Palate

Schwannoma of the palatine tonsil

September 20, 2011     Neena Chaudhary, MS, Deepak Gupta, MS, and V. Natesh, MS
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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.

Cholesteatoma of the nose and maxillary and ethmoid sinuses: A rare complication of palatal surgery

September 20, 2011     Borlingegowda Viswanatha, MS, DLO
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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.

Approach to benign tumors of the palate: Analysis of 28 cases

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
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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.

Osteomyelitis of the hard palate secondary to actinomycosis: A case report

March 1, 2011     Rohit Garg, MD, Paul Schalch, MD, Jon-Paul Pepper, MD, and Quoc A. Nguyen, MD
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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.

Pyogenic granuloma of the hard palate: A case report and review of the literature

August 31, 2009     Jaimanti Bakshi, MS, DNB, Ramandeep Singh Virk, MS, FIMSA, and Mayuresh Verma, MS
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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.

Palatal perforation from cocaine abuse

April 30, 2008     Marc Cohen, MD, Vishad Nabili, MD, and Dinesh K. Chhetri, MD

Marginal-zone B-cell lymphoma of the bony palate presenting as sinusitis

January 1, 2008     Lisa Skultety Ayers, DO, Jacqueline Oxenberg, DO, Seth Zwillenberg, MD, and Mahmoud Ghaderi, DO
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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.

Reduction of snoring with a plasma-mediated radiofrequency-based ablation (Coblation) device

January 1, 2008     Jonas T. Johnson, MD, Jennifer Vates, BS, and Robin L. Wagner, BS
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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.

Necrotizing sialometaplasia: A potential diagnostic pitfall

August 31, 2006     Pavel Komínek, MD, PhD; Petr Blasch, MD
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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.

Massive pleomorphic adenoma of the soft palate

December 1, 2004     Ryan F. Osborne, MD; Sofia Avitia, MD

Second branchial cleft anomaly presenting as a rudimentary pinna in the nasopharynx of a newborn

August 31, 2004     Khwaja Asif Ahmed, MD; Michael D. Poole, MD, PhD
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Abstract
We describe the case of a 4-day-old girl who presented with an epiglottic cyst that was later identified as a rudimentary pinna attached to the soft palate.

Nasopalatine duct cyst

April 30, 2004     Hugh Robertson, MD, FACR; Enrique Palacios, MD, FACR
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