Intracranial complications of frontal sinusitis, although rare today, do still develop despite widespread use of antibiotics. We report a case which demonstrates how silently a frontal lobe abscess may present with subtle changes in mood and behaviour, with no focal neurological signs. Diagnosis and management are discussed and a brief review of the incidence of intracranial complications of frontal sinusitis, mode of spread, clinical presentation, investigations, treatment and bacteriology is presented.

We report two types of neuroendocrine carcinoma of the head and neck, small cell carcinoma of the ethmoid and large cell carcinoma of the larynx, demonstrating a differential response to radiotherapy.

A case of oncocytoma of the larynx is presented. These lesions are rarely found in the larynx, and have been more commonly described in the salivary and thyroid glands. The histopathological diagnosis is often difficult and the light microscopy can be unreliable for oncocytic lesions. For a more accurate definition of these tumours, the use of histochemical stains together with electron microscopy are advocated. With adequate surgery, the prognosis is excellent, and tumours are unlikely to recur. This paper discusses the management of a patient with a benign oncocytoma of the true vocal cord, and presents a review of the world literature.

Cerebellar herniation into the mastoid through the posterior aspect of the temporal bone as a result of chronic suppurative otitis media and mastoid surgery is a rare event. A case is reported in which such a hernia presented subcutaneously behind the pinna; its repair is discussed.

The second case of ovarian carcinoma metastatic to the larynx is presented. The sites of the primaries and metastases of previously reported cases are reviewed, and possible methods of spread discussed.

Metaplastic elastic cartilaginous tissue has been described in the vocal cord, vestibular fold and ventricle of the larynx. This report documents a case in which cartilaginous metaplasia developed in the soft tissue of the epiglottis following an episode of epiglottitis.

Three unusual cases of oropharyngeal lympho-proliferative lesions were seen in recipients of heart and heart-lung transplants. Two caused acute upper respiratory obstruction necessitating urgent ENT intervention. All patients were receiving immunosuppressive drugs including cyclosporin. The two obstructive cases were adenotonsillar enlargement in a 6-year-old, and a tumour of the tonsil and tongue base with cervical lymph node enlargement in a 32-year-old male. Both were caused by Epstein-Barr Virus-associated lymphoproliferative disorder. The third patient, a 32-year-old female, had a presumed low grade T-cell lymphoma that regressed spontaneously.

Histopathological diagnosis of these lympho-proliferative disorders after transplantation usually requires immunocytochemistry to distinguish polyclonal proliferative disorders from true lymphoma. Polyclonal lymphoproliferative disorders after transplantation do not usually require aggressive cytoreductive therapy, but respond to simple measures such as the reduction of immunosuppression.

A cervical fistula from a ‘congenital’ cholesteatoma is described in a 70-year-old man. This was found to communicate with an extradural temporal lobe abscess. The presentation and management is described. No previous report of such a case has been found in a review of the literature.

Temporal arteritis (giant cell arteritis) is a disease of protean manifestation. A case which presented as a submandibular swelling is reported.

The treatment of branchial cysts is by surgical excision. We describe a case where the cyst was medial to the pharyngeal constrictors, making a per-oral approach the safest, and easiest method of removal. The position of the cyst supports the theory that branchial cysts are congenital in origin.

A case of inverted papilloma of the hypopharynx is described. Review of the literature failed to reveal any previous case reports of inverted papilloma of the hypopharynx.

A case of stridor is described which was due to the presence of a foreign body in the larynx of an infant. Following partial removal, compression of the right main bronchus was detected because of continuing low arterial oxygen saturation. The use of pulse oximetry allowed this complication to be identified, and the advantages of this method of monitoring are discussed.

Two patients with carcinomata arising in pharyngeal pouches are reported. In one, the tumour was detected preoperatively by a contrast radiographicstudy. In the second the lesion was a carcinoma in situ. The English literature is reviewed with reference to these two unusual features.

The peritumoural region of a squamous cell carcinoma of the tongue when examined with light and electron microscope showed nodular bodies in the submucosa with all the distinctive features of ‘sporangium’ and ‘spores’ of rhinosporidiosis. The occurrence of rhinosporidiosis in the tongue along with malignancy has not been reported hitherto. Some interesting observations and causal relationships are discussed.

A case report is presented of a man who had a foreign body in his oesophagus complicated by the fact that he also had a large cyst of a lingual thyroid. The problems encountered and his subsequent management are discussed. The possibility that a cyst of the tongue base may contain the only functioning thyroid tissue and the dangers of haemorrhage at its removal are emphasized.

Temporal bone findings in two cases of head injury are reported. In one patient, longitudinal fractures occurred in both temporal bones, and extended to the middle ear bilaterally. Bleeding was seen in the tympanic cavity, mastoid air cells, internal auditory meatus and facial nerve canal. Bleeding was observed in the scala tympani, cochlear aqueduct and endolymphatic sac, but there were no fractures. In the other patient, bleeding was seen in the internal auditory meatus and facial nerve canal. In the right ear, endolymphatic hydrops was observed in all turns of the cochlea.

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm which occurs primarily in male adolescents and is characterized by aggressive local growth. The controversy concerning appropriate treatment for patients with juvenile angiofibroma persists. Radiation therapy and surgical resection have both been reported to be effective to control a high proportion of these tumours. The case reported here demonstrates a locally advanced JNA controlled by radiation therapy.

Orbital pseudotumour is a non-specific inflammation of the orbit which forms a tumour-like mass composed of increased connective tissue and ground substance with vascular proliferation and an infiltrate of chronic inflammatory cells. No demonstrable aetiological agents are found locally, and there is no evidence of specific disease entities such as Hodgkins, SLE or temporal arteritis.

The condition may present in many different ways to the otolaryngologist, and is therefore a rare but important differential diagnosis to be born in mind. We report a rare case of orbital pseudotumour presenting initially with involvement of the maxillary antrum and in association with Riedel's thyroiditis.