The successful repair of a crushed cervical trachea using a composite microvascular graft is presented. The patient has been without a tracheostomy for four years.

Acute dilatation of the oesophagus causing stridor is rare. A case is presented and the literature is reviewed with emphasis on the management of this problem.

A 51-year-old female presented with a sensation of a lump in the throat for five months. Clinical examination was normal.The barium swallow and the CT scan showed a well-defined mass to the left of the upper oesophagus and behind it. The mass was removed surgically and shown pathologically to be a nodule of ectopic thyroid tissue. This very rare pathology is discussed together with a review of the relevant literature.

A case of a malignant parotid salivary gland nerve sheath tumour is reported in a 12-year-old girl who developed a right parotid mass. Initial incisional biopsy showed a tumour with a mesenchymal spindle cell appearance. Immunohistochemical studies showed positive staining of tumour cells for vimentin and focally for S-100 protein. These features together with ultrastructural evidence of basal lamina material suggested that the tumour was of nerve sheath origin. After subtotal parotidectomy the tumour metastasised to cervical lymph node and lung. There was evidence of a partial response to chemotherapy. A detailed illustrated histopathological description of the tumour is given.

Foreign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

Internal jugular phlebectasia is a venous anomaly commonly presenting as a unilateral neck swelling in children. The clinicopathology, aetiology and management are discussed. Bilateral doppler ultrasonography is the diagnostic investigation of choice and should be performed in all suspected cases. Conservative management of the bilateral case is recommended.

A 12-year-old boy presented with a three-month history of a painful parotid swelling. Fine needle aspiration cytology indicated a pleomorphic adenoma—an uncommon lesion in a child. This diagnostic technique plays a useful role in the investigation of head and neck swellings.