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Chondrosarcomas of the larynx are rare cancers, representing less than 1% of all laryngeal tumors. The most often involved site is the cricoid cartilage. They have generally good prognosis, and low metastatic tendency. Surgery is the treatment of choice, partial in small limited tumors or total laryngectomy if tumor extends beyond the half of the cricoid and/or is poor differentiated. Although there are some pathognomonic imaging characteristics for chondrosarcomas, the histology remains the gold standard for diagnostic. The authors present a case of large, medium differentiated chondrosarcoma (grade II), surgically treated by total laryngectomy.

Introduction. The primitive malignant melanoma of nasal mucosa and paranasal sinus is a rare tumor of uncertain etiology, with unpredictable biologic behavior and bad prognosis. Unlike skin melanomas, there are no risk factors and the disease is frequently manifested in older patients, whose clinical otorhinolaryngology complaints are normally non-specific and ranges from nasal obstruction to rhinorrhea and epistaxis. Unfortunately, this disease is diagnosed basically in advanced stages which makes the surgery difficult. Objective. To report a case of primitive malignant melanoma of nasal mucosa, ethmoid and frontal sinuses, that was diagnosed in 2015. It was performed a subtotal resection in another hospital in 24.08.2015, with a large local reccurence. Report. Our patient was a 78-year-old woman with bilateral nasal obstruction, light epistaxis and unilateral rhinorrhea. The ENT, CT and MRI exams showed a tumour with important, invasion of the nasal cavity structures (billateral nasal bones, left frontal process of the maxilla, the superior midpoint of the nasal septum, bilateral middle and superior turbinates, left ethmoid and bilateral frontal sinuses). The patient was submited for surgery: total macroscopic resection in the combined endoscopic approach; transnasal and modified lateral rhinotomy with titaniul plates reconstruction of the external nose architecture. Conclusions. Malignant melanomas of nasal mucosa are, in general, diagnosed in advanced stages. Their histological characteristics in the mucosa makes difficult the surgical treatment, which is one of the most efficient options, because they are resistant to chemo and radiotherapy. The early diagnosis and a good surgical treatment plan are the best option for this tumor nowadays.

In the current medical practice, nasal congestion is one of the most frequent symptoms that bring the patients at doctor. One of the most common causes of chronic nasal obstruction is inferior turbinate hypertrophy. Surgical therapy is reserved for those patients who remain symptomatic despite proper medical therapy. The authors bring into question a number of procedures and surgical techniques addressed to the inferior turbinate hypertrophy, choosing one or another depending on the surgeon’s personal experience, the existing pathology and, not at least, the patient’s wish.

Maxillary sinus ostium may be located anywhere along the ethmoid infundibulum (middle meatus). In rhinosinusal pathology we may find an accessory ostium of the maxillary sinus due to chronic inflam­mations or after previous endoscopic sinus surgery. Existence of the accessory ostium leads to a recirculation mechanism of sinus secretions and a very difficult to treat rhinosinusal simptomatology. For every patient with this pathology we performed an endoscopic exam of the nose and a rhinosinusal CT scan. Treatment is strictly surgical by creating a unique ostium (consisting of both primary and accessory ostium). Endoscopic anatomy of the ostiomeatal unit should be well understood by the surgeon in order to perform a correct endoscopic sinus surgery, obtaining a proper sinus ventilation and avoiding complications. The presence of an accessory maxillary sinus ostium has only an endoscopic surgical treatment for ensuring sinus drainage and increasing the quality of life of our patients. Keywords

The authors present the case of a 58-year-old female patient with a history of multiple episodes of acute dacryocistitis, treated by irrigation of the lacrimal punctum. She is admitted to our clinic for swelling of the lacrimal sac and mucopurulent discharge on applying pressure over the lacrimal sac. In spite of several irrigations, patients’ symptoms persisted and thus surgical treatment was decided. We performed a dacryocystorhinostomy with a lacrimal stent which was inserted by endonasal approach to reestablish the nasolacrimal connection. The patient didn’t require nasal packing and was discharged three days after surgery.

Background. Extraskeletal Ewing’s sarcoma is a rare tumor of mesenchymal origin, which is histologically similar to primary osseous Ewing’s sarcoma. It has been reported a low incidence in the head and neck. Methods. We report the case of a patient with extraskeletal Ewing’s sarcoma presenting with a lateral and posterior left sided neck mass. Magnetic resonance imaging was useful in preoperative evaluation. The treatment consisted in radical resection, and the histological analysis completed the diagnosis. Results. The postoperative management consisted in a combination of chemotherapy for systemic control and irradiation for local control. PET-CT was useful to evaluate the treatment’s efficacy. Conclusions. Extraskeletal Ewing’s sarcoma is a rare and aggressive tumor. A very few cases of cervical tumors were reported. Radical resection followed by radio-chemotherapy has good results in the treatment of this rare tumor.