We present the first documented case of Kearns-Sayre syndrome presenting with a vocal fold palsy.

Two cases of ischaemic optic neuropathy, which occurred as a complication of oncological neck surgery, are reported. These cases are submitted because of the apparent scarcity in the literature of this complication after head and neck surgery. They are also unusual because they presented with different clinical manifestations of ischaemic optic neuropathy after separate forms of bilateral neck dissection. A literature review identifies a small number of similar cases and risk factors and preventative measures are discussed.

A healthy 58-year-old woman presented with recurrent swelling and pain of the nose and both auricules. Bruits were heard over both carotid arteries. Magnetic resonance angiography revealed stenosis of both internal carotid arteries. Relapsing polychondritis was diagnosed. These symptoms improved after treatment with prednisolone and azathioprine. Although relapsing polychondritis is sometimes associated with systemic vasculitis, large vessel arteritis is rare and can negatively affect prognosis. We conclude that the detection of systemic vascular lesions, including those involving the central nervous system, can play an important role in the diagnosis of relapsing polychondritis and that early treatment is essential for a good outcome.

Post-pneumonectomy syndrome is an unusual condition, that can occur a variable period of time after a patient has had a pneumonectomy. Management of this syndrome has been described using a number of different techniques, often with considerable mortality. We present a case report where this condition was treated successfully by insertion of an expandable Nitinol stent. This is the first time this technique has been described to treat this condition, and we feel it may be the procedure of choice in managing these patients.

Sarcomas of the larynx are extremely rare neoplasms that account for approximately one per cent of all tumours of this organ. We present a case of laryngeal chondrosarcoma originating from thyroid cartilage, characterized by an unusual long clinical course over 15 years without laryngeal symptoms or duplication of metastases, treated at the Süleyman Demirel University Medical Faculty, Ear, Nose and Throat (ENT) department.

The authors describe the adaptation of a Montgomery T-tube laryngo-tracheal stent to incorporate an uncuffed fenestrated Shiley tracheostomy tube in the management of a complex case of subglottic stenosis. The combined ‘ trache-stent’ provided a secure, unobstructed airway and optimal phonation. The presence of a removable inner tube facilitated cleaning and reduced patient anxiety regarding the perceived risks of stent obstruction with dried secretions.

The combined ‘ trache-stent’ was upsized at four weeks with minimal evidence of local granulation formation. The device was removed entirely six weeks later after direct laryngoscopy reconfirmed the above findings. Almost two years later the patient retains a good voice and airway using a simple fenestrated tracheostomy tube and speaking valve. The subglottic area is stable and the patient has returned to full-time employment.

An unusual presentation of acute tonsillitis complicated by retropharyngeal and thyroid abscess is reported. Spontaneous rupture of retropharyngeal abscess resulted in necrotic fistulae between the pharyngeal wall and the retropharyngeal space.

An anterior neopharyngeal diverticulum is a recognized cause of dysphagia following laryngectomy. It is easily treated by endoscopic stapling.

A case of an isolated hypoglossal nerve palsy is reported. The differential diagnosis is discussed, in the context of the requirement for careful scrutiny of the entire course of the hypoglossal nerve on imaging, to detect underlying pathology remote from the tongue, and to avoid unnecessary invasive diagnostic procedures prompted by the appearance of a ‘pseudomass’ of the weak tongue both clinically and radiologically.

We present a case of solitary cystic lymph node metastasis from an occult thyroid papillary carcinoma mimicking a lateral cervical cyst, and a case of thyroid papillary carcinoma with a true lateral cervical cyst. Based on a comparison of the radiographical findings of the two cases, differential diagnosis between cystic lymph node metastasis of papillary carcinoma and branchial cyst is discussed.

A case with palatal presentation of scleroma is presented due to its rarity and unusual manifestations. The patient presented with only palatal symptoms. Nasal endoscopy revealed signs of all three stages of scleroma: catarrhal, granulomatous and sclerotic stages. Histopathology was vital in the diagnosis. The patient was treated by medical therapy, and palatal symptoms were relieved by uvulopalatopharyngoplasty.

