A case of nasopharyngeal cyst in a 30-year-old male homosexual intravenous drug user infected with the human immunodeficiency virus (HIV) is presented. The similarity in clinical presentation of nasopharyngeal cyst and Kaposi's sarcoma is discussed.

Kawasaki disease (mucocutaneous lymph node syndrome) is an acute vasculitis of childhood carrying a 1–2 per cent mortality from cardiovasular complications. Despite the extensive literature on Kawasaki disease in paediatric journals, there has been a paucity of documentation in the otolaryngological literature. This is despite the fact that Kawasaki disease may present as an otolaryngological emergency before the diagnosis is established. We describe three cases of Kawasaki disease, all of which presented to the ENT department of this hospital within a period of two months. These cases illustrate the slow evolution characteristic of the disease and highlight the difficulties of diagnosis in the initial febrile stage. We emphasize the importance of considering the diagnosis when treating a young child with a pyrexia resistant to antibiotics, as prompt introduction of therapy may decrease the risk of fatal coronary artery or cardiac involvement.

The old Indian literature describes a technique known as Sutra-Neti. That is, passing a catheter or similar material through the nose and out of the mouth as a means of clearing the airway. One of our patients adapted this method, tying the catheter end to end, in order to control his severe snoring and obstructive sleep apnoea. This was effective for several months. He subsequently responded well to a uvulopalatopharyngoplasty.

We report a case of nasopharyngeal squamous carcinoma complicated by diabetes insipidus and hypercalcaemia. As there was no evidence of bony metastases we conclude that this latter finding was due to a humoral factor produced by the tumour. The management of these problems is discussed.

A 44-year-old man presented with acute airway obstruction. A pedunculated lesion was found arising from the right vallecula. This was confirmed to be an angioleiomyoma, a type of hamartoma rarely found in the oropharynx.

We report a case of endolymphatic hydrops preceded by haemodialysis in the contralateral ear of a patient with known Menière's disease, and discuss the possible mechanism. It is suggested that the sudden decrease of plasma osmolality during haemodialysis acts as a reverse glycerol test. The audiometric and electrophysiological recordings pre- and post- dialysis and the induction of the Menière's triad of symptoms during dialysis, were strongly indicative of the presence of endolymphatic hydrops.

Angiolymphoid hyperplasia with eosinophilia is a rare condition and is poorly recognized in the otolaryngological literature. The condition is characterized by the appearance of cutaneous nodules within the head and neck region especially around the external ear. Variable lymphadenopathy and peripheral eosinophilia can occur and the condition can mimic neoplasia. It is important to be aware of this disease entity in order to avoid overtreatment. Surgical removal is the treatment of choice; however, this often multilobulated and poorly delineated lesion often precludes initial wide excision and local recurrence is common.

We present three cases of this unusual condition and a brief resumé of the literature.

The condition known as ankylosing vertebral hyperostosis or Forestier's disease is described. Eight cases are reviewed where the radiological findings warranted this diagnosis. Their presenting symptoms are summarized as are their responses to treatment. The relevance of this diagnosis is discussed with emphasis being placed on the importance of thorough investigation of these patients. In those for whom no other cause has been found for their symptoms, the various therapeutic options are outlined with the possible complications.

A broken end of the spear presenting as a foreign body in the nasopharynx and right maxillary sinus in a 19-year-old Papua New Guinean is described. The types of foreign bodies and their mechanisms of introduction into this site are summarized.

A high grade adenocarcinoma arising primarily in the pharynx of a 67-year-old man is presented. A CT-scan revealed a tumour mass growing in the pharynx, largely affecting parapharyngeal soft tissues. Lymph node nietastases were found at clinical presentation. Both morphological and immunohistochemical studies displayed similar features to those of intestinal origin. To our knowledge, no previous examples of such neoplasm have been reported at this site. Its possible histogenetical origin is discussed.

Teratomas including dermoid cysts occur in approximately 1:4000 births with the incidence in the head and neck varying according to different authors between 1.6 and 6.9 per cent.

The case presented is of a 28-year-old Caucasian male in whom a dermoid cyst occurred in the floor of the mouth where ultrasound was found useful in the pre-operative assessment.

The role of ultrasound in the pre-operative management of lesions in the head and neck is discussed.

A case of valvular obstruction of the oesphagus following inversion of a pharyngeal pouch is described. This complication has not been described before.

Antrochoanal polyps rarely present with severe epistaxis. We present the case of a young male patient who presented in such a manner, thus leading to the suspicion of an angiofibroma as the underlying pathology. The radiological investigations, treatment and pathological features are discussed.

Pleomorphic adenomas of the salivary gland are usually regarded as benign tumours. We report a case in which a solitary pulmonary metastasis arose from a pleomorphic adenoma of the right parotid gland. The mechanism of metastasis is discussed.

Nasal obstruction caused by the inferior turbinate is a common clinical problem. There are many surgical procedures which attempt to relieve it, but all of them have associated difficulties.

We describe, for the first time, a new method, namely multiple submucosal out-fractures of the inferior turbinates, which is both effective and free from serious complication.

Aneurysmal bone cyst is a cystic vascular osseous tumour which destroys and expands bone. The skeleton may be affected, the femur, tibia and the vertebral column being most commonly involved. It has previously been reported in the sphenoid sinus, this is the first reported case of such pathology in the maxillary sinus.

A rare developmental cyst within the tongue and submandibular triangle ofa male infant containing heterotopic gastric and intestinal epithelium (enterocystoma) is described and its derivation discussed. This cyst was ofsuch a size as to cause feeding difficulties and partial airway obstruction during sleep. Following C.T. scanning, total obstruction necessitated an emergency tracheostomy. Successful enucleation via a median labiomandibulotomy was performed without further complication and two years later there is no sign of recurrence.

A case of atypical supraglottitis in an 11-year-old boy is presented. The epiglottis was only mildly inflamed. The organism isolated from blood culture was Streptococcus sanguis. This organism is a normal commensal of the oral cavity and has not previously been reported as a cause of supraglottitis.