The purpose of this study was to investigate the complication rates and effectiveness of extracapsular dissection compared with superficial parotidectomy for pleomorphic adenomas of the parotid gland from 2002 to 2012. The authors carried out a retrospective cohort study of 198 patients with pleomorphic adenomas of the parotid gland. Extracapsular dissection (ED) or superficial parotidectomy (SP) was performed. The recurrence rate and complications of the two surgical techniques were measured with a univariate analysis of each variable using the appropriate statistical analysis (chi-squared test or t-test). A total of 198 patients were enrolled between January 2003 and December 2012. The study included 97 females (48.99%) and 101 males (51.01%) whose mean age was 50.97 years (range 14–75). The type of surgery performed was ED in 153 patients (77.27%, 80 males and 73 females) and SP in 45 patients (22.73%, 21 males and 24 females). The mean follow-up time was 61.02 +/− 4.9 months for the patients treated with ED and 66.4 +/− 4.5 months for the patients treated with SP. Transient facial nerve injury and facial paralysis were significantly more frequent after SP than after ED (P = 0.001 and P = 0.065, resp.). No significant differences in capsular rupture, recurrence, and salivary fistula were observed after SP or ED: 2.2% versus 3.9%, 2.2% versus 3.3%, and 2.2% versus 0.65%, respectively. Extracapsular dissection may be considered the treatment of choice for pleomorphic adenomas located in the superficial portion of the parotid gland because this technique showed similar effectiveness and fewer side effects than superficial parotidectomy.
Cystic lymphangioma (CL) in adult is a very rare pathology. Its etiology remains unclear, but it is supposed to be congenital or to be a result of obstruction and lymph fluid retention of developing lymphatic vessels. It generally occurs in the head and neck region, probably because of the rich lymphatics in this area. It can be easily misdiagnosed with other cervicofacial masses. We present the case of a 56-year-old-female presented with a right-sided painless cervical swelling. Ultrasonography and magnetic resonance imaging were performed and a surgical complete removal was carried out. Histological examination revealed that the mass was composed by a variety of dilated lymph vessels involved in a fibrovascular stroma. Diagnose of CL was done. With this article, we want to highlight the features of CL and its role in the differential diagnoses of adults’ cervicofacial masses.
Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable and its analysis is crucial to establish effective treatment and prevention of these injuries. The aim of this multicentric retrospective study was to analyze causes, demographics, incidence, characteristics of 987 patients diagnosed with maxillofacial trauma between 2011 and 2015 at Complex Operative Unit of Maxillofacial Surgery of Federico II University of Naples and Magna Graecia University of Catanzaro, Italy; 657 male and 310 female patients were admitted in the study. The most frequently observed fracture involved the mandible (399 patients, 35.4%), followed by zygomatic complex (337 patients, 29.9%), orbital walls (160 patients, 14.2%), and nasal bones (129 patients, 11.4%). The most frequent cause of fracture was assaults (30.4%), followed by road traffic injuries (27.2%), falls (23.2%), sport accidents (15.4%), and others causes (2.6%). Significant variations of etiology have been detected between the 2 hospitals in relationship with different migration flow trends and cultural and socioeconomic features. Epidemiological analysis of maxillofacial fractures is crucial to identify the trauma burden and to help in developing a more efficient system to plan resource allocation and to deliver care and preventive measures establishing clinical and research priorities for effective treatment and prevention of these injuries.
they probably indicate patterns in utilization. Race and socioeconomic status are separate entities, but unfortunately they are all too often interrelated. These statistics could highlight disparities in access, as the cost of inflatable waterslides begins at $900 and can be in excess of $8,000. 9 Other reasons for different utilization could be attributed to cultural practices or preferences.Our study reviewed the largest sample of head and neck water slide injuries in the literature, and our findings largely validate the experiences of prior anecdotal series. Craniomaxillofacial fractures from waterslides are rare, as the forces from most injuries do not appear to be high impact. Of the 46 injuries identified by Paulozzi et al, 20 (43.5%) were in the head and neck. 3 Half of these resulted in lacerations, and all but one of the remaining injuries let to a concussion. Malpass et al found a similar predominance of lacerations (53%) and paucity of fractures (7%). 2 In general, fatalities were rare with only one documented case among published studies. 2 When comparing public and private waterslides, it is important to consider differences in how the slides are operated and used. Unnecessarily risky riding behavior and misuse may in part account for the different patterns of injury observed between waterslide types. Backyard slides are largely without independent supervision by an attendant. Private slides rely only on adult volunteers and a set of unstandardized rules. One prior author assessed the adequacy of uniform control systems (ie, traffic light system, closed circuit television, warning notices, part-time supervision, and rider behavior regulation) in waterslides. Their investigation determined that, despite strict implementation, a small but significant percentage of consecutive riders were still predisposed to interpersonal collision. Despite best efforts waterslides carry an inherent risk of unavoidable injury. Presumably, the probability of avoidable injury with backyard slides would be even greater. Interestingly, we found that the share of cranial injuries was greater with backyard slides. This aligns with our hypothesis that the unsafe practice of headfirst riding may be more prevalent in this group.Waterslides inherently carry injury risk by virtue of their mechanism of action. However, there are certain safe riding habits that can be implemented to reduce the likelihood of head, neck, and body trauma. Sliding feet first in a supine or seated position eliminates the cranium as the first point of contact. Riding on the stomach should always be avoided, and all body parts should remain within the confines of the slide. Riders should not attempt to achieve unsafe traveling velocities by taking running starts. Likewise, mats or other accessories should not be permitted on slides as they may further decrease friction and reduce control. The end of the slide should always remain unobstructed. For public slides, riders should exit plunge pools as soon as possible to avoid blindside collisions. For b...
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