Arterio-venous malformation (AVM) occurring to lips is rare. We describe the case of a 44-year-old man with AVM occurring to the upper lip. A physical examination of the upper lip showed a soft mass with beat, measuring 3cm×1.5 cm in diameter. T1 and T2-weighted MR imaging revealed low signal density mass showing flow void in the upper lip. Angiography confirmed perfusion of the AVM and revealed a feeding vessel from the right facial artery. After this confirmation, preoperative embolization with Gelfoam and Ivalon was immediately performed. Then the patient underwent complete surgical excision using Nd-YAG laser. On histological study, the specimen was composed of variably ecstatic and hyalinized veins and abnormally muscularized arteries. Thereafter the patient showed no evidence of recurrence more than 4 years later.

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Schwannomas are neurogenic neoplasms which are rarely found in the sinonasal tract, and onl 77 cases have been reported in Japan. We present a case of schwannoma occurring in the lef nasal cavity, review the current literature and discuss the clinical details with specif histological features. The patient was a 48-year-old man, who complained of nasal discharge on the left side and headache. On endoscopic examination, the left nasal cavity was occupied with a polypous mass. CT scan of the paranasal sinus revealed that the tumor occupied the left nasal cavity and was pressing out the internal wall of the left maxillary sinus and nasal septum. Biopsy of this polypous mass showed it to be only an inflammatory granulation. Under general anesthesia, the tumor was completely resected by endoscopic sinus surgery (ESS) . Histological examination revealed it to be schwannoma (Antoni A type). The postoperative course was good with no signs of recurrence for 6 month.

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Cervical vagal schwannoma with curtain sign is extremely rare in Japan. A38-year-old female complained of pharyngeal foreign body sensation. She had pharynx mass and curtain sign. Cervical mass was not palpabale and she had no other complaints such as hoarseness or dysphagia. CT scan and MRI revealed a tumor at the right parapharyngeal space.The tumor was removed by transcervical approach and added midline mandibulotomy. The tumor was removed together with the vagus nerve. Histologic appearance of the speciemen was compatible with a neurinoma of Antoni type A and B mixed tissues. Postoperatively, she demonstrated a right vocal cord palsy, hypoglossal nerve palsy, and dysphagia. Hypoglossal nerve palsy and dysphagia improved within 6 months. She underwent arytenoids adduction to repair hoarseness caused by right vocal cord palsy after 15 months. The patient has remained free of the disease for 60 months following surgery.

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A rare case of salivary duct carcinoma (SDC) arising from a tongue is presented. The patient is a 67 year-old male who complaining of a pain and mass in his tongue. Open biopsy revealed SDC. The patient was treated with neo-adjuvant chemotherapy (CDDP+5 FU), partial glossectomy and adjuvant chemotherapy.

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A pediatric case of vocal cord adhesion treated by laser plasty combined with mucosal suture technique was reported. A 3 year and 7 month old girl was referred to our clnic with prolonged stridor for more than 2 years. Fiberoptic observations revealed a limitation of the opening of the glottis during inspiration and a tentative diagnosis of bilateral laryngeal paralysis was made. However, microlaryngoscopy performed after tracheostomy under general anesthesia revealed an adhesion of both vocal cords for the anterior 4/5. The adhesion was separated with C02 laser, and the right vocal cord was laterally fixed according to the Ejnell method. One month after the surgery, however, the adhesion recurred. Therefore, under microlaryngoscopy, the ashesion was separated again and the cut end of the right vocal cord was thinned using a laterally beamed laser tip to leave the upper and lower mucosal edges intact. Both mucosal edges were then sutured together to close the raw surface at the cut end by means of our mucosal suture technique reported elsewhere. The entire procedures were made with a supportive viewing of the surgical field using an angurated telescope attached to the operating table.

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