A retrospective study of 18 patients with malignant tumors of the external auditory canal and temporal bone was undertaken to gain an Asian perspective of this rare disease. Of these patients, 15 (83%) had squamous cell carcinoma (SCC) and 61% had stage T3 tumors at presentation. The mean age was 56 years (range 38-82 years). Seven (39%) of the 18 patients had radiation-associated tumors (RATs), and all had undergone radiotherapy for treatment of nasopharyngeal carcinoma. The 1-year cumulative recurrence for the RAT group was 100%, but there was no recurrence in the non-RAT group (P = 0.001). In malignancies of the external auditory canal and temporal bone, a different classification and staging system for patients with RATs may be warranted to better guide treatment strategies.

Although rare, vallecular cysts can have catastrophic consequences in an anaesthetised patient if airway management is inappropriate. We report a case of difficult intubation in a 46-year-old man with a vallecular cyst, and detail the methods and strategies for successful endotracheal tube insertion. Following a review of the current literature, we also discuss airway management options in adult patients with vallecular cysts.

The aim of cholesteatoma surgery is to obtain a safe, dry and self-cleaning ear. Several methods have been tried and tested to achieve this goal with varying degrees of success. This article reviews some of the more common methods for mastoid reconstruction and obliteration and their results. Current trends appear to favour a combination of mastoid obliteration and reconstructive techniques, with biologic materials such as muscle flaps and bone chips preferred over non-biologic materials such as hydroxyapatite crystals and ceramic. However, there is large variation among the type of biologic flap used, which can vary between fascia, muscle and periosteum. After an extensive review, there is no ideal method for mastoid obliteration and reconstruction, as most methods appear to have a certain degree of success. The basic principles of a low facial ridge, large meatoplasty and an oval mastoid cavity should be adhered to, and the surgeon should choose a method that he or she is comfortable with.

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