Many different congenital malformations of the external ear are encountered in otology and plastic surgery practice. However, there has been only one report in the literature of reverse (convex) conchal deformity in otherwise normal ears. Eight such cases were encountered in the combined otology and plastic surgery practice at the authors’ institution. The condition was bilateral in two patients and unilateral in six patients; these patients had no other otological abnormalities. Two patients sought surgical correction. Modified conchoplasty, done by excising and replacing the conchal cartilage in reverse fashion, is presented. Controversies surrounding the embryogenesis of concha are also addressed.

Two cases of chondrosarcoma of the hyoid bone are described. They were managed with surgical resection and postoperative radiotherapy. These patients are disease free at 26 months and 15 months respectively.

Malignant transformation of respiratory papillomata is not uncommon in the presence of precipitating factors such as tobacco smoking and therapeutic irradiation. Respiratory papilloma changing to carcinoma in the absence of smoking and irradiation is seldom seen, with only about 20 documented cases presented in the literature. Here we report one such case in a 30-year-old male patient.

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Lymphangiomas are uncommon developmental anomalies, and lymphangioma of the tongue, although relatively rare, is the most common cause of macroglossia. 1 The usual clinical manifestations of macroglossia are airway obstruction, noisy breathing, difficulty in chewing/swallowing, drooling, mandibular prognathism, slurred speech, dry/cracked tongue, ulcerating secondary infection and hemorrhage. 2 We present a case in which massive enlargement of the tongue presented in acute upper airway obstruction and led to emergency tracheostomy; a further presenting feature was the absence of surface lesions on the massively enlarged tongue as well as associated Plummer-Vinson (PV) syndrome.

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M inor variations in the external ear are numerous. These include anotia, microtia, macrotia, cryptotia, prominent ears and question mark ear, in addition to the anomalies of the lobule, accessory auricle, preauricular sinus and fistula. However, Yii and Walker (1) reported one additional anomaly of the auricle. In a 12-year-old boy of Asian origin, they found that the conchae were completely reversed, being convex rather than concave, producing an obvious deformity in otherwise normal ears. The present series of eight patients with similar anomalies suggests that this condition may be underdiagnosed or neglected because of lack of other otological abnormalities. However, some patients may be affected psychologically due to the cosmetic disfigurement produced by this anomaly. The surgical correction of this anomaly, in the form of a modified conchoplasty technique, offers a simple and effective means of restoring the patient's self-confidence and well being. CASE PRESENTATIONS At the authors' institution, eight patients (Table 1) with similar anomalies of the concha, in the form of reverse conchal bowl, were encountered over a three-year period between

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