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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The treatment of cancers of the head and neck often involves removal of selected lymph node groups in the neck. It may also include sacrifi ce of structures within the neck in order to achieve clearance of disease. To make this possible, one must fi rst gain adequate access to the neck. There are many techniques described in the literature to achieve this. This article will describe some common incisions and will discuss their strengths and pitfalls. It will also explain in detail the authors' experience of the 'modifi ed hockey-stick incision' and will explain why it is recommended.