No abstract

Introduction Microvascular free flaps (MVFF) are the current standard of care for reconstruction of oral ablative defects; however, pedicled myocutaneous flaps (PMCF) are still used widely in India. The rationale behind the preference for selecting PMCF in the present era is not well understood. The associated complications and swallowing outcomes are variable. Methods We retrospectively analysed the records of patients who underwent reconstructive surgery for oral cancer ablative defects over a 3-year period. Results Ninety-seven pedicled myocutaneous flaps [89 pectoralis major myocutaneous (PMMC) flaps, eight lower trapezius island myocutaneous (TMC) flaps] and 113 MVFFs were performed. The reasons for selecting PMCF were financial constraints 38.7%, MVFF salvage 22.5%, medically compromised 10.7%, vessel-depleted neck 6.4%, old age with PS2 ? 5.3%, early recurrence 5.3%, borderline resectable 4.3%, palliative resection 2.1%. Overall complication rate was 20.4%. Of patients, 50.7% and 34.7% were on regular and semisolid diet, respectively; 66.6% had acceptable swallowing-related social wellbeing. ConclusionPMCFs have an important role in developing countries with patients having financial constraints. The other potential reasons driven by patient factors were discussed. The swallowing outcomes are good, with majority of the people having socially acceptable swallowing function.

Background Primary intraosseous hemangioma (PIH) of the skull base, when localized in the sella, is a rare, benign lesion that can mimic other common sellar tumors. Such tumors may be asymptomatic incidental radiologic findings or present with nonspecific symptoms (e.g., headaches). Case Description :We present a case of a primary intraosseous hemangioma of the body of sphenoid bone extending into the sellar cavity, clinicoradiographically mimicking an atypical pituitary adenoma. Conclusions PIH should be included as a rare differential diagnosis in cases of space-occupying sellar lesions with atypical features. Radiologic and intraoperative findings may be suited to entertain a probable diagnosis; however, a definite diagnosis can only be obtained via histopathologic analysis. Surgical excision may be chosen under the assumption of dealing with a primary pituitary lesion, but extent of resection depends on the accessibility, extent, involvement of surrounding structures (such as the internal carotid artery/cavernous sinus), and control of intraoperative bleeding. When facing inoperable or residual lesions, radiotherapy can be a viable option.

We report the case of a young woman who presented with progressive dysphagia and swelling in the anterior aspect of the neck of short duration. On evaluation, she was diagnosed with amelanotic malignant melanoma of the cervical oesophagus. She underwent total laryngopharyngo-oesophagectomy with gastric transposition with bilateral modified radical neck dissection with feeding jejunostomy and a permanent tracheostomy with postoperative combined chemoradiation therapy. However, in spite of aggressive treatment, the patient expired 8 months after initial presentation with distant metastasis.

We report a case of a middle aged, man with diabetes who presented with dysphagia and odynophagia. On evaluation, he was diagnosed to have an acute prevertebral abscess with an unusual aetiology, an infected pseudocyst of pancreas. Contrast-enhanced CT revealed an enhancing collection in the prevertebral space extending to the retrogastric space and communicating with the body of the pancreas via the oesophageal hiatus. Transoral incision and drainage of the prevertebral abscess were performed. Nasogastric tube was placed in the prevertebral space for continuous drainage and daily irrigation. Supportive intravenous broad spectrum antibiotic therapy along with the surgical intervention led to the resolution of the prevertebral abscess and the infected pancreatic pseudocyst.

We present the case of a 50-year-old man who presented to us with a history of having received radiation therapy for a glomus jugulare tumor. He had been on regular follow-up with serial imaging scans. The MRI done after 4 years of treatment revealed an interval increase in size. Carotid angiogram revealed, in addition to the glomus, multiple lymph nodes of similar pattern of vascularity, well lateral to the carotid sheath, in the ipsilateral neck. He underwent resection of the tumor and a neck dissection. Histopathology confirmed metastatic glomus jugulare in the cervical lymph nodes. He received adjuvant radiotherapy and is doing well. AbstractKeywords ► metastatic glomus ► glomus in cervical nodes ► carotid angiogram in metastatic glomus Indian