Abstract: Maxillary ameloblastoma is a rare odontogenic neoplasm that is histologically benign and originates from epithelial cells present in bone tissue. If excised through conservative surgery, this tumour has a high relapse rate and is locally aggressive. The risk, in particularly extensive forms, that the ameloblastoma will invade extra-maxillary structures such as the orbit, the pterygomaxillary fossa, the infratemporal fossa and the base of the skull, means that surgical treatment is difficult if it is to be oncologically radical while respecting function and aesthetics. Thus, in these cases a complete and in-depth diagnostic work-up and careful planning of surgical treatment are needed: surgery entails an ablative phase with en-bloc resection of the neoformation to margins free of neoplastic infiltration, and a reconstruction phase that, within a short time-frame, will re-establish functionality and provide a good aesthetic result. Our experience in treating 2 cases of maxillary ameloblastoma is reported.

Abstract: Nodal metastases from head and neck primary cancer presenting as a parapharyngeal space mass are rare. This paper reports two cases of papillary thyroid carcinoma metastatic to the parapharyngeal space. This finding can be related to Rouviere's description of a direct lymphatic pathway from the posterior surface of the superior thyroid lobe to the lateral retropharyngeal nodes. Metastatic thyroid cancer should be considered in the differential diagnosis of a parapharyngeal space mass.

Abstract: This paper describes a technique for orbital infero-medial wall reconstruction after "en bloc" resection of squamous cell carcinomas involving ethmoidal and maxillary sinuses utilizing an osteo-chondro-mucous flap of the nasal septum. This technique seems to be superior for many reasons: rapidity in flap preparation, direct access to the donor area in the resection surgical field, reliabilty due to good vascular supply, major functional and aesthetic results (low risk of diplopia and eyeball displacement). In our opinion, among the orbital reconstruction techniques, the osteo-chondro-mucous flap of the nasal septum can be the preferred reconstructive choice in ethmoid-orbital-maxillectomy with excision of the whole medial and two thirds of the lower orbital walls.

Abstract: With regard to the rarity of metastatic tumor of the oropharyngeal region, we report a case of tonsillar metastases from the small cell carcinoma of the lung with controlateral cervical lymphadenopathy. The review of literature and the our clinic experience confirms the opportunity for an exclusively palliative treatment as then one no survivors in such events.

Abstract: Modern surgical treatment of cancer of the hypopharyngo-esophageal cannot be conditioned by the reconstructive procedures. Reconstructive options are based on the size and position of the defect in this important anatomical region. Currently the reconstruction of the hypopharyngo-esophageal tract allows a rapid and suitable restoration of the vital functions, a low morbidity and shortened hospital stay. The purpose of this study was to compare the various reconstructive approaches in terms of morbidity and functional results. Between January 1990 and June 1994, 17 patients with hypopharyngo-esophageal tract malignancies and one with a stenosis received treatment. The reconstructive procedures included 19 flaps: five myocutaneous pectoralis major flaps, one myocutaneous trapezius flap, five deltopectoral flaps, one radial forearm free flap and seven free jejunal grafts. There were six complications: one total necrosis and two stenosis in the free jejunal grafts group, one partial necrosis and one dehiscence in two myocutaneous pectoralis major flaps and one stenosis in a deltopectoral flap. Based on our studies, we believe that the free jejunal graft is the first choice for total reconstruction of the hypopharyngo and cervical esophageal tract. However the radial forearm free flap is certainly a valid solution for subtotal hypopharyngo-esophageal reconstruction. Pedicled flaps and particularly the myocutaneous pectoralis major flaps are a good alternatives for limited reconstructions (< 50%) of the hypopharyngo-esophageal tract.

Abstract: The authors analyzed the data obtained from their experiences in extensive head and neck resections, and, reconstructive treatments using myocutaneous and conventional flaps. They tried to evaluate comparatively the reconstructive approach, in terms of morbidity and functional results. The 145 cases of advanced had and neck cancer, treated from January 1990 to January 1994, were considered in this study. The reconstructive procedures consisted of 193 flaps. In this study, 106 were myocutaneous flaps (pectoralis major or trapezius flap); 72 were conventional flaps (fasciocutaneous, cutaneous or muscular only) and the remainder were 15 free flaps. The morbidity related to both flap procedures had been low: 33% in myocutaneous flaps versus 11% in conventional flaps. This report demonstrated the versatility, usefulness, and reliability of both kinds of these reconstructive procedures, especially in intra-oral reconstruction. The expected morphological and functional results were quite encouraging in terms of swallowing and speech.