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Malignant melanoma of the oral cavity is an exceedingly rare tumor representing 0.2 to 8% of all melanomas. Mucosal melanomas are extremely rare and aggressive neoplasms. Patient reporting to the clinician with a pigmented lesion should raise suspicion in the first visit itself and should be further investigated so as to detect this dreaded malignancy at an earlier stage and thus managed appropriately. We presented two such rare cases who reported at our centre treated with different modalities and had different responses to treatment. In first case report 65 year old male patient diagnosed with malignant melanoma of left upper alveolus underwent multiple modalities of treatment like surgery, chemotherapy, radiation therapy but unfortunately as he defaulted post-surgery and also due to COVID-19 lockdown restrictions he was treated in various centres and finally the result was inoperable residual gigantic mass resistant to chemotherapy and radiation therapy. In second case report, 82 year old male patient reported with malignant melanoma hard palate having good response to initial chemotherapy. He was planned on hypo-fractionated radiotherapy in view of his old age but he refused radiation treatment and is on oral temozolamide and thalidomide with stable disease and good quality of life since past 6 months.

Background: The objective of the study was to compare the incision size, operative time and complications in minimal incision cochlear implantation (MICI) and standard incision cochlear implantation (SICI).Methods: Patients who underwent cochlear implant surgery from August 2015 to August 2017. Patients in the MICI group underwent surgery with 2 cm post aural incision whereas patients in SICI group underwent surgery with inverted J incision. Results: A total of eight patients who underwent cochlear implantation during study period were divided into SICI and MICI group of four patients each. The mean size of incision in SICI group was 7.62cm (SD 0.47) and in MICI group was 2 cm. The mean operative time in SICI group was 211.25 minutes (SD 8.53) and in MICI group was 247.5 minutes (SD 11.9). One patient (25%) in SICI group had flap necrosis where as MICI group had none.Conclusions: The MICI can be performed with a small incision of 2 cm. It causes less trauma to the flap with very less incidence of flap necrosis. Technique can be mastered by surgeon with less experience in Cochlear Implant surgery. Other complications are comparable to SICI though operating time is more initially. This is a small study which indicates that Minimal Incision cochlear Implantation is less traumatic and has a more favourable cosmetic outcome with benefits comparable to that of standard technique.