A rare case of adenosquamous carcinoma of the hypophraynx is presented. The importance of primary surgical treatment is emphasised.

Metastasis of melanoma in the head and neck region is often reported but the report of amelanotic melanoma metastatic to the epiglottis is an extremely rare entity.

This paper describes a patients previously treated for cutaneous amelanotic melanoma who developed metastatic tumour involving his epiglottis. This legion was successfully excised by a intra-oral approach combined with KTP/532 laser surgery. The paper also describes the diagnostic evaluation, management, operative technique and DNA analysis of this rare case.

Although meningiomas represent 15 per cent of tumours of the central nervous system, they rarely metastasize. A case is presented in which metastasis to a cervical lymph node occurred, together with local recurrence, nine years after initial diagnosis and treatment. This case serves to illustrate that malignant meningioma is a rare cause of a neck mass.

A case of acute isolated sphenoid sinusitis is described in a twelve year old boy who presented with ophthalmic complications. The literature is reviewed to emphasize the potential dangers of this condition.

A patient with a massive thyroid oncocytoma is presented. The symptoms of hoarseness and dysphagia were due to compression and were relieved by surgical excision of the tumour.

The tegmen tympani may occasionally be breached by herniation of the temporal lobe with or without dural cover. The clinical presentation may be obvious with CSF otorrhoea but less so with apparent middle ear effusion, CSF rhinnorrhoea, conductive hearing loss, recurrrent meningitis or intracranial sepsis. Diagnosis requires suspicion of the condition, which may be aided by radiological imaging. Surgical repair is to be recommended: various techniques are available but bone enveloped by fascia placed by subtemporal approach is preferred. The features of this problem are highlighted by four cases.

Mucous gland carcinomas of the larynx are rare, with most being represented by ‘non-specific’ adenocarcinoma and adenoid cystic carcinoma. Here we report a unique case of mucoid adenocarcinoma of the larynx occurring in a 46-year-old woman. Despite the presence of regional lymph node metastasis, she remained well four years after surgery.

A case of bilateral vocal cord palsy caused by relapsing polychondritis is presented. The diagnosis was not suspected preoperatively and was made solely on histopathology. A case is made for histological examination of cartilage removed during routine tracheostomy.

A patient complaining of dysphagia was diagnosed as suffering from a fracture of the hyoid bone. The fracture was fixed using the modern technique of tension band wiring. There was subsequent relief of the symptoms. A review of the literature and our perspective is included.

An unusual case of dysphagia due to anomalous styloid apparatus anatomy is presented. Clinical and radiological findings are documented. Variations in anatomy and clinical syndromes are discussed together with management.

Migration of a foreign body from the mouth and throat to the subcutaneous tissue of the neck is very rare. We present a case of a migrating foreign body (a piece of straw) from the floor of the mouth to the neck. To our knowledge, this is the second case reported in the English literature.

Metatastic tumour of the sphenoid sinus from distant primary sites are rare. If sphenoid involvement from adjacent structures is excluded there have been 26 reported cases of metastatic sphenoid sinus tumours. Seminoma metastatizing to other paranasal sinuses has been reported but a careful literature search did not reveal this occurring previously in the sphenoid sinus.

Primary extracranial meningiomas are uncommon; they have been documented in the ear, skin, orbit, parapharyngeal space, parotid gland, mediastinum, and rarely the paranasal sinuses. Tuberoussclerosis is an autosomal dominant neurocutaneous syndrome characterized by multiple connective tissue tumours. We report the first case of a tuberous sclerosis patient with a maxillary antral meningioma.