This study aims to investigate the facilities available in Accident and Emergency (A&E) departments and the education of casualty officers in the treatment of epistaxis in the UK. Fifty departments were chosen at random and a telephone survey undertaken. The results show a paucity of facilities and inadequate training of A&E officers in a majority of departments. Recommendations for treatment standards are made.

A case of a solitary fibrous tumour arising in the deep soft tissues of the neck is reported. This rare tumour has not previously been described in this site. We discuss the clinical presentation and pathological features.

It is now widely accepted that snoring causes significant social dysfunction. In the absence of obstructive sleep apnoea syndrome, palatal surgery offers a very good chance of eliminating or reducing snoring. The traditional operation of uvulopalatopharyngoplasty remains the ‘gold standard’, but may be complicated by velopharyngeal incompetence, severe post-operative pain and even nasopharyngeal stenosis. A newer technique to reduce snoring caused by palatal flutter by using a neodymnium: yttrium aluminium garnet laser to stiffen the soft palate has been introduced recently by another unit. We show that this procedure can be carried out using a CO2 laser, and present the initial results of the first 29 patients operated on at The Royal National Throat, Nose and Ear Hospital.

The case of an elderly male with Shy-Drager syndrome is presented. His presentation to the Sleep Clinic for assessment of snoring illustrates bilateral abductor vocal fold palsy as a rare presentation of the syndrome. This case emphasizes the need for thorough investigation of all patients with sleep-related breathing disorders with video and sound recordings prior to anaesthesia and surgery.

A patient suffering from persistent hoarseness was eventually shown to have laryngeal leishmaniasis. The incubation period for the disease must have been at least 16 years, following infection in Southern Europe. Mucosal leishmaniasis is rare in the Eastern hemisphere, and laryngeal leishmaniasis has not previously been reported in the UK. Previous Mediterranean cases have run a similar chronic course and have caused diagnostic difficulty, in particular being mistaken for malignancy. Treatment with aminosidine was ineffective, but the patient responded to liposomal amphotericin.

Abstract The combination of a narrow oesophageal lumen and a hypertonic pharyngo-oesophageal (P-E) segment following laryngectomy and secondary tracheo-oesophageal puncture (TEP) can cause obstruction of a voice prosthesis and consequently prevent phonation. The ‘Allan Johnson’ modification of the Bivona voice prosthesis incorporates a stainless steel slide and has been successfully used to remedy such a circumstance.

Carcinosarcoma of the salivary glands are rare tumours, often associated with a history of pleomorphic adenoma. A case of carcinosarcoma of the parotid arising following irradiation to the resection site of a pleomorphic adenoma is presented. The clinical and histological features are discussed and the literature reviewed.

Spheno-choanal polyp is a rare entity which presents in a similar manner to the more common antro-choanal polyp. There is often difficulty clinically in differentiating the two conditions, although their radiological characteristics are distinct. A case of spheno-choanal polyp is presented and the plain radiograph and the CT findings reviewed.

IBS of buried α and β iron suicide layers was achieved by the implantation of 2 MeV 56Fe+ ions into (100) single crystal silicon substrates over a dose range of 3 × 1017 to 1 × 1018 cm“-2followed by a high temperature anneal. No photoluminescence was observed from the as-implanted samples which contained a discontinuous layer of βFeSi2 precipitates approximately 1.5 μm below the silicon surface. Upon annealing at 700°C, a 200 nm polycrystalline βFeSi2 layer was formed which gave a PL signal centred at 1.55 μm. After a 900°C anneal, the layer transformed to αFeSix with a resistivity of approximately 280μΩcm.