plan. Methods By means of prospective research methods, the sequences of 3D-iMSDE and 3D-T2-fast field echo (3D-T2-FFE) were obtained in 30 healthy volunteers and 40 patients with parotid gland tumors, respectively. All patients with parotid mass were found by physical examination, by maxillofacial surgeons or by ultrasonography or other imaging examinations. Facial nerve trunk with its first branches and parotid ducts were evaluated independently on images of iMSDE and T2-FFE sequence for volunteers. The signal intensity ratio (SIR) of both facial nerve and parotid ducts were compared respectively in two sequences The relationship between intraparotid facial nerve and parotid ducts with the lesion were analyzed on images of iMSDE and T2-FFE sequences for 40 patients. The results were compared with intra-operative anatomy and post-operative pathological findings.Wilcoxon symbolic rank test, t test and chi-square test were used Results The image scores of intra-parotid facial nerve and parotid ducts in iMSDE sequence were higher than that of T2-FFE sequence in all 30 healthy volunteers. The difference was statistically significant (Z=-6.197,P<0.05). Both the facial nerve and parotid duct on images of iMSDE sequence had higher SIR than that of T2-FFE. The differences were statistically significant (t=10.772,11.586, respectively;P<0.05). Forty patients with parotid gland tumors had a total of 41 lesions. Compared with the intraoperative anatomy, the accuracy of iMSDE and T2-FFE sequences in showing the relationship between the facial nerve and its primary branches with the mass were 36/41 (87.8%), and 22/41 (53.7%) respectively, and the accuracy of the two sequences in showing the relationship between the dominant duct of the parotid gland and the mass were 38/41 (92.7%) and 30/41 (73.2%), respectively.The accuracy rate in showing the relationship between facial nerve and its primary branch and the mass on images of iMSDE sequence were higher than that of T2-FFE sequence, and also in showing the relationship of parotid duct and the mass. The statistical differences were significant (χ2=9.725, 5.513;P<0.05,respectively). In the iMSDE sequence, the relationship between the facial nerve and its first branches (temporofacial and cervicofacial division) with the tumor was correctly demonstrated in 36 cases. 38 cases of parotid ducts were satisfactorily displayed on image of iMSDE sequence. Conclusions The 3D-iMSDE MRN sequence can correctly show the relationship between intraparotid facial nerve and parotid duct and the parotid gland neoplasms. Key words: Parotid neoplasms; Facial nerve; Magnetic resonance imaging; Parotid duct

Long-Term Outcomes of Sialendoscopy in the Management of Sialolithiasis and Idiopathic Chronic Sialadenitis with Ductal Scars.

We aimed to present the long-term outcomes and sialendoscopic findings in only patients with sialolithiasis and ductal scars in idiopathic chronic recurrent sialadenitis who experienced unsuccessful results with conservative treatment and were treated with sialendoscopy. We retrospectively analyzed the patients with a diagnosis of only sialolithiasis and ductal scars in chronic recurrent sialadenitis who underwent sialendoscopy between January 2011 and June 2016. We collected clinical and intraoperative data including patient age, sex, date of the procedure, the involved gland, operative findings and complications. Follow-up data included whether the symptoms were resolved or recurred and whether any further procedures were performed. Of a total of 38 patients, 16 were excluded from the study due to missing clinical or follow-up data, and analysis was conducted on 22 patients. Twelve were diagnosed with sialolithiasis, while the remaining 10 were diagnosed with idiopathic chronic sialadenitis and had ductal scars. Stone sizes ranged from 2 mm to 10 mm. Mean follow-up time was 39.5 months. The final success rate was 100%. Of the 10 patients with ductal scarring, five had scar in the parotid gland duct, and five in the submandibular gland duct. The mean follow-up time of all ductal scar patients was 47.1 months. The final success rate was 70%. Sialendoscopy is a minimally invasive method for the diagnosis and treatment of sialolithiasis and ductal scars of the salivary glands after failure of conservative treatments in adults.

Quantitative Analysis of Parotid Gland Secretion Function in Sjögren's Syndrome Patients with Dynamic Magnetic Resonance Sialography.

