Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P203

Poster Presentations

Rural Head and Neck Cancer Screening:
Reaching an Underserved Population
Garrett G. Casale, MD (Presenter); Katherine L. Fedder, MD;
Matthew A. Hubbard, MD; Mark J. Jameson, MD, PhD
Objectives: Head and neck cancer presents patients with significant impacts on their quality of life. Patients with head and
neck cancer often present with late-stage, locally advanced
disease, and although most of these patients are treatable, the
treatment offered often is associated with significant functional changes for the patient. In our experience at the
University of Virginia, a large number of our patients with
head and neck cancer present from Appalachia, a medically
underserved region.
Methods: We held our screening in Abingdon, Virginia. We
promoted the event by contacting local churches. We also
published advertisements in newspapers in Abingdon and the
surrounding area, and a story was published about our screening by a local television news station. Finally, we published
advertisements on social media. We held our event at Abingdon
Ear, Nose, and Throat Associates. Our screening consisted of
a full head and neck examination with in-office laryngoscopies for those with symptoms that warranted endoscopic
evaluation.
Results: We screened 28 patients from Abingdon and the
surrounding areas. Average age was 61.4 years. Eleven of our
patients were male, and 17 were female. All patients underwent a full head and neck examination, and 8 patients were
evaluated with flexible laryngoscopy. We polled our patients
on how they heard about the screening. Of our patients, 14
(50.0%) heard about the screening on social media, 6 (21.4%)
heard about the screening in church, and 8 (28.5%) heard
about our screening from local news sources.
Conclusions: Social media represents an easily accessible
and high-impact method of reaching patients for head and
neck cancer screening. We were successfully able to reach our
target population.
Sebaceous Cyst of the Parotid Gland? An
Unexpected Diagnosis
Susan Kurian, MD (Presenter); John Logan Sobiesk, MD;
Nestor Dela Cruz, MD; Cherie-Ann O. Nathan, MD
Objectives: Sebaceous lymphadenoma, or benign lymphoepithelial cyst with sebaceous differentiation, is a rare salivary
gland neoplasm with marked difficulty in clinical diagnosis.
We present this case to increase awareness of this rare entity
so that patients can be treated appropriately.
Methods: A 73-year-old man presented with a progressively
enlarging right parotid gland mass of 2-month duration

characterized by occasional pain and facial twitching. The
patient underwent both a computed tomography and magnetic
resonance imaging scan that revealed a 2-cm soft-tissue mass in
the right parotid gland without adjacent lymphadenopathy. Fineneedle aspiration on 2 attempts showed benign salivary gland
tissue with scattered lymphocytes and enucleated squamous
cells. A positron emission tomography scan was also ordered by
an outside physician showing the mass had no significant uptake.
Results: The patient underwent surgical resection. Intra-
operatively, the mass was encapsulated, fluctuant, and noted
to be in the accessory parotid lobe. Gross examination of the
mass showed caseous material within the center of the mass,
followed by pathologic diagnosis of sebaceous lymphadenoma. The decision was made to preserve the superficial lobe
of the parotid gland that was uninvolved, and the patient
remained disease free 1 year later.
Conclusions: Sebaceous tumors of the salivary glands are
extremely rare and often misdiagnosed, with patients potentially undergoing extensive workup prior to surgical excision
and definitive diagnosis. Fine-needle aspiration can be nondiagnostic, leading to difficulties in surgical planning, unnecessary studies, and potential overresection with accompanying
surgical morbidity. For sebaceous lymphadenoma, resection of
the mass with clinical follow-up is the mainstay of treatment.
Secondary Voice Prosthesis Insertion
With Flexible Transillumination Device
Under Local Anesthesia-A New Surgical
Technique
Amanda Sampaio Almeida, MD (Presenter); Flavio M.
Gripp, MD; Carlos T. Chone, MD, PhD
Objectives: Voice prosthesis (VP) insertion is the most intelligible technique for speech rehabilitation after total laryngectomy. It is inserted under general anesthesia using a rigid
esophagoscope with risks such as esophageal perforation and
mediastinitis. This study aims to describe a new secondary tracheoesophageal puncture technique (TEP) with VP insertion
under local anesthesia with a low-cost device and evaluate
success and surgical complications.
Methods: Medical charts of patients submitted to secondary
TEP and VP insertion under local anesthesia between 2014
and 2019 in a tertiary public university hospital were retrospectively analyzed. With a transoral flexible transillumination device of aluminum of 2.3 mm with fiberoptic light, the
anterior wall of the esophagus is visualized through the tracheostoma. A tracheoesophageal fistula is made with a blade
and passed through the fistula. Then a bended trocar is introduced into the lumen using the device as a guidewire. Once in
the lumen, a thin guidewire is passed through up to the mouth,
and the VP is positioned with retrograde insertion. Then, the
patient is discharged without hospitalization.
Results: Fifteen patients with a mean age of 61 years were
identified. Of these, 87% had a successful surgical outcome.
In 3 patients after a failed attempt at VP insertion, a pharyngoesophageal stricture was treated with dilation or aggressive

Head and Neck

Conclusions: Rosai-Dorfman disease represents a rare,
benign disorder whose presentation often mimics malignancy.
We present the first reported case of Rosai-Dorfman disease
involving the parapharyngeal space and discuss its presentation, diagnosis, and management.

P203

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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