Teratomas of the head and neck due to their obscure origin, bizarre microscopic appearance, unpredictable behaviour and often dramatic clinical presentation are a clinical surprise. This article focuses on pediatric head and neck teratomas and on their diversity and rarity and also reviews the recent terminology of this group of tumours.

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This study was designed to assess the efficacy of functional endoscopic sinus surgery (FESS) in chronic rhinosinusitis (CRS) patients with minimal radiological findings, and based on one centre, prospective randomized controlled study, conducted in the Department of Otorhinolaryngology, Lady Hardinge Medical College, New Delhi. All the CRS out-patients ([18 years) refractory to 3 weeks of medical therapy were radiologically evaluated with computerised tomographic scan (CT) of nose and paranasal sinuses. These patients were grouped based on CT scoring (Lund Mackay staging system): group A (CT score 0-6) and group B (CT score 7-24); with 35 patients in each group. All the patients underwent FESS using Messerklinger technique. Symptom scoring of all the patients was done using visual analog scale preoperatively and postoperatively at 1-, 3-, 6-and 12-month follow-up. CRS patients with minimal evidence of disease on CT showed statistically significant improvement in symptom scores after FESS. There was no significant difference noted in the overall symptom score improvement as well as for improvement in specific symptoms in both the groups. Further, there was no correlation between the pre-operative symptoms and CT scores. A good subjective outcome in terms of symptom improvement can be obtained with FESS in patients with CRS with minimal evidence of disease on CT.

To review the need of emergency recanalization surgical procedure in cases of bilateral choanal atresia. A retrospective analysis was undertaken for the cases of bilateral choanal atresia which were recanalized between January 2000 and February 2010 in a teaching hospital. Out of 135,954 live births (0.004%), six cases of bilateral choanal atresia were diagnosed and operated during this period. Five cases were hospital deliveries from our hospital whereas one case was referred from another hospital. Three cases were recanalized with dilatation procedure whereas the other three were endoscopically recanalized with micro-drill. All the cases were operated in routine operation theatre. All were managed with orogastric tube or oropharyngeal airway during the waiting period for surgery. No neonate required emergency intubation or tracheostomy. The average age at the time of surgery was 10 days (range 5-21 days). As per our observations recanalization surgery for bilateral choanal atresia is not a surgical emergency. Neonates can be managed temporarily with orogastric tube/oropharyngeal airway during waiting period. Subsequently surgery can be done in routine and unhurried operation theater by experienced surgical hands thus minimizing the morbidity.

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