The natural course of basal cell carcinoma of the middle ear is described. This tumour is extremely rarely found in the middle ear and only two cases have been reported to date. The appearance of the tumour was heralded by earache and deafness, followed years later by wide local destruction of the temporal and parietal bones, base of skull, facial palsy and multiple distant metastases.

The patient refused both surgical and irradiation therapy and died 10 years after the initial diagnosis.

A localized amyloid deposit in the nose is extremely rare and involvement of the nose involvement in systemic amyloidosis is presented.

One hundred and one patients presenting with a squamous cell carcinoma of the larynx underwent surgery i n our department between January 1980 and May 1985. In most of these patients, nodes were removed from the main lymphatic drainage pathways and subjected to immediate frozen section examination. The results from frozen section examination of the nodes were then compared with those from the surgical specimens of cervical neck dissections performed on the patients according to the classic rules. In addition, margin resections were made and examined by frozen section after removal of the tumour. In the event of a positive finding, these resections were continued until healthy tissue was reached, the specimens being examined in addition by classic methods.

Immediate frozen sections enable the margins of the resection to be verified correctly. In our series we were brought to extend the limits of resection in 10 cases out of 68 (15 per cent). It can also be seen that the accuracy of the pathologist's reading of the frozen sections is satisfactory. The overal level of error is three out of 68 (4.5 per cent). All the errors correspond to false negatives.

The aim of avoiding neck dissections in the presence of N0, thanks to nodal selection with frozen section, is not attained. We find a 6/61 rate of false negatives for N0 - N1 (10 per cent) when we compare the frozen sections of the selected nodes and the neck dissections. This is due to the fact that the surgeon may be led astray by a reactive hyperplastic node whilst other less inflammatory neighbouring nodes are in fact the site of metastasis.

A 70-year-old patient with bilateral vocal cord paralysis, accompanied by inspiratory stridor and increased snoring, is presented. Respiratory dysfunction, deteriorating over 18 months, necessitated permanent tracheostomy. Only two and a half years after the onset of symptoms the patient developed extrapyramidal signs combined with severe autonomic failure, duggesting a diagnosis of Shy-Drager syndrome. Vocal cord palsy preceding any other neurological or autonomic manifestations of that syndrome has been infrequently described. This diagnosis should be considered in cases of vocal cord palsy of undetermined etiology, especially when associated with increased snoring or episodes of sleep apnea.

Non-Hodgkin's lymphoma of the larynx is uncommon and when it occurs presents as a non-ulcerating supraglottic mass with a predilection for the ventricle. No case of the lymphoplasmacytic variety occurring in the larynx has been reported in the literature to date. We present such a case with distant leisons in the soft palate and nasal cavity, mimicking nasal polyps.

Abstract Uvulopalotopharyngoplasty (UPPP) has been recently popularized for the treatment of snoring and sleep apnea syndrome (SAS). All reported cases so far have been adults and the use of this procedure in the pediatric age group has not as yet been reported. Obstructive sleep apnea in children has been classically treated previously either medically or by adeno-tonsillectomy. The case of a three year old child with obstructive sleep apnea secondary to a large uvula and a redundant soft palate is reported. The child was successfully treated by UPPP, and remained free of symptoms for a follow-up period of one year.

In recent years endotracheal tubes with low pressure cuffs have become available with the aim of reducing trauma to the trachea and larynx. This paper uses laryngographic methods to analyse intubation trauma in 20 short to medium term intubations.

No difference in laryngeal trauma was found between low pressure, large diameter cuffs when compared ot standard cuffs.

Benign papillary endothelial hyperplasia is a very rare lesion of the nasal cavity; histologically, it may be mistaken for an angiosarcoma. An awareness of this and the ways in which it differs from angiosarcoma will prevent incorrect diagnosis and inappropriate treatment by surgery or radiotherapy. A case report of each condition involving the nasal cavity is presented.

A case of Osteopertrosis (Marble Bone Disease) in a child is presented. Agenesis (non-pneumatization) of all paranasal sinuses has been one of the salient features in this case.

Vascular tumours of the nasal cavity are uncommon and are either hamartomas or ture neoplasms, mostly benign. We present an unusual case of angiomyolipoma of the nasal cavity. The harmartomatous lesion is often described in the kidney and may be associated with tuberous sclerosis. To our knowledge, there is no previous report of the lesion in the nasal cavity, and no association with tuberous sclerosis has been demonstrated in this case.

Two cases of chondrosarcoma of the maxilla are reported together with the clinical and histological differential diagnosis. The origin of this rare tumour in the maxilla, a bone with exclusive membranous ossification, is discussed in accordance with the new concept of cell differentiation in neoplasia.