We present a rare case of tracheostomy for removal of laryngeal foreign bodies consisting of three connected fish vertebral bones in a 15-month-old girl. Recent endoscopic techniques have made it possible to extract nearly all tracheobronchial foreign bodies with rigid bronchoscopes. However, the three connected foreign bodies in this report could not be extracted entirely by single endoscopy because the glottis as an exit was narrow due to severe oedema. Accordingly, tracheostomy was required to assist ventilation, prevent prolonged post-operative endotracheal intubation, remove the secondary tracheal foreign bodies and to provide a conduit for the introduction of a bronchoscope.

This suggests that tracheostomy should be considered to avoid the potential dangers of severe laryngeal oedema and to secure the route for removal of foreign bodies from the trachea when treating patients with multiple laryngeal foreign bodies and laryngeal oedema.

Arachnoid cysts are benign cysts occurring in the intra-arachnoid space and containing cerebrospinal fluid. They constitute approximately 1 per cent of all intracranial masses. They are uncommon in the posterior cranial fossa. Common presenting symptoms include headaches, seizures, focal neurologic signs and vague dizziness. Magnetic resonance imaging is the preferred method of investigation, and the treatment for symptomatic cysts is generally surgical drainage.

We report the unusual presentation of a young patient with a posterior fossa arachnoid cyst that manifested in the form of isolated unilateral sensorineural hearing loss. The patient underwent posterior fossa craniotomy and marsupialization of the cyst. To our knowledge, posterior fossa arachnoid cyst presenting with isolated hearing loss alone has not been reported in the English literature. A review of the literature pertaining to posterior fossa arachnoid cysts, including the clinical features, diagnosis and management, is also presented.

Endoscopic treatment of hypervascular lesions of the hypopharynx is challenging because of difficulty in controlling bleeding during surgery. We report a highly vascular hypopharyngeal solitary fibrous tumour treated by endoscopic laser surgery combined with ligating loops. Application of dual ligating loops provided easy and secure haemostasis of the feeding artery before resection. Since the endoscopic approach is less invasive than the external approach, we confirm that it is worthwhile to attempt an endoscopic approach using ligating loops before resorting to the external approach in the treatment of hypervascular hypopharyngeal lesions.

Functional endoscopic sinus surgery (FESS) is a widely practiced technique in the UK. This procedure has variable complication rates and can have some serious consequences. We present a case of surgical emphysema of the neck, face and the pre-vertebral space following FESS. Emphysema of the face and neck has been previously reported. However, to our knowledge, emphysema of the pre-vertebral space following FESS has not been documented. Pre-vertebral emphysema following FESS is an unusual and potentially serious complication.

This case report describes the development of a post-treatment enlargement of the sternoclavicular joint, diagnosed as a pseudo-tumour, in a patient who had previously undergone radical neck dissection and post-operative radiotherapy for metastatic mucoepidermoid carcinoma. Although pseudo-tumour has been previously reported in the surgical literature, it remains an uncommonly recognized condition. We present a review of the literature and discuss the condition's pathogenesis. We also highlight its importance to both the surgeon and the oncologist when considering the differential diagnosis of a swelling in the clavicular region, typically occurring following radical surgery for malignant disease in the neck.

Synovial chondromatosis is a condition which often affects the major joints. On rare occasions, it may affect the temporomandibular joint. We report such a case, which was mistakenly diagnosed and treated as a parotid mass. We include relevant radiological and histological investigations and a brief literature review.