Neurilemmomas (schwannomas) are solitary neurogenic tumors that arise from cells of the neural sheath. They are slow growing and represent a proliferation of Schwann cells. Extracranial neurogenic tumors of the head and neck are uncommon, with benign tumors occurring with greater frequency than malignant tumors. These tumors often mimic primary or metastatic disease in the head and neck. Schwannoma of the salivary gland is a particularly rare form of an extracranial neurogenic tumor, with most presenting in the parotid gland originating from a peripheral branch of the facial nerve. An unusual case of neurilemmoma of the submandibular gland is presented, and the literature concerning this subject is reviewed. We believe this tumor originated in an autonomic nerve of the submandibular gland. The mass was discrete and well demonstrated on CT scan. Total excision of the gland resulted in complete resolution of symptoms with no cranial nerve deficits.
Lemierre's syndrome, caused by Fusobacterium necrophorum, is a potentially fatal sequelae of a sore throat characterised by septicaemia, internal jugular vein thrombophlebitis and metastatic abscesses. The Chief Medical Officer reported in February 2001 that the incidence is increasing. Two cases seen in one year, with different presentations, are reported. The first patient presented with sepsis, jaundice, hepatic abscesses and portal vein/superior mesenteric vein thrombosis, whilst the second presented with sepsis, sore throat and internal jugular vein thrombophlebitis. Both patients were treated with antibiotics and anticoagulants with a favourable outcome.
The highly vascular nature of the head and neck area provides a particularly enhanced challenge to the head and neck surgeon when a vascular lesion is encountered. Vascular malformations in this area are classified according to the microanatomical architecture and clinical appearance of the lesion. Although bleeding is a common presentation with vascular malformations, other local and systemic problems may be associated with this problem. An unusual case of an arteriovenous malformation of the ethmoid and maxillary sinuses which caused persistent and recurrent epistaxis is presented. A review of the current literature concerning vascular lesions of the head and neck area is included. Adequate treatment of this lesion presently includes angiographically controlled vascular embolization followed by complete surgical excision.
Postoperative bleeding after tonsillectomy is a problem that has earned the respect and cautious attention of the most experienced surgeons. The incidence of postoperative hemorrhage after tonsillectomy, as well as many factors affecting this incidence, has been extensively investigated. A possible factor that has not been well studied as a possible influence in postoperative tonsillectomy bleeding is the choice of anesthetic. A study was completed comparing the incidence of postoperative tonsillectomy bleeding between patients operated on using general anesthetic and local anesthetic. One hundred ninety-two patients consecutively undergoing tonsillectomy at Naval Hospital, Oakland, California, were included in the study. Three of 150 patients (3%) having general anesthesia and 13 of 87 patients (15%) having local anesthesia experienced postoperative bleeding. Possible factors influencing this difference in postoperative bleeding incidence are discussed. The possibility is suggested that surgeons (and previous reports) may underestimate the rates of postoperative bleeding as a result of patients being treated by other than the operating physician.
Although approximately 13% of lipomatous tumors occur in the head and neck, most of these are found in the immediate subcutaneous tissues, and lipomas of the deep head and neck tissues are rare. Lipomas consist of adipose tissue separated by fine fibrous trabeculae; if the amount of fibrous tissue is appreciable, the designation of fibrolipoma is used. We describe an unusual case of a parapharyngeal fibrolipoma with airway narrowing and ipsilateral compromise of the carotid artery and internal jugular vein blood flow. Diagnosis of deep head and neck lipomata is facilitated by utilizing computed tomographic analysis and angiography. The transcervical approach to the skull base which allows complete resection of this lesion is described.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.