Parapharyngealspace tumor has been known to be uncommon. It accounts only about 0.5% of head and neck neoplasm.Most of the lesions are benign in nature and salivary gland neoplasm being the most common.A 32-year old Ma lay gentle man presented with long-standing parapharyngeal mass which m ialized the latera l pharyngeal wa ll. Biopsy was taken intraorally by soft pa late mucosal incisionrevealed carcino ma e x-p leo morphic adeno maand t ranscervical approach successfully re moved the mass in total. Post-operative radiotherapy was commenced and patient is we ll until recent fo llo w up.Despite of the rarity of pleomorphic adenoma in parapharyngeal space, it should be a mong the differential diagnosis and a complete removal should be the aim as ma lignant transformation is possible in this type of pathology. Computed tomographyscan e xtending fro m base of skull till upper thora x a re important in p lanning the approach for complete removal of the mass followed by radiotherapy in malignant transformation cases.
Introduction: External laryngotracheal (ELT) trauma is rarely encountered in clinical practice. In most
circumstances, this injury is overlooked by the primary attending team. Surgical management of ELT trauma
is complicated, because there is no established management approach for this potentially life-altering, high
morbidity injury. It is important for this injury to be identified early, as any delay in surgical intervention
may result in poor airway and phonatory outcomes. The aim of surgical reconstruction is to minimise the
above debilitating morbidities by restoring the main laryngeal functions as much as possible. Methods: We
reviewed the outcomes of six surgical interventions for ELT trauma at Tengku Ampuan Afzan Hospital from
June 2007 to June 2014. Clinical presentations, computed tomography (CT) scans features, intraoperative
findings, and postoperative outcomes were evaluated. Results: All patients made a good recovery in terms of
phonation except for one patient who had reduced speech function. After one year, one patient was still
dependent on a fenestrated tracheostomy. This article describes the surgical reconstruction techniques used
to achieve these positive outcomes. Stenting is helpful to aid healing and re-epithelialisation. Conclusion:
Prompt recognition and non-traumatised airway control are essential for addressing laryngotracheal trauma.
Subcutaneous emphysema is an important hallmark that should alert the attending physician to the
possibility of ELT trauma. Immediate surgical intervention using appropriate techniques can produce
favorable patient outcomes.
The occurrence of pharyngocutaneous fistula (PCF) after total salvage laryngectomy following radiotherapy
as primary treatment is quite common. In most cases, pharyngocutaneous fistula can heal spontaneously
with conservative measures. Here, we are reporting a 69-year-old male with a residual carcinoma of the
larynx following failed radiotherapy as primary treatment whose later underwent a salvage total
laryngectomy. Post-operatively, it was complicated by the formation of pharyngocutaneous fistula which
was failed to heal with conservative measures and few attempts of surgical repair. The fistula later healed
with the application of Montgomery Salivarybypass tube after 3 weeks. The application of the salivary
bypass tube should be considered and used to promote healing in persistent pharyngocutaneous fistula
especially in a post radiotherapy patient.