Shigeyasu Ishizaka

Fibrolipoma of the parotid in a child

Fibrolipoma is a rare benign tumor found predominantly in middle and later life; it is very uncommon in children1 There are many reports in literature of resected fibrolipomas of the oral cavity.2,3 However, there are only a few reports of fibrolipoma in the parotid. This report describes a case of a S-year-old girl with fibrolipoma of the parotid gland. This is the youngest such patient to be found in the literature. lobules of yellow adipose tissue separated by white fibrous septa. No hemorrhage, necrosis, or calcification was noted. Microscopic examination of sections stained by hematoxylin and eosin showed lobules of mature adipose tissue mixed with a network of fibrous connective tissue (Fig 4). The fibrous elements contained numerous fibrocytes, suggesting the presence of mature collagen. The adipose component consisted of mature adipocytes. The histopathological features were consistent with a fibrolipoma.

Clinical Analysis of Tracheostomy in Infant

Tracheostomy was performed in 7 patients during a 3-year period (2002-2004) at our hospital. The causative diseases were central nervous system disorders (3 cases), laryngo-tracheal stenosis (1 case), Edwards syndrome (trisomy 18) (1 case), werdnig-Hoffmann disease (1 case), Trauma (1 case). Five cases were neonates less than one day old. A vertical incision is made in the midline of the trachea. A 4-0 nylon suture is then placed through the tracheal wall on either side of the vertical incision. Complications after surgery included 3 cases of stomal granulation. Staphylococcus aureus (MRSA) was detected in the peristomal region in 2 of these three. Therefore, MRSA infection seemed to be one of the factors precipitating the development of granulation.

A Case of Embolization for Recurrent Epistaxis after Maxillary and Ethmoidal Artery Ligation.

Maxillary and ethmoidal artery ligation is generally effective for treating severe epistaxis. However, we have occasionally experienced continuous or recurrent bleeding after this procedure. We encountered a 81-year old male with severe epistaxis occuring 5 years after ligation of the internal maxillary artery and anterior ethmoidal artery. Nasal packing was not effective and angiography was performed by Seldingers method in order to confirm the site of bleeding. As a result, the reconstruction of flow to the internal maxillary artery through a collateral was found, and embolization was performed with a gelatin sponge. No further epistaxis or side effects from the embolization occurred. Therapeutic intraarterial embolization is useful for controlling severe epistaxis such as that caused by failed ligation.