triamcinolone (Trivaris / Trivaris)

Management of Adult-onset Eyelid Xanthogranuloma: Debulking Surgery Coupled with Intralesional Corticosteroids.

Kamaluddin Najmatuzzahra N, Pratiwi Andi A

Adult-onset xanthogranuloma (AOX) is a rare, benign inflammatory disorder within the spectrum of non-Langerhans cell histiocytosis, often manifesting as localised skin lesions in middle-aged adults and frequently misdiagnosed due to its nonspecific presentation. A 43-year-old woman developed a painless, progressively enlarging mass on her right upper eyelid over four months, with histopathology confirming AOX. Following surgical debulking and adjunctive intralesional corticosteroid (triamcinolone acetonide) injection, the patient exhibited significant clinical improvement and no recurrence at three months. This outcome supports emerging evidence that a combination of surgery and corticosteroid therapy effectively reduces lesion size and recurrence rates in localised AOX. The multimodal approach combining surgical excision and intralesional corticosteroid injections provides a conservative and effective management strategy for AOX, with favourable outcomes and minimal complications. Further research is warranted to standardise treatment protocols for this rare orbital disease.

Palatal Island Flap With Adjuvant Radiotherapy for Hard Palate Adenoid Cystic Carcinoma: 2-year Outcomes.

Ongkasuwan Pattana P

Adenoid cystic carcinoma (ACC) of the minor salivary glands most commonly arises in the hard palate and exhibits perineural invasion, indolent growth, and late recurrence, often requiring multimodal therapy. Reconstruction must restore oronasal separation, speech, and deglutition; data regarding the tolerance of palatal island flaps to postoperative radiotherapy and long-term functional outcomes remain limited. A 35-year-old woman with T1N0M0 ACC of the right hard palate (American Joint Committee on Cancer, 8th edition) underwent wide local excision with partial palatal ostectomy followed by reconstruction using a contralateral palatal island flap. After complete mucosal healing, adjuvant intensity-modulated radiotherapy (66 Gy in 33 fractions) was administered. Two-year outcomes were assessed using Thai-language validated versions of the EORTC QLQ-C30, EORTC QLQ-HN43, FACT-H&N, and UW-QOL questionnaires. Final pathology demonstrated cribriform and tubular ACC with perineural invasion. The tumor approached the medial (0.4 mm) and lateral (1.7 mm) margins, which were close but uninvolved. Acute toxicity consisted of grade 2 donor-site oral mucositis treated with topical triamcinolone. At 2-year follow-up, surveillance with magnetic resonance imaging of the skull base, computed tomography of the chest, and bone scintigraphy demonstrated no evidence of locoregional recurrence or distant metastasis. Speech was fully intelligible on speech-language pathology assessment, the Functional Oral Intake Scale score was 7, and quality-of-life outcomes remained favorable across all instruments. This case suggested that a palatal island flap may tolerate adjuvant radiotherapy when irradiation is delivered after complete flap healing, with favorable oncological, functional, and quality-of-life outcomes at 2 years.

Orbital decompression with intraorbital corticosteroid injection during the active phase of thyroid eye disease: outcomes in a real-world cohort.

Neuhouser Adam J AJ, Skender Sarah S, Spadaro Jane Z JZ, Kahana Alon A

Orbital decompression is an effective surgery for reducing orbital congestion and proptosis for patients with thyroid eye disease (TED). However, it is commonly stated that elective orbital decompression, i.e., for reasons other than compressive optic neuropathy, should await the quiescent phase of the disease. The reason is to avoid inducing a flare-up of the orbitopathy secondary to surgical inflammation. Still, this means that patients with moderate to severe TED who are suffering from symptoms associated with TED must wait months to years before initiating surgical treatment. The purpose of this study is to evaluate the effectiveness of orbital apex decompression combined with intraorbital corticosteroid injection in patients with active TED, defined as Clinical Activity Score (CAS) ≥3. This retrospective, single-center cohort study included patients with active TED (pre-operative CAS ≥ 3) who underwent single or staged orbital decompression between February 2023 and September 2025. All lateral wall decompressions included an intraorbital injection of a combination triamcinolone and dexamethasone as part of the operative technique. Primary outcomes included change in CAS, change in proptosis, and postoperative disease progression (≥ 2-point increase in CAS at ≥ 8 weeks). Secondary analysis compared outcomes in patients with and without perioperative treatment using disease-modifying therapy (DMT). Thirty-six patients met inclusion criteria; 14 had preoperative dysthyroid optic neuropathy. Mean CAS decreased from 4.7 to 1.6 (Δ -3.1; 95% CI -3.92 to -2.36), and mean proptosis decreased from 22.7 mm to 19.7 mm (Δ -3.0 mm; 95% CI -3.28 to -2.23). One patient with severe TED met criteria for postoperative disease progression. Outcomes were consistent across subgroups regardless of perioperative DMT exposure. No patients developed new-onset diplopia. Orbital decompression combined with intraorbital corticosteroid injection during active TED was associated with clinically meaningful reductions in CAS and proptosis, with infrequent postoperative deterioration and no major surgical complications. These findings provide real-world evidence supporting use of this combined approach during active disease, including in patients without dysthyroid optic neuropathy. These results are specific to a particular surgical technique and to the perioperative management of underlying thyroid status and risk factors associated with TED exacerbation.

Retraction Note: Triamcinolone Acetonide Produced by Bacillus velezensis YEBBR6 Exerts Antagonistic Activity Against Fusarium oxysporum f. sp. Cubense: A Computational Analysis.

Nayana R U Krishna RUK, Nakkeeran S S, Saranya N N, Saravanan R R et al.