Pediatric free flap reconstruction is a reasonable option for various head and neck defects such as skull base, congenital, and mandibular defects.

Objective: To determine the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of FNAB in detecting parotid malignancies in our institution. Methods: Design:           Retrospective Chart Review Setting:           Tertiary Government Hospital Participants: Postoperative records of seventy six (76) patients with tumors of the parotid gland preoperatively diagnosed by FNAB. Results: The sensitivity of FNAB was 46%. The specificity and positive predictive value were both 100% and negative predictive value was 90%. Overall accuracy in diagnosing malignant parotid tumor was 91%. Conclusion: FNAB in this institution is a poor predictor of malignancy, having a sensitivity rate of only 46%. While this may serve as a basis for not recommending pre-operative FNAB for patients with parotid tumors in the interim, other factors should also be considered, including concerns with the actual performance and interpretion of FNAB in our institution. Keywords: Parotid neoplasm, Cancer of the parotid, fine needle aspiration biopsy, sensitivity, specificity, accuracy

Objective: To report a case of foreign body lodged within the sphenoid sinus and its extraction.   Methods:             Design: Case Report             Setting: Tertiary Government Hospital             Patient: One   Results: An 11-year-old girl was hit in the eye by an unknown object from an improvised slingshot. She had loss of vision of the left eye and headache, without loss of consciousness. A plain craniofacial Computed Tomography (CT) scan showed a round opaque foreign body abutting the left sphenoid sinus, left posterior ethmoid cells and medial aspect of the left orbital region with adjacent soft tissue densities extending into the apparently ruptured, irregular left globe. The left posterior part of the lamina papyracea was not visualized, probably fractured or ruptured.  Transorbital enucleation of the left eye and endoscopic-guided removal of the foreign body (a glass marble) were performed with no intra – operative and post – operative complications. Conclusion:  Foreign body of the sphenoid sinus is a rare condition. Adequate imaging is important for localization and planning the optimal surgical approach. Endoscopic guidance may aid in extraction. Keywords: Sphenoid sinus foreign body, Computed Tomography (CT), Endoscopic-guided, transorbital approach

Objective: This study focuses on evaluating the relationship between physical findings, particularly collar size and Body Mass Index (BMI), and polysomnographic parameters in male patients seen at a Sleep Disorders Laboratory, suspected to have Obstructive Sleep Apnea (OSA).    Methods: Design: Cross-sectional study Setting: Academic tertiary private hospital Participants:  Charts of 149 adult male patients referred for polysomnography between July 1, 2005 and June 30, 2006 were reviewed.  Height, weight, and external neck circumference measurements were obtained.  The data from polysomnography results were noted and correlated with the physical measurements.    Results: The mean collar size for the OSA group was 42.03 cm with a mean BMI of 29.14 while the mean collar size for the normal group was 39.05 cm with a mean BMI of 25.36.  A significant difference was noted in both the collar size and body mass index (BMI) between the OSA group and the normal group (p<0.005).  Results showed a significant correlation between collar size and BMI.  Collar size and BMI measurements were also correlated with increasing severity of sleep apnea in the OSA group.  The ³40 cm collar size among male adults with symptoms of OSA was 80% sensitive and 67% specific with a positive predictive value of 94% in predicting true OSA.   Conclusion: This study suggests that the external neck circumference and the degree of obesity determined through BMI measurement may be important predictors of sleep apnea in adult Filipino males suspected to have OSA.  Given the high probability of having true OSA in symptomatic male adults with a collar size ³ 40 cm, outright definitive management may be opted for in these patients, while those with a collar size < 40 cm may need to undergo further confirmatory tests.     Keywords: obstructive sleep apnea, external neck circumference, collar size, body mass index, polysomnography, obesity

Objective: To determine the prevalence of, and describe transglottic cancer with thyroid cartilage invasion as a possible risk for, thyroid gland invasion in a series of patients with laryngeal carcinoma who underwent total laryngectomy with thyroidectomy. Methods Study Design:            Retrospective case series Setting:                       Tertiary government hospital Subjects:                    61 laryngeal carcinoma patients who underwent total laryngectomy with hemi- or total thyroidectomy from January 2010 to August 2017. Results Out of 61 patients with laryngeal carcinoma, 11 patients had supraglottic, 11 glottic, 2 subglottic and 37 had transglottic involvement. Eleven had thyroid cartilage invasion, all of whom had transglottic tumors. Of these 11 patients, only 1 had thyroid gland invasion. This was a case of a 78 year-old male patient, with poorly differentiated SCC stage IVa transglottic tumor with thyroid cartilage invasion. Conclusion Thyroid gland invasion was uncommon in our sample of laryngeal carcinoma patients who underwent laryngectomy and thyroidectomy. Although transglottic involvement with thyroid cartilage invasion may increase the risk of thyroid gland invasion, it could not be confirmed by our series. Perhaps thyroidectomy should not be routinely performed on all patients with laryngeal carcinoma who undergo total laryngectomy, but more rigorous studies are needed to establish this.   Keywords: laryngeal carcinoma, transglottic, thyroid cartilage invasion, thyroid gland invasion, thyroidectomy