This case represents the first report of ethmoid silent sinus syndrome. We argue that, in anatomically susceptible individuals, the silent sinus syndrome can present due to chronic ethmoidal sinusitis.

SummaryPressures in the cuffs of three commonly used tracheal tubes (Portex Pro®le SoftsealÒ, Mallinckrodt Lo-ContourÒ and Mallinckrodt Hi-ContourÒ, size 8.0 mm and 9.0 mm internal diameter), in¯ated with air, were measured during simulated ascents in an altitude chamber to 10 000 ft. There was no detectable difference in performance between sizes for each type of tracheal tube. When averaged over the two sizes for each type of tube, cuff pressure reached the critical perfusion pressure 50 cmH 2 O (37 mmHg) for tracheal mucosa at a higher altitude in the Portex Pro®le Softseal (2837 ft, 95% CI 2488±3186 ft) than in the Mallinckrodt Lo-Contour (2128 ft, 95% CI 1779±2476 ft; p 0.02) and Mallinckrodt Hi-Contour (1820 ft; 95% CI 1471±2168 ft; p 0.002) tracheal tubes. When the cuffs of the 9.0-mm tracheal tubes were in¯ated with saline, much smaller increases in pressure were measured with increasing altitude, although in¯ation of the cuffs with saline was technically dif®cult. Commonly used tracheal tubes with air-in¯ated cuffs can be used for aeromedical retrieval, but air should be evacuated from the cuffs after increases in altitude of as little as 2000±3000 ft.

A previously unreported case of recurrent late postaugmentation collections, namely, a seroma and a subsequent hematoma, in an otherwise well female patient is reported. The authors found no obvious reason for the recurrence in this patient.

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Introduction. De novo pleomorphic adenomas in the parapharyngeal space are rare and cause difficulties in its surgical management. We report the largest de novo pleomorphic adenoma arising from the parapharyngeal space and discuss its surgical management. Presentation of Case. A 34-year-old male presented with a giant de novo pleomorphic adenoma arising from the parapharyngeal space, which was initially misdiagnosed as an impacted wisdom tooth. Measuring 8.4 × 6.5 × 3.9 cm in size and weighing 87.3 g, this is the largest primary salivary gland tumour arising de novo from the parapharyngeal space reported in the literature, presenting challenges in its surgical management. Discussion. Parapharyngeal space tumours cause nonspecific symptoms and may be difficult to diagnose, which can allow the tumours to become very large and cause obstructive and compressive symptoms in an anatomically difficult area. A combined trans-cervical and trans-oral approach can be used to safely perform an en bloc resection. Conclusion. We report the diagnosis and surgical management of the largest pleomorphic adenoma arising de novo from the parapharyngeal space reported in the literature.