ABSTRACT
Pharyngocutaneous fistula occurring after total laryngectomy is a bothersome complication as it can even cause a massive bleeding due to carotid artery rupture. Preoperative radiation, extensive diseases which need flap reconstruction, low albumin or hemoglobin level, history of smoking, or underlying diseases have been domestically reported to have a relationship with the condition. To reduce this complication, simultaneous coverage for the pharyngeal closure has been developed using flaps, such as the pectoralis major muscle, the radial forearm or the anterolateral thigh, which are distant from the radiation field. However, these methods need additional surgical techniques and times. Another method advocated is pharyngeal reinforcement using flaps that can be easily obtained from the same surgical field, such as the sternocleidomastoid or the infrahyoid muscle or the acellular dermal graft with relative significances. Here we suggest reinforcement of pharyngeal closure after total laryngectomy using the sternohyoid and omohyoid muscle flaps.
ABSTRACT
Juvenile xanthogranuloma (JXG) is a rare benign histiocytic tumor, which was first described by Adamson in 1905. JXG typically presents as solitary or multiple yellow-brown skin nodules in infants, most often on the head, neck or upper trunk. Extracutaneous forms are rare and there are only several cases reported in the nasal cavity up to date. Previous cases were presented with the mass effect such as nasal obstruction. We recently experienced a pediatric patient with epistaxis and the nasal endoscopy suggested pyogenic granuloma. However, biopsy of the mass revealed JXG. Herein, we report a case of disseminated juvenile xanthoma misdiagnosed as pyogenic granuloma.