Inflammatory Salivary disease in childhood is an infrequent clinical entity. That associated with sialolithiasis is rare. We report a case of a child with spontaneous passage of a submandibular calculus. We believe she represents the youngest patient documented to demonstrate the phenomenon.

A 12-year-old girl is presented with Down's syndrome and lingual tonsillitis causing sleep apnoea. In order to overcome her sleep apnoea she adopted a functional sleeping posture. The sleep apnoea was successfully treated by a single staged lingual tonsillectomy without preliminary tracheostomy. A return to a normal sleeping posture occurred spontaneously in the early post-operative period.

We report a case of congenital hypoplasia of the larynx and trachea in the presence of an essentially normal cartilaginous structure. To knowledge this abnormality is not recognized in the literature. Previously reported hypoplasitc laryngeal anomalies have all shown anatomical defects ranging form clefts to atresia (Smith and Bain 1965, Gatti et al.,1987). Similarly total congenital tracheal stenosis is accompanied by abnormalities of the cartilaginous structure, usually complete tracheal rings. These types of anomaly typically present either at, or soon after, birth and are associated with other congenital abnormalities. In this particular case the largngotracheal hypoplasia occurred in the context of a hereditary condition of multiple congenital abnormalities known as G syndrome (also known as Opitz-Frias syndrome or the Opitz-G syndrome).

Intractable aspiration is a life-threatening condition. The problems encountered in a young child with severe intractable aspiration due to bilateral bulbar palsy following the surgical removal of a cerebellar astrocytoma are described. The various options of surgical treatment are discussed and Sasaki's technique of triple layer closure of the larynx using a superiorly based sternohyoid muscle flap is outlined in detail.

A case of hyperextension fracture of the hyoid bone is presented. The management is discussed, with reference to the mode of injury, emphasizing that symptomatic treatment only may be necessary. The literature is briefly reviewed.

The term tumefactive fibroinflammatory lesion is used to describe an unusual fibrosclersing disorder that behaves in a malignant way clinically but is histologically benign. Lesions in the head and neck are believed to be part of the broader fibrosclerosing syndrome which include pseudotumour of the orbit, Reidel's thyroiditis, sclerosing cholangitis and mediastinal fibrosis. Clinical diagnosis is often difficult and relies heavily on histopathology. Steroid is suggested as the first line of management, while surgery or radiation therapy is reserved for failures.

The toothbrush is an unusual foreign body in ENT practice. Three cases of toothbrushes are presented.