Faculty Bibliography

We present a case of intramuscular hemangioma of the masseter muscle. We stress that, although there can be apparent vascular infiltration of the muscle, this lesion is benign; it should not be mistakenly diagnosed as an angiosarcoma.

Computerized tomography has manifest usefulness in the roentgenologic identification of intracranial masses, and acoustic neuromas are no exception. Nonetheless, traditional roentgenographic examinations for the workup of acoustic neuromas should not yet be completely discarded in favor of this new modality. Computerized tomography scanning is an insensitive and unreliable technique for delineating the size and configuration of the internal acoustic canals. With current technology, it will not reliably show neuromas less than 1.5 cm in cross-sectional dimension. Technical artifacts may also contribute to false-negative and though rare to false-positive findings. The false-negative rate will be unacceptably high in the presence of small lesions if this technique is treated as a definitive examination rather than a screening one. Though uncommon, it may also be negative in the presence of relatively large lesions

Eleven cases of lipoma in the parotid region have been reviewed. Nine tumors were found to be compressing the lateral surface of the parotid gland (periparotidlipoma). One lesion was totally surrounded by salivary tissue, and another involved both the superficial and the deep lobes of a parotid gland (intraparotid lipoma). The tail of the gland was involved most frequently (six patients). The tumors were predominantly right sided (eight cases). All patients were treated by surgical excision. Only one tumor has recurred and this has apparently been successfully treated by a reexcision

The authors describe the use of the infrahyoid ("strap") muscles as a muscle transposition flap to obliterate the "dead space" created during resection of the anterior floor of the mouth for carcinoma concomitant with suprahyoid neck dissection or radical neck dissection. The flap is particularly useful if the mandible is partially resected and immediately stabilized with a steel pin or bolt.

Nondelayed regional skin flaps for reconstruction following radical ablative surgery in the head and neck have become a significant advance. Radical extirpation of large, recurrent or postirradiation persistent cancer would be prohibitive without the use of regional skin flaps in reconstruction. The incorporation of portions of rib, clavicle or scapula within a skin flap has allowed reconstruction of the mandible for both functional and cosmetic improvement.

The diagnosis of carcinoma primary in the mastoid bone is usually made while performing a mastoidectomy in an effort to control presumed chronic mastoiditis. The association of chronic infection, serosanguineous otorrhea, and severe otalgia, common warning signs of carcinoma of the middle ear or external auditory canal, may or may not be present with a carcinoma primary in the mastoid bone. If the amount of bony mastoid destruction seen by roentgenography is out of proportion to the degree of clinical infection, malignancy should be strongly suspected. The authors present a case of primary carcinoma of the mastoid bone, and review the diagnosis and treatment.