Outpatient tonsillectomy in children may be safe even with permissive criteria, when an appropriate setting is available.

Choristomas of the internal auditory meatus are very uncommon tumors. Because of their rarity and the lack of a consistent clinical and radiological pattern, they are usually misdiagnosed as vestibular schwannomas. Surgical exploration usually shows involvement of the vestibular, cochlear or facial nerve by the tumor, representing a diagnostic and therapeutic challenge to the surgeon. In this report, a case of a smooth muscle choristoma of the internal auditory meatus is presented. The lesion involved the vestibular and cochlear nerves and was extremely adherent to the facial nerve. Microscopic examination of the tumor revealed nerve fibers, smooth muscle and a small amount of adipose tissue. No striated muscle was found. The contemporary terminology, diagnosis and management of this infrequent lesion are analyzed.

Introduction. Transoral robotic surgery (TORS) radical tonsillectomy is an emerging minimally invasive surgical procedure for the treatment of cancer of the tonsil. The detailed surgical technique and claims for its reproducibility have been previously published. Case Presentation. We present a patient with a T2N2bM0 epidermoid carcinoma of the tonsil to illustrate step by step the surgical procedure for TORS radical tonsillectomy. Neck dissection and TORS were staged. No surgical reconstruction of the defect was required. No tracheostomy was necessary. The patient could eat without any feeding tube and was on full oral diet on the fifth postoperative day. Discussion. The transoral approach offers the benefits of minimally invasive surgery to patients with cancer of the tonsil. The excellent exposure and high precision provided by robotic instrumentation allow the surgeon to closely follow and accomplish the surgical steps, which is the best warranty for safety and effectiveness.

On considering a function-preserving treatment for laryngeal and hypopharyngeal cancer, swallowing is a capital issue. For most of the patients, achieving an effective and safe deglutition will mark the difference between a functional and a dysfunctional outcome. We present an overview of the management of dysphagia in head and neck cancer patients. A brief review on the normal physiology of swallowing is mandatory to analyze next the impact of head and neck cancer and its treatment on the anatomic and functional foundations of deglutition. The approach proposed underlines two leading principles: a transversal one, that is, the multidisciplinary approach, as clinical aspects to be managed in the oncologic patient with oropharyngeal dysphagia are diverse, and a longitudinal one; that is, the concern for preserving a functional swallow permeates the whole process of the diagnosis and treatment, with interventions required at multiple levels. We further discuss the clinical reports of two patients who underwent a supracricoid laryngectomy, a function-preserving surgical technique that particularly disturbs the laryngeal mechanics, and in which swallowing rehabilitation dramatically conditions the functional results.

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