Glomus tumors known as paragangliomas are neoplasms arising from the neural crest. They are named according to the place they originate from. Tumors originating from the carotid body at the carotid bifurcation are called Carotid Body Tumors (CBT). Surgical intervention is planned according to the Shamblin classification. 17 patients were operated after being diagnosed with CBT in our clinic between February 2007 and June 2010. 12 (70.5%) of the patients were male, and 5 (29.4%) of the patients were female. The average age was 42 (ages ranging between 32 and 47). Nine of the patients were diagnosed and treated with Shamblin type I tumor, seven of the patients with type II and one patient with type III. Only one patient had bilateral carotid tumor. In all patients with Shamblin type I and II, blunt dissection of the tumor was conducted smoothly by means of thermal cautery in the subadventitial plane. The patient with Shamblin type III had tumor invasion in the carotid artery and adjacent tissues were in an adherent state. Therefore mass resection was carried out by resecting 2 cm of the distal portion of the common carotid artery and 3 cm of the proximal portion of the internal carotid artery. 6 mm of synthetic polytetrafluoroethylene graft was interpositioned between the common carotid artery and the internal carotid artery. External carotid artery was anastomosed to this graft in an end-to-end fashion. The patient developed vocal cord paralysis postoperatively on the lesion side. The patient who underwent bilateral tumor excision developed Baroreflex Failure Syndrome. In the two patients thrombus developed in the internal carotid artery in the early postoperative period. These patients underwent thrombectomy and developed hemiplegia on the lesion side. One of them died on the seventh post-operative day while in follow-up in the intensive care unit. Surgical resection is the recommended treatment for carotid body tumors. Shamblin I and II type tumors' dimensions and pathological characteristics allow dissection. However Shamblin III tumors may require carotid artery resection and reconstruction due to tissue invasion. The possibility of post-operative cranial nerve paralysis and arterial thrombosis should be taken into account.

Granular cell tumors are benign subcutaneous or submucosal lesions of neurogenic origin. In this case study one patient was diagnosed and treated successfully with complete surgical resection of a laryngeal granular cell tumor that was originated from the left arytenoid region that very rare location. There is no evidence of recurrence 2 years after surgery. Granular cell tumors should be considered in the differential diagnosis of laryngeal masses, particularly in the posterior glottis.

Dear Editor, Dermoid cysts of the floor of mouth are quite uncommon, and only 1.6% of dermoid cysts are located in the floor of the mouth. 1 These cysts are classified into two types by location as follows: sublingual type is located between the oral mucosa and geniohyoid muscle and submental type arises between geniohyoid muscle and the skin. These cysts are distinguished into two groups as follows: one is the midline type, the other is the lateral type. 2 Various surgical techniques were reported for excision of the dermoid cysts of the floor of the mouth; midline vertical, bilateral incision along the mandibular crest, midline glossotomy, modified midline glossotomy and transcutaneus approaches. 3 This paper describes a technique that ensures success for enucleating large median geniohyoid dermoid cysts of the floor of the mouth which do not need an extraoral or transcutaneous route (Fig. 1). This technique has been used by the senior author in a case series of three patients over a period of 2 years, and one of them was reported in a previous case report as having a large dermoid cyst of the floor of the mouth. 4 Surgical steps1. The operation is performed under general anaesthesia with nasal entubation. 2. Braun cannulas are placed before incision to prevent Wharton duct injury. 3. Dingman retractor is placed and local anaesthetic is injected into the sublingual space. 4. The incision is done as inferior based U-shaped -reverse U -and then a thin mucosal flap is elevated over the cyst wall superiorly and bilateral laterally. (Fig. 2) 5. While dissecting the cyst with meticulous blunt dissection, the borders of the cyst are also determined. 6. After determining the borders of the cyst, aspiration and a small incision to the thick fibrous wall of the Fig. 2. U shaped flap elevation and aspiration of the cyst content to decrease the size.

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