Dermoids, or hairy polyps, are rare lesions affecting the head and neck region. To date approximately 120 cases have been recorded. They arise during early embryogenesis and are invariably benign. Unlike the more differentiated types of teratoma, hairy polyps are derived from only two germinal layers, ectoderm and mesoderm. Most originate in the oro-nasopharyngeal region, either as pedunculated or sessile masses. They usually present at, or soon after, birth with signs of upper aerodigestive tract obstruction. Treatment consists of surgical removal. In young children with airway compromise, the expertise of an experienced paediatric anaesthetist is essential.Three new cases of hairy polyp are described to add to the present literature. Two originated in the nasopharynx and one in the oropharynx. Interestingly, one patient, a neonate, also suffered from severe osteopetrosis. All lesions were removed by simple surgical excision under general anaesthesia. There were no operative or post-operative complications.
Direct upper airway infiltration by thyroid neoplasia is a rare occurrence, a unique case of papillary thyroid neoplasia presenting as a pyriform fossa mass is described and the management of these problem patients is discussed, emphasising the controversy between radical and conservative surgery.The possibility that the thyroid tumour resulted from previous radioactive iodine prescribed for thyrotoxicosis is also considered.
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