The CCR can be applied successfully in the UK. Had the CCR been in use during the study period, a 17.4% reduction in radiography could have been achieved without compromising patient care.

We describe the case of a 50-year-old previously well female, who presented with a slowly growing mass in the right submandibular region. Imaging confirmed the absence of a normally placed thyroid and the presence of a lingual thyroid. The submandibular mass was excised and histological examination confirmed ectopic thyroid tissue. The embryological descent of the thyroid and the Sistrunk procedure are discussed as well as the importance of thyroid scanning in neck lumps.

Introduction Despite numerous descriptive publications, the guidelines for treatment of cervical spinal tuberculosis (TB) are not very clear. The authors report a case of a young girl with cervico-thoracic spinal TB extending from C5 to T3 vertebrae presenting with weakness of the right hand and unsteady gait. Case report An 11-year-old female who is an immigrant to the UK from Afghanistan, presented to our clinic with a 10-day history of difficulty in walking with an unsteady gait and 3-month history of progressive weakness in both her arms, the right side more affected than the left. Her immunisation history was unclear. Examination of the arms showed bilateral thenar and hypothenar wasting, more so on the right than the left. An MRI scan revealed a large para-spinal abscess extending from C3/4 to T4/5 with a significant anterior epidural cord compression from C5/6 to

Laryngocoele is a well known but uncommon condition in Otolaryngology. CT scanning is superior to other imaging modalities in establishing the diagnosis, delineating the anatomy and aiding in the management. A case is presented with a review of the literature

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