Background: Antrochoanal polyp (ACP), also known as Killian polyp, is a benign lesion of maxillary sinus origin with infective etiology. ACPs most often present with nasal obstruction and rhinorrhea, but may rarely prolapse causing acute respiratory distress. We herein report a rare case of ACP-causing stridor. Case description: Large ACPs may extend into the nasopharynx and reach almost up to the epiglottis. A 19-year-old girl presented with nasal obstruction, dysphagia, and stridor. She was diagnosed with left ACP reaching the suprahyoid epiglottis. The patient underwent functional endoscopic sinus surgery (FESS). The postoperative period was uneventful. Conclusion: Though the ACP is a common lesion, it has various presentations and may extend into the hypopharynx. ACP is managed surgically with complete excision to reduce the risk for recurrence and with less morbidity. Clinical significance: It is important to keep in mind that ACP when untreated can lead to stridor.

Introduction: The non-recurrent laryngeal nerve (NRLN) is an indulgent and unusual entity, because of the low prevalence and knowledge; the diagnosis may be difficult. When injured it may lead to functional alterations such as vocal cords paralysis and airway obstruction, awareness of this diagnosis is definitive to avoid its damage surgical interventions. Presentation of cases: In our two patients a total thyroidectomy was performed because of a benign pathology. during the intervention a laryngeal nerve without a recurrent pathway was found and documented their origin directly from the vagus nerve. Discussion: The diagnosis of NRLN is usually incidental during a surgical procedure. That is the reason why it can be easily damaged in different ways (transection, electrothermal etc). NRLN is documented in the right side in higher percentage, and it is directly related to a vascular malformation known as lusoria artery. Conclusion: The anatomy knowledge has a determining factor in the surgical outcomes. In this way the iatrogenic damage can be minimized and consequences due to the damage of the RLN can be prevented.

Isolated laryngotracheal amyloidosis is a rare disorder, accounting for only 0.2–1.2% of benign masses of the larynx. In the larynx, the rarest site mentioned in literature for amyloidosis is the subglottis and tracheal wall. Here, we present a case of a 69-year-old male who complained of progressive hoarseness, was diagnosed with subglottis and tracheal wall amyloidosis, and was treated with endoscopic microlaryngeal surgery and excision with coblation. As it is a slowly progressive disease, long-term follow-up is always recommended.

Background: Sinonasal teratocarcinosarcoma (SNTCS) is a very rare aggressive neoplasm of the sinonasal tract and affects older individuals. The tumor accounts for <1% of all sinonasal neoplasm and shows a striking male predominance. The admixture of epithelial, mesenchymal, and primitive neuroepithelial elements is essential for the diagnosis of this tumor. However, the morphological differential diagnosis of SNTCS is wide and can lead to potential diagnostic error if any one of the three elements predominates in a biopsy. Case description: We report three cases of SNTCS from a single center. All three patients were middle-aged adults, including one male and two female patients. The age range was between 42 and 46 years. All of the three patients presented with nasal obstruction, pain, and nasal bleeding. The imaging study revealed a direct intracranial extension of the tumor in one of the patients. Two patients underwent frontal craniotomy, and the third patient underwent transnasal decompression of the tumor. On light microscopic examination, all three cases revealed similar morphology. The tumor tissue was composed of three distinct components, including malignant epithelial, mesenchymal, and primitive neuroepithelial elements. Immunohistochemistry (IHC) showed strong pan-cytokeratin (AE1/AE3) positivity in the epithelial component. The mesenchymal component showed varied differentiation, including osseous and rhabdomyoblastic differentiation. The primitive neuroepithelial element showed positivity for cluster of differentiation 99 (CD99) and synaptophysin IHC. Conclusion: Sinonasal teratocarcinosarcoma (SNTCS) is often underdiagnosed because of the rarity of this tumor and its histomorphological overlap with a wide range of sinonasal malignancies. A careful morphological assessment of the biopsy sample and a battery of ancillary investigations, including IHC, confirm the diagnosis.