We report a case of polymorphous low grade adenocarcinoma involving the palate of a 12-year-old girl, the first example of this tumour occurring in the paediatric age group. The tumour displayed infiltrative growth, neural invasion, variegated histological patterns, and minimal cytological atypia. The patient remained disease-free four years after wide local excision of the tumour. The distinction of polymorphous low grade adenocarcinoma from pleomorphic adenoma and adenoid cystic carcinoma is also discussed.

A cystic dilatation of a paranasal sinus by an entrapped air mass has beentermed pneumosinus dilatans or a pneumocoele. The occurrence of this condition in the maxillary sinus is quite rare. In the present case, a mid-face mass mimicking an osteoma was the presenting sign of the disease. The pathogenesis, clinical features and radiological aspects of this entity are reviewed. In order to avoid confusion with other conditions ofdifferent aetiopathogenesis, we propose to label the lesion as ‘air cyst’ of the paranasal sinus, a term that best describes the nature of the lesion.

A case report of pseudolymphoma of the parapharyngeal space is presented, together with a literature review of pseudolymphoma and management suggestions for such lesions when they occur in the head and neck. To the best of the authors' knowledge, this represents the first case report of pseudolymphoma presenting within the parapharyngeal space. The key to management of these lesions is based on accurate diagnosis, with differentiation of pseudolymphoma from lymphocytic lymphoma, the disease process which it mimics.

Nasopharyngeal carcinoma hs been reported to have a higher incidence of distant metastases as compared to other head and neck cancers. Distant metastases of nasopharyngeal catcinoma has been reported in the bones, lungs, liver, distant lymph nodes, brain and porta hepatis. This report presents a case of nasopharyngeal carcinoma with secondaries in the extradural space at the thoracic level of the spinal cord which hitherto has been an unreported site.

A rare case of intracranial extension of a naso-ethmoid schwannoma is presented. Its subsequent removal with few sequelae confirmed the benign nature and good prognosis of the disease.

We reviewed our experiences with 20 patients with established facial palsy who had a total of 24 gold weights inserted. All patients had corneal symptoms: ulceration, exposure keratitis or discomfort abolished. Functional improvement i.e. reduction of lagophthalamos and restoration of the blink reflex was good in our opinion and that of the patients in all cases. Dissatisfaction with the cosmetic result was expressed by two patients due to the prominence of the weight under the thin eyelid skin. Three patients had to have the weight replaced because it was too light. Two patients had their weightsremoved because of recurrent eyelid infections. In two patients the weights were removed as they had migrated over the tarsal rim. In one of these patients the weight was replaced immediately in the appropriate position, in the other it was not replaced as dissatisfaction hadbeen expressed due to the bulky appearance of the weight under the eyelid skin.

Primary malignant smooth muscle tumours of the maxilla are extremely rare. A case of leiomyosarcoma of the maxilla associated with previous irradiation is presented. The aetiology, pathology and clinical aspects of this tumour are reviewed.

The impaction of a cannabis-filled condom in the upper oesophagus of a 28-year-old prisoner is reported. The history was deceptive and smoking and drug abuse denied. The ENT surgeon being unaware of the identity of the drug faced tackling a possibly lethal foreign body, technically difficult to remove by the usual forceps method. (The Dormier basket is recommended for this task but we were unable to try it). Passage of the condom into the stomach occurred during attempted removal and its further progress was uneventful, indicating that gastroscopic removal of cannabis is unncessary unless obstructive symptoms occur.

Stridor due to obstructive causes is relatively common. Functional airway obstruction with paradoxical vocal cord motion is uncommon. Only 12 cases have been reported in the literature in the past 15 years. The majority were young female patients. We have recently encountered two cases. Lack of awareness of this condition caused several problems in management.

Iatrogenic implantation of squamous epithelium may result in formation of an epidermoid cyst. These cysts have been described in various sites around the head and neck following otological procedures. A case of iatrogenic epidermal cyst in the parotid region following repeated myringoplasty is reported. The clinical features and differential diagnosis are discussed.

Pseudomonas pseudomallei, a gram negative organism causing melioidosis, is found in tropical and subtropical regions. It may manifest as a pulmonary lesion, osteomyelitis, soft tissue abscesses, abscesses in various organs or in septicaemic form. Melioidosis of the parapharyngeal space has not been reported so far. A case of melioidosis of the parapharyngeal space which was successfully treated by drainage and prolonged antibiotic therapy is reported here. Melioidosis should be suspected in severe forms of deep neck space infection, especially if the patient comes from an endemic area.

A case of extraskeletal myxoid chondrosarcoma of the maxillary sinus in a 45-year-old man is reported and discussed. This is the first report of this tumour in thissite.

A case of sphenoid sinus mucocoele following radiotherapy in a patient with nasopharyngeal carcinoma is reported. Diagnosis was made by radiological investigation and confirmed at surgery performed via a sublabial transeptal approach. Its content was completely removed and continuous drainage of the sinus was maintained by an indwelling tube. It is felt that the sphenoid mucocoele developed as a result of occlusion of the sinus ostium by scarred mucosa following radiotherapy.

A patient who developed bilateral tinnitus and symmetrical high frequency sensorineural hearing loss due to therapy with the anti-depressant Mianserin hydrochloride is presented together with a short review of available literature.

The standard teaching is that only malignant thyroid masses produce recurrent laryngeal nerve palsy. An unusual exception to this rule is reported.