A retrospective study of 18 patients with malignant tumors of the external auditory canal and temporal bone was undertaken to gain an Asian perspective of this rare disease. Of these patients, 15 (83%) had squamous cell carcinoma (SCC) and 61% had stage T3 tumors at presentation. The mean age was 56 years (range 38-82 years). Seven (39%) of the 18 patients had radiation-associated tumors (RATs), and all had undergone radiotherapy for treatment of nasopharyngeal carcinoma. The 1-year cumulative recurrence for the RAT group was 100%, but there was no recurrence in the non-RAT group (P = 0.001). In malignancies of the external auditory canal and temporal bone, a different classification and staging system for patients with RATs may be warranted to better guide treatment strategies.

Radiation-associated tumours are rare complications of radiotherapy. This study seeks to highlight and discuss the clinically challenging problem of radiation-associated tumours (RATs) in the temporal bones of seven patients previously irradiated for nasopharyngeal neoplasm.Seven patients (six males and one female) with radiation-associated temporal bone tumours are presented (five squamous cell carcinomas, one osteogenic sarcoma and one chondrosarcoma). The initial nasopharyngeal disease for which radiotherapy was indicated was nasopharyngeal carcinoma (six patients) and nasopharyngeal lymphoma (one patient). The latency period between radiotherapy and presentation of temporal bone tumours ranged from five years to 30 years with a mean of 12.9 years. All the patients underwent surgical tumour resection. Three patients had post-operative radiotherapy and one patient underwent pre- and post-perative chemotherapy. Two patients died from the disease within three months of treatment with one patient surviving 36 months at the time of writing. One patient died from an unrelated medical condition three months after surgery.With refinement in radiotherapy techniques and the resultant increase in patient survival, there may be more patients with radiation-associated tumours in the future. It remains imperative for clinicians to be vigilant when patients previously irradiated for nasopharyngeal carcinoma present with otological symptoms as the key to the successful management of this condition lies in the early detection and expedient treatment of this difficult disease.

When undertaking UPPP, both subjective and objective benefits should be weighed against the risk of long-term ill effects. Patients should also be warned that the long-term side effects such as VPI, dry throat, and abnormal swallowing sensation might be more common than previously expected.

Radiological imaging and FNAC are useful diagnostic modalities in assessing recurrent nodal disease in the post-irradiated neck in patients with NPC. Although routine CT scan criteria for pathologic lymphadenopathy cannot be accurately applied in the post-irradiated neck, it is a useful surveillance tool in the routine follow-up of patients with post-irradiated neck with NPC. Clinicians, however, must understand their limitations when assessing these patients. The possibility of negative neck dissection must be conveyed to the patients.

The nasal cavity and paranasal sinuses are probably one of the last frontiers in the head and neck region where the use of topical antimicrobial agents is not yet established. Although the anatomy of the nasal cavity and the paranasal sinuses can theoretically be exploited for the administration of antimicrobials in rhinosinusitis, very few studies have been conducted to test the feasibility of this mode of therapy. We review the anatomical and physiological factors that should be considered in the use of topical nasal antimicrobial agents and the current status of topical nasal antimicrobial usage, and we make recommendations for the administration of topical nasal antimicrobial agents.

Oesophageal penetration and migration of oesophageal foreign bodies into the thyroid gland is extremely rare with only occasional case reports appearing in the medical literature over the years. This is a retrospective review of four patients who were managed for penetrating oesophageal foreign bodies in the thyroid gland over an 11-year period. The clinical, radiological and intra-operative findings of the four cases are discussed.

The preliminary review has demonstrated that the modified MMA technique for the treatment of OSA is highly effective in the treatment of severe OSA without the significant facial profile change commonly associated with the traditional MMA technique.

This is the first report documenting that most benign parotid tumors are WT and not PA. MT risk is greater in those less than 50 with pain and a noninferior pole lesion. Cystic lesions such as WT require great care in the evaluation of FNA findings.