Neuroepithelial Structures of the Oral Soft Tissues Including the Juxtaoral Organ of Chievitz: A Literature Review and Audit of Diagnosed Cases

Abstract

The juxtaoral organ of Chievitz (JOOC) is a part of microanatomy composed of bland epithelial islands closely associated with small nerves and usually described within the soft tissue on the lingual aspect of the posterior mandible. Similar structures are documented in the posterior tongue. There is a risk of misinterpretation as carcinoma showing perineural invasion. An audit was undertaken of diagnosed cases of the JOOC and similar neuroepithelial structures identified within the oral soft tissues of surgical specimens. Nineteen cases were identified. Epithelial islands ranged < 0.5–4 mm in maximum dimension and lay in close association with small nerves. Epithelial cells showed a squamoid appearance but were without keratinisation. There was no atypia and mitotic figures were not seen. In 53% of cases the epithelial cells showed cytoplasmic clearing, in 26% of cases there was brown pigment and in 11% of cases there were calcifications. In 53% of cases, these neuroepithelial structures lay within the soft tissue lingual to the mandible in the retromolar area, 26% of the structures were placed buccal to the mandible, 11% of the structures lay adjacent to the maxillary tuberosity and 11% of the structures were within the posterior tongue.