It is hoped that a better understanding of the normal age related development of balance will be helpful in dealing with children presenting with disequilibrium and vertigo.

The results of a postal questionnaire indicate an exponential rise in the practice of functional endoscopic sinus surgery (FESS) in the UK and a major complication rate of 0.23%. Cerebrospinal fluid leak was the most common serious complication accounting for 24 of the 36 reports.

We report two cases of unilateral choanal atresia and one of choanal stenosis treated successfully by endoscopic fenestration, with no recurrence at a mean follow-up of 18 months. Rigid endoscopy and axial CT scanning confirm the clinical diagnosis and this technique avoids the need for stenting or prolonged postoperative stay.

A total of 17 patients with yellow nail syndrome are described. Their symptoms, age of onset and severity are examined with particular reference to the presence of rhinosinusitis. Fourteen of the patients (83%) suffered severe rhinosinusitis, which pre-dated nail changes in four, coincided with yellow nails in six, and occurred later in the remaining patients. In general, patients responded poorly to conventional medical and surgical treatment, with the exception of functional endoscopic sinus surgery (FESS) which may be of value in these patients. The frequent association of rhinosinusitis with yellow nails may warrant its recognition as part of the syndrome. Careful inspection of the fingernails in all patients presenting with severe rhinosinusitis is warranted.

We report the previously undocumented development of an orbital metastasis and skin metastases in a patient with polymorphous low grade adenocarcinoma (PLGA) 15 years after initial presentation. The clinical course, treatment and changing histological features are discussed.