No abstract

A 68-year-old man was referred to our institution for suspicion of tonsillary malignancy with a 2month history of odynophagia and right otalgia. Clinical examination disclosed an enlarged but mobile right tonsil without mucosal ulcération. The remainder of the head and neck examination findings were within normal limits.

A radiologic-anatomic study was performed to determine the nature of the low-signal-intensity curvilinear structures currently seen in the normal parotid gland on axial T1-weighted magnetic resonance (MR) images. These structures are considered by some to represent the intraparotid facial nerve. After cannulation of the Stensen duct, the authors imaged the parotid gland of two cadavers in situ before and after intraductal injection of gadolinium tetrazacyclododecanetetraacetic acid. Retrograde filling was obtained in one gland. The same sections were used throughout a subsequent anatomic study, allowing correlation of the MR findings with the macroscopic and histologic appearance of the gland. Comparison of MR images and gross and histologic sections established that two intraparotid facial nerve segments, although identified from the histologic study, were not visible on corresponding MR images. Many areas of low signal intensity seen within the gland were found to represent the main duct and some afferent ductal branches.

According to the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology – Head and Neck Surgery, various surgical methods such as laryngeal framework surgery, laryngeal re-innervation, and injection laryngoplasty might be used to palliate inferior laryngeal nerve paralysis. In the present case report we document the survival and exact location of the boluses of autoiogous fat in one patient in whom this material was used for injection laryngoplasty.