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Objective(s): Despite advancements in imaging techniques and cytological analysis, plunging ranula remains a challenging surgical, radiologic, and pathologic phenomenon. Of the 18 patients we evaluated at our institution, we highlight three cases that illustrate the high rate of misleading imaging and cytological results when assessing plunging ranula. Methods: Imaging results, biopsy findings, operative techniques, and pathological reports were reviewed from patients who had either a preoperative or postoperative diagnosis of ranula and underwent surgery by a single head and neck surgeon at a tertiary care center. Results: Of the 18 identified patients, computed tomography was correct on preoperative imaging 73% of the time and magnetic resonance imaging was correct on preoperative imaging 71% of the time. Two patients underwent preoperative ultrasound and their ultrasound reports did not accurately diagnose the presence of a ranula. Two patients underwent preoperative fine needle aspiration biopsy due to inconclusive preoperative imaging, in which results suggested either a ranula or epidermal cyst. Both ultimately did not match the final pathology. Three of eighteen patients (17%) underwent an inappropriate initial surgery due to incorrect imaging diagnoses and/or biopsy findings. Conclusion: Despite use of preoperative modalities to distinguish plunging ranula from other cystic floor of mouth lesions, surgeons must be aware that no workup modality is fully precise. The potential for revision surgery must be included in all preoperative discussions for presumed plunging ranula. Level of Evidence: 4 Laryngoscope, 134:2689–2696, 2024 [ABSTRACT FROM AUTHOR]

Background and Objectives: There has been a significant increase in the use of fermentation for protein modification by the food industry. This research aimed to investigate the use of solid‐state fermentation (SSF) by Aspergillus oryzae NRRL 5590 on pea and navy bean protein isolates (PPI and NBPI, respectively) to enhance their physicochemical and functional properties. Findings: The impact of fermentation was more profound on PPI than NBPI with a higher degree of hydrolysis achieved for the former (9.3% vs. 4.4%). Fermented PPI had significantly increased protein content, surface charge and hydrophobicity, solubility, and foaming properties, but decreased emulsion stability. For NBPI, modifications were only observed for surface hydrophobicity and water hydration capacity (WHC), which both increased after fermentation. Overall, navy bean proteins were less susceptible to protein hydrolysis than pea proteins upon fermentation, possibly due to the phaseolin protein in navy bean. Conclusions: In summary, fermentation may be used to enhance the solubility and foaming properties of PPI and WHC of NBPI for their use as ingredients in applications where such higher functionalities are favorable. Significance and Novelty: The results provide insights into pulse protein modification by bioprocessing, specifically fermentation, and opportunities for potential value‐added applications for pea and navy bean proteins. [ABSTRACT FROM AUTHOR]

Background and Objectives: Fermentation has been increasingly used as a "clean" processing technique to modify proteins. The goal of this research was to assess the use of solid‐state fermentation (SSF) by Aspergillus oryzae on pea (pea protein isolate [PPI]) and navy bean protein isolates (NBPI) for different time periods (0–48 or 0−72 h, respectively) and its impact on their nutrition and volatile profile. Findings: The SSF process resulted in higher total phenolic content and lower protein digestibility, and consequently, the protein quality was reduced for both pulses. The quantity of the volatile compounds initially present in the samples did not change substantially after SSF; however, many new compounds were identified in fermented PPI, which have been reported to have pleasant sensory properties. Conclusions: The protein quality of PPI or NBPI was not improved by A. oryzae SSF; however, the results suggest the potential for using SSF to positively modify the volatile profile of PPI. Significance and Novelty: The findings of this research strengthened our knowledge base of fermented pulse ingredients with the use of protein isolates and navy beans, narrowing the somewhat limited gap for fermentation application to high protein substrates. [ABSTRACT FROM AUTHOR]

Herein we present an unusual case of a primary HPV+ perigeniculate, extra‐axial middle fossa skull base tumor and our management thereof. Laryngoscope, 133:3158–3160, 2023 [ABSTRACT FROM AUTHOR]

Objectives: Adenoid cystic carcinoma (ACC) is a commonly encountered salivary gland malignancy. However, it rarely occurs in the gingiva, an area generally thought to be devoid of minor salivary glands. We present a case occurring in this unusual site and review other reported cases. Methods: A 56 year-old male presented with a right-sided mandibular toothache for 1 year and underwent dental extraction. Due to persistent pain, follow up examination revealed a large gingival lesion. A biopsy was positive for adenoid cystic carcinoma. Results: The patient underwent a complete right segmental mandibulectomy and was reconstructed with a fibular osteocutaneous free flap. Three months postoperatively, during the planning for adjuvant radiation therapy, the patient developed pain in the left mandible. Imaging revealed extensive involvement of the left native mandible. Deep bone biopsies in several areas of the left mandible revealed ACC. He then underwent a complete left hemi-mandibulectomy and reconstruction with a fibular osteocutaneous free flap. Tensor fascia lata suspension slings were placed due to concern for an open mouth deformity attributable to disruption of bilateral masticator slings. He will undergo adjuvant radiation therapy. Our review of the literature revealed 50 cases of gingival ACC published since 1972. Disease recurrence and distant metastases were noted in several patients, occurring at the latest after 30 years follow-up. Conclusions: Given its indolent behavior, high proclivity for late recurrence and metastasis, and overall infrequency, ACC represents a pathology that requires early diagnosis and comprehensive long-term surveillance. While ACC is well described in oral cavity sites with high densities of minor salivary glands, it is not commonly seen in the gingiva. As such, gingival ACC may display a unique biological and/or clinical character. We offer the first literature review of this rare entity. [ABSTRACT FROM AUTHOR]