ObjectiveTo evaluate the secretory function of parotid glands by dynamic magnetic resonance (MR) sialography and determine the clinical performance of this technique in diagnosing and evaluating Sjögren's syndrome (SS) patients.Materials and MethodsThis study enrolled 29 healthy volunteers (25 women and 4 men; mean age, 34.8 ± 6.3 years; age range, 26–47 years) and 25 primary SS (pSS) patients (23 women and 2 men; mean age, 37.7 ± 7.9 years; age range, 25–50 years) with decreased secretory function. The volume of the parotid gland ducts was precisely measured for both groups at single pre- and 6 post-gustatory-stimulated phases. Time-dependent volume change ratio curves were generated, four parameters were derived from the curves: the slope of the increase in the first post-stimulation phase (slope1st), the peak value, the time-to-peak, the total saliva secretion post-stimulation. All values were used to quantitatively evaluate the secretory function of the parotid gland. The repeated measurement analysis, Mann-Whitney U test and receiver operating characteristic curve were applied.ResultsTime-dependent volume change ratio curves demonstrated that there is a statistically significant difference between the two groups (F = 8.750; p = 0.005). A quickly increasing curve was shown in the volunteer group, whereas a slowly increasing curve was shown in the pSS patient group. The slope1st, peak value and total saliva secretion post-stimulation of the patient group were significantly lower than those of the volunteer group (p = 0.005, p = 0.003, and p = 0.002, respectively). The time-to-peak between the two groups was not significantly different (p = 0.383). The slope1st can be used as a discriminator to diagnose SS patients (p = 0.015; odds ratio = 4.234; area under the curve = 0.726).ConclusionDynamic MR sialography is proven to be an effective method in evaluating salivary gland function and has a great potential in diagnosing and evaluating pSS patients.

Complications associated with the bichectomy surgery

ABSTRACT This research study aimed at reviewing, in the literature, the aspects related to the buccal fat pad structure, named the Bichat Ball, evaluating the anatomy of the area, the buccal fat pad clinical applications and the possible complications of its surgical removal, as well as reporting a series of cases that presented such complications. The most important anatomical structures surrounding the buccal fat pad and that are frequently involved in surgical complications are the parotid gland duct, the facial nerve branches, the blood vessels and the muscular tissues. In Dentistry, the buccal fat pad clinical application has an aesthetic purpose and it can be removed or repositioned. The removal occurs to avoid intra-oral trauma, "nibbling", and the pedicle repositioning occurs for protection or to be used as a graft. The complications of the surgical removal of the buccal fat pad are not frequent, however, hematoma, infection, facial nerve and facial vessel injuries may occur. Therapies involved in it include drug therapy, drainage, laser therapy and compresses.

Cutaneous lymphangitic carcinomatosis associated with parotid gland duct carcinoma: An unreported case

Cutaneous lymphangitic carcinomatosis associated with parotid gland duct carcinoma: An unreported case

A novel technique in the treatment of post traumatic parotid duct sialocele

&lt;p&gt;Stenson's duct of parotid gland is a major duct which drains saliva into the oral cavity. Deep penetrating wound in the form of cut or crush injury to the buccal area carries the risk of parotid duct injury. It is in the form of ductal exposure, laceration, total severing, or crushing of the duct. These conditions are difficult to diagnose because of complex anatomy and variable nature of injury. Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of which may lead to complications like sialocele or salivary fistula. Many techniques have been proposed for diagnosis and management of parotid duct injuries. This article presents an easy and an innovative technique to diagnose and manage the parotid duct injuries using an "epidural catheter" which is often used for inducing spinal anesthesia. The technique of epidural catheter usage, its advantages, and limitation over other techniques proposed for the management of parotid duct injury are discussed. &lt;/p&gt;

A Case of Spontaneous Passage of Salivary Calculus from the Parotid Gland Duct into the Oral Cavity

A Case of Spontaneous Passage of Salivary Calculus from the Parotid Gland Duct into the Oral Cavity

Orbital implantation of submandibular salivary gland for dry eye syndrome

Dry eye syndrome or keratoconjunctivitis sicca is a disorder with reduction of tear secretion. In recent times, tear supplements form a major product by several pharmaceutical companies. In earlier days, parotid gland duct transfer into lower fornix through subcutaneous route had been performed. Among the three pairs of salivary glands, submandibular salivary gland secretion has the consistency more watery and akin to tears. Since the transfer of it is autologous, no rejection occurs and tissue acceptance with the resumption of secretary property is immediate and permanent.

Transoral Stensen's Duct Approach: A 22-case retrospective study.

Parotid gland duct lithiasis is preferentially managed using minimally-invasive techniques such as sialendoscopy and lithotripsy. However, these 2 techniques cannot remedy all obstructions and other techniques such as the Transoral Stensen's Duct Approach (TSDA) may sometimes be helpful. A retrospective study of patients treated with TSDA was conducted to evaluate this procedure between 2006 and 2013. Criteria for inclusion were: failures for lithiases (22 patients and 28 lithiases) treated with sialendoscopy and/or lithotripsy for parotid gland duct obstruction. Mean follow-up was 47.4 months. Pain intensity, swelling and occurrence of infectious episodes were evaluated immediately and after middle-term and long-term follow-up (up to 36 months). The best results were obtained for anterior lithiasis, with an 87.5% immediate success rate. Morbidity was low with 2 transient facial nerve upper buccal branch palsies and 2 post-operative stenoses. TSDA is an easy-to-perform and safe technique that can be recommended in cases of sialendoscopy or lithotripsy failure for anterior-third parotid duct lithiasis. Even if this technique has shown limitations for more posterior lithiases, or other causes of obstruction (stenosis, megaduct), it requires no specific material and may be useful. It may avoid an external combined approach or a parotidectomy.