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Introduction: Modern trends in post malignancy reconstructiontarget more aesthetic and functional outcome withmore patient satisfaction.This study aims to weight the oncological,technical, aesthetic and functional considerations andpropose a novel scoring system in selection of an ideal localand locoregional flap for oncoplastic head and neck reconstruction.Patients and Methods: 52 local and locoregional flapswere created in 52 patients those were squeduled for headand neck tumour resection and defects reconstruction. Thesecases have been classified into six groups according to theflaps used in reconstruction. Oncological, technical, aestheticand functional considerations were reviewed in each case.The data were collected as a prospective study throughout a2-year period.Results: By analysis of the pre-requisites, operativefindings and outcomes of reconstructions, multipleparameters;oncological, technical, aesthetic and functional were evaluated.All significant positive considerations were grouped andcompared in each flap type. According to the weight of theseconsiderations, a proposal of a scoring system (OTAF score)was formulated.Conclusion: This study provides a simplified systematicmethod of flap selection for post malignancy head and neckreconstruction through a scoring system (OTAF score) usingoncological, technical, aesthetic and functional considerations.Individualized selection for each case still has its place howeverfurther evaluation and modifications of this scoring systemis essential to maximize the results of our reconstructive tools.

There are several causes of syncopal attacks because of carotid sinus alterations. Recently parapharyngeal tumours have been implicated in its etiology. We reported a man with a cavum tumour who had several syncopes and an haemodynamical angina because of severe bradyarrhythmias. Implicated clinical entities in parapharyngeal space lesions syncope-syndrome, its physiopathological characteristics and differential diagnosis are discussed.

Arteriovenous (AV) malformations are rare and may occur at various locations, like in the brain, liver, lungs, or in the subcutaneous tissue. This case report describes an AV malformation from the right occipital artery. The value of combined B-mode ultrasonography and color Doppler mode imaging of masses in the neck region is discussed.

Malignant melanoma (MM) is one of the uncommon malignancies of the nose. We present an unusually big proliferative like MM in the vestibule of the nose. Malignancy of nose constitutes less than 1% of all malignancies (3% of head & neck tumour). MM however contributes only 2% of all malignant neoplasms of the nose (Moore & Martin. 1955).

Spontaneous hernias of the pleural cupola are extremely rare tumours in the neck area. The most common tumours in children are lymph node abnormalities, and cysts that are remnants of the branchial arches. Due to diagnostic and therapeutic difficulties, we would like to present the case of a 10-year-old girl, with a neck tumour that was observed during coughing and was accompanied by dyspnea. The girl was admitted to the Paediatric Hospital of Warsaw Medical University. Finally, the neck tumour was diagnosed as a hernia of the pleural cupola, which was subsequently treated surgically. In a review of the literature we found two case reports of similar disorders that appeared spontaneously. All cases of neck tumours in children require very precise radiological diagnostic investigation. Spontaneous lung hernia is an extremely rare cause of neck tumours, which is treated surgically if it becomes symptomatic.

The authors report a case of the successful function-preserving treatment of a rare neck tumour, chondrosarcoma originating from the hyoid bone. The proposed combined treatment allowed to preserve the respiratory, voice-generating and protective functions of the larynx. The dynamic follow up failed to reveal the development of relapse or metastases during 1 year after surgery.Описан случай успешного лечения редко встречающейся опухоли шеи (из подъязычной кости) - хондросаркомы. При проведении комбинированного лечения удалось сохранить дыхательную, голосообразующую и защитную функции гортани. При динамическом наблюдении в течение 1 года рецидива и метастазов опухоли не обнаружено.

The BMJ ’s first mention of anaesthesia appears in January 1847, some three or four months after William Morton successfully anaesthetised a patient for excision of a neck tumour at Massachusetts General Hospital. George Edwards described the case of an above knee amputation under ether anaesthesia performed on a young woman of highly nervous temperament who “dreaded the pain of the operation exceedingly.”1 Consequently, it was deemed “a favourable opportunity to test the efficacy of this new discovery.” A chemist assisted in the preparation of the ether and its administration, and the young …

A patient with recurrent squamous carcinoma metastatic to the neck after radical neck dissection and high dose radiation therapy developed paroxysmal hypotensive episodes that were severe, spontaneous and characterised by suppressed sympathetic but not enhanced parasympathetic activity. Intravenous pressors were successful in treating acute episodes but neither drug therapy nor surgical neck exploration reliably prevented syncopal attacks. Glossopharyngeal and/or vagal nerve infiltration by tumour with episodic activation of the afferent limb of the baroreflex arc producing vasodilatation primarily due to sympathetic withdrawal is the likely mechanism of life threatening syncope in this patient.

Human head and neck tumour tissues derived from 16 different patients were transplanted in athymic nude mice. Treatment of tumour-bearing animals with methotrexate had little or no effect on the doubling time of the xenografts. Included were three tumour lines derived from patients in whom methotrexate did demonstrate antitumour activity. These results are also in contrast to clinical experience with methotrexate, showing remissions in 50% of patients with head and neck cancer. It is unlikely that this lack of effect of methotrexate is attributed to a difference in drug pharmacokinetics between man and nude mouse, since a xenografted rat tumour was found to be sensitive. With regard to possible resistance mechanisms underlying methotrexate inactivity, we found no evidence of increased dihy-drofolate reductase activity in the methotrexate-insensitive human xenografts. It is possible that in this model a selection occurs favouring the outgrowth of a resistant subpopula-tion of tumour cells.