To report an unusual observation whereby hearing was improved by insertion of cotton wool onto a retracted tympanic membrane, and to explore potential explanations for this.

We report the case of a 56-year-old woman with a severe mixed hearing loss who was noted to have a significant improvement in her hearing using a technique shown to her many years ago by a Russian physician. Upon application of a moist piece of cotton wool, gains of up to 40 dB were observed. This was associated with a significant subjective improvement in hearing. We discuss potential mechanisms for this effect, including amplification, a baffle effect and phase differences.

The mechanism of the hearing improvement observed in this case is unknown, but is likely to be related to sound amplification from the relatively large surface area of the cotton wool to the smaller oval window.

To demonstrate the importance of thorough investigation of patients with Horner syndrome, and to explain the relevant anatomy.

A 46-year-old man presented with right-sided Horner syndrome. No other abnormality was found. Magnetic resonance imaging showed calcification of the stylohyoid ligament, with a pseudoarthrosis in the mid-portion of the ligament. This pseudoarthrosis was displacing and compressing the internal carotid artery and the adjacent sympathetic chain, causing Horner syndrome.

In this case, magnetic resonance imaging was invaluable in elucidating the cause of the Horner syndrome. This is the first described case of pseudoarthrosis of a calcified stylohyoid ligament causing Horner syndrome.

To report what we believe to be the first case in the English language literature of unilateral cavernous sinus thrombosis complicating contralateral sphenoid sinusitis.

A 62-year-old man presented to his general practitioner with a severe, right-sided, temporal headache. He was diagnosed with temporal arteritis and treated with systemic steroids. After five days, he developed right proptosis, ophthalmoplegia and ptosis. He was referred to the neurologists. After an urgent computed tomography head scan and computed tomography angiogram, a diagnosis of carotido-cavernous fistula was made. However, this was subsequently excluded after a negative cerebral angiogram. A review of the scans enabled diagnosis of right cavernous sinus thrombosis secondary to left sphenoiditis. The patient was referred to the otolaryngology team. After an urgent endoscopic sphenoidotomy and medical treatment, all symptoms and signs improved dramatically.

Sphenoiditis can lead to contralateral cavernous sinus thrombosis. Urgent surgical sphenoidotomy, with appropriate medical treatment, can be successful in this life-threatening complication.

We report a young man with bilateral enlarged internal auditory canals who developed sudden sensorineural hearing loss following weight-lifting exercise.

We present a detailed clinical history, including the patient's high resolution computed tomography and magnetic resonance imaging scans.

The patient reported left-sided hearing loss immediately following weight-lifting exercise. He had no vestibular disturbance. He was treated with a combined regimen of steroids and an antiviral drug, but his profound hearing loss did not resolve. During another session of weight-lifting exercise, he suffered another episode of sudden hearing loss.

To the best of our knowledge, this is the first report of a patient with patulous internal auditory canals, with no other anomalies, who developed bilateral sudden hearing loss after weight-lifting exercise. Although no definitive conclusions can be drawn, close surveillance and lifestyle warnings should be considered in such patients, even if they are clinically asymptomatic.

We report a rare case of a 51-year-old woman with ocular and nasal infestation by Oestrus ovis.

Clinical case report and review of current literature regarding nasal and ophthalmomyiasis.

Myiasis is infestation of the tissues and organs of vertebrates by certain dipteran fly larvae. Oestrus ovis myiasis is endemic in the region from North Africa to South Asia, but few cases are reported within the UK. A 51-year-old patient presented and was treated successfully in Sunderland Royal Hospital for combined ocular and nasal infestation with Oestrus ovis.

Oestrus ovis has a largely subtropical distribution; however, it is important to remember the diversity of disease which can present within the UK from an external source. This point is illustrated by this rare case, which highlights the fact that prompt treatment can avoid poor outcomes for our patients.

We report a case of anterior spinal artery syndrome, an extremely rare complication, following head and neck surgery.

A case report and literature review concerning anterior spinal artery syndrome is presented.

A 64-year-old man developed an anterior spinal artery infarction following total laryngectomy and bilateral neck dissections for post-radiotherapy glottic carcinoma. Anterior spinal artery infarction is a rare syndrome. It typically presents with weakness, loss of pain and temperature sensation below the level of the injury, with relative sparing of position and vibratory sensation. Recovery is variable.

To the best of our knowledge, this is the first case report in the English language literature of anterior spinal artery syndrome following a head and neck procedure. This case report highlights a rare complication, and also the susceptibility of head and neck surgery patients to different complications. In head and neck cancer patients suffering anterior spinal artery syndrome following primary surgical treatment, we recommend that the management of this complication should be as aggressive as that of the primary cancer.