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International Forum of Allergy &... Dec 2017Isolated sphenoid sinus opacifications (ISSOs) represent a relatively uncommon disease with the potential for serious complications. To better understand this disease,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Isolated sphenoid sinus opacifications (ISSOs) represent a relatively uncommon disease with the potential for serious complications. To better understand this disease, we performed a systematic review to further characterize the underlying pathologies, associated symptoms, and treatment outcomes of patients with ISSOs.
METHODS
A systematic review of ISSO case series was performed utilizing the Medline, Embase, Web of Science, and Cochrane databases in accordance with guidelines established by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Data of interest included disease pathology, associated symptoms, and treatment outcomes.
RESULTS
Of the initial 1051 hits from the 4 databases, 17 articles, with a combined 1133 ISSO patients, were ultimately included in the review. On a weighted analysis, the underlying pathologies were classified as chronic rhinosinusitis without nasal polyps (CRSsNP) (28.3%), mucoceles (20.3%), fungal sinusitis (12.5%), malignant neoplasms (7.7%), intracranial lesions (7.0%), benign neoplasms (5.7%), chronic rhinosinusitis with nasal polyps (CRSwNP) (3.4%), and other lesions (4.7%). Cranial neuropathies were present in 16.3% (95% confidence interval [CI], 10.1-22.5%) of ISSO patients. A favorable surgical complication rate of 1.5% (95% CI, -0.1% to 3.2%) was found in patients undergoing surgery for an ISSO.
CONCLUSION
ISSOs are caused by diverse pathologies. Given the considerable rates of neoplastic disease and cranial neuropathies, patients affected by an ISSO should be monitored closely and treated aggressively. Prompt surgical intervention, with either diagnostic or therapeutic intent, is often indicated.
Topics: Humans; Paranasal Sinus Diseases; Sphenoid Sinus
PubMed: 29024448
DOI: 10.1002/alr.22023 -
The American Surgeon Feb 2018Appendiceal mucoceles (AMs) are rare mucin-containing neoplasms with malignant potential. Lack of evidence-based data exists defining clinicopathological features for... (Review)
Review
Appendiceal mucoceles (AMs) are rare mucin-containing neoplasms with malignant potential. Lack of evidence-based data exists defining clinicopathological features for management. MEDLINE search between 1995 and 2015 was performed using search criteria "Appendix mucocele." Systematic review of patient-, pathologic-, and treatment-related characteristics was performed and data analyzed. Among 276 cases of non-perforated AMs, 163 (59%) patients were female, with variable and nonspecific presentation. Patients were treated with appendectomy (52.1%), right hemicolectomy (17.6%), partial cecectomy (17.2%), and ileocecetomy (13.1%). Pathologic evaluation revealed the following: cystadenoma/low-grade appendiceal mucinous neoplasm (54%), unspecified/benign (25%), retention cyst (14.1%), cystadenocarcinoma (4.2%), and mucosal hyperplasia (2.9%). All 11 (4.2%) patients with cystadenocarcinoma were female (P = 0.004), odds ratio for malignancy 1.07 times higher for women. Synchronous colonic malignancy was reported in three patients (27%) with cystadenocarcinoma (P = 0.007), odds ratio of 12.1. AMs have low risk for malignancy. Treatment should begin with appendectomy-only and subsequently guided by pathologic diagnosis.
Topics: Adenocarcinoma, Mucinous; Appendectomy; Appendiceal Neoplasms; Cecum; Colectomy; Cystadenocarcinoma; Cystadenocarcinoma, Mucinous; Cystadenoma, Mucinous; Humans; Ileum; Mucocele
PubMed: 29580358
DOI: No ID Found -
Materials (Basel, Switzerland) Mar 2022The mucocele is the most common minor salivary gland associated disease of the oral cavity. It is also considered one of the most common biopsied oral lesions in... (Review)
Review
The mucocele is the most common minor salivary gland associated disease of the oral cavity. It is also considered one of the most common biopsied oral lesions in pediatric patients. In recent years, extensive evidence has been published about the usage of lasers in treating mucoceles in pediatric patients. The aim of the present study was to assess the effectiveness of laser irradiation in the treatment of pediatric mucocele. An electronic search of databases (PubMed, Scopus, Web of Science and Google Scholar) was carried out in order to identify all relevant articles using a combination of the following keywords: "Pediatric", "Oral", "Mucocele", "Dental", "Oral Medicine", "Soft Dental Lasers", "Hard Dental Lasers", and "Lasers," for all case reports, case series, case-control and cohort studies published from 2007 to 2021. After limiting the search results, removing duplicate titles, and eligibility evaluation, 17 papers were enrolled in the study. Out of the total studies included, 10 articles were related to the diode (635 nm, 808 nm, 810 nm, and 980 nm), 5 to CO (10,600 nm), 3 to Er, Cr: YSGG (2780 nm), and 1 involving KTP lasers (532 nm). All studies indicated successful clinical results on mucocele excision with better intra- and post-operative indicators. The general characteristics and outcomes were summarized, and the quality of the studies was assessed using CARE guidelines in this systematic review. The reduction or absence of pain and bleeding, hemostasis, reduced operating time, minimal analgesic consumption, and an antibacterial effect were among the advantages of laser irradiation in the included studies. The laser has proven itself to play an effective role in the treatment of oral mucocele in paediatric patients.
