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We describe the largest reported epineural ganglion of the ulnar nerve arising in the cubital tunnel. A 54-year-old male, driver presented with progressive symptoms of left sided cubital tunnel syndrome. Surgery demonstrated a 11 × 3 cm ganglion which was successfully removed. Post-operatively the patient demonstrated partial recovery with no recurrence of the ganglion.

At present there is a fashion for ‘tunnel and plug’ ear piercings (Figure 1). The initial piercing is performed as with any normal ear piercing, creating a hole approximately 1 mm in diameter in the lobe of the ear. Clients are advised to allow the ear to heal for a period of 6 weeks with a stud in place. Gradually increasing sizes of ear plugs are then placed into the lobe, increasing by 0.2e0.6 mm every 2e3 weeks as tolerated. It is advised that once a 10 mm piercing is in place that the dilated hole will remain stretched despite the piercing being removed. Prior to this point being reached any stretch can recover and will constrict with removal of the piercing. This advice is obviously a generalisation which will vary between individuals.

We propose that the simple method of passing an extra suture through the Mitek anchor eyelet before bony insertion provides a safety net against failure of the preloaded suture and gives extra strength to the core repair.