1/6. Unusual parotid gland foreign body.A foreign body in the parotid gland whether from the oral cavity or through the skin is extremely uncommon. A case is described of the tip of a golden-colored pencil accidentally piercing the deep lobe after a fall. Emergency surgical removal was performed, and the diagnosis of the foreign body was quite easy. In contrast, determination of the location in the gland had to be done by a microscope, with fluoroscopy during the operation and was quite difficult. During removal, great attention was paid to avoiding facial nerve injury. This was done by identifying the facial trunk at the pointer using a microscope. The dissolved material including copper and zinc metal powder, paste, and clay, was found in the deep lobe associated with the surrounding abscess. Although these materials are assumed to be harmless to human tissues, the complete and immediate removal is to prevent salivary fistule resulting from inflammation.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/6. Unusual primary and secondary facial blast injuries.PURPOSE: To discuss unusual facial injuries resulting from a bomb blast. MATERIALS AND methods: In March 1997, a bomb consisting of a bag of nails was detonated in a coffee shop in Tel Aviv. Two of the wounded were brought to our level 1 Trauma Center with unique facial injuries. Computed tomography (CT) scan and CT angiogram were performed. RESULTS: The blast occurred to the immediate right of the victims who were sitting in an open cafe. Both had tympanic perforation. The first patient showed indirect damage to the facial nerve from a piece of shrapnel located anterior to the carotid artery and medial to the right mandibular angle. The second had a piece of shrapnel lodged in the parapharyngeal space that was initially missed and discovered only on reexamination 3 days later after the patient complained of pain in the temporomandibular joint; there was no facial nerve deficit. The port of entry was probably a small wound in the anterior wall of the external ear canal. CONCLUSIONS: The wounds are probably attributable to the spalling effect of the shrapnel passing through the parotid gland, which has mixed-density tissue. These cases show that nerves are susceptible to damage even in the absence of direct engagement and that the emergency room physician should be alert to even small skin imperfections in blast victims to avoid missing penetrating wounds.- - - - - - - - - - ranking = 0.16666666666667keywords = gland (Clic here for more details about this article) |
3/6. Reconstruction of half of the face.A 29-year-old man underwent a severe electrical burn involving the entire right side of the face, resulting in destruction of the temple, orbit, a portion of the nose, zygoma, and maxilla, through-and-through destruction of the cheek and lips, and a portion of the parotid gland and buccal mucosa. This massive and debilitating wound was an acute surgical emergency, as far as life-support measures were concerned. Gradually, the patient underwent debridement, and finally resurfacing of the entire right side of the face with a large deltopectoral flap. Over four years, this flap, the area of the orbit, and the area of the lips underwent rehabilitation and the transportation of residual regional muscles, and the debulking and repositioning of the flap was carried out. The orbit was finally rehabilitated with a prosthesis.- - - - - - - - - - ranking = 0.16666666666667keywords = gland (Clic here for more details about this article) |
4/6. The crocodile tear syndrome.Gusto-lacrimation, or "crocodile tear syndrome," is a rare complication, with 95 cases reported in the literature. Two patients are presented here, one after a facial fracture which apparently extended into the temporal bone proximal to the optic ganglion, and one after a Bell's palsy. The mechanism appears to be a misdirection of regenerating gustatory fibers destined for the salivary glands, so that they become secretory fibers to the lacrimal gland and cause homolateral tearing while the patient is eating. A simple procedure, involving subtotal resection of the palpebral lobe of the involved lacrimal gland, proved to be an effective corrective measure in these cases. Although it was not done in these cases, it would perhaps be advisable to do a Schirmer's test to assist in determining the amount of gland to be removed.- - - - - - - - - - ranking = 0.66666666666667keywords = gland (Clic here for more details about this article) |
5/6. Post-traumatic sialoceles and mucoceles of the salivary glands.Three cases of post-traumatic sialocele involving the parotid region and one case of post-traumatic mucocele involving the submandibular region are presented. Computed tomography (CT) with contrast showed enhancing borders after a few weeks. Cases earlier than 2 weeks from occurrence showed no enhancement because of the absence of a well-developed capsule. patients who had the disease longer showed better enhancement of the periphery with contrast because of capsule development. By CT scanning alone it is difficult to differentiated these lesions from other cystic lesions of the face and neck, although certain characteristics like location and rim enhancement may favor one lesion over the other.- - - - - - - - - - ranking = 0.66666666666667keywords = gland (Clic here for more details about this article) |
6/6. Traumatic chiasmal syndrome: a feature photograph.Traumatic chiasmal neuropathy results from injury to the face, sphenoid and clivus. Its pathogenesis remains enigmatic. Because of its close relationship to the pituitary gland, hypothalamus and internal carotid artery, a neuro-ophthalmic evaluation and imaging is needed in such cases. We present a patient who developed traumatic chiasmal syndrome after an automobile accident. Computed tomographic scan showed fracture of the sella turcica. A carotid angiography showed a traumatic pseudoaneurysm of the internal carotid at the base of the skull.- - - - - - - - - - ranking = 0.16666666666667keywords = gland (Clic here for more details about this article) |