BackgroundWorld literature suggests parapharyngeal space lesions account for only 0.5% head and neck tumours and the majority of the minor salivary gland tumours are malignant. The parapharyngeal space is very rare site for this tumour.Case presentationTwo cases of primary pleomorphic adenomas arising de novo from minor salivary glands in the para pharyngeal space are reported. Review of literature, clinical features, pathology, radiological findings and treatment of these tumours are discussed.ConclusionPleomorphic adenoma arising de novo in the parapharyngeal space is of rare occurrence. High index of suspicion and an adequate clearance of the tumour with a cuff of surrounding dispensable normal tissues is the key to successful treatment of such tumours.

Peroral wide excision seems to be an adequate procedure for T1-2N0 localized squamous cancer of buccal mucosa. Prophylactic selective neck dissection should be considered in only T2 N0 cases as only T stage of the disease could be significantly correlated with the development of the metastatic neck nodes.

Objective:To analyze various demographic, clinical, and histopathologic factors in T1-2 N0 squamous cell carcinoma (SCC) of the oral tongue to define a high-risk group for regional recurrence that will benefit from elective neck dissection.Materials and Methods:Retrospective outcome analysis of a patient cohort without palpable or ultrasound (USG) detectable nodal metastases undergoing per oral wide glossectomy for T1-2 N0 SCC of oral tongue. Patients were followed up using palpation and serial USG neck and fine-needle aspiration cytology.Results:Of the 176 patients, 69 (39%) showed recurrence during follow-up. Fifty-eight cases developed regional neck node metastases, i.e., overall regional node recurrence rate of 33%. Fifty-three (91%) with regional neck node metastases were salvaged successfully with further treatment. In 110 cases with tumor thickness more than 5 mm, 39% cases developed regional neck node metastases. This association was significant with P = 0.0402. Among 44 cases with perineural invasion, 54% developed regional neck node metastases. Similarly in 39 cases with lymphovascular invasion, 61% developed regional neck node metastases. Association of both of these parameters with the development of regional neck node metastases was significant.Conclusion:We recommend prophylactic selective neck dissection in early stage SCC of oral tongue, especially with depth of invasion more than 5 mm, perineural and lymphovascular invasion.

The use of inverse planning in intracavitary brachytherapy of cervix has shown a significant improvement in the target volume coverage when compared with manual planning.

BackgroundFree‐flap reconstructions (FFRs) are the standard‐of‐care following resections for oral cancer. This study assessed an alternative, the pedicled submental flap (SF) for its versatility, oncological outcomes, and comparative operative time and cost.MethodsThis was a longitudinal prospective study of 1169 patients of oral cancer reconstructed with the SF. Oncological outcomes in terms of recurrence rate and disease‐free survival (DFS), were analyzed in 730 cases with a minimum of 18 months follow‐up. Surgical time and cost were compared between 20 SFs and 14 FFRs performed consecutively.ResultsSF was used to reconstruct defects in the cheek (29.2%), mandible (41.6%), tongue (26.3%) and palate (2.7%) with a 94% flap survival. N+ at level 1 did not adversely affect the recurrence rate as compared with N+ at levels other than level 1 (27.52% vs 29.81%). SFs took a shorter time (186 minutes vs 474 minutes) and cost significantly less than FFRs (P < .0001).ConclusionsSF can reconstruct various oral defects, is sturdy, and esthetically and functionally satisfactory. The procedure time is much shorter than for FFR and costs considerably less. With careful case selection and meticulous clearance, SF reconstruction is oncologically safe even in N+ neck.