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The RP is a safe procedure with no significant difference in FNP rates when compared to the AP and, considering the shorter CST and the lesser VHT resected in the RP, it is superior to the AP. Surgeons engaged in parotidectomy should be familiar with both methods of dissection.

Background: Patients presenting with a cystic lateral neck lesion may present diagnostic challenges against a backdrop of varied non-malignant and malignant etiologies. Patients: A total of 133 consecutive cases who underwent cystic neck tumor removal were evaluated for etiology and diagnostic procedure in order to develop an algorithm for therapeutic efficiency. Results: In 92 of 133 cases, a non-malignant tumor was diagnosed. In 41 cases, malignant lymphadenopathy was found. In cases with malignancy, males (p=0.001) and the elderly (p=0.001) were affected more frequently. Primary tumors were discovered by pan-endoscopy before neck surgery or in a second panendoscopy (with tonsillectomy and mapping biopsies) in cases with histologically confirmed squamous cell carcinoma. During intraoperative frozen-section evaluation (40 cases), a total of 30 patients underwent neck dissection during the first neck operation. Conclusion: In patients older than 40 years who present with cystic neck lesions, we recommend pan-endoscopy and intraoperative frozen section in cases where malignancy is suspected in order to avoid secondary neck dissections and delays in therapy.A cystic lesion of the lateral neck is a relatively rare occurrence for an Ear, Nose and Throat (ENT) specialist. The majority of cases are interpreted as branchial cleft cysts that arise from the second branchial arch and become symptomatic in children and younger adults (1). On the other hand, there are a wide variety of neck mass etiologies including congenital, local or systemic inflammatory, benign and malignant causes (2). Cystic metastases may represent a unique entity with different etiological features such as a lack of exposure to risk factors and presentation in younger or female patients. Patient age may be an independent predictive factor for malignancy (2, 3). In this way, a cystic neck lesion may represent a cystic metastasis of squamous cell carcinoma (SCC) from the head and neck, particularly in human papillomavirus-related carcinoma of Waldeyer's ring (4). However, cystic metastases should be separated from central necrosis following rapid tumor growth (5). Branchial cleft cyst carcinoma has long been a subject of discussion (6,7).This study investigated the data of patients who were admitted to the ENT Department by an ENT practitioner and diagnosed with a "branchial cleft cyst" requiring surgical treatment. The objective of the present study was to evaluate the significance of a cystic cervical mass in relation to etiology, diagnostic procedure and an algorithm for increased therapeutic efficiency.

Postoperative haemorrhage following tonsillectomy occurs in 5.98% of all cases with up to 10 deaths reported annually in Germany. When comparing tonsillectomy (TE) and tonsillotomy (TT), the same long-term frequency of ENT infections is displayed in children and young adults. However, taking postoperative haemorrhaging into account, TT is more favourable. Chronic tonsillitis is one of the most common indications for TE in the adult population; however, a histopathological characterization may reveal objective criteria and provide a foundation for routinely performing TT in adults too. Three essential parameters hyperplasia (HP), grade of inflammation (GOI) and activity of inflammation (AOI), which are responsible for, and associated with a clinically relevant disease were histopathologically examined in the tonsils of 100 adult patients with chronic recurrent tonsillitis. The parameters were analysed and compared separately in the pharyngeal and basal parts of the tonsils as well as in three sections (upper and lower pole of the tonsil, middle part) as this may influence the indication for TT. The comparison of the basal and pharyngeal portions displayed a significant difference in the GOI and the HP in all three sections: grade 2 HP as well as GOI were more commonly found in the basal than pharyngeal portions (p> 0.001). AOI (grade 2) displayed the same properties in the middle section (p < 0.002), but did not reach statistical significance in the cranial and caudal sections (p = 0.107 and p = 0.186). An overabundance of grade 1 GOI, AOI, and HP was seen in the pharyngeal sections. The results show that two out of three relevant parameters that demonstrate histopathological changes in recurrent inflamed tonsils have a significantly stronger presence in the basal section of the tonsil as opposed to the pharyngeal section. The processes initiated by inflammation next to the surface responsible for a clinically relevant recurrent tonsillitis seem to cause stronger reactions in the deep follicular portion of the tonsils.

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A postoperative stay in hospital is sufficient for 3 days, but should vary individually. On young children with symptomatic hyperplasia of the tonsils a lasertonsillotomy should be performed.