Tumours at the skull base may show perineural infiltration of the mandibular nerve. Subsequent retrograde spread into the cavernous sinus, Gasserian ganglion, the trigeminal nerve and the pons may be seen. The patient, a known and treated case of nasopharyngeal carcinoma (NPC), complained of trigeminal neuralgia and difficulty in chewing. Magnetic resonance imaging (MRI) revealed a Gasserian ganglion and trigeminal infiltration with resultant atrophy of the muscles innervated by the mandibular nerve. Proximal cranial nerve involvement should be suspected in patients with skull base malignancy presenting with trigeminal neuralgia. MRI is the modality of choice in delineating the pathological process.

We have employed helical computed tomography (CT) to evaluate ear, nose and throat diseases, and present herein seven typical cases: middle ear surgery, osteoma of the external ear canal, maxillary fracture, tripod fracture, submandibular gland calculus, epiglottic abscess and vocal fold palsy. Helical (CT) facilitates the assessment of these diseases and its high diagnostic value is described.

Epithelial-myoepithelial carcinoma (EMC) accounts for approximately one per cent of salivary gland tumours. This tumour is gaining wider recognition following inclusion into the WHO histological classification of salivary gland tumours in 1990. Salivary gland tumours characteristically present with an enlarging mass. We describe an unusual presentation of a salivary gland tumour with stenosis of the external ear canal in the absence of a palpable mass. EMC usually arises from the salivary glands but isolated cases have been described arising primarily from the paranasal sinuses, trachea and lacrimal gland. The management of this tumour is still evolving with surgical excision being the main-stay of treatment. The efficacy of radiotherapy has not yet been established but high local recurrence rates despite apparently adequate excision and the possibility of a multicentric origin of the tumour may herald an increasing role for radiotherapy in the future. We stress the importance of awareness of adjacent structures when considering the cause of cartilaginous canal stenosis.

Spindle-cell carcinoma of the nasal septum is an extremely rare malignancy. Such a case along with the salient features of this variant of squamous cell carcinoma and a review of literature on carcinoma of the nasal septum is depicted.

A case of chronic facial pain and headache is presented. This was found to be due to two pieces of windscreen-glass lodged in the superior meatus of the patient's nose since a road-traffic-accident 14 years earlier. Despite being reported as normal, review of previous X-rays of her sinuses showed that the glass was visible. The importance of carefully assessing the intranasal area on sinus-views is illustrated.

A case of facial nerve paralysis secondary to acute suppurative parotitis is described. This is a rare complication in the absence of malignant processes in the parotid.

Lipomatous tumours of the tongue are rare and most of them are benign ordinary lipomas. In this report, we describe the first case of atypical lipoma of the tongue in a 78-year-old male, and review the current literature and controversies surrounding the nomenclature and biology of this unusual lesion.

Primary adenocarcinomas of the oral cavity in minor salivary glands are distinctive lesions which can be subclassified according to their growth patterns or histomorphology. Polymorphous low-grade adenocarcinoma (PLGA) of minor salivary tissue has been recognized as a distinct entity. We report an unusual case of PLGA of the tongue. Only a few previous cases have been reported in the English literature. The treatment is discussed and a review of the current literature concerning this tumour is included.

We present an extremely rare case of epithelial-myoepithelial carcinoma (EMC) arising in the nasal cavity. The patient was a 56-year-old Japanese male with a polypoid tumour arising from the nasal septum. Histopathological examination revealed the tumour to consist of a solid proliferation of clear-cells and, in some areas, small or elongated duct structures with a double-layered arrangement of inner cuboidal cells and outer clear-cells. Dual differentiation toward myoepithelial and ductal cells were confirmed immunohistochemically. The occurrence of EMC in the nasal cavity is possible and this entity should be generally recognized by surgical pathologists, not only those engaged in head and neck surgery.

Hairy polyp of the nasopharynx is an unusual but well-recognized entity, generally presenting as a single mass at birth or in the first year of life. We describe the clinico-pathological features of a previously unreported bilateral hairy polyp in an adult and briefly discuss the pathogenesis of this condition.

We report the case of an acute onset facial paralysis which was caused by a benign lymphoepithelial cyst found in the parotid, an association which is a rarity in the literature. The diagnosis and surgical management is discussed. This report emphasises the clinical principle that parotid masses causing an acute facial palsy are not necessarily malignant in nature. Intra-operative frozen section histology is helpful in saving the patient from unnecessarily radical surgery.

We report a silver tattoo of the nasal mucosa that occurred after silver nitrate cautery for nasal bleeding. Ths type of tattoo is a very rare potential mimic of melanoma and appears not to have been described before. It has similar features to an amalgam tattoo of the oral mucosa on histology and energy dispersive X-ray analysis (EDAX).