Palate

Upper aerodigestive amyloidosis

July 20, 2015     Jaime Eaglin Moore, MD; Amanda Hu, MD; Al Hillel, MD
article

As the patient was asymptomatic, close observation and only laser excision were recommended if the patient's condition progressed.

Sweet syndrome: A case report and review of the literature

July 20, 2015     Robert B. Contrucci, DO; Donna Bilu Martin, MD
article

Abstract

Sweet syndrome (acute febrile neutrophilic dermatosis) is a disorder of unknown etiology. It has been associated with autoimmune processes, malignancies, infections, drug reactions, and gastrointestinal disorders such as inflammatory bowel disease. We describe the case of a 51-year-old man who presented with severe pain in his tongue and throat and referred pain in his right ear, along with odynophagia, fever, and hoarseness of 48 hours'duration. An oral and oropharyngeal examination revealed the presence of aphthous ulcerations, as well as a 3 x 3-cm raised inflammatory lesion on the right anterior lateral tongue and a 5 x 5-mm bulla on the hard palate in the midline. In addition, erythematous papules and macules were noted on his face, neck, and extremities. Cultures, a biopsy, and laboratory tests yielded a diagnosis of Sweet syndrome. The patient was prescribed oral prednisone, and his signs and symptoms resolved within 2 months. Although Sweet syndrome is uncommon, even in dermatology practice, its head and neck and oral manifestations and its association with paraneoplastic disease warrant the need for otolaryngologists to be aware of the condition.

Giant palatal pyogenic granuloma

February 2, 2015     Yu-Hsuan Lin, MD; Yaoh-Shiang Lin, MD
article

The differential diagnosis for a pyogenic granuloma should include hemangioma, bacillary angiomatosis, peripheral giant cell granuloma, peripheral ossifying fibroma, and some malignancies, such as Kaposi sarcoma, squamous cell carcinoma, and achromic melanoma.

Lingual hamartoma associated with a cleft palate in a newborn

October 17, 2014     Opeyemi O. Daramola, MD; Mariko Suchi, MD, PhD; Robert H. Chun, MD
article

Abstract

A hamartoma is a benign malformation of native tissue that may occur in any area of the body. Hamartoma of the tongue is a rare developmental lesion. We describe the case of a pendulant lingual hamartoma in a 2-day-old girl that had not been identified on prenatal ultrasonography. We also review the utility of prenatal imaging options, the role of preoperative imaging, the mechanical relationship between lingual hamartoma and cleft palate, the histopathology of this tumor, surgical treatment, and emergency airway management.

Management of soft palate agenesis in Nager syndrome with an elongated, superiorly based pharyngeal flap

October 17, 2014     Oneida A. Arosarena, MD; Troy Hemme, DO
article

Abstract

Nager syndrome, or preaxial acrofacial dysostosis, is associated with aberrant development of the first and second branchial arch structures, as well as abnormal development of the limb buds. It is a rare disorder, and its clinical manifestations have not been completely defined. Absence of the soft palate has been reported in patients with Nager syndrome. In this report we describe the use of an elongated, superiorly based pharyngeal flap for the treatment of severe velopharyngeal insufficiency in a patient with Nager syndrome and absence of the soft palate. We also describe the dysmorphisms associated with Nager syndrome and present a differential diagnosis for the condition.

Transnasal endoscopic resection of a calcifying cystic odontogenic tumor

August 27, 2014     Daniel Schuster, MD; Joel Cure, MD; Bradford A. Woodworth, MD
article

Abstract

Calcifying cystic odontogenic tumor (CCOT) is a rare histologic subtype of odontogenic tumor. Treatment requires complete enucleation. We report what we believe is the first case of CCOT to be removed via a transnasal endoscopic approach. A 16-year-old boy was referred to our department by his dentist for evaluation of an expansile mass of the left maxillary sinus. The dentist had noted an area of hyperlucency of the left palate during a routine examination. Computed tomography confirmed the presence of a large tumor. Complete resection of the tumor was achieved via a transnasal endoscopic surgical approach. Resection of odontogenic tumors is necessary because of their tendency to expand and produce a mass effect on surrounding structures. We believe resection via an entirely transnasal endoscopic approach is a valuable and important technique in the treatment of odontogenic tumors that leaves the patient with a more cosmetically acceptable postoperative appearance.

Polymorphous low-grade adenocarcinoma

January 21, 2014     Lester D.R. Thompson, MD
article

PLGA affects the palate (60% of cases) most commonly, especially at the mucosal junction of the hard and soft palates; the next most common sites are the cheek and the lip, often the upper lip.

Ice-cream stick injury resembling torus palatinus

September 18, 2013     Rumi Khajotia, MBBS, MD, FAMA, FAMS; S.T. Kew, FRCP
article

The size of a torus palatinus usually varies from barely discernible to very large, and it may be flat or lobular.

Peripheral osteoma of the hard palate

August 21, 2013     Borlingegowda Viswanatha, MS, DLO, PhD
article

Abstract

Peripheral osteomas of the hard palate are relatively rare. Two cases of osteoma of the hard palate are reported, along with a review of the literature.

Unusual hard palate foreign body: A case report

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.

Two-flap palatoplasty: Description of the surgical technique and reporting of results at a single center

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.

Chondromyxoid fibroma of the nasal cavity and palate

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.

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