Harold Baurmash

Sialochemistry in Sjögren's syndrome

The value of sialochemistry in the study of Sjögrens syndrome was explored by comparative examination of a spectrum of parotid components in twelve subjects with a positive diagnosis of the disease and twelve control subjects with normal gland function. The subjects with Sjögrens syndrome all exhibited a marked reduction in flow rate and phosphate concentration and a marked elevation in sodium and chloride concentration. The concentration of IgA was somewhat elevated (commensurate with reduced flow rate); the levels of IgG, IgM, and albumin were normal. The major functional abnormality in the parotid gland in Sjögrens syndrome appears to be luminal transport in the ductal region; leakage of serum components is minimal. Sialochemistry can be helpful in differentiating Sjögrens disease from other diseases of the salivary gland and in assessing degree of pathologic change.

Marsupialization for treatment of oral ranula: A second look at the procedure

Simple marsupialization to manage oral ranula has fallen into disfavor because of excessive failures and the high incidence of iatrogenically caused cervical ranula that may follow this procedure. With the simple addition of packing the entire pseudocystic cavity with gauze after its unroofing, the rate of recurrence is minimized. It is recommended that oral ranula be treated initially by marsupialization with packing and, if recurrence occurs, then the offending sublingual gland should be excised.

Extraoral parotid sialolithotomy

The extraoral approach to duct surgery for the removal of parotid stones can be a simple procedure once the stone is accurately located in relation to the skin surface. The combination of sialography and sonography can provide this information. A case report demonstrates the step-by-step approach to diagnosis, localization, and surgery for the management of such extraglandular sialoliths.

The nonsurgical treatment of hemangioma with sotradecol

Abstract A relatively new sclerosing agent, sodium tetradecyl sulfate, appears to be more effective and less toxic than the soaps. Five cases of oral hemangioma were successfully treated with this drug.

Direct bonding of arch bars in the management of maxillomandibular injuries

The shortcomings of the conventional arch bars for the treatment of maxillomandibular injuries are described. A mesh-backed arch bar bonded to the teeth is recommended as a means of overcoming these problems.

A conservative approach to the management of orofacial vascular lesions in infants and children: Report of cases

gland. Indeed, a link may be postulated between the chronicity of this patient’s symptoms and her longterm use of combination antihypertensive therapy. Goldberg and Topazian state that submandibular secretions are more alkaline and contain higher concentrations of calcium and phosphates than parotid secretions. These secretions, taken in conjunction with the anatomic location of the submandibular duct, its length, its tortuous course, and its lack of dependent drainage, can create an environment in which salivary stones are more prone to form, especially under conditions of salivary stasis. Thus, conditions are ideal for deposition of calcium salts around foci of desquamated epithelium.

Salivary Immunoglobulins in Diseases Affecting Salivary Glands

Inflammatory disorders of the salivary glands cause marked abnormalities in secretion of immunoglobulins. The changes are reversible, however, in a relatively short period of time. More subtle changes in immunoglobulin transport are present in such diseases as Sjogrens syndrome and diabetes. No changes are discernable in alcoholic cirrhosis. Apparently salivary gland basement membranes are much more resistant to derangement than plasma membranes and the secretory IgA system can continue to operate in the face of numerous affronts. If nothing else these findings suggest that vaccination procedures in the region of the salivary glands may produce an inflammatory response, but it would be readily reversible. In addition, one could anticipate a functioning s-IgA system even in salivary glands with alterations in electrolyte transport. It is difficult to anticipate the situation in immunologically compromised patients, such as those on hemodialysis. Fortunately these patients represent a small population and for them at least, caries is a relatively minor concern.

Thyroglossal tract abnormalities

Abstract The embryonal development of thyroglossal cysts and fistulas has been traced. A complete knowledge of the associated embryology will serve to explain their clinical and pathologic characteristics. A review of the differential diagnosis of the more common cervical lesions was presented. In light of the embryonal antecedent of the thyroglossal cysts and fistulas Sistrunks rationale for radical surgical excision of the thyroglossal tract is advocated.

Differentiation of submaxillary lymphadenopathy and submaxillary salivary gland pathology

Abstract Emphasis has been placed on an outline of the diagnostic criteria utilized in differentiating submaxillary lymph node disease from submaxillary salivary gland disease. Six case reports have been presented to illustrate some conditions capable of producing submaxillary triangle swellings. At the same time, they serve to highlight the measures and resources used in making a diagnosis. It is not one piece of evidence alone but, rather, the sum total of information harvested from an exhaustive history and examination that leads to a valid diagnosis.

Chronic parotitis; with illustrative case report.

Chronic parotitis is initiated when a salivary obstruction or decrease in salivary production leads to an inadequate ductal lavage. Such a condition favors a low-grade, ascending duct infection originating from the oral cavity. With the ensuing inevitable duct damage, repeated infectious flareups can be anticipated.