Intermittent facial spasms as the presenting sign of a recurrent pleomorphic adenoma

The intimate anatomical relationship of the facial nerve to the parotid parenchyma has a significant influence on the presenting signs and symptoms, diagnosis and treatment of parotid neoplasms.However, to our knowledge, hyperactivity of this nerve, presenting as facial spasm, has never been described as the presenting sign or symptom of a parotid malignancy.We report a case of carcinoma arising in a recurrent pleomorphic adenoma of the left parotid gland(i.e., carcinoma ex pleomorphic adenoma) that presented with hemifacial spasms.We outline the differential diagnosis of hemifacial spasm as well as a proposed pathophysiology.Facial paralysis, lymph node enlargement, skin involvement, and pain have all been associated with parotid malignancies.To date the development of facial spasm has not been reported with parotid malignancies.The most common etiologies for hemifacial spasm are vascular compression of the ipsilateral facial nerve at the cerebellopontine angle(termed primary or idiopathic)(62%), hereditary(2%), secondary to Bell's palsy or facial nerve injury(17%), and hemifacial spasm mimickers(psychogenic, tics, dystonia, myoclonus, myokymia, myorthythmia, and hemimasticatory spasm)(17%).Hemifacial spasm has not been reported in association with a malignant parotid tumor but must be considered in the differential diagnosis of this presenting symptom.

海南汉族PLAG1基因rs6474051多态性与腮腺良性肿瘤的关联性

目的探讨海南汉族PLAG1基因rs6474051多态性与腮腺良性肿瘤的关联性。方法以65例海南汉族腮腺良性肿瘤患者为实验组,69例正常体检者为对照,对所有入选者行PLAG1基因rs6474051多态性检测并行统计学分析。结果 CC、CT、TT三种基因型的检出例(率)在实验组中为33(50.8%)、25(38.5%)、7(10.7%),对照组中为44(63.8%)、24(34.8%)、1(1.4%),统计学分析P=0.05。等位基因C/T在两组中的检出率分别为70%/30%和80.6%/19.4%,组间差异具有统计学意义(P=0.023)。结论PLAG1基因rs6474051多态性与海南人群腮腺良性肿瘤可能存在关联,等位基因T可能是其易感基因之一。

低龄原发腮腺多形性腺瘤:1例报告并文献复习

多形性腺瘤最常见于腮腺,以30~50岁为多见,罕见低龄患者;其复发率高,并且具有癌变的潜在危险,在低龄患者中复发率较成人偏高。因此,在临床应尤其重视对低龄原发多形性腺瘤的治疗,这对预防其复发有着重要的意义。本文报道1例原发低龄腮腺多形性腺瘤患者的临床资料,并结合文献复习,讨论该疾病的临床特征与与年龄的关系,并得出:早期发现,选择合适的术式及切口,术后随访可有效降低低龄患者的肿瘤复发率。

腮腺多形性腺瘤与沃辛瘤MRI影像学特点的对比分析

多形性腺瘤和沃辛瘤是腮腺最常见的两种良性肿瘤。发生于腮腺的多形性腺瘤MRI平扫T1WI表现为等或稍低信号,T2WI表现为高信号,因含黏液其信号高于脑脊液;如发生坏死、囊变,T2WI表现为高低混杂信号;肿瘤有纤维包膜,T1WI和T2WI均表现为低信号,与正常组织分界清楚。沃辛瘤(腺淋巴瘤)内上皮成分嗜酸性并具有淋巴组织及密集排列的细胞核,故T2WI多以低信号为主,且信号均匀居多,可作为与混合瘤的鉴别点。本文研究发现腮腺多形性腺瘤与沃辛瘤在MRI成像上有不同的影像学特点,期望对临床工作有所帮助。

对接受腮腺包膜外切除术的良性腮腺瘤患者进行超声引导下耳大神经阻滞麻醉的效果研析

目的:探讨对接受腮腺包膜外切除术的良性腮腺瘤患者进行超声引导下耳大神经阻滞麻醉的临床效果。方法:选择2019年2月至9月期间在苏州大学附属第三医院接受腮腺包膜外切除术的40例良性腮腺瘤患者作为研究对象。将这40例患者分为单纯全麻组(n=20)和全麻联合神经阻滞组(n=20)。对两组患者均进行腮腺包膜外切除术。对单纯全麻组患者进行全身麻醉,对全麻联合神经阻滞组患者进行全身麻醉联合超声引导下耳大神经阻滞麻醉。然后,比较两组患者进行手术的时间、异丙酚的使用量、舒芬太尼的使用量、拔管的时间及在PACU(麻醉后监测治疗室)停留的时间。结果:与单纯全麻组患者相比,全麻联合神经阻滞组患者进行手术的时间更长,P>0.05。与单纯全麻组患者相比,全麻联合神经阻滞组患者舒芬太尼的使用量、异丙酚的使用量均更少,其拔管的时间、在PACU停留的时间均更短,P<0.05。结论:对接受腮腺包膜外切除术的良性腮腺瘤患者进行超声引导下耳大神经阻滞麻醉的临床效果确切,可有效地缩短其在PACU停留的时间。