The levels of prostaglandian E2 (PGE2) were measured in aspirates of the effusion fluid from children suffering from secretory otitis media. The effects of naproxen 5 mg./kg. twice daily for eight weeks on the condition were studied in a placebocontrolled double-blind trial.

Nineteen middle-ear aspiraes from 13 children, six of whom had bilateral aspirations were examined. Detectable levels of PGE2 and those without.

In a separate trial of naproxen, 11 patients received active drug and 13 received placebo. Naproxen had no significant effect on otalgia or hearing loss compared to placedo.

These findings suggest that is it unlikely that non-steroidal anti-inflammatory drug will be of therapeutic benefit in secretory otitis media.

The caloric test response from the unaffected ear in a case of acoustic neuroma may be normal, hypoactive or hyperactive; each has a different pathophysiological connotation: a normal response is the anticipated finding; a hyperactive contralateral response is due to the presence of a large neuroma with brainstem compression; and a hypoactive response may result from several factors, such as lack of mental alertness during the test, drugs like barbiturates, raised intracranial tension, or the presence of bilateral neuromas.

One hundred and six patients with nasal fractures, treated by reduction in 65 percent, were seen three months and three years after the trauma. The results were compared with a normal group.

Sixteen patients (15 per cent) had sustained recent nasal injuries, and another four patients had undergone correction of the nose during the follow-up period. These patients were left out of the statistical analysis, which thus comprises 88 patients.

Ninety per cent were satisfied with the result, and 84 per cent reported normal passage of air. Physical examination revealed a considerable number of deformities in all groups. including the normal group. Deviation of the external nose was significantly more common in the patients than in the normals. During the follow-up period, secondary deformity—saddling or hump—developed in some cases. Most deformities were slight and of little importane to the patient. Septal deformities were present in over 50 per cent of all groups, including the normal group. There was no aggravation of septal deformities or increasing nasal stenosis during the follow-up period. There patients were interested in secondary corrective treatment.

It is concluded that closed reduction of nasal fractures affords satisfactory long-term results. The study does not support the view that a large number of cases of nasal fracture should be treated by open reduction.

Oxymetazoline, a derivative of imidazoline, is a widely used nasal decongestant. In contrast to other topical decongestants related to phenylephrine, sympathomimetic amines, it also induced a reduced nasal mucosal blood flow. The purpose of the present investigation was to evaluate the duration of effect of oxymetazoline on nasal airway resistance and mucosal blood flow. During the eight hours of study, the blood flow was reduced by 30–40 per cent in six hours. A similar decongestant effect of about 30 per cent was found during the same interval. The pharmacological profile of oxymetazoline seems questionable, since a reduced nasal mucosal blood flow might not be of value in the treatment of upper airways infections.

The purpose of this paper is to define the incidence of squamous cell carcinoma (SCC) of the head and neck as seen at the Free University Hospital, Amsterdam, the Netherlands, in the last six years, according to the latest revised classification system of the International Union against Cancer (UICC, 1982). In addition, male to female ratios, relative frequencies at the various sites, age distribution, incidence of second or third primary and the relationship of distant metastases to the nodal metastases and the T-stage of the primary lesion are reported. These incidences are compared with those in other countries and the major differences are discussed.

Acyclovir is a specific anti-viral agent which has been used in the treatment of the Ramsay Hunt Syndrome with encouraging results. To our knowledge, no previous study has been published utilizing this treatment. A discussion is also undertaken of the underlying pathology and prognosis of the Ramsay Hunt Syndrome, with a summary of those cases in which Acyclovir was prescribed.

The fourth example of an acinic cell carcinoma arising in the sinonasal tract is presented. Because of its unusual and atypical histologic appearance, correct diagnosis required electron microscopic analysis and the demonstration of intracellular amylase by immunohistochemical stains.