We reported two cases of rhabdomyosarcoma of the paranasal sinus using VAIA chemotherapy and operation. In spite of using same chemotherapy, they took contrary course. The first case (30-year-old male) of rhabdomyosarcoma of left paranasal sinus (T4N2bM0) with left neck lymph nodes swelling underwent left radical neck dissection, superfacial parotidectomy, and ethomoid sinus dissection using Killian's method after 4 course of VAIA chemotherapy. But tumor was reccurenced to his neck and axial area, and finally occurred hepatic and pancreatic metastasis. He died 4 months after his operation. The second case (57-year-old male) of rhabdomyosarcoma of left paranasal sinus (T4NOM0) underwent left radical neck dissection, superfacial parotidectomy, and total maxillectomy (including eye ball resection) with opened craniofacial area after 4 course of VAIA chemotherapy. Reconstruction of this patient's dead space was used rectum abdominal free flap. He now lives 1 year 11 months after initial presentation with tumor free. We concluded that the patient who had neck lymph node metastasis at initial presentation should be taken intensive chemotherapy, because it's prognosis would be poor even if we had done operation. These patients may have a possibility of distant metastasis more than N0 patients. The patient who had no neck lymph node metastasis should be done more extended operation after using VAIA for 4 course. After then adj uvant VAC chemotherapy is need. The chemotherapy of VAIA is one of the effective chemotherapy for rhabdomyosarcoma.

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Of tumors developing in the cerebellopontine angle, auditory neurinoma is most prevalent accounting for 80-90%, followed by meningioma for 5-10%. Generally, meningioma occurs as a large tumor in the posterior cranial fossa, and its invasion to the internal auditory canal is frequently observed. However, the case of meningioma mainly occupying the internal auditory canal is very rare. We experienced a patient who had meningioma in the internal auditory canal. This tumor occupied the majority of the space in the internal auditory canal and invaded into the vestibule partially. Hence, it was difficult to differentiate from auditory neurinoma. The subject was a 48-year-old man with severe sensorineural hearing loss of the left ear. He had history of dizziness and facial paralysis. On MRI, the tumor mainly occupying the internal auditory canal was found although a trace was in the cerebellopontine angle. The illness was diagnosed as acoustic neurinoma because the main site was the internal auditory canal. He underwent translabyrinthine approach. In the postoperative histopathological examination, the tumor was diagnosed as meningotheliomatous meningioma. No remaining tumor was found on postoperative MRI. Since part of tumor expanded to the vestibule, selection of translabyrinthine approach seems to be appropriate.

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Neck tumor has many origin. They are congenital or cystic tumor, inflammation, neoplasm (including the haematological neoplasm and metastatic lymphonode swelling). It is important to make an accurate diagnosis, because the each disease will be treared in several consultation in the hospital. This time 2 cases of the report of schwannoma is discussed about the preoperative diagnosis. The first case underwent the operation of tumorectomy, with the preoperative diagnosis of metastatic lymphonode tumor with the use of CT. The second case had the operation of tumorectomy with the preoperative diagnosis of schwannoma with MRI. And MRI is usefull for the accurate preoprative evaluation and a high degree of suspicion of schwannoma.

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Recently, the anchors have been become much smaller. This has made anchor useful in head and neck surgery.
Sometimes it is difficult to fix soft tissue to bone in head and neck surgery. The most important point is long-time holding strength for the fixation of soft tissue to bone. We have used suture anchor in reconstruction of skull base and reconstruction of neck following radical neck dissection. These techniques are discussed in this paper. Suture anchors have potential applications for many other surgeries of head and neck. More study needs to be done.

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Adenoid cystic carcinoma in the lacrimal sac is extremely rare. A 52-year-old man presented with bloody rhinorrhea and swe lling of the lacrimal resion. Biopsy of nasal cavity tumor showed it as adenoid cystic carcinoma. The tumor was resected bylef t partial maxillectomy and lacrimal sac tumor biopsy was performed. The diagnosis of lacrimal sac tumor biopsy was a denoid cystic carcinoma as same as nasal cavity tumor, so left orbital exenteration and additional left partial maxillect my were performed. The inferior nasal meatus tumor was suspected origianting in the lacrimal sac, invasing nasolacrimal duct and extention of nasal cavity. After an uneventful postoperative course, the patient received a total of 5000 rails.

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A 24-year-old man with hearing loss caused by large vestibular aqueduct syndrome, underwent a cochlear implant. The cochleostomy was performed at the scala tympani in the standard fashion, and once the cochlea was opened, a small amount of fluid derived from both perilymph and cerebrospinal fluid (CSF) began leaking pulsationally from the cochleaostomy. A pulsational leak of CSF may depend on the communication between the perilymphatic and the arachnoid space being brought by the anatomical abnormality between the fundus of the internal auditory canal and the inner ear. The leak fortunately stopped with the packing of pieces of the temporalis fascia. However, we should keep in mind the report of a case receiving the placement of an intraoperative lumbar drain to control a profuse CSF leak.

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