Primary Mucosal Malignant Melanoma of the Maxilla: A Case Report and Review of Literature

 

Abstract

Primary mucosal malignant melanoma of oral cavity is a rare malignancy arising from the melanocytes. Mucosal melanomas of the head and neck comprise just over 1% of all melanomas and of these about 50% arise in the oral cavity. Oral mucosal melanomas are therefore rare, representing about 0.5% of oral malignancies and less than 0.01% of all oral biopsies. It tends to metastasize and locally invade tissues more than other malignant tumours of the oral cavity. It occurs commonly in the maxillary gingiva more frequently on the palate and lesser often in the mandibular gingiva. Here, we present a case of a mucosal malignant melanoma involving the maxillary bone along with the immunohistochemical profile of the neoplasm.

Keywords:Mucosal malignant melanoma; Maxilla; HMB-45

Abbreviations:WHO: World Health Organization; PET: Positron Emission Tomography; WLE: Wide Local Excision; MND: Modified Neck Dissection; AJCC: American Joint Committee on Cancer; CTLs: Cytotoxic T lymphocytes

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Round Window Electrochleography in Cochlear Implantation

 

Abstract

Introduction: In this study which was achieved at Izmir Bozyaka Teaching and Research Hospital, identifying the sensitivity and reliability of round window electrocochleographic records on children during cochlear implantation and investigating the applicability of the method on particularly problematic patient groups was aimed.

Material and Methods: In this study, the golf-club electrode was placed on the round window niche during cochlear implantation of 30 patients after posterior tympanotomy. Then click stimulus was given by TDH 39 headphones over the speculum which was placed in the external ear canal and the responses that obtained from the stimuli were recorded with Medelec Snergy Amplifier device. The round window ECoG records which were obtained from these 30 patients were compared with the preoperative ABR results. Round window ECoG responses were acquired during operation in 22 patients who had no response to ABR preoperatively. Two patients responded to both preoperative ABR and perioperative round window ECoG. And 7 patients had no preoperative ABR and perioperative round window ECoG responses.

Discussion: Our outcome data shows that round window ECoG is more sensitive than ABR while deciding for cochlear implantation. The results are statistically significant. Outside of the study, there were 8 patients more. These 8 patients had some abnormalities and because of these abnormalities it was difficult for us to decide for cochlear implantation. We performed round window ECoG to these 8 patients via trans canal way. In these patients we again found that round window ECoG is more sensitive than ABR for determination of residual hearing and it can be a guiding test for us to decide for cochlear implantation in patients with abnormalities.

Conclusion: As a result, round window ECoG is a very sensitive method for determination of residual hearing and it might be used in patients who has abnormalities such as bony labyrinth abnormalities, auditory neuropathy, and meatus acousticus internus stenosis that complicates our decision for cochlear implantation.

Keywords:Cochlear implantation; round window electrocochleography; auditory brainstem response (ABR)

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