Teratomas are tumours that rarely exist in children. Their location in head and neck is, however, an unusual finding.

A strange case of middle ear congenital teratoma reaching the cervical area is presented here. In the last 20 years it is only the second case to be published in the English literature. The tumour was revealed by the presence of a peripheral congenital facial palsy.

Two cases are presented in which patients flying home shortly after translabyrinthine removal of a vestibular schwannoma (acoustic neuroma) developed acute bacterial meningitis on landing. This complication has not been described before. The incidence and management of CSF leaks after vestibular schwannoma surgery is also discussed.

Two cases of rhinoenetomophthoromycosis are presented. This rare disease can prodice progressive deformity of the nose and facial structures. A review of the clinical symptoms along with its diagnosis and treatment is described.

Aglossia is a rare anomaly often accompanied with several congenital defects including varying degrees of limb deficiency, micrognathia and oral synechiae. We report on a girl with aglossia and persistent anterior buccopharyngeal membrane. Other anomalies observed on the patient were oesophageal atresia, hypoplastic epiglottis, ptosis of the left eyelid, and conductive deafness which is probably an additional symptom of this syndrome group.

A Case Is reported of a 59-year-old Caucasian male with oculopharyngeal myopathy and sensorineural hearing loss. He presented with progressive ptosis, sensorineural hearing loss over several years and symptoms of mild dysphagia. Further enquiry into his family history revealed that every male member in his family that lived beyond the age of 60 exhibited identical symptoms. Symptoms of ptosis and dysphagia are consistent with the rare autosomal dominant condition of oculopharyngeal myopathy, believed to be due to mitochondrial disease. The combination of ptosis, dysphagia and sensorineural hearing loss with normal distant muscle group biopsy has not been described before.

An unusual case of recurrent frontal sinusitis with abscess formation secondary to orbital decompression for Graves' disease is described. The infection was refractory to antibiotics treatment, external drainage and the sinus obliteration procedure. Since the sinus outflow was obstructed by prolapsing tissue following excessive removal of the orbital walls, sinus re-aeration by supporting the prolapsed tissue with a silastic sheet and stenting the sinus drainage tract was attempted. This led to a complete resolution of the infection with an excellent long-term result.

A 42-year-old man with normal hearing presented with a long history of vertigo and tinnitus. CT scan showed large osteomata of the internal auditory canal. Magnetic resonance imaging (MRI) was normal. The osteomata were removed surgically via the retrosigmoid approach and examined histologically. His symptoms were abolished. As MRI has become the gold standard in the search for small acoustic tumours it is likely that symptomatic bony lesions, rare though they are, will be missed if MRI is the sole imaging modality. A review of the literature is included.

A case of angiofibroma limited to the right posterior nasal cavity, nasopharynx, and pterygopalatine fossa was operated upon transnasally under endoscopic control. The tumour was completely excised without complications. Endoscopic follow-up for the next two years and contrast computed tomography (CT) excluded any residual tumour or recurrence. The advantages, limitations and possible complications of this approach are discussed. It seems that in limited lesions of angiofibroma, the option of a transnasal endoscopic approach could be cautiously considered by experienced surgeons.

Vestibular nerve dysfunction as the major neuro-otological symptom in one of the osteopetrosis group of bone disorders is unusual. We describe a patient with Engelmann's disease who presented in this manner and who benefited from an eighth nerve decompression procedure. Surgical decompression of the internal auditory meatus to relieve vertigo has to our knowledge not been previously reported in this condition.

Non-Hodgkin's lymphoma (NHL) of the head and neck has been described in several sites including the larynx, the pharynx, Waldeyer's ring, the nose and paranasal sinuses. NHL of the temporal region has not been previously described. We describe a 65-year-old woman with a diffuse swelling of the right temporal region. A histological diagnosis of NHL was made following complete excision of the lesion. No further treatment was given and there was no evidence of recurrence at six months.

