Congenital absence of salivary glands in Down syndrome

Association between Antimicrobial Peptide Histatin 5 Levels and Prevalence of Candida in Saliva of Patients with Down Syndrome

There are no studies on Candida colonization and micropeptides of saliva in any patient. Therefore, we studied the effects of the salivary antimicrobial peptide histatin 5 on oral fungal colonization; subjects were subdivided into Down syndrome (D) and normal (N) groups by age: N-1 and D-1, age <20 years; N-2 and D-2, age >40 years. Histatin 5 concentration in saliva was measured by enzyme-linked immunosorbent assay. Oral Candida species were identified using CHROMagar Candida. Candida colonization was significantly enhanced in the D-1 and D-2 groups compared to the N-1 and N-2 groups. There was no predominant difference in salivary histatin 5 concentration between the D-1 and N-1 groups, but it was significantly lower in the D-2 group than in the N-2 group. Only in the N-2 group was there a correlation between the concentration of histatin 5 and total protein, while no correlation was found in the other groups. In elderly patients with Down syndrome, the decrease in histatin 5 shown in this study may lead to oral Candida colony formation. Therefore, the results of this study suggest that a deficiency of the antimicrobial peptide histatin 5 could possibly induce oral Candida infection in DS.

First-Trimester Nonvisualization of the Parotid Gland and Aneuploidy in Fetuses With Increased Nuchal Translucency: A Prospective Cohort Study

OBJECTIVES

Aplasia and hypoplasia of the major salivary glands, particularly the parotid glands, were reported to be associated with trisomy 21. This study aimed to evaluate the value of first-trimester nonvisualization of the parotid gland in a high-risk population of fetuses with increased nuchal translucency (NT).

METHODS

A single-center prospective observational cohort study was conducted. The feasibility of imaging the parotid gland was assessed in 100 sequential cases of routine low-risk NT scans. In a 2-dimensional image in an axial plane at the level of the fetal mandible, the parotid glands appear as bilateral hyperechoic round areas. Cases referred for counseling for an NT measured above the 95th percentile for gestational age were evaluated for visualization of the parotid glands. Prenatal findings were correlated with fetal genetic analysis results.

RESULTS

Forty-two cases with increased NT constituted the final study group. Within the group with nonvisualization of the parotid gland, genetic testing revealed 9 cases of trisomy 21, 3 cases of trisomy 18, and 1 case of monosomy X. The sensitivity and specificity of nonvisualization of the parotid gland as a predictor of aneuploidy were 76% and 80%, respectively. The positive likelihood ratio, negative likelihood ratio, and relative risk were 3.82 (95% confidence interval [CI], 1.67-8.74), 0.29 (95% CI, 0.12-0.71), and 4.33 (95% CI, 1.69-11.09; P < .01). The negative predictive value was 95.14%.

CONCLUSIONS

First-trimester nonvisualization of the parotid gland may constitute a potential method for detection of aneuploid fetuses within a high-risk population.

Ten must know pseudolesions of the head and neck

Patients may present in the emergency setting for a variety of head and neck complaints such as fever, trouble swallowing, or a newly palpable mass. When reviewing radiologic head and neck exams for etiology of complaints, it is important to be familiar with the multiple pseudolesions that may mimic pathology. These may be normal variant anatomy, normal anatomy located in an atypical location, as well as iatrogenic or self-introduced foreign bodies. This review article discusses ten common pseudolesions encountered in the head and neck and their typical imaging appearance so that one does not mistake them for ominous pathology, thus preventing unnecessary follow-up, biopsy, or continued concern for the patient.

The Dental Needs and Treatment of Patients with Down Syndrome

Down syndrome is a common disorder with many oral conditions and systemic manifestations. Dentists need to take a holistic approach including behavioral, oral, and systemic issues. This review of the literature focuses on oral anomalies, systemic interaction, management, and recommendations.

Major salivary gland aplasia and hypoplasia in Down syndrome: review of the literature and report of a case

Salivary gland aplasia and hypoplasia are rarely described in the medical literature. This article presents a case of aplasia and hypoplasia of the major salivary glands in a patient with Down syndrome. A literature review, as well as an overview of the diagnosis and management of this condition, is presented.

