Middle-ear effusions of the mucoid type were collected from 14 children with secretory otitis media and analysed by a sensitive assay for hyaluronic acid. The concentration of the polysaccharide varied between three and 42 μg/g. in different patients but was in the same range in effusion material taken from the two ears of the same patient. As the hyaluronic acid concentrations were high compared to the serum levels, the results indicate that the effusion material contains a component derived from connective tissue.

Thirty-three of 58 patients with carcinoma of the external auditory meatus and middle ear were treated by radiotherapy. Nineteen patients suffered a recurrence. This proved to be unsuitable for petrosectomy in all patients with a tumour of the middle ear. A few patients with tumours of the external auditory meatus, usually of non-squamous variety, have survived for a reasonable period after ‘salvage’ petrosectomy.

The bithermal caloric test remains, four decades after its first description, the single most valuable test of vestibular function. However, there are several variations described in the exact procedure of caloric stimulation and in the method of evaluating and representing the test results. For the past 10 years, we have followed a procedure using a constant standardized stimulus and a particular system for caloric nystagmus representation, viz., the Butterfly Chart, and have found it to be very satisfactory. This paper describes our experience with the use of the Butterfly Chart and its clinical application in over 4,500 cases.

A prospective study comparing surgical and antibiotic treatment for recurrent tonsillitis in adults suggests that, whilst tonsillectomy is very effective, adequate medical treatment provides an equally good alternative in the majority of patients.

Histoplasmosis is a rare disease in India. We are reporting this disease in a middle-aged non-Caucasian male who has never travelled outside India. Successful treatment was achieved with the nephrotoxic anti-mycotic drug (Amphotericin B), despite a pre-existing renal impairment.

We describe the assessment procedures used at Charing-Cross Hospital to investigate laryngectomees who failed to develop oesophageal voice and give the results of assessment in 50 patients. Anatomical or physiological abnormalities in the reconstructed pharynx were found in all patients, and we feel these significantly contributed to the failure of achieving an oesophageal voice. The four cases of failure were due to hypotonicity of the pharyngo-oesophageal muscles, hypertonicity, frank spasm and stricture. This distinction can be used as a functional classification of failure as treatment for each group has to be different if successful surgical voice restoration is to be achieved. Patients with hypotonicity need to use external pressure; those with mild hypertonicity are able to use a low pressure tracheo-oesophageal voice prosthesis; those with spasm need a pharyngo-oesophageal myotomy prior to “puncture”, while those with stricture need surgical correction.

Various forms of dressings, including proflavine wool, have been used traditionally for pinnaplasties.

We report the use of Silastic Foam as a dressing in seven of our pinnaplasty cases. The advantages of Silastic Foam dressing over conventional dressings are mainly:

1. Patient comfort.

2. No change of dressing is required.

Embolization to treat intractable epistaxis is becoming increasingly popular. Twelve cases of facial nerve paralysis after embolization of branches of the external carotid artery have been reported. In this paper, a new case is reported. In epistaxis. embolization should be reserved for patients with contraindications to ligation or in emergency procedures.