April 17, 2013 Allison N. Rasband-Lindquist, MD; Rodney Lusk, MD
article
Abstract
Foreign bodies embedded in the palate are exceedingly rare, and may imitate oral lesions. The majority of cases occur in infants and children. The following report discusses the unique presentation of a foreign body in the hard palate of an infant. This report emphasizes that foreign bodies must be considered in the differential of lesions found in the oral cavity of children.
March 1, 2012 Emmanouel Koudoumnakis, MD, Ioannis M. Vlastos, MD, PhD, Kostas Parpounas, MD, PhD, and Michael Houlakis, MD, PhD
article
Abstract
Two-flap palatoplasty is commonly used to treat cleft palate defects, but only a few reports on outcomes have been published in the literature. We conducted a retrospective analysis of 257 cases of cleft palate treated with two-flap palatoplasty at a single center in Greece over a 13-year period. Our outcomes data included surgical complication rates, the results of speech assessments, midface development, and other parameters. We found a low rate of short- and long-term complications that required revision surgery, such as symptomatic fistula (5.4%) and velopharyngeal insufficiency (5.3%). Speech outcomes in relation to intelligibility, hypernasality, and nasal emissions were satisfactory in 70 to 86% of patients. Dental arch relationships, as estimated by the 5-Year-Olds Index, were judged to be either good or excellent in 62% of those evaluated. A considerable proportion of patients (45%) who had otitis media with effusion experienced a spontaneous resolution without the use of tympanostomy tubes 2 to 8 months after their operation. We conclude that two-flap palatoplasty is an effective procedure that warrants further attention. We describe the surgical technique in detail. Our technique includes a modified intravelar veloplasty that incorporates near-total muscle retropositioning.
October 26, 2011 Brian Thomas, MD, Candice Black, DO, Tate Maddox, MD, and Giridhar Venkatraman, MD
article
Abstract
We present an exceedingly rare case of chondromyxoid fibroma of the nasal cavity and palate. This rare tumor usually occurs in the metaphyses of the long bones. Our patient's tumor was diagnosed by biopsy, and it was resected en bloc. At the 2-year follow-up, the patient was doing well with no signs of recurrence. We review the pathologic characteristics, differential diagnosis, and treatment of chondromyxoid fibroma of the nasal cavity.
September 20, 2011 Borlingegowda Viswanatha, MS, DLO
article
Abstract
A 10-year-old boy presented with a complaint of a left-sided nasal obstruction with an associated foul-smelling discharge. Physical examination and anterior rhinoscopy revealed that a whitish, friable mass had completely filled the left nasal cavity. On computed tomography, a soft-tissue mass was seen filling the cavity and extending to the paranasal sinuses with bone erosion. A biopsy of the mass suggested that it represented a cholesteatoma. The lesion was removed via nasal endoscopy, and histopathology confirmed the diagnosis of a cholesteatoma. No recurrence was noted during 6 months of follow-up. Cholesteatoma of the paranasal sinuses is a rare entity, as only a few dozen cases have been reported in the literature.
September 20, 2011 Neena Chaudhary, MS, Deepak Gupta, MS, and V. Natesh, MS
article
Abstract
Schwannomas can originate in any peripheral, autonomic, or cranial nerve except the olfactory and optic nerves. Between 25 and 48% of all schwannomas have been reported to arise in the head and neck, with the acoustic nerve being the most common site of origin there. Schwannomas of the palatine tonsil are rare; as far as we know, only 6 such cases have been previously reported in the literature; 5 of these 6 occurred in adults and the other in an adolescent. We report a new case in a 42-year-old woman, which was diagnosed on the basis of histopathology.
August 15, 2011 Ahmet Ural, MD, Murat Livaoğlu, MD, Devrim Bektaş, MD, Osman Bahadır, MD, Atilla Hesapçıoğlu, MD, Mehmet İmamoğlu, MD, and Abdülcemal Ümit Işık, MD
article
Abstract
We conducted a retrospective analysis of 28 patients-15 men and 13 women, aged 17 to 71 years (mean: 41.6)-who had undergone surgery for the treatment of a benign tumor of the hard or soft palate. The most common chief complaint was a palatal mass, which was reported by 14 patients (50.0%). Tumors were more common in the hard palate than in the soft palate by a margin of 23 to 5 (82.1 to 17.9%; p = 0.001). The most common histopathologic diagnosis was pleomorphic adenoma, which occurred in 9 cases (32.1%). Most patients were treated with local excision with clear margins, which was sufficient in almost all cases, as there were only 2 recurrences, both of which occurred in men with a hard-palate pleomorphic adenoma. For these 2 patients, a wider excision and repair with palatal islet flaps was performed, and no further recurrence or malignant transformation was observed during follow-up. Two patients with a soft-palate hemangioma were treated with an intralesional steroid injection and radiofrequency ablation, which reduced the size of their lesion considerably.