Pseudocyst of the auricle is a condition where spontaneous serous fluid collection is seen on the lateral surface of the pinna. The aetiology of this condition is not known. Several methods of treatment have been advocated in the past. We report 10 cases of unilateral pseudocyst who were treated with aspiration and pressure dressing by a plaster of Paris cast over the pinna for two weeks.

A case is presented with irreversible blindness in one eye and restriction of the infratemporal visual field in the other eye, due to electrocoagulation performed for delayed bleeding after functional endoscopic sinus surgery (FESS). Although blindness due to rhinosurgery is a well-known, but rare complication, a review of the recent literature did not reveal a similar incident. The use of electrocoagulation especially under conditions of poor visualization, that may be the case in post-operative bleeding following (endoscopic) sinus surgery, is strongly discouraged.

A case of left otalgia in a patient suffering from longstanding ulcerative colitis is reported. The patient was treated for an exacerbation of his disease with courses of mesalazine and sulphasalazine during which time he developed otalgia. The otalgia disappeared with cessation of the drugs. It is concluded that in the absence of any other head and neck cause that the otalgia was a complication of the drug therapy.

A professional musician with intolerable hyperacusis and dysharmonic diplacusis in a severely deafened ear was successfully relieved of his symptoms by deliberate destruction of the cochlea.

Metastatic lesions in the cerebellopontine angle are rare. We encountered one such metastatic lesion from clearcell renal carcinoma that had a striking clinical appearance, bleeding from the ear and multiple lower cranial nerves' involvement. While the overall prognosis in CNS metastasis from systemic malignancy is gloomy, useful palliation can be achieved in patients with solitary lesions.

This case study describes a therapeutic strategy using a cochlear implant for a bilateral acoustic neuroma deafened patient. The cochlear nerve had previously been sacrificed on one side during tumour removal, but on the remaining side a functioning cochlear nerve was assessed by electric promontory stimulation in spite of a neuroma extending into the vestibular labyrinth. The patient was successfully stimulated with a Nucleus 22- channel implant after removal of the intracanalicular portion of the neuroma via a middle fossa approach.

We report a very unusual case of a patient with a previously undiagnosed congenital absence of the left dural venous drainage system and a prominent system on the right. Due to its prominence it was at risk during a cortical mastoidectomy performed as part of an endolymphatic sac decompression procedure. Manipulation of the lateral venous sinus resulted in partial occlusion of the already compromised venous drainage. The result was a rise in intra-cranial pressure and papilloedema, from which the patient recovered. The abnormality was only detected on post-operative imaging.

Sensorineural hearing loss, tinnitus, dizziness and ataxia are recognised symptoms associated with Chiari malformations but they are rarely the presenting complaints. Patients with such symptoms are frequently referred to otolaryngologists and audiological physicians. We report a case of a 13-year-old girl who presented complaining of tinnitus and impaired hearing, and was subsequently diagnosed as having a type I Chiari malformation. Pure tone audiogram showed a mild hearing impairment on the left side and the speech audiogram was normal. Auditory brain stem responses and the electronystagmography were abnormal. The patient underwent posterior fossa decompression following which her tinnitus disappeared, the hearing problem recovered and some of the abnormal electrophysiological parameters were corrected.

The clinicopathological features of two unusual cystic lesions, one arising in the nose, a calcified mucocoele or a calcified retention cyst and the other in the maxillary sinus a dentigerous cyst originating in a supernumerary tooth, are described. The literature on these two rare lesions is briefly reviewed.

Laryngeal lymphangiomas are uncommon and virtually always represent extension of cervical disease. The exceptionally rare lymphangioma that remains isolated to the larynx has been reported only twice prior to this case.

A six-month male infant presented with an undiagnosed mass in the supraglottis which had caused respiratory compromise requiring a tracheostomy. The diagnosis was made histologically and the treatment was begun. Therapy consisted of staged laser resections carried out cautiously to preserve laryngeal competence. After three laser treatments the lesion was controlled and the patient prepared for decannulation. This interesting case is presented with a review of the literature.