These data confirm the preventive effect of a salivary stent placed during pharyngolaryngectomy, for patients at high risk of fistula development.

Schwannomas are rare and slow growing tumours, arising from Schwann cells which provide myelin; less than 1% of them degenerate into a malignant state. Although most studies are based on acoustic schwannomas, the majority of these tumours are non-vestibular and extracranial. Up to 45% of them can be localised in head and neck districts, where they represent a diagnostic challenge because they are in differential diagnosis with lipoma, brachial cyst, paraganglioma and adenopathy. Between February 2002 and September 2012 our experience considers 18 patients affected by schwannomas localised in the neck in 14 cases, in the oral cavity in 2 cases, in the upper lip in 1 case and finally in the nose in 1 case. A painless neck mass was the major symptom referred, as well as dysphonia and oral pain. Ultrasound scan with fine needle aspiration biopsy was done in half of the group and was diagnostic in 30%, whereas magnetic resonance imaging was diagnostic in 77%, confirming its primary role in diagnostic work-up. The surgical approach was mainly by cervical incision and the intraneural extracapsular enucleation was the technique used without nerve injury in 89% of cases. Follow-up period was 6-120 months and no evidence of relapse was registered.

Nose has an important role in the aesthetics of face. It is easy to understand the reason of the major interest that has revolved around the correction of its imperfections for several centuries, or even from the ancient times. In the last decade, all the surgical or medical minimal-invasive techniques evolved exponentially. The techniques of rejuvenation and corrections of nasal imperfections did not escape this development that is much widespread in the medicine of the third millennium. In many cases, the techniques of surgical correction involve invasive procedure that necessitates, for the majority of cases, hospitalisation. The author, using a different approach, has developed mini-invasive techniques using botulinum toxin A (BTxA) and absorbable fillers for the correction of nasal imperfections. BTxA allows to reduce the imperfections due to hypertension of muscles, while the absorbable fillers allow to correct all the imperfections of the nasal profile from the root to the tip in total safety. The correction is based on the precise rules that allow avoiding the majority of side effects. Results are long lasting and well appreciated by patients.

frequency so that soft tissue (nerve, vessel, dura mater, etc) will not be damaged even on accidental contact with the cutting tip; this renders the piezoelectric device suitable for bone surgery. Rhytidectomy Approach to the Excision of a Branchial CystLucia Oriella Piccioni, MD (presenter); Daniela Sarandria, MD; Pietro Limardo, MD; Mario Bussi, MD OBJECTIVE: Branchial cysts are congenital anomalies of the branchial apparatus related to the partial obliteration of a branchial sulcus. They are usually located anterior to the sternocleidomastoid muscle. The treatment is complete surgical excision. The traditional surgical approach is a horizontal incision in the neck. This technique is easy and radical but it produces a cervicotomy scar with aesthetic results sometimes unsatisfactory. In this work we present a novel application of the rhytidectomy approach to the excision of branchial cysts. METHOD: A 28-year-old man with a right laterocervical cyst. This lesion was surgically removed with a rhytidectomy approach. We evaluated the operating time and the aesthetic and functional results. The incision was conducted in the retroauricular sulcus and extended to the hairline. We preserved the great auricular nerve, the spinal accessory nerve, jugular vein, and carotid artery. RESULTS: Operating time was 90 minutes. The patient had no nerve deficits and 3 months after surgery, he was satisfied with the aesthetic result. CONCLUSION: The use of rhytidectomy in treatment of a branchial cyst improves aesthetic results with hidden scar, allowing no nerve or vasal injuries instead of a minimum additional operating time.