PubMed: 35407784
DOI: 10.3390/ma15072452 -
The Laryngoscope Sep 2009The endoscopic modified Lothrop procedure (EMLP; also known as Draf III or frontal drillout) has recently gained popularity as a minimally invasive alternative to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES/HYPOTHESIS
The endoscopic modified Lothrop procedure (EMLP; also known as Draf III or frontal drillout) has recently gained popularity as a minimally invasive alternative to frontal sinus obliteration. This systematic analysis was designed to assess the safety and efficacy of the EMLP.
STUDY DESIGN
Literature review and meta-analysis.
METHODS
We performed a search of all English studies published from 1990 to 2008 that reported results from a minimum of five patients undergoing the EMLP. Of the 33 papers reviewed, 18 studies (evidence level II-2 or II-3) containing data from 612 patients met inclusion criteria.
RESULTS
The most common indications for EMLP were chronic frontal sinusitis (75.2%) and mucocele (21.3%). Patients had an average age of 47.9 years (range, 14-89 years) and were followed for 28.5 months postoperatively. Only 20.3% of procedures were performed without image-guidance. Stents were rarely used (6%). The rate of major and minor complications was <1% and 4%, respectively. No deaths were reported. A majority of patients were discharged within 24 hours. Postoperative endoscopic findings, qualitatively reported in 394 patients, demonstrated frontal sinus patency or partial stenosis in 95.9% at last follow-up. Where specifically assessed (n = 430 patients), improvement in symptoms was achieved in 82.2% of cases, with 16% reporting no significant change, and 1.2% reporting worsening of symptoms. The overall failure rate (requiring further surgery) of EMLP was 13.9% (85/612). Of the failures, 80% underwent revision EMLP, whereas 20% elected osteoplastic frontal sinus obliteration.
CONCLUSIONS
When performed by an experienced surgeon, EMLP is a safe and efficacious procedure that is well tolerated.
Topics: Chronic Disease; Endoscopy; Frontal Sinus; Frontal Sinusitis; Humans; Mucocele; Otorhinolaryngologic Surgical Procedures; Treatment Outcome
PubMed: 19554631
DOI: 10.1002/lary.20565 -
Medicina Oral, Patologia Oral Y Cirugia... Nov 2023There are different surgical techniques to remove Oral mucoceles, including conventional surgery with scalpel, removal of the lesion with CO2 laser, and micro... (Meta-Analysis)
Meta-Analysis
BACKGROUND
There are different surgical techniques to remove Oral mucoceles, including conventional surgery with scalpel, removal of the lesion with CO2 laser, and micro marsupialization. The present systematic review was conducted with the aim of comparing the recurrence rate of different surgical techniques for treatment of the oral mucoceles.
MATERIAL AND METHODS
An electronic search for randomized controlled trials published in English until September 2022 related to different surgical methods for the treatment of oral mucocele was performed in Medline/PubMed, Web of Science, Scopus, Embase and Cochrane databases. A random-effects meta-analysis was conducted to compare the recurrence rate of different techniques.
RESULTS
Among 1204 papers initially identified, after the removal of duplicate articles and screening of the titles and abstracts, fourteen full-text articles were reviewed. Seven articles comparing the recurrence rate of oral mucocele in different surgical techniques were found. Seven studies were included in qualitative studies, and five articles were included in the meta-analysis. The risk of mucocele recurrence in the micro-marsupialization technique was 1.30 times that of the surgical excision with scalpel technique, which was not statistically significant. The risk of mucocele recurrence in the CO2 Laser Vaporization technique was 0.60 times that of the Surgical Excision with Scalpel technique, which was not statistically significant.
