<p class="abstract">The term atypical lipoma was introduced to describe the relatively benign course of well-differentiated liposarcomas when they occur in extremities compared to their retroperitoneal counterparts. A 32-year-old lady presented with dysphagia, excessive snoring and difficulty in breathing for three months<span>. On examination, a smooth globular retropharyngeal swelling was seen extending anteriorly till epiglottis obscuring the view of vocal cords. The CECT scan demonstrated features suggestive of a lipomatous lesion with possible sarcomatous change. Excision was done through a transcervical approach and histopathology showed features suggestive of atypical lipoma of retropharyngeal space</span>. As the tumor was removed in toto, adjuvant radiotherapy was not advised. Hence if any swelling in the retropharyngeal space is noted, the probability of soft tissue tumors must be ruled out by a CT/MRI scan before attempting incision and drainage or any other surgical procedure. Postoperative adjuvant radiotherapy is limited to high-grade tumors, incompletely excised tumors and more radiosensitive liposarcoma subtypes such as myxoid sarcomas.</p>

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<p class="abstract">The lips are major aesthetic components of the face, which are also necessary for facial expression, speech, and eating. In oncological resections, the main goal in lip reconstruction is achieving oral competence than speech and facial expressions. Malignant lesions involving lip warrant a wide excision to ensure a disease-free margin, which usually results in large defects. Defects up to 1/3rd of lips are closed primarily. Defects measuring 1/3rd to 2/3rd of the lower lip may be closed with Karapandzic, Abbe or Estlander flaps. A 45-year-old male presented with an exophytic lesion in the lower lip involving the facial skin with bilateral level 1b cervical lymphadenopathy. Contrast-enhanced computed tomography scan showed heterogeneous irregular lesion over the lower lip with bilateral enlarged necrotic level 1b cervical lymphadenopathy. Biopsy from the lesion was suggestive of moderately differentiated squamous cell carcinoma. Wide local excision with left modified radical neck dissection and right supraomohyoid neck dissection was done. The central lower lip defect was reconstructed with bilateral Karapandzic flap. The postoperative period was uneventful, although the patient had microstomia. The patient was advised adjuvant radiotherapy based on histopathology and was in regular follow up.</p>

<p class="abstract"><strong>Background:</strong> Among all forms of tobacco, smokeless tobacco is known to be more carcinogenic than smoking according to various studies. Smokeless tobacco is consumed through various forms in our region like kaddipudi, gutkha, khaini, pan, etc. This study aims at evaluating the different chewing patterns of tobacco and to assess their impact on the oral mucosa.</p><p class="abstract"><strong>Methods:</strong> The patients who attended ENT department with the habit of chewing tobacco were taken into this study after considering the inclusion and exclusion criteria. A detailed questionnaire including various habits and chewing patterns were filled and received from all the subjects, and a comprehensive ENT examination was done for them.  </p><p class="abstract"><strong>Results:</strong> In our study, a total of 120 subjects were included who chewed tobacco in various combinations, which we divided into 6 categories; of which 97 users were under category 2 (betel leaf, betel nut, slaked lime and kaddipudi). Among 120 subjects, 35 had malignancy, 51 potentially malignant lesions, 30 early changes and 4 had no changes. There was a statistically significant correlation noted between the duration of chewing for &gt;15 years (p=0.000); frequency of chewing &gt;5 times/day (p=0.004) and also overnight tobacco placement (p=0.027) with the occurrence of potentially malignant lesions and malignancy.</p><p class="abstract"><strong>Conclusions:</strong> In our study, the combination of betel leaf, betel nut, slaked lime with kaddipudi was the most commonly used combined form of smokeless tobacco. The duration, frequency of tobacco chewing, and overnight placement were statistically significant associated with potentially malignant lesions and malignant lesions.</p><p> </p>

<p class="abstract">A branchial cleft cyst is a congenital abnormality typically located over the lateral aspect of neck. A 3 year old boy presented with a gradually progressive painless swelling below his chin since 1 year. CT scan demonstrated well defined cystic lesion in submental region. Excision was done and histopathology showed the cyst lined by stratified squamous epithelium and at places lined by pseudo stratified ciliated columnar epithelium with subepithelial lymphocytes suggesting branchial cyst. Branchial cleft cysts should also be considered as one of the differential diagnoses in cystic midline lesions of the neck, if it’s not moving with deglutition and with tongue protrusion.</p>