A discussion of the rationale of management of acute haematoma auris and a description of a simple, reliable method of management using Otoform K Silicone impression material to form ear splints.

A group of 67 children were studied (mean age 7 years, 2 months) who underwent adenoidectomy and/or tonsillectomy because of either recurrent otitis media or upper respiratory tract infection. The mean pre-operative intratympanic pressure was –67.3 mmH20 (SD 65.1); three months post-operatively it was –21.9 mmH20 (SD 32.4), a highly significant improvement (p<0.001). The size of the adenoids had a nearly significant effect on the pre-operative intratympanic pressure (p<0.05). In children with large vs small adenoids the difference was highly significant (p<0.001). In a group of five children, tonsillectomy along (adenoidectomy performed earlier) did not have any effect on the intratympanic pressure. No change in intratympanic pressure was seen in children with nasal allergy as compared with non-allergic children after adenoidectomy.

Soft-tissue reaction to ceramic ossicular replacement prostheses (CORP) has been evaluated histologically in rabbits and humans. One week after implantation, severe inflammatory and foreign body reaction was observed in the fibrous connective tissue surrounding the prosthesis. Though some inflammatory response was seen after one month, after three months the CORP was surrounded by a layer of fibrous connective tissue without any foreigh body giant cell, histiocyte or inflammatory cell infiltration. Our satisfactory clinical results in humans without placing a cartilage between the CORP and the fascia graft may be due to the excellent softtissue compatibility of CORP, as demonstrated in this study.

Measurements of nasal airways resistance in normal subjects have shown a significant difference between values obtained in the two respiratory phases. Higher overall values are found during expiration in both the unprepared and decongested nose but these differences fail to maintain statistical significance after application of a decongestant. This indicates that the phase of respiration in which measurement is made must be routinely recorded especially when measurement is made without decongestant, and comparisons of data made only with recordings from equivalent parts of the nasal cycle.

A significant decrease in the pH of saliva has been detected in patients with recurrent aphthous ulcers (RAU). The decreae in pH was more prominent at night than between meals, and some persistent decrease was noticed even after recovery. The total proteins of saliva in RAU were also significantly decreased.

These findings were similar to those observed in patients complaining of petic ulcers, so it is recommended that patients with RAU should be treated with antacids as well as anticholinergic drugs, and that the possibility of concomitant peptic ulceration should also be investigated.

Fifty-seven operations on 53 patients represents the total experience of tracheostomy in children under 13 years during 1964–1985 in an area with half a million inhabitants. No complications occurred during surgery and no deaths were related to the operations. Complications followed 16 out of 30 (53%) operations on children under three years and four out of 27 (15%) of the remainder, an overall complication rate of 35%. Many fewer operations have been required since 1973 because of the successful employment of nasotracheal intubation in the treatment of upper and lower airway obstruction caused by acute infection. Obstruction by-pass remains the commonest function of tracheostomy, with congenital lesions and trauma now the commonest causes of obstruction as opposed to acute infection in the earlier years. Despite the successful use of nasotracheal intubation there were absolute indications for tracheostomy—blockage of the nasotracheal tube; inability to intubate a child with epiglottitis; and necessity for an artificial airway of long duration.

We report a 55-years-old male with cerminous adenoma originating in the osseous part of the right external auditory canal, and describe the clinical features and surgical treatment.

We describe a 65-year-old woman who presented with a left tonsillar tumour. Biopsy revealed metastatic anaplastic cell carcinoma of the thyroid. Metastatic tumours are rare in the tonsils. This case, to the best of our knowledge, is the first in which the thyroid was the primary site.

Major salivary glands have been rarely reported as sites of necrotizing sialometaplasia, a disease primarily affecting minor salivary tissue, particularly that of the palate. Eight cases of necrotizing sialometaplasia of the parotid and submandibular glands are presented and added to six reported earlier by Donath (1979). The clinical and pathologic findings in the 14 cases give strong support to the vascular-based-infarct genesis of necrotizing sialometaplasia.

Twelve cases of adenolymphoma with inflammation are described. Pre-operatively, three of these patients presented clinical signs of inflammation in the parotid gland. In ten cases purulent exudate could be aspirated from the tumour. Rupture of the cyst may cause an aseptic inflammation in the surrounding tissue. It is concluded that adult patients with clinical or cytological signs of inflammation in the parotid gland must be supervised until the gland is normal in order not to miss an underlying tumour.

A case of trigemino-facial zoster presenting as Superior Orbital Fissure Syndrome is reported. Geniculate ganglion involvement was limited to the vestibular branch of the cochleo-vestibular nerve, without any hearing impairment of facial palsy. this case clearly illustrates that herpes zoster cranialis is a polyneuropathy of multifocal asynchronous viral activity and can present in numerous forms.