INTRODUCTIONThe term lymphadenopathy refers to nodes that are abnormal in size, shape, consistency or number.1 Cervical lymphadenopathy is one of the commonest presentations of underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and non-specific), in immune deficiency disorders and also in rare disorders like inflammatory pseudotumour (plasma cell granuloma) and Kikuchi-Fujimoto disease. Various diagnostic modalities like fine needle aspiration cytology, ultrasonography (USG), computerized tomography and PET CT neck are now available to diagnose underlying disease in cervical lymphadenitis. These investigating tools have high sensitivity and specificity for cervical lymphadenopathy. The standard modality in the workup of a neck mass is fine needle aspiration (FNA). FNA can be used for both cytology and culture (in cases in which a suspected infectious neck mass does not respond to conventional antibiotic therapy). If FNA is unsuccessful or if sufficient information is not obtained from an initial FNA, the FNA should be repeated before open biopsy. 2Aetiology and clinical presentation of cervical lymphadenopathy is certainly different in different groups of population. Understanding prevalent conditions and ABSTRACT Background: Cervical lymphadenopathy is one of the commonest presentations of underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and nonspecific), immune deficiency disorders and rare disorders like Inflammation. Pseudotumour (plasma cell granuloma) and Kikuchi-Fujimoto disease. Methods: The present study is a prospective study conducted in our institution Dr B.A.M. Central Railway Hospital, Mumbai. Our study included 115 patients with cervical lymphadenopathy presenting with swelling of more than 1.5 cm size in longest diameter. All the patients included in our study are more than 12 years of age, in whom the lymph node did not regress after adequate antibiotic therapy in acute cases (i.e. Conservative management for at least 2 week), and all the chronic cervical lymphadenopathy patients. Results: Tuberculosis was found to be the most common cause of cervical Lymphadenopathy in 54.78% cases followed by reactive lymphadenitis in 22.61% cases, chronic nonspecific lymphadenitis in 12.17% cases and metastatic lymphadenopathy in 7.83% cases. Other causes were unknown primary in 1.74% cases and non-Hodgkin's lymphoma in 0.87% cases. Sensitivity and specificity of FNAC was 79.36% and 100% respectively. Conclusions: Tuberculosis, reactive lymphadenitis and malignancy are the most important cause of cervical Lymphadenopathy. They present in different age groups with different clinical feature. Fine Needle Aspiration Cytology (FNAC) is extremely sensitive and highly specific investigation for early diagnosis.

The anteriorly based partial thickness sternocleidomastoid (SCM) muscle flap is among the various methods described to correct parotidectomy defects, but its indications and limitations are not clearly demonstrated in several reports. This study was done to test the aesthetic outcome of this method, its indications and limitations. At Dr. Babasaheb Ambedkar Memorial hospital, Mumbai, 20 patients presenting with benign parotid tumors underwent parotidectomy. 16 underwent superficial parotidectomy and 3 underwent adequate parotidectomy, 1 had total parotidectomy. The anteriorly based partial thickness SCM muscle flap was used to correct the contour deformity and to prevent Frey syndrome. The aesthetic result was evaluated by assessing and scoring the overall appearance of the scar, the degree of symmetry of the reconstructed parotid region and the site of the donor muscle in comparison to their contralateral normal sides. The overall aesthetic appearance was good in 17 patients, and moderate in 3 patients. 17/20 patients had an overall deep satisfaction with the result. The residual hollowness following total parotidectomy defect and the poor quality of scars were the main reasons affecting the aesthetic outcome. Superficial parotidectomy through modified Blair's incision with immediate reconstruction with anteriorly based partial thickness SCM flap allows a satisfactory aesthetic outcome and minimal donor site morbidity. Scores of the above two parameters were accessed. Patients' satisfaction was assessed by patients questionnaire.

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Tuberculosis has become a rare disease in the developed countries but it is still a serious problem in the developing countries. Incidence of tuberculous osteomyelitis of the jaw bones is very low. This rare incidence is the primary reason that the lesion gets misdiagnosed many times. Here we report the diagnosis, treatment and follow up of a case which is not a classical presentation of tuberculous osteomyelitis of mandible. Early diagnosis of tuberculous osteomyelitis will certainly reduce the morbidity of this disease condition.

<p class="abstract"><span lang="EN-IN">Ganglioneuromas occurring in the neck are uncommon. Schumacker and Lawrence (1939) stated that cervical ganglioneuroma is a rarest neck tumor. These tumors arise from cells of mantle layer of primitive neural tube and from the neural crest which migrate to a station or intermediate point in the autonomic paraganglionic nervous system. They have thus been described in neck arising elsewhere than from the cervical sympathetic chain e.g. larynx, pharynx and from nodus ganglion of vagus nerve. They may also spread or arise intraspinally. It doesn’t show sex predilection. Both sexes almost equally affected. Most often present as painless, slow growing lateral neck mass. At time of presentation they present with Vocal cord paralysis. Family history may be present. Definite preoperative diagnosis may be difficult and investigations not usually helpful. We are presenting a unique case of management of left cervical vagal nerve ganglioneuroma who presented to us left side neck swelling and hoarseness of voice.</span></p>