The thyroid cartilage and thyroid gland forming a lump at the suprasternal notch is a surprising congenital anomaly which I believe has not been previously reported.

A case with co-existent low hyoid bone, pharyngo-oesophageal junction and intrathoracic cricoid cartilage with no cervical trachea is presented. Its pathogenesis is suggested and its surgical importance is discussed.

A case of rare leiomyoma of the nasal cavity is reported. The pathological and clinical characteristics of this tumour are discussed.

Bilateral chylothorax is a rare complication of radical neck dissection and was first described in 1907. Stuart (1907) reviewed a number of patients with injuries to the thoracic duct in the neck and reported on three patients with bilateral chylothotax, all of whom died. The condition was not reported again until 1951 when the first of the five single case reported published to date appeared. The rarity with with which this complication is reported makes it difficult for clinicians to be familiar with it. A further case is reported and the relevant literture, and certain aspects of the aetiology and management are discussed.

This case demonstrates actinomycosis in a previously unreported site, and outlines some of the difficulties encountered in diagnosing and treating this rare but unimportant condition.

Primary hyperparathyroidism presenting with advanced bone disease is an important differential diagnosis of ‘tumours’ affecting the craniofacial skeleton. We describe a case of primary hyperparathyroidism presenting with a brown tumour of the maxilla causing local symptoms.

Differentiation from other giant cell lesions of the maxilla is necessary. The histological and radiological features of brown tumour, non-ossifying fibroma and reparative granuloma are all similar. Differentiation relies on plasma calcium estimation and the diagnosis of hyperparathyroidism is confirmed by serum parathyroid hormone assay.

We report a case of congenital hypoplasia of the larynx and trachea in the presence of an essentially normal cartilaginous structure. To knowledge this abnormality is not recognized in the literature. Previously reported hypoplasitc laryngeal anomalies have all shown anatomical defects ranging form clefts to atresia (Smith and Bain 1965, Gatti et al.,1987). Similarly total congenital tracheal stenosis is accompanied by abnormalities of the cartilaginous structure, usually complete tracheal rings. These types of anomaly typically present either at, or soon after, birth and are associated with other congenital abnormalities. In this particular case the largngotracheal hypoplasia occurred in the context of a hereditary condition of multiple congenital abnormalities known as G syndrome (also known as Opitz-Frias syndrome or the Opitz-G syndrome).

Intractable aspiration is a life-threatening condition. The problems encountered in a young child with severe intractable aspiration due to bilateral bulbar palsy following the surgical removal of a cerebellar astrocytoma are described. The various options of surgical treatment are discussed and Sasaki's technique of triple layer closure of the larynx using a superiorly based sternohyoid muscle flap is outlined in detail.

Malignant cartilaginous tumours of the larynx are very rare, and usually arise from the cricoid cartilage. We report the first documented case of a chondrosarcoma of the epiglottis. The diagnosis, histology and treatment of these tumours are discussed.

A case of a primary squamous cell carcinoma of the nasal septum in a young female with initial symptom of septal perforation is reported. Carcinoma of the nasal septum is an uncommon entity and there are a few cases reported in the literature. The functional impact of their treatment and the high mortality makes it important to diagnose it at early stage. We discuss the differential diagnosis of septal perforation and recommend early wide surgical excision.

A case is described in which recurrent laryngeal oedema was the presenting feature of thyroid lymphoma. Conventional isotope scanning was of no value in reaching the diagnosis.