Salivary gland myoepitheliomas are rare tumours, accounting for less than 1 per cent of neoplasms of the salivary glands. Myoepithelioma of the palate is very rare, and only a few cases have been reported in the world literature. Histological and immunohistochemical analysis supports the myoepithelial origin of this tumour. Here, we report three cases of myoepithelioma of the palate in adult males and review previously reported cases.

Introduction: Sphenoid sinus mucoceles comprise 1–2 per cent of paranasal sinus mucoceles. Endoscopic marsupialisation is currently the treatment of choice.

Case report: We present a patient with a sphenoid mucocele whose sphenoid sinus cavity appeared normal on endoscopy due to a horizontal plate of accessory septa, below the sphenoid ostia. The mucocele was in the inferior portion of the sinus below the septa, expanding the sinus inferiorly.

Conclusion: Intra-operative imaging was essential in the successful management of this patient's condition. Although endoscopy offers direct visualisation, endoscopic surgeons must be aware of the anatomical variations in this region. Intra-operative imaging modalities such as image guidance systems and image intensifiers are often vital for safe surgery.

In the UK, the prevalence of drug misuse has risen in the last decade. Otorhinolaryngological surgeons need to be aware that small amounts of illegal substances, such as heroin, cannabis and cocaine, may be hidden in the external auditory meatus. We report, for the first time, concealment of heroin in the external auditory meatus. The medico-legal and ethical considerations are also discussed.

Objectives: To demonstrate a potentially life-threatening complication following tonsillectomy in a diabetic patient and discuss the possible pathogenesis.

Methods: Case report and review of the world literature concerning parapharyngeal abscess post-tonsillectomy.

Case report: A 20-year-old female patient underwent an uneventful tonsillectomy following a history of recurrent tonsillitis. She re-presented 14 days post-surgery with a large erythematous tender right mid cervical neck swelling. Clinical and radiological evaluation confirmed a parapharyngeal abscess. She proceeded to have an incision and drainage of the abscess through a horizontal skin crease incision and subsequent intravenous antibiotic therapy. She was discharged home well three days post-surgery.

Conclusion: Diabetes mellitus is a well-recognised systemic disease that may leave an individual more susceptible to infection. We report the first case in a young healthy diabetic patient and highlight a potential serious complication following a routine tonsillectomy.

Background: Dentures in the oesophagus have been associated with various complications; however, Horner's syndrome following denture impaction has not been reported in our locality.

Case report: Horner's syndrome developed in a 26-year-old woman following accidental swallowing of an upper denture which then became impacted in the oesophagus. The denture was retrieved via cervical oesophagotomy. The syndrome abated completely by the seventh day post-surgery. The clinical features of Horner's syndrome are discussed.

Conclusion: Compression of the stellate ganglion, with resultant Horner's syndrome, can be associated with denture impaction in the cervical oesophagus.

We report a case of an accessory submandibular gland and duct which is extremely rare.

Material and methods: A 20-year-old male presented with complaints of painful swelling in the right submandibular region. As a part of the radiological investigation, a radiograph occlusal view was taken digital sialography, magnetic resonance imaging and magnetic resonance sialography were performed.

Results: Digital sialography revealed a small calculus distal to the punctum with diffuse dilatation of the main duct and intraglandular branches, which passed out spontaneously prior to magnetic resonance examination. The presence of an accessory submandibular duct was well delineated on both digital as well as magnetic resonance sialography.

Conclusions: Magnetic resonance sialography is helpful in delineating the anatomy of the submandibular duct non-invasively and without associated radiation exposure. To the best of our knowledge this is the first report of magnetic resonance identifying an accessory submandibular duct and gland.

We report the first case in the world literature of laryngeal spindle cell carcinoma metastasising to the orbit. A 65-year-old woman was previously treated for T3 N0 Mx laryngeal spindle cell carcinoma, with laryngectomy and post-operative radiotherapy. Five months following this treatment, she developed proptosis, diplopia and reduced right visual acuity, secondary to an enlarging mass within the right orbit. This was biopsied, and subsequent histology confirmed a diagnosis of metastatic spindle cell carcinoma. Subsequent post-mortem examination demonstrated additional pulmonary, hepatic and cardiac metastatic disease, in the absence of any other primary tumour or locoregional disease. The radiological investigation of patients with laryngeal spindle cell carcinoma is discussed and contrasted with that of laryngeal squamous cell carcinoma.