Giant Cervical Lymphangioma Extending from Skull Base to Clavicle- A Rare Case.

Lymphangiomas are congenital benign lesions commonly seen in pediatric age group with a rare occurrence in the region of head and neck, commonly presenting as asymptomatic masses. Cervical lymphangioma is a rare entity among adults, and giant sized lymphangiomas in this region have sparse mention in literature. This case report describes the rare presentation of a giant cervical lymphangioma and the challenges involved to treat such masses in the region of head and neck. We encountered a rare case of a 52 year old female who presented with a 10 × 5 cm swelling in the right posterior triangle of neck swelling since 6 months extending from skull base up till clavicle. Pathological and radiological entities confirmed the lesion as a "giant cervical lymphangioma". Head and neck lymphangiomas are congenital lesions of benign origin. Lymphangiomas have been classified as macrocystic if larger than 2 cm, and microcystic if less than 2 cm. Our description of a macrocystic 10 × 6 cm lesion is hence definitely one of the largest cervical lymphangiomas encountered till date. It's a problematic and arduous plan of treatment for such masses in head and neck with a high chance of recurrence if incompletely removed.

Assessment of middle ear function after conventional or endoscopic microdebrider assisted adenoidectomy.

Objectives: To compare pre- and post-operative pure tone audiometric and impedance audiometric analysis following conventional and endoscopic microdebrider assisted adenoidectomy and compare the outcomes. Methods: Patients diagnosed with chronic adenoiditis were divided in groups of 25 each. Patients in the first group underwent conventional curettage adenoidectomy, while those in second group underwent endoscopic microdebrider assisted adenoidectomy. Pre- and post-operative pure tone and impedance audiometry were performed for all patients and outcomes were compared. Results: The endoscopic microdebrider assisted method resulted in significantly better outcomes compared to conventional curettage. Criteria such as hearing threshold (p value 0.004 at second follow-up), peak pressure (p value 0.045 at first follow-up) and tympanogram (p value 0.016) showed that the endoscopic method was better, while peak compliance (p value 0.340 at first follow-up) did not show any significant difference between groups. Conclusions: The endoscopic microdebrider assisted method for adenoidectomy has a definite advantage of better visualisation resulting in better clearance of tissue, leading to enhanced middle ear function compared to conventional curettage.