March 1, 2011 Rohit Garg, MD, Paul Schalch, MD, Jon-Paul Pepper, MD, and Quoc A. Nguyen, MD
article
Abstract
Osteomyelitis of the hard palate is a rare and difficult-to-eradicate sequela of actinomycosis. In this case report, we illustrate the necessity of aggressive surgical management of actinomycotic infection of the hard palate. The patient was initially treated with multiple local debridements supplemented with oral and then parenteral antibiotics, but his disease progressively worsened. His condition eventually resolved only after a partial palatectomy was performed to remove all the necrotic bone, followed by a prolonged course of intravenous and oral antibiotic treatment.
August 31, 2009 Jaimanti Bakshi, MS, DNB, Ramandeep Singh Virk, MS, FIMSA, and Mayuresh Verma, MS
article
Abstract
We describe the case of a 35-year-old man who presented with a 4 x 4-cm ulcerated swelling over the hard palate that had progressed over 6 months. The lesion was associated with recurrent bleeding and occasional pain. Based on the lesion's clinical appearance and other characteristics (i.e., the slow progression, ulceration, and lack of regional lymphadenopathy), a provisional diagnosis of pyogenic granuloma was made, even though pyogenic granulomas of such size are rare. The mass was excised via a transoral route with a 0.5-cm margin of healthy mucosa, and the base was curetted. Histopathologic examination of the excised specimen confirmed the diagnosis. We discuss the etiopathogenesis of this entity and the various treatment options, and we review the relevant literature.
April 30, 2008 Marc Cohen, MD, Vishad Nabili, MD, and Dinesh K. Chhetri, MD
January 1, 2008 Lisa Skultety Ayers, DO, Jacqueline Oxenberg, DO, Seth Zwillenberg, MD, and Mahmoud Ghaderi, DO
article
Abstract
The diagnosis of low-grade B-cell lymphoma consistent with marginal-zone lymphoma has proven to be challenging when the disease involves the hard palate. The diagnosis is complicated by the nonspecific nature of the presenting symptoms and a difficult-to-differentiate histologic picture. We describe a case of low-grade B-cell lymphoma of the hard palate with a delayed presentation. We also compare the features of this case with the features of the small number of other such cases that have been reported in the literature. Finally, we review the etiology of low-grade B-cell lymphoma, we discuss its radiologic and pathologic features, and we briefly describe the treatment options.
January 1, 2008 Jonas T. Johnson, MD, Jennifer Vates, BS, and Robin L. Wagner, BS
article
Abstract
We evaluated the effectiveness of using a plasma-mediated radiofrequency-based ablation (Coblation) device to perform volumetric tissue reduction of the soft palate as a means of controlling snoring in 23 patients with loud snoring and mild or no sleep apnea. Tissue reduction was achieved by performing a channeling procedure designed to shrink the tissue surrounding the treatment zone. The soft palate was treated at three separate sites, and each channel was completed in approximately 11 seconds. Data regarding the primary outcome—that is, pre- and postoperative subjective assessments of snoring intensity provided by the patients’ bed partners—were available for comparison for 21 of the 23 patients. Of the 21 patients, treatment was deemed successful in 10 (48%). Postoperatively, the overall mean intensity of snoring on a scale of 0 (no snoring) to 10 (terrible snoring) fell by 4 points (p < 0.05). Likewise, the loudness of snoring was also significantly reduced on objective SNAP recordings; the mean intensity fell from 12 to 8 dB (p < 0.05). Of the 10 successfully treated patients, 2 required only one procedure, 5 were improved after two treatments, and 3 underwent three operations. Seventeen of the 23 patients (74%) reported an improvement in quality of life. Surgical complications were mild to moderate, and pain was easily manageable in most cases. Our findings suggest that this procedure can be an effective treatment for socially unacceptable snoring. We hope that in future studies, investigators will evaluate outcomes over a longer term.
August 31, 2006 Pavel Komínek, MD, PhD; Petr Blasch, MD
article
Abstract
Necrotizing sialometaplasia is a benign, spontaneously healing inflammatory condition. It usually affects the hard palate, and it can mimic a malignancy both clinically and histologically. We report a new case of this rare disorder.
