Needle aspiration of neck abscesses with CT-scan guidance was studied in 17 children with 18 abscesses from 1986 to 1991. Clinical and radiologic findings were analyzed according to treatment outcome. A majority of abscesses (55.6%) resolved after treatment with one to two attempts at needle aspiration and parenteral antibiotics. Unilocular abscesses were more likely than multilocular abscesses to resolve with needle aspiration. In general, abscesses in younger children who presented with smaller neck masses on physical examination and smaller abscess cavities on CT scan resolved with needle aspiration. The data support the use of needle aspiration as an effective initial treatment for pediatric neck abscesses. CT scan was found beneficial in documenting the abscesses and in guiding treatment. A treatment protocol is suggested for the use of needle aspiration in the management of neck abscesses in children.

We report a case of a 62-year-old man with epistaxis and right-sided nasal obstruction. Nasal endoscopy revealed an exophytic mass arising from the anterior septum that extended posteriorly to the osteo-meatal complex. Excision with endoscopic sinus surgery was performed. Carcinosarcoma was diagnosed based on histopathology and immunohistochemical studies. The patient declined surgery and opted for chemoradiation therapy for the residual tumor. Six weeks after completion of the treatment, clinical resolution of the right nasal mass was noted. Carcinosarcomas are rare and rapidly growing tumors that have a high recurrence rate and are associated with poor patient prognosis. This report emphasizes the need for patients with prolonged nasal obstruction and epistaxis to consult otolaryngologists and undergo nasal endoscopy for definitive diagnosis and appropriate treatment.

Sinonasal renal cell-like adenocarcinoma (SNRCLA) is a newly defined, rare malignant tumor of the nasal cavity. The clinical course and response to treatment remain uncertain. The purpose of this study is to report a new case of SNRCLA and review the literature to determine clinical characteristics, treatment options, and outcomes. A 26-year-old male presented with headache, epistaxis, and nasal obstruction. Physical examination revealed a tumor involving bilateral ethmoid sinuses and MRI revealed extension through the cribriform plate. Surgical excision with endonasal and a bifrontal craniotomy was performed followed by adjuvant radiotherapy (RT). After RT, the patient had persistent disease requiring salvage surgery. There are few previously reported cases of SNRCLA. A literature review yielded 14 previously reported cases with convincing diagnostic evidence of SNRCLA. Common presenting symptoms were epistaxis and nasal obstruction. Surgical excision was the primary treatment in fourteen cases, nine received RT, and none received chemotherapy. However, three cases had persistent or recurrent disease. Surgical excision is the mainstay of treatment for SNRCLA and adjuvant RT has been used in some patients with varying outcomes. The tumor is low grade with no reported cases of metastases or death. The best practice for treatment is yet to be determined.

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A literature review of the results for adult and pediatric groups will be given. A case report of a 23-year-old man with congenital ptosis will be used to illustrate the correction of severe blepharophimosis-ptosis with fascia lata strips. Intraoperative technique for suspension and adjustment will be discussed.In conclusion, levator ptosis is a surgically correctable condition. Surgical suspension to the frontalis muscle is the procedure of choice.