The objective of this study is to report the occurrence, demographic and clinical findings of lip mucoceles in children. A restrospective study was conducted at the paediatric dental clinic situated at Hospital Sultanah Aminah, Johor Bahru. The period of study was 3 years beginning 2003 to 2005. Out of 1407 new cases seen over the period of study 17 (1.2%) patients presented with lip mucoceles. All lesions occurred in the lower lip. There was no sex or racial predilection. The average duration of the lesion prior to seeking treatment was 2.8 ± 2.8 months. Most patients (76.5%) first saw a medical practitioner for the problem. No spontaneous resolution of the lesions in any of the patients was noted. The preferred method of treatment of lower lip mucoceles in children is surgical excision of the involved minor salivary glands. Salivary gland mucoceles in children predominantly involve the lower lip and can be treated successfully by complete removal of the involved and associated minor salivary glands.
Plunging epidermoid cyst of the floor of mouth is indeed an uncommon entity. A 34-year old Malay
gentleman had presented to our centre with a floor of mouth lesion that extended into the submental
region. Clinical findings and imaging studies pointed towards the impression of a plunging ranula.
Histopathological examination of a completely excised mass via intraoral approach, confirmed the
diagnosis of an epidermoid cyst. He was well on follow up with no subsequent recurrence. We discuss
the nature of epidermoid cyst and its surgical management.
141 salivary gland lesions that were subjected to fine needle aspiration (FNA) cytology at the University Hospital, Kuala Lumpur, from January 1993 to October 2000 were reviewed with a view to assess the sensitivity and utility of cytological diagnosis in diseases of salivary glands. The highest number of cases was seen in the sixth decade of life. There was no gender preponderance in salivary gland neoplasms except in Warthin's tumours that occurred predominantly in males. The parotid gland was the most frequent salivary gland needled. Seven cases (5%) presented with bilateral salivary gland enlargement. Cytological study yielded a neoplastic diagnosis in 74.5% cases. Of the neoplastic lesions, 71.4% could be definitely designated as benign and 25.7% as clearly malignant. Pleomorphic adenoma and acinic cell carcinoma were the most common benign and malignant neoplasms diagnosed respectively. 53 cases had histological correlation; of these, 49 (92.5%) were neoplastic. The overall diagnostic accuracy of FNA cytological diagnosis in salivary gland lesions was found to be 73.6%.
Sialolithiasis is a commonly encountered disease of the salivary glands, reported to represent up to 30% of all salivary gland diseases. However, the condition is rarely encountered in the pediatric population. The formation of a salivary stone is believed to be secondary to the deposition of calcium salts around a nidus. The formation of a nidus is commonly associated with desquamated epithelial or sloughing from a recent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. Neglected and poorly treated acute infection may progress to life-threatening abscess formation. Here we are describing our encounter with a 10-year-old boy with recurrent submandibular sialolithiasis. He was initially treated with conservative measures and antibiotics regimen. Failure of medical treatment and recurring symptoms led to submandibular gland excision followed by a full recovery.
Parotid swellings are uncommon. Over a twelve-year period, 110 cases of parotid swellings were treated at the Department of Plastic Surgery, Hospital Kuala Lumpur, of which 97 cases were histologically proven to be parotid tumours. 75% of these tumours were benign tumours, and 80% of the benign tumours were pleomorphic adenomas. Among the malignant tumours, 6 cases were adenoid cystic carcinoma and 5 were carcinoma ex-pleomorphic adenoma. There were equal number of male to female patients, with an age range of 14 to 83 years. There is a positive correlation between the final histological diagnosis and FNAC results in 74% of cases. Surgical treatment of choice for benign parotid tumours was near-total parotidectomy whilst for malignant tumours was total radical parotidectomy with sural nerve graft.