Hemangiopericytoma an Incidental Parotid Swelling: a Rare Case Report.

Hemangiopericytoma of the parotid gland is a very rare presentation in the head and neck region. It occurs mainly in the lower extremities, retroperitoneum, and pelvis. Here we reported a case of 14-year female patient present with painless swelling of the right cheek over the parotid region since 5 years.

Study of Clinicopathological Presentation and Management of Malignant Tumours of the Ear and Temporal Bone at Tertiary Care Cancer Hospital.

Tumors of the ear can be benign or malignant. They can occur on the external ear or in the ear canal, the middle ear, and inner ear. Tumors in different areas of the ear behave differently. They are rare which causes several problems in diagnosis and appropriate treatment. The purpose of this study was to analyze retrospectively the patients with malignant neoplasm of the ear. The main objectives of this study were to study the clinicopathological presentation of ear and temporal bone malignancy and to study the management of different types of malignancy of ear and temporal bone. This study is conducted at our tertiary care cancer hospital from Feb 2015 to Jan 2020. This study includes 15 patients treated for malignancy of the external and middle ear. The entire patient was thoroughly examined for malignancy. Details ENT examination was done. History of smoking and tobacco chewing asked. The patient factors considered in this study were age, sex, diagnosis, treatment (surgery, radiotherapy, and chemotherapy), complications, follow-up, and recurrence. This study includes [n = 15] patients. Due to a variety of malignant lesions of the ear and temporal bone they were classified into two groups, Superficial location lesions [n = 5] 3 of disease limited to pinna and 2 cases of primary of parotid origin involving pinna. Deep location involving external auditory meatus and middle ear [n = 12]. In this study of [n = 15] cases lowest age was 18 years. male and highest age was 75 years. male and most common age group was 56-65 years in which [n = 7] patients present. In this study we studied [n = 11] male patients and [n = 4] female patients. The most common symptom present was ear discharge [n = 8], the next common symptom was hard of hearing [n = 7]. A less common symptom was facial weakness [n = 3]. In sign, mastoid tenderness was commonest in [n = 5], and less common was facial palsy in [n = 3]. In our study of [n = 15] patients we did lateral temporal bone resection in [n = 5] patients, wide local excision of lesion in [n = 4] patients, lateral temporal bone resection with postero-lateral neck dissection with PMMC flap done in [n = 2] patients. In our study of [n = 15] cases of ear malignancy most common histopathology is squamous cell carcinoma [n = 12] cases, least were basal cell carcinoma [n = 1], melanoma [n = 1], and Rhabdomyosarcoma [n = 1]. Malignant tumors of the ear and temporal bone are rare. Neoplasm's of the external and middle ear constitutes a group of various histopathological and clinical tumors that differ in diagnostic difficulties, treatment, and prognosis. Surgery is the mainstay of treatment followed by reconstruction. Radiotherapy and chemotherapy play an adjuvant role in post-operative management in the high-risk category. Prognosis is worst as the tumor stage advances. And most of the cases diagnosis was often made in the advanced stage especially for middle ear tumors that diminished the possibility of effective treatment.

Use of Latissimus Dorsi Myocutaneous Island Flap for Pharyngeal Reconstruction in Setting of Postoperative Wound Infection in Salvage Laryngectomy.

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.

Use of Combined PMMC and Nasolabial Flap for Reconstruction of Full Thickness Cheek Defect Involving Lip Commisure.

Head neck cancer constitute significant cancer burden and among it carcinoma of oral cavity involving buccal mucosa is most common entity in India. Very often it involves lip commisure. Radical surgery along with radiotherapy still remains treatment of choice. Reconstruction of composite defect of oral cavity fallowing ablative surgery remains difficult task. Reconstruction of lip commisure defect after primary tumor excision is still a big challenge. Micro vascular technique primary repair is main modality of treatment which needs great surgical expertise in plastic surgery which is not possible in every institution. We propose a novel surgical reconstructive technique of use of combine pectoralis major myocutaneous flap (PMMC) with nasolabial flap for full thickness cheek defect involving large lip commisure. Both flaps having distinct advantage of relative ease in elevating flap and robust vascularity with acceptable aesthetic and functional outcome.