We present two cases of a previously unreported association between occipital meningocele and Mondini deformity of the cochlea. The probability of the association is supported by the intimate relationship between the development of these structures; the existence of dysembryoplastic factors that can cause both abnormalities; and the universal existence of cochlear abnormalities in anencephalic foetuses. The importance of considering the association is emphasized, in terms of early identification and referral of children with hearing loss, and avoidance of duplication of investigations.

Facial nerve haemangioma is a rare benign neoplasm accounting for 0.7 per cent of all tumours involving the temporal bone. The diagnosis of a facial nerve tumour is often missed or delayed. Early diagnosis is imperative as it influences the eventual outcome for facial nerve function. Prognosis is related to the size of the tumour, the severity and the duration of pre-operative paralysis. The definitive diagnosis of a facial nerve tumour rests exclusively with high resolution imaging of the temporal bone using enhanced magnetic resonance imaging (MRI) and thin-sectioned computed tomography (CT). This case emphasizes the crucial role that high quality imaging can play in the diagnosis of facial nerve tumours, and elegantly illustrates the imaging features of facial nerve haemangiomas.

This report describes the development of chondroid metaplasia within a fibroepithelial polyp situated on the tongue. Although fibroepithelial polyps in this location are not unusual, chondroid metaplasia in such a lesion in this position has not, as far as the authors are aware, been described previously. The aetiology and the pathogenesis of the lesion are discussed.

The effect of a therapeutically administered high calorie diet in a severely malnourished patient is discussed in this case report. In patients with advanced head and neck cancer prolonged periods of malnutrition prior to admission are frequently encountered. This case report highlights the need to constantly monitor the electrolyte and vitamin levels during the early stages of instituting enteral or parenteral nutrition. By vigilant monitoring and a high index of suspicion re-feeding syndrome or severe hypophosphataemia and its associated complications can be avoided.

Solitary fibrous tumours of the thyroid gland are rare; only five cases have been reported in the literature. Clinically, they present as a long-standing firm mass in the thyroid. Histologically, they show a range of appearances including so-called ‘patternless growth pattern’, spindle-cell morphology, alternating hypo- and hyper-cellular areas, keloid-like hyalinization and a prominent haemangiopericytoma – like architecture. The behaviour of extrathoracic solitary fibrous tumours is unpredictable and requires careful, long-term follow-up.

A 20-year-old woman presented with nasal obstruction and slight epistaxis. The obstructing lesion was excised and microscopy showed a neoplasm composed of comparatively uniform undifferentiated cells forming solid nests. The cytoplasm of the cells was clear but poorly demarcated, partly vacuolated and contained much glycogen. Although widespread in the nasal mucosa, the cells did not penetrate into the underlying bone.

The cells expressed the MIC2 gene (using the CD99 marker). Electron microscopy showed simple cells with a small number of mitochondria, many glycogen particles; there were no neurosecretory granules present.

Early surgical treatment followed by chemo- and radiotherapy have greatly improved the prognosis of EWS: extraskeletal Ewing’s sarcoma (EWS/PNET).

We present a case report of a lady with a laryngocele and a squamous cell carcinoma of the larynx. The pathogenesis of the relationship between these two entities is discussed and the literature reviewed. This association means a carcinoma must be outruled if a laryngocele is detected clinically or radiologically.

In Langerhans’ cell histiocytosis, radiological findings on temporal bone involvement show destructive bone lesions involving the mastoid, with the squamous part and middle ear less affected. Computed tomography (CT) is the preferred imaging modality for describing the extent of temporal bone involvement. CT also has an important role in monitoring disease activity and response to treatment. Bone scintigraphy seems to be less sensitive than radiography in detection of these lesions.

The temporal bones of a 26-month-old white female with a paralytic syndrome clinically and pathologically identical to poliomyelitis were examined. The aetiological agent was unknown although a non-poliomyelitis enterovirus infection seemed likely.

There was a complete absence of the cochlear neurons and substantially reduced peripheral and central axons with loss of some inner hair cells but preservation of outer hair cells. Scarpa’s ganglion, and the geniculate ganglion were partially atrophied. The saccule and utricle were mildely dilated and Reissner’s membrane of the apical turn was bulging.

In two previous audiological studies a 10-20 dB bilateral sensorineural hearing loss was found in poliomyelitis patients and a neuronal lesion was postulated which is now supported by our findings. This is a rare example of an almost pure neural hearing loss.