(18) FDG PET-CT seems effective in detecting residual disease and in predicting recurrent disease within the first 2 years of follow-up after nonsurgical treatment. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1271-E1276, 2016.

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Background: Obstructive Sleep Apnea (OSA) is caused by a partial or complete obstruction of the upper airway. OSA is a very inconvenient and relatively common disorder with daytime and nocturnal symptoms. The intervention and management of OSR is dependent on the patients' case severity. The aim of this study was to evaluate the role and the optimal choice of Tonsillectomy for treatment of OSR. Methods: a systematic search in the scientific database (Medline, EMBASE, Google Scholer and Ovid) from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case-control studies were analyzed and included based on the preset inclusion and exclusion criteria. Results: the search has yielded twelve studies to be included in the present SR (n = 206 patients, 34.4 ± 10.0 years and body mass index: 29.3 ± 9.6 kg/m2) met criteria. Tonsils sizes were hypertrophied, large, enlarged, extremely enlarged, or grades 2 to 4. Apnea-Hypopnea Index decreased by 65.2% (from 43.7± 21.7 /hour to 13.7 ± 12.7 /hour) (n = 198). The AHI mean difference (MD) was −30.2 per hour (95% confidence interval [CI] −39.3, −21.1) (P value < 0.00001). The AHI SMD was −1.37 (−1.65, −1.09) (large effect). Lowest oxygen saturation improved from 77.7 ± 11.9% to 85.5 ± 8.2% (n = 186). Lowest oxygen saturation MD was 8.5% (95% CI 5.2, 11.8) (P value < 0.00001). The Epworth Sleepiness Scale decreased from 11.6 ± 3.7 to 6.1 ± 3.9 (n = 125). Individual patient outcomes (n = 52) demonstrated an 85.2% success rate (AHI < 20/hour and ≥ 50% reduction) and a 57.4% cure rate. Conclusion: tonsillectomy is an effective and safe surgical intervention for treatment of OSA in adults, particularly among carefully selected patients with large tonsils and mild to moderate OSA severity.

Mammary analogue secretory carcinoma is a rare salivary gland tumor that has a wide range of clinical presentation ranging from indolent, local and slowly growing tumors to a very aggressive, infiltrative and widely metastasizing forms. We report a case of an unfortunate patient whose tumor had a very quick ominous disease course with aggressive clinical and histological presentation. This case is the first case, to our knowledge, to be reported in the literature from Saudi Arabia of MASC with features of high grade transformation

Branchial cleft cysts are birth defects that happen when the first through fourth pharyngeal clefts do not close properly and most of these cysts develop from the second cleft. Second branchial cleft cysts are almost always in the neck, so it is rare for them to present in the nasopharynx. We report an extremely rare case of a branchial cleft cyst that is located in an unusual site in the nasopharynx in a 36-year-old male with no prior medical history. Computed tomography scan findings showed non-enhancing thickening of the right side mucosal-pharyngeal space, obliterating the fossa of Rosenmuller with no invasion or erosion. The patient was admitted for nasopharyngeal mass excision, and the mass was sent for histopathology. When a cystic lesion is noted in the lateral nasopharynx, branchial cleft cysts should be on the list of possible diagnoses. Surgery is primarily the treatment. The marsupialization approach is a simple way to treat nasopharyngeal branchial cleft cysts as it is safe and has limited complications