FOUR cases of bilateral congenital choanal atresia are presented. Three of them (75 per cent) were shown by Electric Response Audiometry (ERA) tests to have, in addition, congenital nerve deafness; and two had other congenital anomalies. Thus, congenital nerve deafness should be considered as a possible congenital anomaly associated with choanal atresia. Early diagnosis and treatment of congenital choanal atresia can prevent death from asphyxia during the neonatal period, but after surgical correction of the atresia the possible existence of additional anomalies has to be determined and treated.

By the use of electric response audiometry we are able to detect sensorineural hearing loss during the neonatal period and can plan the rehabilitation of deaf infants.

Tetanus resulting from ear injury is extremely rare. However, the otologist should be aware that it does occur. A case of otogenic tetanus recently treated by the authors is presented.

In Western countries tetanus in now a rare disease because of extensive immunization programmes. Otogenic tetanus is extremely uncommon in North America, but occurs more frequently in tropical regions (De and De, 1970).

Less than forty new cases of tetanus are seen in the Province of Ontario (population, 8·4 million) each year (Department of Statistics, Government of Ontario).

It has been stated that the operative treatment of otogenic tetanus should include radical mastoidectomy (Black and Atkins, 1972). This is probably true in severe cases but milder cases do not require this form of therapy.

Most children in Canada receive primary immunization with Diphtheria, Tetanus and Pertussis vaccine (DTP) in the early years of life. However, especially in large urban centres, there is a large non-immunized or partially immunized immigrant population.

Tetanus occurring in such an immigrant is described.