CONCLUSIONS
The results of this systematic review showed that there is no significant difference between the recurrence rate of surgical excision, CO2 laser and marsupialization techniques for the treatment of oral mucoceles. Although more randomized clinical trials are needed for definitive results.
Topics: Humans; Mucocele; Neoplasm Recurrence, Local; Mouth Diseases; Surgical Instruments; Laser Therapy
PubMed: 37330953
DOI: 10.4317/medoral.26015 -
The Journal of Evidence-based Dental... Jun 2023Oral mucoceles could be managed with minimally invasive therapy (MIT) or conventional surgery, and both modalities reportedly possess advantages and demerits. This... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Oral mucoceles could be managed with minimally invasive therapy (MIT) or conventional surgery, and both modalities reportedly possess advantages and demerits. This review aims to investigate and compare the postoperative disease recurrence and complications of these interventions with each other.
METHODS
Relevant studies were searched in 5 databases (PubMed, Embase, Scopus, Web of Science and Cochrane Library) from inception to December 17, 2022. The pooled relative risks (RRs) with 95% confidence intervals (CIs) of disease recurrence, overall complications, nerve injury and bleeding/hematoma in MIT vs conventional surgery were calculated in meta-analysis. Trial Sequential Analysis (TSA) was performed to confirm our conclusions and assess the need for future trials.
RESULTS
Six studies (1 randomized controlled trial and 5 cohort studies) were included for systematic review and meta-analysis. The results showed no significant difference in recurrence between MIT and conventional surgery (RR=0.80; 95% CI, 0.39-1.64; P = .54; I=17%), and the results of the subgroup analysis were consistent. The incidence of the overall complications (RR=0.15; 95% CI, 0.05-0.47; P = .001; I=0%) and nerve injury (RR=0.22; 95% CI, 0.06-0.82; P = .02; I=0%) was significantly lower in MIT than in conventional surgery, but the incidence of bleeding/hematoma presented no significant difference (RR=0.34; 95% CI, 0.06-2.07; P = .24; I=0%). The results of TSA suggested that the conclusion of MIT significantly reducing the risk of overall complications was stable; and additional clinical trials were need in the future for confirming the conclusions regarding disease recurrence, nerve injury and bleeding/hematoma.
CONCLUSIONS
For mucoceles in the oral cavity, MIT is less likely to induce complications (i.e., nerve injury) compared with surgical removal, and the control of disease recurrence is comparable to that of conventional surgery. Therefore, the application of MIT for mucoceles could be a promising alternative to conventional surgery when the latter is not applicable.
Topics: Humans; Mucocele; Neoplasm Recurrence, Local; Hematoma
PubMed: 37201978
DOI: 10.1016/j.jebdp.2023.101841 -
Journal of Oral Pathology & Medicine :... Jan 2021Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to...
BACKGROUND
Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion.
METHODS
Biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases.
RESULTS
Of the 65 205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13 cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty-nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables.
CONCLUSION
Despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.
Topics: Diagnosis, Differential; Endothelial Cells; Endothelium, Vascular; Female; Hemangioendothelioma; Humans; Hyperplasia; Middle Aged; Mouth Mucosa
PubMed: 33188642
DOI: 10.1111/jop.13127 -
The International Journal of Oral &... 2014To analyze available evidence on the incidence of anatomical variations or disease of the maxillary sinuses as identified by cone beam computed tomography (CBCT) in... (Review)
Review
PURPOSE
To analyze available evidence on the incidence of anatomical variations or disease of the maxillary sinuses as identified by cone beam computed tomography (CBCT) in dentistry.
MATERIALS AND METHODS
A focused question was developed to search the electronic databases MEDLINE, EMBASE, the Cochrane Oral Health Group Trials Register, and CENTRAL and identify all relevant papers published between 1980 and January 19, 2013. Unpublished literature at ClinicalTrials.gov, in the National Research Register, and in the Pro-Quest Dissertation Abstracts and Thesis database was also included. Studies were included irrespective of language. These results were supplemented by hand and gray literature searches.
