Due to its rarity, cervical thymic cyst is seldom included in the differential diagnosis of a neck mass. Approximately 80 cases have been reported thus far, and most of these cases have occurred asymptomatically in children and adults. Only 5 cases have involved patients younger than 1 year of age. The authors report four new patients with thymic cyst in the neck. Two of the patients were newborns in whom the cyst caused airway obstruction and dysphagia. All four patients underwent successful resection of the lesions, with complete resolution of symptoms. The embryology, histopathology, and differential diagnosis of cervical thymic cysts are also reviewed. The authors recommend that despite its infrequent occurrence cervical thymic cyst should be considered in the evaluation of neck masses in children.

Many techniques have been developed for medialization of the paralyzed vocal fold. The purpose of this study is to evaluate autologous fat as an alternative to alloplastic substances for use in vocal fold medialization. Eight dogs underwent left recurrent laryngeal nerve sectioning. Autologous fat was harvested, and the paralyzed vocal fold was medialized by injecting the fat into the thyroarytenoid muscle. The animals were divided into three groups for evaluation at 1, 3, and 6 months. Videolaryngoscopy was performed prior to sacrificing the animals. The larynges were sectioned coronally, and histologic studies were performed. The studies confirmed the preservation of viable fat at the injected site in all animals. Only a minimal inflammatory response was observed in the 1-month group. It would appear that fat injection is a viable alternative to Teflon injection and thyroplasty; it eliminates the need for alloplastic materials, does not appear to migrate, and does not require an open procedure.

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Although the head and neck region is the second most common area for giant lymph node hyperplasia (GLH) after the mediastinum, only 51 cases have been reported in the literature. When faced with this rare tumor, head and neck surgeons often have difficulties because of a lack of definitive diagnostic tools and unpredictable location of GLH mimicking various neoplasms. We report five cases of GLH in the head and neck. Four patients had asymptomatic, solitary posterior triangle neck masses, and one had a parotid mass. Initial evaluation included routine laboratory tests, fine-needle aspiration biopsy, and contrast computed tomography (T). Final diagnoses were made by histopathologic evaluation of the excised specimen. Excision was both diagnostic and therapeutic in all five cases. The purpose of this report is to review our experience with GLH and to evaluate specific characteristics of GLH confined to the head and neck. CASE REPORTSCase I. A 25-year-old man with a 1-year history of an asymptomatic right neck mass was seen on Aug. 8, 1983. A rubbery, nontender, 6 x 8 cm mass fixed to the surrounding tissue was palpated deep to the right sternoclei 2 domastoid muscle at the level of the larynx. The rest of the physical examination was unremarkable. Results of routine chemistry, complete blood cell count (CBC), and uranalysis (UA) were normal. However, the patient tested From the Departments of Otolaryngology-Head and Neck Surgery (Drs. Yi and Rice), Pathology (Dr. deTar), and Radiology (Dr. Becker),