[Magnetic resonance imaging anatomy of the feline salivary glands]

OBJECTIVE

The aim of the study was to define anatomical characteristics of feline salivary glands using magnetic resonance imaging (MRI) and to describe landmarks for their reliable identification.

MATERIAL AND METHODS

Heads of 37 adult cats without signs of diseased salivary glands on clinical examination or history were examined. In cats included in the prospective part of the study, the MRI study was completed within one hour after euthanasia (n = 16). In the retrospective part, previously performed MRI studies were evaluated (n = 21). The prospective part of the study included the following standardized sequences: T2-weighted (T2W) turbo spin echo (TSE), T2W fat-suppressed TSE and proton density weighted (PDW) TSE images in a transverse plane as well as T1-weighted (T1W) fast field echo (FFE) in the transverse, sagittal and dorsal planes. In the retrospective part, T2W TSE and T1W TSE transverse images pre- and post-contrast were analyzed. Initially, identification and delineation of the salivary glands from surrounding tissue was assessed. Anatomical structures of the head were then identified and defined as landmarks. The dimensions of the glands were measured on T2W TSE images and the signal intensity in relation to that of fat and muscle was described using all sequences.

RESULTS

In total, 95.9% of the parotid glands and 100% of the mandibular glands could be visualized on T1W TSE and FFE images and on T2W TSE images. Additionally, 93.3% of the zygomatic glands were identified on T2W TSE sequences and 82.5% on T1W TSE and FFE images. The ventral buccal glands could be demarcated in some sequences (T2W TSE: 51.4%, T1W TSE and FFE: 18.9%). Anatomical landmarks facilitated gland identification. Comparing the size of the salivary glands of both groups revealed differences of up to 2 mm.

CONCLUSION

Both the large salivary glands (Glandula [Gl.]. parotis and Gl. mandibularis) and the small salivary glands (Gl. zygomatica and Gl. buccalis ventralis) of the cat can be reliably identified on MRI images.

Congenital Unilateral Agenesis of the Parotid Gland: A Case Report and Review of the Literature

Congenital unilateral agenesis of the parotid gland is a rare condition with only few cases reported in the literature. A review of 21 cases in the available literature is presented in this article. We report on a further case of a 34-year-old woman with agenesis of the left parotid gland and lipoma of the right cheek. Clinicopathological characteristics of described cases in the literature were discussed.

[Computed tomographic anatomy of the salivary glands in the cat]

OBJECTIVE

The aim of the study was to define anatomical characteristics of the feline salivary glands in cross-sectional images obtained by unenhanced computed tomography (CT) and to describe landmarks for a reliable identification.

MATERIAL AND METHODS

Heads of adult normocephalic cats without indications of cephalic disease were examined. Cats were included in the prospective part of the study when examined no later than 1 hour post mortem (n = 16). In the retrospective part of the study, previous CT-studies were evaluated (n = 25). The results of both groups were evaluated separately. Initially, the possibility of identifying and delineating the salivary glands from the surrounding tissue was assessed. Anatomical structures of the head were then defined as landmarks. Dimensions and density (Hounsfield units, HU) of the salivary glands were determined based on transversal and reconstructed sagittal images.

RESULTS

In total, 94.3% of the parotid glands, 90.7% of the mandibular glands and 96.8% of the zygomatic glands could be delineated. The remaining salivary glands could not be identified. Anatomical landmarks, including the external ear canal, the musculus (M.) masseter, the M. pterygoideus medialis and the bulbus oculi facilitated the identification. Comparing the size of the salivary glands of both groups revealed differences (measured lateromedially and rostrocaudally) in size of ≤   2 mm. The definable salivary glands varied significantly in their density. The mean density of the glandula (Gl.) parotis was 65 HU, of the Gl. mandibularis 62 HU and of the Gl. zygomatica 57 HU. The comparisons of densities of both sides of the glands did not show statistically significant differences.

CONCLUSIONS

The large salivary glands (Gl. parotis and Gl. mandibularis) and the Gl. zygomatica of the cat can be reliably identified in CT-images. CT landmarks and data regarding the size and density of each gland could be gathered. The remaining minor salivary glands could not be delineated accurately. The difference in depicting the glands can be explained mainly by a lack of contrast with the surrounding tissue.