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History Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Plan a full examination of the parotid gland to rule out a parotid tumour. A parotid mass with facial nerve palsy is suggestive of malignancy, e.g. mucoepidermoid, adenoid cystic subtypes.
Gastrointestinal tract and salivary glands
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The parotid glands are the largest of the salivary glands and lie just below the zygomatic arch in front of, and below, the ear. The parotid duct (Stenson’s duct) is about 5 cm in length and runs forwards over the masseter muscle opening on the surface of a small papilla on the inner surface of the cheek, opposite the second upper molar tooth. The submandibular glands are paired and lie on either side of the neck, forming part of the soft tissues on the medial margin of the mandible, between the body of the mandible and the hyoid bone. The submandibular duct (Wharton’s duct) is about 5 cm in length and runs forward, medially and upwards, beneath the mucous membrane of the floor of the mouth and opens at a small papilla at the base of the frenulum of the tongue. The two sublingual glands are the smallest of the salivary glands and lie on the anterior part of the floor of the mouth, on the surface of the mylohyoid muscle. The glands secrete directly into the oral cavity through multiple ducts (ducts of Rivinus), which may open adjacent to the frenulum of the tongue or may join to form a single duct (Bartholin’s duct) that empties into the submandibular duct.
Otorhinolaryngology (ENT)
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Indications for total parotidectomy➣ High grade parotid gland malignancy➣ Deep lobe involvement➣ Facial nerve involvement
Bell’s palsy with abnormal findings in the ipsilateral parotid gland
Published in Acta Oto-Laryngologica Case Reports, 2023
Takaaki Hijioka, Yoshihiro Aoki, Hideaki Moteki, Naoto Mizushiro
A 7-year-old boy without a significant medical history presented to the emergency department with a left facial paralysis and swelling of the ipsilateral parotid gland that had progressed for 5 days. He had no history of parotid gland swelling and had received one dose of the mumps vaccine at 2 years of age. On admission, a physical examination revealed facial asymmetry at rest without forehead movement on the left side. He was unable to close his left eye completely and had an obvious drooping of the left corner of his mouth. The left tympanic membrane was intact with no periauricular rash. Mild, non-tender swelling was noted in the left parotid gland (Figure 1(a)). Blood examination revealed a white blood cell count of 7.88 × 109/L (normal range: 3.30–8.60 × 109/L), a C-reactive protein level of 0.1 mg/L (normal range: 0–1.4 mg/L), and an amylase level of 104 U/L (normal range: 44–132 U/L). The hearing test demonstrated no laterality; however, the stapedial reflex was absent on the left side. Ultrasonography revealed hypoechoic masses in the left parotid gland (Figure 1(b)). T2-weighted magnetic resonance imaging (MRI) revealed heterogeneous hyperintensity in the posterior part of the left parotid gland (Figure 1(c)). Serological test results for mumps, herpes simplex virus type 1, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus were negative.
Survival after lymphadenectomy of nodal metastases from melanoma of unknown primary site
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Hans Petter Gullestad, Truls Ryder, Mariusz Goscinski
Surgery for all patients with clinical nodal disease has been consistent throughout the whole period.Neck: Selective nodal dissection as a standard and modified radical dissection with extensive disease. Superficial parotidectomy when the parotid gland or level II was affected.Axilla: Full en bloc dissection (level I-II-III). This involved complete clearance of the axillary content up to the apex of the axilla defined by the musculus subclavious tendon [15].Groin/Pelvis: Radical groin dissection with identification of Clocquet’s node. Whenever suspicious or confirmed metastatic nodes were present in the pelvic area, an ilioinguinal dissection was performed.
The impact of botulinum toxin type A in the treatment of drooling in children with cerebral palsy secondary to Congenital Zika Syndrome: an observational study
Published in Neurological Research, 2021
Henrique F Sales, Caroline Cerqueira, Daniel Vaz, Débora Medeiros-Rios, Giulia Armani-Franceschi, Pedro H Lucena, Carla Sternberg, Ana C Nóbrega, Cleber Luz, Danilo Fonseca, Alessandra L Carvalho, Larissa Monteiro, Isadora C Siqueira, Igor D Bandeira, Rita Lucena
Botulinum toxin type-A – 500 U vials of AbobotulinumtoxinA (Dysport®) – was administered as part of the participants’ medical treatment by a neuropediatrician, according to the anatomical references described in the literature. All the subjects received topical anaesthetic (EMLA®) 30 minutes prior to administration. Intraglandular injections with a 25 mm needle were made at two administration points in the parotid gland and one in the submandibular, bilaterally at a dose of 25 U per gland, according to the references described in the literature [7,8]. The needle was inserted at a depth of 1 cm into the preauricular region of the parotid gland, behind the angle of the ascending mandibular branch, and then into the inferoposterior region of the gland, located just before the mastoid process. The submandibular administration occurred through percutaneous injection into the submandibular triangle. For participants who received BTX-A in other muscles in order to reduce spasticity, the total administered dose was duly recorded. The applications were performed only once on each child.