The incidence of schwannoma in the head and neck region is between 25 and 45 %. The vestibular nerve is involved in most cases followed by the parapharyngeal space. Schwannoma, also known as neurilemmoma, is a benign neoplasm that originates from the Schwann cells. These cells form the myelin sheath around myelinated peripheral axons. Here, we report a case of parapharyngeal space schwannoma in a 27-year-old female.
Neurofibroma may occur in any parts of myelinated nerves having Schwann cells. However it is extremely rare in the nasal septum. We have had experience with an isolated neurofibroma of the nasal septum which was successfully removed by trans-nasal endoscopic excision. This article aimed to describe the clinical, endoscopic surgical and pathological features of this unusual tumor of nasopharynx.
Salvage laryngectomy frequently associated with more postoperative complication as compared with primary total laryngectomy. It carries a high risk of postoperative infection with reported rates of 40-61%. Problem related to local wound healing, especially development of pharyngo-cutaneous fistula constitutes the most common postoperative complication in these patients. In setting of treatment failure and gross extra laryngeal disease with fungating wound with infection, the situation even get worse while considering patient for salvage total laryngectomy. Postradiotherapy, poor blood supply of skin in irradiated portion adds extra pinch of salt in poor wound healing. We are here reporting case of management of salvage laryngectomy patient who had severe postoperative infection causing series of flap loss and pharyngeal leak in setting of preoperative gross extra laryngeal disease with skin involvement. In the present article, we were able to manage the case with PMMC and latissimus dorsi myocutaneous flaps.
<p class="abstract"><strong>Background:</strong> Head neck cancer is major cause of morbidity and mortality worldwide. India has one of the highest incidences of oral cancer and accounts for about 30% of all new cases annually. Ablative surgery is main stay of treatment which is followed by reconstructive surgery. Microvascular surgery revolutionized onco-reconstruction which requires great expertise even in tertiary cancer centre and it is not possible many times due to long waiting list for it or patient condition. Here there is role locoregional pedicled flap which mitigate this problem to great extent to achieve acceptable functional and aesthetic outcome. One such flap worth to keep in surgeon armamentarium is submental island flap. Submental artery island flap (SIF) is an axial fasciocutaneous flap that includes skin, subcutaneous tissue, platysma, and fat and is pedicled on the submental artery and veins.</p><p class="abstract"><strong>Methods:</strong> This study conducted in our institute a tertiary level cancer hospital. This is retrospective study. Data extracted from department database between periods February 2015 to May 2017. It includes 12 patients diagnosed with different sub site oral cancer, operated in department of head neck oncology for oral cancer and reconstruction fallowing ablative surgery done by submental island flap by ablative surgeon. </p><p class="abstract"><strong>Results:</strong> Submental island flaps are comparable in their outcome with radial forearm free flap. They carry a good color match with facial tissue. It is thin and has a reliable vascular morphology.</p><strong>Conclusions:</strong> When combined with the reported experience of other surgeons, our preliminary experience shows that the SIF is an excellent alternative in the reconstruction of head and neck defects because of its reliability, versatility, and relative ease of application. Neck dissection can plan as an adjunctive procedure to the SIF with certain limitation.
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