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Complications are infrequent after cochlear implant surgery but they might occur despite careful preoperative planning and meticulous surgical technique. Among the most commonly encountered problems are those associated with the postauricular flap. An exposed, and therefore contaminated, device requires immediate attention and intervention. Cochlear implantation revision surgery is justified by two main reasons, the high price of these devices and the difficulty of reimplantation, due to cochlear fibrosis and ossification after its removal. There are multiple options in cochlear implantation revision surgery with infected device. However, the temporoparietal fascia flap is highly vascularized and provides some advantages over other alternatives. We report a case of a 5 year old boy with bilateral sensor neural hearing loss, who suffered a device extrusion three years after its implantation.

First branchial arch cysts are uncommon. Therefore, together with its variable clinical and age presentation they are often misdiagnosed at first. The treatment is surgical, requiring a correct procedure to avoid future recurrences. In this paper we describe a typical case of first branchial arch cyst in which as described in other reports, we first made several misdiagnoses and therefore an inadequate treatment and lastly, with the correct diagnosis, we performed a meticulous complete excision under facial nerve monitoring.

Hemangiomas are frequent tumors that manifest in variable forms. Rapidly Involuting Congenital Hemangiomas (RICH) are a rare subtype, only recently described, which, in contrast to the typical infantile hemangioma, undergo accelerated involution, sometimes within days. Their different initial appearance and posterior evolution may cause confusion with other tumors of infancy or even with congenital malformations. We present a case of RICH in the upper lip that after rapid involution produced a morphologic sequel that resembled a microform cleft lip. The authors review the specific characteristics of this rare tumor and describe the technical detail of surgical correction in this patient.

Poland's syndrome is considered to be a polimalformative entity with different degrees of severity. We retrospectively reviewed our patients with Poland's syndrome diagnosis, treated between 2000 and 2006. The aim of our study is to assess the different choices of surgical treatment for mammary reconstruction according to the importance of malformation and taking into account our own experience and literature references. A total o f 13 patients (5 males and 8 females) were studied and only 6 of them (1 male and 5 females) underwent surgery. Surgical indication was based on Foucras's classification, considering 3 grades of severity. We propose a surgical approach adapted to each stage, as well as surgical refinements to improve the aesthetic aspect. Most of our patients were very satisfied with final results even though they underwent complex procedures with a considerable rate of complications.

Septal haematoma after nasal trauma is a complication that can lead to septal abscess if unrecognized or early intervention is not performed. It can cause compression and thereby necrosis that evolve to a septal abscess in which cultures reveal saprophyte bacteria. Cartilage necrosis and destruction can produce impaired breathing and aesthetic deformities with collapse of the dorsum and the tip of the nose. We present a 10 year old masculine infant, that suffered a nasal fracture with a septal haematoma that remained undiagnosed. The patient developed a septal abscess that required drainage and resulted in nasal sequelae with collapse of dorsum and cranial displacement of tip and columella. Functional and aesthetic reconstruction was performed using rib cartilage grafts. No complications occurred. Functional and aesthetic improvement was observed. Result after 2 months of follow-up is considered favourable.

Liposuction has become one of the most frequent aesthetic procedures. The "typical" patient is a young female with fat deposits in the trochanteric region. Gradually the safety of the technique together with the high satisfaction rate of the patients have contributed to the widening of its indications to other pathologies of the adipose tissue in different age populations. However, there is scarce literature regarding liposuction in childhood. The authors present their experience with liposuction as the treatment of congenital as well as acquired lipodystrophies in the paediatric age. Some particular details of the technique are described and the advantages of liposuction versus open surgery in these cases are analyzed.

Progressive hemifacial Atrophy (PHA) or Romberg's Disease is a rare entity of unknown etiology, which most often affects only one side of the face and can include all tissue planes in different grades of severity. Of the several treatments proposed, pedicled or free flaps seem to achieve the best cosmetic results in severe cases. In mild to moderate cases, free autologous fat transplant may obtain optimal results with lower complexity, cost and morbidity. The presence of multiple adipoblasts might increase the possibilities of graft take, particularly in children. Furthermore, refinements in the processes of extraction, preparation and reintroduction of the fat have contributed to improve the results that may be long lasting. We present 2 cases of PHA in 2 girls (11 and 13 years old), that were treated by lipofilling. No complications occurred. In both cases we observed a small reduction in the volume of the initial graft. Thus the procedure was repeated 6 months later to improve facial symmetry. Results have been excellent in one year follow-up.

Nasal gliomas are tumors of extracranial neuroglial tissue. The incidence is very low, with little more than 300 cases described unliterature. It is important to make a correct diagnosis study of this lesion, to avoid the possible complications derived from an erroneous treatment. We review a case of one girl with midline nasal tumor, she was operated on with total extirpation of the tumor, we analyze the previous diagnosis study and their histopathology.