Abstract. The present study aimed to describe the techniques used and the results obtained with the infrahyoid flap for the reconstruction of medium-sized oropharyngeal defects following resection for advanced squamous cell cancer. During a period of 1 year, six patients with oropharyngeal defects were reconstructed using the infrahyoid flap. The tumor characteristics, location and size of the defect, resective and reconstructive techniques employed and the complications and outcomes of the speech and swallowing functions, as identified in the follow-up visits every 3 months, were evaluated. All flaps were performed simultaneously in association with tumoral excision and ipsilateral supraomohyoid neck dissection. The mean size of the skin paddle was 7.0x3.5 cm. The donor site was primarily sutured. The postoperative course was uneventful and all flaps were viable. One case of marginal skin paddle loss occurred without affecting the survival of the flap. Five patients received postoperative radiotherapy and one patient received concurrent postoperative chemotherapy. During the follow-up period (mean, 63 months), all patients showed excellent oral swallowing. Speech was excellent in five patients and in one patient speech was classified as good. The aesthetic results of the cervical donor site were good. Based on the present case report and the literature review, the infrahyoid flap is a simple and safe procedure for the reconstruction of the oropharynx, with a high success rate, minimal donor site morbidity and good aesthetic and functional results. The infrahyoid flap is a valid surgical option that may be considered in selected oncological patients undergoing reconstruction of medium-size oropharyngeal defects.

Pregnancy pyogenic granuloma is considered a benign common growth that usually develops on the gingiva in the second and third trimester of gestation, in response to local irritation, trauma or hormonal factors. Here, the authors report a case of a primigravida who presented an extragingival pyogenic granuloma with a rapid progression in the post-partum. The occurrence on the lower lip in the first few days after delivery was a relatively rarity in the present case which provoked a meaningful state of anxiety and cancerophobia to the female. Complete excision was curative and brought immediate relief of pain and discomfort. This clinical report highlights the possibility of pyogenic granuloma presenting like a rapid-growing mass on the lip and the importance of clinical differential diagnosis of such presentation in this atypical location.

FIGURE 1. Histopathology. Hematoxylin and eosin Â10 (Â40 in the inset photo (upper right): diffuse infiltration by large cells with irregular nuclei, some cerebriform, with evident nucleoli and scant cytoplasm. Numerous mitotic figures can be observed.

Background: Schwannoma was first described as a pathological entity by Verocay in 1908, and are slow growing benign tumours of the tissue that covers nerves (nerve sheath) with a well-developed capsule. Typically, symptoms of schwannomas are based on the affected nerve, and may arise from any cranial or spinal nerve that has a sheath. Objectives: Here we discuss four cases of schwannomas of the neck along with review of literature. Methods: We present four cases of schwannomas of the head and neck. Findings: In our series of four cases, site of the lesion, clinical history and features were important in arriving at a provisional diagnosis. Computed tomography and magnetic resonance imaging played an important role in demonstrating the spread of schwannomas preoperatively. Histologically, there are two main patterns: Antoni A pattern, with palisading nuclei surrounding pink areas (Verocay bodies), and Antoni B pattern, with loosely arranged stroma and fewer cells. Conclusion: Masses in the neck are common and it is often difficult to establish the nature of these lesions on clinical examination. Differential diagnosis of nodules in this area must include schwannomas that may mimic other conditions such as metastasis or infection. Fine-needle aspiration of these masses is useful, but not always diagnostic. Complete surgical excision is the treatment of choice, and the possibility of nerve injury should be kept in mind. Schwannomas are benign tumours, and their prognosis is excellent because local recurrence is rare.

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