Intramuscular hemangiomas (IMH) are uncommon tumors in the head and neck region, occurring most often in the trunk and extremities. Preoperative misdiagnosis is common because of the deep location of these tumors. Ten recent cases of head and neck IMH are presented, five of which involve the masseter muscle--the most frequent site of involvement in the head and neck. Masseter IMH occurred almost exclusively in the pediatric age group. The clinical presentation, radiographic and histologic findings, treatment, complications, and outcome of these patients are presented. The vital role of preoperative diagnosis using magnetic resonance imaging (MRI) is discussed, as well as a review of the natural history of IMH and indications for surgical intervention.

Torticollis is a common clinical sign that is found in a variety of disorders. Childhood torticollis differs from the adult form in that congenital types are common and many frequently encountered disorders found in adults are unusual. Pediatric torticollis related to otolaryngologic conditions is reviewed, and three illustrative cases are presented.

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Although there are many possible routes of infection in AST, the clinician must be aware of a possible fistula between the piriform sinus and the perithyroidal space--especially in patients with recurrent episodes of AST. Diagnosis of this congenital tract requires a high index of suspicion and radiographic demonstration by a barium swallow or endoscopic visualization. Effective treatment of AST with intravenous antibiotics and appropriate surgical intervention have greatly reduced the mortality and secondary complications. Complete fistulectomy, however, is required for permanent cure.

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