Randall G. Michel

Ceruminous gland adenocarcinoma. A light and electron microscopic study

Tumors of ceruminous gland origin in the external auditory canal are rare in man. A case is described in which such a tumor presented as an invasive vascular temporal bone neoplasm, mimicking a glomus jugulare tumor. Light and electron microscopic study of this tumor confirmed a diagnosis of ceruminous gland adenocarcinoma. Tumors of ceruminous gland origin appear to have a distinctive clinical behavior by virtue of their unique anatomical location in the external auditory canal. Our experience with this case establishes another clinical picture characterizing the histologic type of ceruminoma designated as a ceruminous gland adenocarcinoma. We feel that the generic term „ceruminoma,”︁ with its implied histologic subgroups, is useful to the clinician when he encounters a tumor arising from the modified sweat glands of the external auditory canal.

Tomographic diagnosis of palatal defects.

We present the results of a pilot study conducted to evaluate the effectiveness of palatal tomography in patients suspected of having palatal defects not detectable by other methods. Twelve patients were involved in the projects, ranging in age from 3 to 11 years. There were 8 boys and 4 girls. Each patient was evaluated with voice recordings, lateral cineradiographic x-rays, and palatal tomograms. Nine of the 12 patients were found by tomography to have palatal defects that had not been detected either by cineradiography or by clinical investigation, including physical examination of the palate. The results of this study are presented with clinical findings.

Evaluation of sclera as a homograft in facial plastic and reconstructive surgery.

Augmentation of deficient soft tissue contours accounts for a large part of facial plastic and reconstructive surgery. An attempt to use homograft sclera in the feline animal model is presented. Augmentation of nasal dorsum and the chin contours was carried out in the cat model with preserved homograft sclera. Serial soft tissue radiographs and histologic study of the homografts demonstrated complete resorption of the grafts by six months. Further physical and chemical alterations of homograft sclera appear to be necessary prior to its implantation for the purpose of soft tissue augmentation.

Sjögren's syndrome and serous otitis media

Extrasalivary lymphoid abnormalities in Sjögrens syndrome are well described. Patients have been found to have lymphoid infiltration of many organ systems. The nature of the lymphoid abnormalities constitutes a spectrum ranging from benign to malignant disease. A case of an elderly patient with long standing Sjögrens syndrome is presented because of the unusual manifestation of a benign lymphoid mass in the nasopharynx producing unilateral eustachian tube obstruction and serous otitis media. Serous otitis media associated with Sjögrens syndrome is recognized, but to our knowledge in previous cases an extrasalivary lymphoid abnormality has not been implicated as the underlying pathology.

P018: Tissue Welding Tonsillectomy: Incidence of Complications

embolized. This controlled the patient’s bleeding. After the procedure the patient had left-sided ptosis, blindness, and no pupillary constriction to direct light. Review of the angiogram demonstrated that the anomalous third terminal branch of the external carotid gave rise to the ophthalmic artery. The ophthalmic artery provides blood supply to the optic and oculomotor nerves. Embolization interrupted the blood supply to these nerves and all the structures they innervate. CONCLUSIONS: The incidence of an anomalous origin of the ophthalmic artery ranges between 1-3%. Failure to recognize this variant can result in catastrophic sequelae for patients undergoing embolization of the distal maxillary artery for epistaxis.