Treatment of solid neck masses are discussed

Diagnosis and management of laryngeal cleft is presented.

Cervicofacial lymphadenitis caused by nontuberculous mycobacteria (NTM) is an increasingly recognized condition in otherwise healthy children, most commonly between 1 and 5 years of age. It typically presents as a firm, painless cervical, submandibular, or parotid mass that slowly enlarges over weeks, with progressive thinning and violaceous discoloration of the overlying skin and, in advanced stages, spontaneous fistulization. Although NTM lymphadenitis remains rare in absolute terms, several population-based series suggest a rising incidence, including data from québec indicating a marked increase in hospital-based diagnoses over recent decades. This trend underscores the need to refine management strategies that balance cure, complication risk, and long-term cosmetic outcomes.

definitive diagnosis relies on microbiologic confirmation by PCR or culture, but clinicians frequently rely on a combination of clinical presentation, tuberculin skin testing, interferon-gamma release assays, and imaging to guide initial management. Available therapeutic options include observation, systemic antibiotic therapy, non-excisional procedures (fine-needle aspiration, incision and drainage, curettage), and complete or partial surgical excision. Current literature generally supports complete excision of affected lymph nodes as the modality with the highest cure and lowest recurrence rates, with reported success exceeding 95%, compared with lower cure rates for antibiotics alone, observation, or non-excisional interventions. However, complete excision may require extensive dissection in anatomically sensitive regions, exposing children to risks such as facial nerve palsy, wound infection, conspicuous or widening scars, and contour deformities—particularly concerning in young children with elastic skin and a long lifetime of scar maturation ahead.

emerging data suggest that partial excision can achieve comparable clinical resolution in some patients, raising a critical question: are the peripheral lymph nodes and surrounding tissues routinely removed during “complete” excision truly involved by active NTM infection at histopathology, or does an intact immune system clear residual disease without the need for maximal surgery? To date, this specific question has not been systematically examined.

this presentation will synthesize current evidence on the epidemiology, diagnostic pathways, and comparative effectiveness of medical and surgical management for pediatric cervicofacial NTM lymphadenitis. It will then introduce an ongoing project that correlates the histopathologic status (microabscesses, caseating and non-caseating granulomas) of peripheral tissues with clinical outcomes following partial versus more extensive excision. By highlighting this knowledge gap, the proposal aims to stimulate discussion on whether a de-escalation of surgery—tailored to disease extent—could maintain high cure rates while reducing complications and improving cosmetic results.

DIFFERENT TOPICS OF PEDIATRIC EAR SURGERY IS PRESENTED AS AN INSTRUCTIONAL COURSE

In every pediatric head and neck surgery, there are key moments that define short-and long-term outcomes, potential complications, and challenge us to make the best intraoperative decisions.   recognizing these crucial moments and developing strategies to optimize our judgement in each case requires awareness, experience, and humility.  in this panel, four pediatric otolaryngologists with high volume, focused practices in pediatric head and neck surgery will discuss these "critical ten seconds" across a broad range of common pediatric head and neck surgeries. When does the margin really matter? How might specific treatment aims influence a decision to deviate from the “usual” surgical approach? When is it time to sacrifice a key nerve or make a cosmetically undesirable incision? When is it time to be our own worst critics and reassess our scope, pass on a surgery, or phone a colleague for assistance? What mental heuristics will bring us through the hardest times? We will share experiences from both our most overtly challenging head and neck tumor cases as well as those that were surprisingly and unexpectedly difficult. we will incorporate decision making science into our discussion, including concepts of cognitive bias and decision fatigue. anticipatory strategies that allow for early identification of surgical inflection points will be presented. participants should leave the session with strategies to cope with difficult intraoperative decisions in common pediatric head and neck surgeries, so that we can all bring our best to those critical ten seconds for every child. We will also consider the postoperative phase, particularly after near-misses or difficult decision-making scenarios, and how structured debriefing with colleagues provides opportunities for reflection and improvement. 

The topic pott’s puffy tumor is suitable for a round table or an instructional course.

the session will focus on diagnostic considerations, non-surgical treatment options, surgical treatment options, and multidisciplinary management of pott’s puffy tumor.

since pott’s puffy tumor patients can be children, adolescents and adults, this could be in the pediatric or rhinology track

Infant mental health is an emerging critical subspecialty that has the potential to influence paediatric ENT practice. It is the understanding that what happens in the first 3 years of life has significant repercussions for future mental resilience and wellbeing. Many children with chronic conditions has poorer mental health throughout childhood and adulthood. Knowing some simple, basic, easily applicable infant mental health skills can equip the paediatric ENT surgeon to provide a better care for each child.