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Fifteen cases of nasal septal perforation were repaired with a tragal cartilage–temporoparietal and deep temporal fascia sandwich technique using a modification of the approach previously described (Hussain and Kay, 1992). Successful closure was achieved in 14 patients (100 per cent) after an observation time of up to two years. The operative technique and advantages of the modified approach are described.

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Deep-lobe parotid tumors are relatively uncommon. Most of these tumors present as external masses. They can also present in the oral cavity or oropharynx. Magn etic resonance imagin g and ultrasound-guided fi ne-needle asp iration fo r biopsy and cytology have made it possible to establish a definitive diagn osis and ident ify the exac t location of the tum or in almost all cases bef ore surgery. Traditionally, deep-lobe tumors have been man aged by a formal superficial p arotidectomy and identification and preserva tion ofthefacial nerve.followedby removal ofthe deep lobe that contains the tumor Superficial parotidectomy is associated in most cases with peria uric ular depression seco ndary to a loss ofvolume, leading to variable aesthetic def ormities. A comp lete parotidectomy is more likely to be asso ciated with a larger aesthetic defici t secondary to a greater loss of tissue volume. The incidence ofgustatory sweating is high after superficial parotidectomy, particularly in the early postoperativep eriod. We hypothesize that