Obtaining reliable pre-operative diagnosis is crucial in planning treatment for patients with salivary gland tumors. The purpose of this study was to evaluate the accuracy of pre-operative clinical diagnosis of salivary gland tumors managed at a single tertiary university hospital over a period of 20 years. A retrospective analysis of the period between 1992 and 2011 was carried out to review the cases of patients with salivary gland tumors. A total of 101 patients were enrolled and general data were described. Clinical diagnosis was compared with the final pathological diagnosis to reveal the clinical diagnostic accuracy. Of the parotid and submandibular gland tumors, 86 and 67% were benign, respectively. The clinical diagnostic accuracies for diagnosis of parotid tumors as benign or malignant were 100 and 57%, respectively. The clinical diagnostic accuracies for diagnosis of submandibular tumors as benign or malignant were 67%. Therefore, the overall clinical judgment of benign and malignant tumors in the submandibular gland is unreliable. The accuracy for a parotid tumor to be clinically interpreted as benign was 100%. While it is difficult to draw any conclusion for non-parotid gland tumors, surgical intervention should be recommended in patients with parotid tumors clinically suspected to be malignant, and all submandibular, sublingual and minor salivary gland tumors.

With damage to a duct or papilla after sialendoscopy, a stent may be necessary to prevent re-stenosis and for maintaining the salivary duct open after complete sialendoscopy. However factors affecting outcomes and complications after stent placement remain unclear. This study aimed to report preliminary experiences in salivary duct stent placement after sialendoscopy. Data from 35 procedures in 33 patients who received sialendoscopy with salivary duct stent placements at Mackay Memorial Hospital between October 2013 and June 2014 were recorded and compared for clinical data, as well as procedural techniques, findings, and outcomes. In the 35 stent placement procedures, the hypospadias silastic stent tubes were used in 27 and the Fr. 5 pediatric feeding tubes were used in the remaining eight. When the hypospadias silastic stent tubes were used for stenting, the stent obstruction and irritation rates were higher compared to those who used the Fr. 5 pediatric feeding tube (100 vs. 0 % and 67 vs. 33 %, respectively). None of the stents secured by a 5-0 nylon suture were complicated by dislocation but when the stents were secured by 6-0 nylon sutures, the dislocation rate went as high as 47.4 %. The duration needed for salivary duct stent placement might be potentially shortened to only 2 weeks. If a salivary duct stent is intended to be placed for a certain period before its scheduled removal, a suture strength equivalent or stronger than the 5-0 nylon suture should be considered for stent fixation.

A vestibular schwannoma, often termed an acoustic neuroma, is a type of benign primary intracranial tumor of the myelin-forming cells of the vestibulocochlear nerve. The typical clinical presentation often includes ipsilateral sensorineural hearing loss/deafness, vertigo and tinnitus. In the present study, the case of a young male patient who presented with recurrent unilateral facial palsy without hearing impairment is presented. The patient was diagnosed with vestibular schwannoma and received steroidal treatment with prednisolone for two weeks. The patient’s facial weakness recovered three weeks following treatment, however, the tumor subsequently grew. The patient then underwent Gamma Knife radiosurgery with a margin dose of 13 Gy. Six months after the radiosurgery, the tumor was stable without progression, and the patient’s facial nerve function and hearing remained intact.

It is generally believed that radiofrequency energy delivered to the tissue determines the RFA lesion size. The purpose of this study was to re-evaluate this relationship and propose a potentially parameter of temperature-time integration as a better indicator of RFA lesion size. Using an Ex Vivo lesioning model, fixed 300 J RFA lesions were created under target temperature settings of 65, 75, and 85 °C. The lesion sizes were recorded and compared. Under the target temperature of 65 and 75 °C, the RFA procedures were sustained for a period of time after reaching the target temperature. The correlation between the lesion size and the sustained time (Ts) after reaching the target temperature was calculated. Under the same amount of energy output (300 J), the lesion size created under the three different target temperatures (65, 75, and 85 °C) differs significantly. When the target temperature was set to 75 °C, the correlation coefficient between the Ts and the lesion area and the maximal effective radius (Mer) were 0.913 and 0.971, respectively. When the target temperature was set to 65 °C, the correlation coefficient between the Ts and the lesion area and the Mer were 0.962 and 0.923, respectively. The RFA lesion size is not proportional to the total delivered energy. The Temperature-time integration appears to be a much better indicator that critically influences the lesion size.

While conservative approaches for chronic sialoadenitis are in current use, the utility of intraductal injection therapy remains unclear. The purpose of this study is to provide evidence that substances delivered through intraductal injection of the salivary gland are able to be effectively distributed throughout the gland. Methylene blue dye (0.1 %) was injected intraductally into a porcine parotid gland (5 ml) of one group and the porcine submandibular gland (1 or 2 ml, n = 6 for each preparation) of another group. After the injection, the ductal systems were evaluated, sectioned, and observed microscopically. Color area analysis was performed on submandibular gland sections, and the infiltration ratio of the dye was calculated. The papillae of both Stensen's and Wharton's duct openings were easily identified with intraductally delivered methylene blue dye. The dye infiltration began from the central ductal region of the gland and could be easily observed to gradually disperse to the peripheral regions in each acinar. There were no statistically significant differences in infiltration ratios between anterior, midline, and posterior section of the submandibular gland. Also, there were no statistically significant differences in the ratios between 1 and 2 ml injections at all the three section positions. This study demonstrated that desired substances can be evenly delivered throughout the salivary gland through intraductal injections. The use of intraductal injections might serve as a potential therapeutic procedure in the management of salivary gland diseases.