A case of a pharyngeal diverticulum complicating a total laryngectomy is presented. Possible aetiology and management are discussed.

Ossification of the tympanic membrane after myringoplasty is recorded for the first time. Myringoplasty was performed for closure of a perforation which followed the surgical treatment of Otitis media with effusion and had included the insertion of a long-term T-tube.

A rare case of a strangulated antrochoanal polyp is reported.

Presented herein is a case report of sudden sensorineural hearing loss in the setting of haemoglobin SC disease. The relationship of the two is rare; the authors have found that this is only the second report in the literature. In this instance, partial exchange transfusions were performed in an attempt to decrease viscosity and improve blood flow. Thereafter, hearing stabilized and then slowly improved. The evidence for the beneficial role of these transfusions in this setting is, at best, circumstantial, but it is theoretically sound and worthy of further study.

A case is described of a primary cerebral lymphoma which presented with bilateral cerebellopontine angle lesions. No similar case has been reported in the English language in the last 25 years. The literature is reviewed and discussed.

Benign paroxysmal positional vertigo (BPPV) is a self-limiting condition characterized by vertigo and nystagmus induced by certain head positions. The most common causes of BPPV are post-traumatic following head injury and post-viral labyrinthitis. We present an interesting case of BPPV following an otherwise uneventful neurosurgical removal of a parietal osteoma using hammer and chisel. Caution should be exercised during such procedures as disabling vertigo can result for a considerable period of time.

A nasopharyngeal carcinoma was the first event in an otherwise symptom free HIV person. No reports of simultaneous nasopharyngeal carcinoma and HIV infection are known to us. A 46-year-homosexual man was admitted to the ENT department with a three week history of pain in the throat referred to the left ear. He was found to have an irregular tumour in the nasopharynx with a lymph node metastasis to the left side of the neck. The poor response to radiotherapy and the very aggressive progress after treatment raised suspicion of a co-existing disease process. The risk of sexually transmitted HIV was confirmed post mortem and could explain the rapid progression of the tumour. No anti-HIV treatment was given concurrently with radiotherapy.

Prostatic metastases in the nose and paranasal sinsuses are rare. Seven cases have previously been reported in the world literature. We describe the clinical presentation of a patient with prostatic metastases and the use of prostate specific antigen in confirming the diagnosis. We also review the literature about metasases involving the nose and paranasal sinuses.

Bilateral facial palsy is an uncommon condition and few clinicians have experience of more than the occasional case. Unlike its unilateral counterpart, an aetiological, factor is often demonstrable. A Wide variety of recongnized disease may give rise to the condition and thus thorough investigation is required. This paper presents an unusual example of this rare condition.

A report of a case with a vascular malformation of the internal auditory canal (IAC) is presented. A review of the literature of this rather rare lesion is also made in an attempt to outline its clinical features, radiological diagnosis and management. The differential diagnosis and distinction between vascular malformations and other internal auditory canal tumours are discussed.

Maxillary antral mucoceles are extremely rare. We report a case of a large antral mucocele presenting with facial asymmetry. The CT scan was essential for delineating the extent of the lesion and aiding in the pre-operative diagnosis. The pathogenesis, clinical features and radiological aspects of this entity are reviewed.

Glomus tympanicum tumours are highly vascular tumours of the middle ear. Their removal by conventional surgical methods requires an extensive procedure in many cases, often with ossicular disarticulation to allow adequate exposure prior to the ‘chaotic’ and haemorrhagic event of tumour removal. This paper reports on the use of an NdYAG laser in a case of a large glomus tympanicum tumour. The laser facilitated a transcanal approach, avoided ossicular disarticulation and allowed accurate and almost bloodless ablation of the entire tumour.

The NdYAG laser appears to be a very useful treatment modality in the management of these highly vascular tumours. Care should be taken to avoid accidental energy transmission to the cochlea.

Leishmaniasis is an uncommon condition in Western Europe, except around the Mediterranean coast. However, it may occasionally be seen in the United Kingdom, in patients who acquired the infection in foreign lands. An unusual case of localized cutaneous leishmaniasis recidiva affecting the nose after septal surgery is presented.

A rare finding of a fourth branchial arch anomaly discovered at laryngectomy is presented. Clinical and histological findings are documented. The incidence and presentation of fourth branchial arch anomalies is discussed.

Orbital complications of ethmoiditis are not uncommon in children. They are, however, much rarer in the very young. A case is presented in which a neonate of gestational age 39 weeks developed a periorbital abscess. The relevant literature is reviewed with respect to embryology, aetiology and treatment.

A case report of a rare tumour, not yet documented at this site, showing a characteristic histological appearance is described.

We report a well-documented case of fatal thyroid cancer with histopathological characteristics of primary squamous carcinoma. A possible primary tumour elsewhere was excluded. The possible histogenesis of this unusual tumour and the therapy of choice are briefly discussed.

Two cases of nasopharyngeal cyst, in a two-year-old girl and a six-year-old boy, are described. The cysts were located in the right lateral wall of the nasopharynx in both cases. Histopathological examinations revealed that the cyst walls were lined with columnar epithelium. The positions of the cysts and pathological features indicated that they were of branchial origin, and they were assumed to originate in the second branchial pouch because of their anatomic location. They differed from previously reported cases in that they extended nearly to the base of the skull, occupying the parapharyngeal space. It was considered that they might have originated from the dorsal part of the second branchial pouch or the layer of endodermal cells cut off from the lower part of the eustachian tube.

We report a case of two simultaneously occurring hypopharyngeal-oesophageal diverticula. one apparent originating above. the other below the cricopharvngeal muscle. The radiological and clinical findings of tis rare condition are condition are presnted.

A case of sphenoid sinusitis due to Pseudallescheria boydii is described in a 52-year-old non-immunocompromised woman. Treatment should always involve surgical drainage, and antifungal chemotherapy may be of benefit if there is histological evidence of invasion of surrounding tissue. For P. boydii infection miconazole should be the agent of choice, rather than amphotericin B. For this reason it is important to obtain culture and histological examination of sinus contents if fungal infection is suspected.