Intranasal melanoma is a rare, aggressive malignancy with poor prognosis, with five-year survival rates of 6–30 per cent. We hypothesised that intranasal melanoma confined to the nasal septum may have a more favourable outcome if detected early and treated with wide local excision or septectomy. This case series reviews management at a regional head and neck centre.

Intranasal melanoma cases were identified from a list of those with International Classification of Diseases – Revision 10 code C30.0 (“neoplasm of nasal cavity”) and analysed retrospectively for survival time and treatment modality.

Eleven patients (May 2010–December 2024) were identified. Eight (72.7 per cent) underwent surgery. Patients treated with subtotal septectomy or rhinectomy had longer mean survival (250 weeks) compared to those receiving endoscopic debulking and chemoradiotherapy (104 weeks).

Our findings may identify utility of early septectomy in patients with septal disease. Furthermore, larger studies are required to elucidate the role of septectomy in septal intranasal melanoma.

The occurrence of juvenile nasopharyngeal angiofibroma is reportedly higher in India than in some other parts of the world, and our centre has seen a four-fold increase in its occurrence across seven decades.

This paper reports a retrospective archival analysis of 701 juvenile nasopharyngeal angiofibroma cases from 1958 to 2013, and considers probable environmental factors in an Indian context that may affect its biology and the global distribution, as reported in the literature.

A continuously progressive increase in occurrence was evident, but the rapid rise observed in the current decade was alarming. The world map of juvenile nasopharyngeal angiofibroma incidence does not reflect true global distribution given the paucity of reporting. Our centre has dealt with approximately 400 cases in the last 24 years.

With the alarming increase in juvenile nasopharyngeal angiofibroma incidence, there is a need for a registry to define its epidemiology. The world literature needs to reflect the status of juvenile nasopharyngeal angiofibroma incidence in the third world as well. Environmental factors known for hormone disruptive actions may influence its occurrence. Such aspects need to be considered to plan specific prevention policies.

We report a case of otogenic fungal pachymeningitis in a diabetic patient who presented with multiple cranial nerve palsies and nasopharyngeal swelling.

We present a case report, we describe the investigations, management and clinical course of fungal pachymeningitis, and we present a review of the world literature on fungal and non-fungal pachymeningitis.

To our knowledge, this is the first report of fungal pachymeningitis with magnetic resonance imaging features suggestive of nasopharyngeal carcinoma. It is also the first reported case with aspergillus cultured from both a dural biopsy and the ear canal.

Fungal pachymeningitis is a rare condition which may present to otorhinolaryngologists. Its clinical and radiological findings can be confused with those of nasopharyngeal carcinoma; fungal pachymeningitis should thus be included in the differential diagnosis of nasopharyngeal carcinoma.