Neomycin was instilled daily, uni-or bilaterally, into the middle ear of guinea pigs for three months. The cochleae were examined, by light and electron microscopy, six months after the end of treatment. The organs of Corti of the treated ears were completely destroyed, and in the most advanced lesions, were substituted by a single layer of very thin flat cells. In the spiral ganglion only some glial cells and a few neurons could be observed. All surviving neurons were myelinated, and their ultrastructure was greatly altered, with disappeared, losing it amorphous and filamentous components. The spiral limbus and the stria vascularis were atrophic and were also covered, in the final stages, by flat elongated cells. In view of its morphological characteristics, this epithelium may arise from the displacement of the interdental cells and perhaps from the cochlear surface of Reissner's membrane.

A scanning electron microscopic study of the endolymphatic sac of the mongolian gerbil is presented. As described in other animal species and in man. three rather distinct regions on the epithelial surface can also be recognized in this rodent. Light and dark cells are seen to line the sac epithelium throughout. At the level of the intermediate portion, however, a different cell-type—the granular cell—is present, with its luminal surface covered by large amounts of solid material.

On the basis of light and transmission electron microscopic studies presented elsewhere, a higher degree of functional specialization in this portion of the gerbilline sac is proposed.

Many antibiotics, chemotherapeutic agents and other chemicals have been tried in the treatment of scleroma without much success (Toppozada et al, 1967). The most popular of these drugs are streptomycin and aureomycin (Botros et al, 1954; Zwiefach, 1955; El-Mofty, 1962), terramycin and chloromycetin (Hoover and King, 1953) and ampicillin, septrin and vibramycin (Ssali, 1975).

El-Mofty and Attia (1957) attributed considerable value to the use of 20 per cent aureomycin ointment locally in treating the disease. Nigonol in the form of a local injection was tried by Toppozada et al. (1967) and they claimed good results. Shaer et al. (1981) reported that local application of 2 per cent acriflavine solution over an eight-week period was an effective and safe remedy for rhinoscleroma.

Rifampicin has been used systemically with success as a new antibiotic for the treatment of scleroma (Riad, 1982). The aim of the present study was to evaluate the response of rhinoscleroma to local medication with rifampicin.selected for this study. The cases were diagnosed by clinical, histopathological (Fig. 1) and bacteriological data. Twelve cases were in the atrophic stage while eighteen were in the granulomatous stage of the disease. Rifampicin was applied locally into the nose in two forms:

1. Nasal instillations: used mainly in the atrophic cases. One ampoule of rifampicin (Rifocin-Lepetit®) 125 mg. diluted in 20 ml. saline solution was used and 2 ml. of the solution was applied twice daily.

2. Nasal infiltration: used mainly in the granulomatous cases. One ampoule of rifampicin (Rifocin-Lepetit®) 125 mg. was infiltrated into the granulomas every other day.

Treatment was continued for eight weeks. Punch bio-spies were taken from the nasal lesions after four and eight weeks during the course of therapy and six months after the cessation of treatment. Biopsies were fixed, dehydrated, embedded in paraffin, sectioned and stained with H and E. Part of each specimen was submitted to bacteriological studies for the isolation of K. rhi-noscleromatis (Levine, 1951).

A further new application of the fibreoptic laryngoscope as an adjunct to the excision of pharyngeal pouches is described. Its use facilitates the procedure and thus reduces the time of surgery. This is clearly advantageous, particularly as many patients with pharyngeal pouches are elderly and may be less than fully fit especially if overspill from the pouch has caused recurrent chest infections.

Near-total laryngectomy with myomucosal valved neoglottis is the most recent of the various surgical proceedures for speech rehabilitation. The electrolaryngographic wave form (Lx), which was recorded initially to explore the site and mechanism of phonatory function of the neoglottis, has been successfully used in speech rehabilitation of these patients. In a pilot study it was tried as a visual feedback. The results confirm its utility for speech rehabilitation of these laryngectomees.

Summary Initial combination drug regimen containing cisplatin in patients with stage III and IV head and neck cancer produced a high percentage of clinical response. This trial was initiated to assess the role of multimodality treatment (chemotherapy plus radiotherapy) versus chemotherapy alone. Ninety-six patients entered into this study; 80 patients were evaluable at time of analysis (Table I). Patients were randomized between chemotherapy and radiotherapy (group I) and chemotherapy alone (group II). The chemotherapy administered consisted of cisplatin, bleomycin and methotrexate and was given in 2 cycles over 35 days. Local radiotherapy followed. In group II 3 cycles of chemotherapy were given without radiotherapy. The overall tumour response after chemotherapy rose up to 75 per cent. After radiotherapy in group II the response rate sank to 59 per cent. In both regimes the remission duration was very short. Patients receiving only two cycles of chemotherapy do not have a statistically shorter survival than patients, who were treated by chemotherapy plus radiotherapy, or by a 3rd cycle of chemotherapy.

Two patients with Moebius' syndrome are described, a brother and a sister. In addition to bilateral congenital facial nerve paralysis, both had deafness, an external deformity of the auricles, and a latent squint. The deafness in both cases was sensorineural in type; although there was paralysis of the motor part of the facial nerve, taste and lacrimation were intact. This report shows that not all components of the facial nerve are always effected in this syndrome.

Hemangiomas of the temporal bone are uncommon benign tumours, occurring most frequently at two sites: the internal auditory meatus (IAM) and the geniculate ganglion.

In this paper the authors discuss the pathology, clinical onset and features, and the therapeutic management of two of these lesions. A review of the literature is also presented, paying attention to the controversy regarding the origin, pathogenesis and histologic classification of this rare lesion of the temporal bone

Osteomas are common benign tumours of the paranasal sinuses, but are usually asymptomatic and found as a coincidental finding during routine radiological investigations. We present a case report of a patient with an isolated osteoma of the middle turbinate presenting with unilateral nasal obstruction which required removal via a lateral rhinotomy approach. The aetiology, pathology and presenting features of these tumours are reviewed and their subsequent management discussed. In particular, adequate pre-operative radiological assessment to determine involvement of the cribriform plate region by computerized axial tomography (CAT Scanning) is emphasized since this may indicate the need for a cranio-facial surgical approach rather than a lateral rhinotomy to achieve complete removal.

Oedema, hypertrophy, polyposis, atrophy or empyema of the maxillary sinus are common features of rhinoscleroma. However, actual involvement of the antrum by the nasal granuloma is rare and primary scleroma of the antrum is of extreme rarity. Three cases of antroscleroma are presented, one secondary to an extensive rhinoscleroma and two primary. The difference in the physical, biological and microbiological environment in the antrum from that in the nose might explain the rarity of antroscleroma.