A case of malignant external otitis is presented. This occurred in a healthy 72-year-old non-diabetic, non-immunocompromised man after ear syringing. The infection was treated with oral ciprofloxacin for eight weeks with complete resolution.

Kawasaki syndrome is a panvasculitis occurring principally in childhood. Symptoms include fever, ‘strawberry tongue’, cervical lymphadenopathy and dermatological signs. A rare case of Kawasaki syndrome in an adult presenting to the Otolaryngology department is reported. The clinical features of the disease are described highlighting its systemic nature. Treatment options and possible complications are discussed.

Extraskeletal Ewing's sarcoma is rarely found arising in the head and neck region. An unusual case arising in the nasal fossa in a young child is reported and the differential diagnosis, pathology and treatment discussed.

Osteomas involving the middle ear and causing a functional disturbance are rare. We report a case of a patient with an osteoma arising from the lateral semicircular canal. The main symptom was vertigo and to halt this the defect of the canal was obliterated with a bone chip and fibrin glue after removal of the tumour.

From 1971 to 1986, 94 patients suffering from T1 glottic carcinoma underwent cordectomy at the University ENT Clinic of Thessaloniki, Greece. There were five female and 89 male patients with a median age of 61.7 years.

Two year survival rate was 93.7 per cent; five year survival rate was 93.2 per cent. Seventeen of the patients suffered recurrence, but 11 of them after laryngectomy or radiotherapy are alive with no sign of the disease. Tracheostomy was not performed in the majority of our cases. The relationship between the site of recurrence and survival as well as the role of radiotherapy before and after cordectomy in some of our patients are discussed.

We believe that despite the good results of radiotherapy in T1 carcinoma of the vocal cord and the introduction of other treatment modalities such as CO2 laser, cordectomy by laryngofissure is still of value with very good survival results and minimal discomfort for the patient.

Two cases of cervicocephalic arterial dissection of the intrapetrous carotid artery are described. One patient presented with intolerable objective pulsatile tinnitus, the other with a cerebral infarction. Both were successfully treated with anticoagulants. The significance of minor degrees of trauma and of neck extension in the aetiology of these apparently spontaneous lesions is discussed.

Three patients who developed a post-cricoid carcinoma 5–21 years after radiotherapy for carcinoma of the larynx are presented. These patients received radiotherapy when they were young. It is suggested that alternative forms of treatment, especially partial laryngectomy with the aid of a laser should be considered in the primary management of small tumours of the larynx of young patients.

A case of lymphogranuloma venereum of the tonsillar lymph tissue is presented. The similarities of tonsils to cervical lymph nodes are discussed and the importance of histological examination of abnormal tonsil tissue is reiterated.

It is difficult to predict the tumour invasion into the mandible by oral cancer pre-operatively, and consequently the decision to preserve or sacrifice the mandible is largely individualistic. The present study of 44 cases analyses the reliability of pre-operative parameters to assess mandibular involvement. Clinical, radiological and scintigraphic features have been compared with the detailed histology of the bone. This study confirms the usefulness of superior marginal resections in lesions which are close to but not involving the mandible, as well as for superficial lesions which are actually seen to involve the mandible but their CT and bone scans are negative for tumour invasion.

The occurrence of multiple primary malignancies in patients with laryngeal cancer is well known. The possibility that lung cancer patients may be at risk of subsequent laryngeal cancer is less well recognized. The possibility of laryngeal cancer developing later has implications for the follow-up of lung cancer patients.

Three cases of subsequent laryngeal primary cancer occurring in survivors of bronchial cancer are presented and the implications are discussed.

Pulsatile tinnitus resulting from an abnormal communication between the occipital artery and the transverse or lateral sinus is a rare clinical entity. We report three cases which presented over a period of three years who had such abnormalities demonstrated angiographically and were cured of their symptoms by exploration and ligation of the occipital artery.

A case of leiomyoma of the nasal septum is presented together with electron micrographs.

The aim of this paper is to highlight Potts puffy tumour as a pathological entity distinct from other causes of peri- and supraorbital swelling. This uncommon condition is usuallynot recognised initially and is easily confused with neoplasms or local eye pathology. A case is reported and investigations and management reviewed.

The records of 44 cases of non-Hodgkins lymphoma (NHL) presenting to the ear, nose and throat department in the Grampian area from 1980–1988 were examined in relation to site of occurrence, histology, age at presentation, clinical stage, treatment and survival. The median age was 67 years and there was a preponderance of high grade histology, especially in disease affecting the tonsil. Most deaths occurred in the first year; patients with high grade disease and those in stages three and four had a significantly poorer survival during the first year. The site of disease had no influence on survival.

We report a case of osteoradionecrosis of the temporal bone which presented with symptoms and signs of cerebellopontine angle lesion. The clinical, radiological, histological and bacteriological findings are reported. The occurrence of osteoradionecrosis of the temporal bone and the factors which predispose to it are discussed with particular emphasis on the time lapse between radiotherapy and its development. This presentation has not previously been reported.

Craniometaphysial dysplasia is a rare cause of conductive hearing loss. It is a genetic disorder of bone due to decreased osteoclastic activity inthe endosteal and periosteal regions of craniofacial and long bones. The characteristic temporal bone abnormalities are attic fixation, abnormallyshaped ossicles and obliterated foramina ovale. Computerised tomography is helpful in predicting operative findings; surgery should be reserved for those with a severe hearing loss.

Sixteen patients with end stage squamous cell carcinoma of the head and neck were admitted to a phase II study of alternating courses of cisplatinum (100mg/m2) and VAC (vincristine 1.4mg/m2, adriamycin 50 mg/m2, cyclophosphamide 750 mg/m2) given at three weekly intervals. Only two patients achieved a response (12 per cent). The median survival time was 62 days which is much the same as that of a similar group of patients who received no chemotherapy in a previous trial (70 days).

Pharyngo-cutaneous fistula following laryngectomy is a serious complication. The incidence worldwide varies from 7.6 to 50 per cent. The value of prophylactic antibiotics in preventing fistulae is well recognized but the type of antibiotics and the length of administration of the antibiotics is variable depending on the individual surgeon.

Below we present the Plymouth Head and Neck Unit experience where, in the last five years, 33 patients underwent laryngectomy (30 total, three vertical hemi-laryngectomies).The prophylactic antibiotics used in all patients was parenteral cefotaxime 1G or cefuroxime 750 mg, given at eight hours pre-operatively, with the premedication and at eight, 16 and 24 hours post-operatively. Only two patients developed pharyngo-cutaneous fistulae, both after total laryngectomy (six per cent of total). Three patients developed skin cellulitis and five patients developed chest infection which required further treatment with antibiotics.

Unilateral secretory otitis media is a well recognized presenting feature of nasopharyngeal tumours. In the case described the underlying cause was of oncocytic metaplasia arising in the nasopharynx.