Magnetic resonance imaging is a routine investigation in cases of asymmetric sensorineural hearing loss, but it is not routinely used to investigate bilateral sensorineural hearing loss.

This case report illustrates the benefits of magnetic resonance image scanning in the latter patient group.

A 53-year-old man with rapidly progressive, symmetrical, bilateral, sensorineural hearing loss was found also to have anosmia, imbalance and incoordination. Magnetic resonance image scanning demonstrated leptomeningeal haemosiderosis. Progressive, bilateral, sensorineural hearing loss is the most common presentation of this condition and magnetic resonance imaging is the diagnostic investigation of choice.

There are potential treatments for leptomeningeal haemosiderosis which prevent further irreversible damage, if a bleeding source can be found. Hearing loss may be due to cochlear or retrocochlear pathology. Cochlear implantation may be indicated.

Adenosquamous carcinoma is a very rare tumour which is characterised pathologically by the simultaneous presence of distinct areas of adenocarcinoma and squamous cell carcinoma. Generally, adenosquamous carcinoma has an aggressive clinical course and is associated with a poor prognosis. Most cases have been treated by surgery alone or combined with radiotherapy. Chemotherapy is rarely used in treating adenosquamous carcinoma, and it has been difficult to establish treatment guidelines due to the paucity of cases.

We report a case of adenosquamous carcinoma which arose in the maxillary sinus of a 77-year-old man. Despite surgical treatment and chemoradiotherapy to the primary site, he developed bilateral neck metastases after the surgery. The patient was treated with S-1, a novel oral fluoropyrimidine anticancer agent, with a complete (albeit finite) response.

This report presents the aggressive character of adenosquamous carcinoma and the possible role of S-1 in the treatment of this uncommon neoplasm.

We present a patient with a rare combination of amiodarone-induced thyrotoxicosis and Eisenmenger's syndrome.

Case report and review of the world literature regarding the morbidity and mortality of surgical management of amiodarone-induced thyrotoxicosis and the potential hazards of non-cardiac surgery in patients with Eisenmenger's syndrome.

Failure of maximal medical therapy necessitated surgical management to treat amiodarone-induced thyrotoxicosis which, in this particular patient, carried significant risks. Total thyroidectomy was performed leading to rapid resolution of thyrotoxicosis, and the patient made an uncomplicated recovery. We present this case because of its rarity and the potentially hazardous nature of surgical intervention in patients with Eisenmenger's syndrome. The pathogenesis of amiodarone-induced thyrotoxicosis and the differing approaches of medical and surgical management are discussed.

Based on our findings, we propose that surgical management should be considered earlier in the treatment algorithm (or possibly as first-line therapy) for amiodarone-induced thyrotoxicosis.

We report three generations of one family suffering from bilateral conductive hearing loss due to a congenital anomaly of the incus and stapes fixation.

All three female patients presented with similar symptoms and findings of hearing impairment since birth. Their computed tomography findings were the same. An abnormally shaped incus, fixed stapes and hanging tympanic portion of the facial nerve were seen at surgery. Stapedotomy could not be performed because the hanging facial nerve blocked the operating field.

Although several cases of familial ossicular anomaly have been reported, this is the first report of an incus anomaly and stapes fixation combined with a facial nerve anomaly.

Melioidosis is an infectious disease caused by a saprophytic bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It may manifest as a pulmonary lesion, osteomyelitis, abscesses in soft tissue and various organs, or as septicaemia.

We report a case of a 40-year-old, diabetic man who presented with a neck lump resulting from super-infection of a tuberculosis cavity with B pseudomallei. The patient was successfully managed by drainage along with meticulous excision of the capsule and prolonged antibiotic and anti-tubercular treatment.

Melioidosis may be confused diagnostically with tuberculosis, as both diseases are endemic in the same regions. Our patient was unfortunate to suffer from both endemic diseases simultaneously, perhaps representing the first such case in the world literature.

Increased awareness of melioidosis is important as, although the organism is easy to culture, it may be dismissed as a contaminant.

We report an advanced presentation of osteomyelitis of the temporal bone secondary to malignant otitis externa.

We present a case report and a review of the world literature concerning osteomyelitis of the temporal bone secondary to malignant otitis externa.

A 60-year-old diabetic man developed osteomyelitis of the temporal bone and a temporoparietal abscess as advanced complications of malignant otitis externa. He was successfully treated in our institution using a post aural incision after draining the abscess and excising the fistula, a modified radical mastoidectomy with canal wall down procedure with sequesterectomy and debridement of surrounding area done.

The terms ‘osteomyelitis of the temporal bone’, ‘skull base osteomyelitis’ and ‘malignant otitis externa’ have not been clearly defined, and have in the past often been used interchangeably in the literature. Osteomyelitis of the temporal bone can occur secondary to malignant otitis externa, acute otitis media, chronic suppurative otitis media or trauma. Here, we present the management of an advanced case of osteomyelitis of the temporal bone.