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This article discusses a rare cause of facial swelling secondary to an ectopic mandibular third molar and highlights the important of not overlooking plain radiographs when investigating facial swellings.

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Anatomically, the surgical management of tongue base lesions is a challenging prospect for any head and neck surgeon. William Trotter described a median labio-mandibular glossotomy for access to such lesions (Meis JM, Enzinger FM. Myolipoma of soft tissue. Am J Surg Pathol 1991;15:121–5). Not widely reported, this approach still remains an important tool in the armamentarium of head and neck surgeons. We outline the use of this approach to remove a myolipoma from the tongue base.