RESULTS
Twenty-two studies were identified. Twenty were retrospective cohort studies, one was a prospective cohort study, and one was a case control study. The main indication for CBCT was dental implant treatment planning, and the majority of studies used a small field of view for imaging. The most common anatomical variations included increased thickness of the sinus membrane, the presence of sinus septa, and pneumatization. Reported sinus disease frequency varied widely, ranging from 14.3% to 82%. There was a wide range in the reported prevalence of mucosal thickening related to apical pathology, the degree of lumenal opacification, features of sinusitis, and the presence of retention cysts and polyps. More pathologic findings in the maxillary sinus were reported in men than in women, and the medial wall and sinus floor were most frequently affected.
CONCLUSION
CBCT is used primarily to evaluate bony anatomy and to screen for overt pathology of the maxillary sinuses prior to dental implant treatment. Differences in the classification of mucosal findings are problematic in the consistent and valid assessment of health and disease of the maxillary sinus.
Topics: Anatomic Variation; Cone-Beam Computed Tomography; Humans; Maxillary Sinus; Maxillary Sinusitis; Mucocele; Nasal Mucosa; Nasal Polyps; Paranasal Sinus Diseases
PubMed: 25397794
DOI: 10.11607/jomi.3644 -
Journal of Surgical Case Reports Jun 2018Appendicular mucocele is a rare well-described clinico-pathological occurrence. It denotes an obstructive dilatation of the appendicular lumen by mucinous secretions.
INTRODUCTION
Appendicular mucocele is a rare well-described clinico-pathological occurrence. It denotes an obstructive dilatation of the appendicular lumen by mucinous secretions.
CASE REPORT
A 60-year-old patient presented with right lower abdominal pain and nausea for 2 years. Abdominal CT scan suggested a diagnosis of a appendicular mucocele. Following informed consent, surgical exploration revealed a cystic mass arising from the body of the appendix with inflamed walls with no evidence of perforation. Simple appendectomy was performed as the caecum and the mesenteric nodes were free of pathological involvement. The final diagnosis of mucinous cystadenoma was confirmed by histopathology. Postoperative course was uneventful. The patient was in good health during a four years regular follow-up.
DISCUSSION
Appendicular mucocele is a rare disease with vague symptoms. Abdominal imaging is an important diagnostic tool, but histopathology is the standard for definitive diagnosis. Surgery for benign appendicular mucoceles has an excellent long-term prognosis.
PubMed: 29991998
DOI: 10.1093/jscr/rjy102 -
International Journal of Pediatric... Nov 2020The diagnosis of ankyloglossia, or tongue-tie, and the number of frenotomies performed has increased over 10-fold from 1997 to 2012 in the United States. The sharpest...
INTRODUCTION
The diagnosis of ankyloglossia, or tongue-tie, and the number of frenotomies performed has increased over 10-fold from 1997 to 2012 in the United States. The sharpest increase has been in neonates. For parents considering frenotomy for their breastfeeding newborn, there is controversy surrounding the evaluation of tongue-tie and the benefit of a frenotomy. Complications from tongue-tie procedures are thought to be low, though it is not well reported nor studied.
OBJECTIVES
The aim of this study is to describe a case of a sublingual mucocele after laser frenotomy in a neonate with tongue-tie and to investigate major complications reported after tongue-tie release in pediatric patients through a systematic review of the literature.
CASE REPORT
We present a 6-week-old female who underwent a laser frenotomy procedure performed by a dentist who presented with a new cyst under her tongue.
MATERIAL AND METHODS
A systematic literature search of articles published from 1965 to April 2020 was conducted in Ovid MEDLINE(R), Ovid EMBASE, and Scopus. Citations were uploaded into a systematic review software program (DistillerSR, Ottawa, ON, Canada), followed by full text screening.
RESULTS
47 major complications were reported in 34 patients, including our patient. Most of the cases were located in the United States and Europe. The most frequent indications for the procedure were breastfeeding problems (n = 18) and speech impediment (n = 4). The procedure was performed by dentists (n = 6), lactation consultants (n = 5), and otolaryngologists (n = 4). The bulk of the major complications after frenotomy included poor feeding (n = 7), hypovolemic shock (n = 4), apnea (n = 4), acute airway obstruction (n = 4), and Ludwig angina (n = 2).
CONCLUSIONS
Reporting of complications after frenotomy is lacking. Risks to neonates may be different than risks to older children and adults. Practitioners across different specialties should be monitoring and studying this more rigorously to better guide patients and families on the risks and benefits of this procedure.
Topics: Airway Obstruction; Ankyloglossia; Apnea; Female; Humans; Infant; Lingual Frenum; Postoperative Complications; Ranula; Shock
PubMed: 32927351
DOI: 10.1016/j.ijporl.2020.110356