We report two cases of poorly differentiated mucoepidermoid carcinoma of the larynx which both remain well after surgical management. The first underwent a radical neck dissection for recurrent disease following radiotherapy and the second a total laryngectomy with elective post-operative radiotherapy.

Although well differentiated (‘low grade’) mucoepidermoid tumours of the larynx may respond to radiotherapy surgical management is generally recommended for all grades of such tumours especially for poorly differentiated (‘high grade’) tumours. Elective post-operative radiotherapy is often advocated for high grade tumours; radical neck dissection is generally undertaken only in the presence of lymphadenopathy, although elective radical neck dissection has been proposed for high grade tumours. These cases emphasise the value of comprehensive surgical management for this condition.

Such laryngeal tumours are difficult to diagnose histologically from biopsy and are often initially reported as squamous cell carcinoma.

Neurological complications are rare after central venous cannulation. We report a case of right vocal cord paralysis after internal jugular vein cannulation. The mechanism of neural injury is discussed.

A patient with an intracavernous carotid aneurysm usually presents with symptoms and signs of a space occupying lesion, producing one of a variety of types of cavernous sinus syndromes (Jefferson, 1938). Epistaxis is an unusual feature in these patients and when present is nearly always associated with a traumatic aneurysm (Mahmoud, 1979). There are only two reported cases of non-traumatic intracavernous carotid aneurysms presenting with epistaxis and diagnosed during the lifetime of the patient (Troupp, 1962; Labayle and Legent, 1964). The authors present a third such case. The importance of considering aneurysms in the differential diagnosis of epistaxis is emphasised. The radiological investigations and management of these patients is discussed.

A spacer device was modified to deliver aerosols of beclomethasone diproprionate, ipratropium and bromide sal-butamol, to an asthmatic child with a tracheostomy, where symptoms were poorly controlled with nebulized therapy. This resulted in a marked improvement in symptoms and a dramatic reduction in the time spent administering drugs.

Lipomata are the most common benign tumour of the head and neck. They may undergo a variety of changes, one of which is ossification which, although rarely seen, has a characteristic radiographic appearance. We present a case of a retropharyngeal lipoma which demonstrates ossification and discuss the features which differentiate this from an osseous lipoma. Current theories on the aetiology of lipomata and their ossification are reviewed.

Penetrating injuries of the neck are a cause of retropharyngeal abscess. Should a foreign body become lodged in the retropharyngeal tissues its removal may avoid this complication, but surgery can in itself be hazardous. Between 10 and 15 per cent of cases of retropharyngeal cellulitis resulting from whatever cause do not progress to abscess formation if treated conservatively. Consequently, it is important to have evidence of abscess formation before surgery is undertaken, as illustrated by this paper in the form of a case report and a review of the current literature.