Agenesis of the parotid is a rare entity. It is usually unilateral but bilateral cases have been described as a rare cause of xerostomia. Accessory parotid tissue is also uncommon and is not normally associated with aplasia of the parotid gland. The embryological, histological, clinical and radiological findings of these two entities will be discussed in addition to the report of an obscure case of bilateral parotid agenesis together with bilateral accessory parotid tissue.

We describe the first case of nodular fasciitis affecting the deep lobe of the parotid gland in a 39 – year-old male telephone engineer and its possible association with the high usage of mobile phones.

We present the rare case of a 74 – year – old woman with extensive intramedullary osteolysis of the petroclival skull base straddling both sides of the basi – occiput and basi – sphenoid. She presented with clinical features of recurrent spontaneous cerebrospinal fluid (CSF) otorrhoea despite three previous attempts at repair of the CSF leak. Recent advances in imaging techniques enable accurate radiological diagnosis of skull base lesions. We performed T1- and T2-weighted magnetic resonance (MR) images, a fluid attenuated inversion recovery (FLAIR) sequence MR, and a diffusion scan to study the characteristics of the skull base pathology. This revealed extensive osteolysis, with cystic spaces within the clivus and the petrous pyramid extending also to the basi – occiput. The leak was sealed using the technique of subtotal petrosectomy with obliteration of the eustachian tube and blind pit closure of the ear canal. The patient has been followed up for six months with no recurrence of symptoms.

Inverted papilloma is the most common benign tumour of the nose and paranasal sinuses, and usually arises in the lateral wall of the nasal cavity and the middle meatus. The diagnosis is suggested on computed tomography (CT) when there is a mass continuous from the middle meatus into the adjacent maxillary antrum, through an expanded maxillary ostium. The mass may contain areas of high density or calcification, and there may be sclerosis of the wall of the affected sinus. The main advantage of magnetic resonance imaging (MRI) is in defining the extent of the tumour, and in differentiating it from adjacent inflammatory tissue, but there are no certain signal intensity or enhancement characteristics to help differentiate inverted papilloma from sinus malignancy. In the differential diagnosis, antro – choanal polyp, malignant sinus tumours and chronic rhinosinusitis and fungal disease need to be excluded. The combination of bone deformity and sclerosis with the typical antro – meatal mass suggests a slow – growing tumour such as inverted papilloma.