A prospective survey of 60 patients requiring manipulation under anaesthetic for nasal fractures has been carried out using pre- and post-operative photographs in conjunction with a standardized proforma. The results are presented and discussed.

Primate intrinsic laryngeal muscles studied consisted of Type I and Type II fibres. Type II fibres were larger than Type I fibres. The coefficient of variance of these muscles suggested that the fibre-size variation was similar in all of these muscles. Denervation resulted in shrinking of Type II fibres at two weeks in all the muscles, while at four weeks the thyroarytenoid showed an inflammatory reaction and far greater reduction in size than the other muscles. At eight weeks, however, all the muscles were fibrosed. We conclude that laryngeal muscles begin to show evidence of denervation at two weeks and are fibrosed in eight weeks. The thyroarytenoid muscle showed inflammatory degeneration, while the posterior cricoarytenoid and cricothyroid muscles showed classical changes of denervation. These findings should have clinical significance in the timing of reinnervation procedures.

Two cases of monostotic fibrous dysplasia of the ethmoid are presented. This condition is of interest to the rhinologist because of the difficulty of differential diagnosis, its location, and the frequent tendency to local recurrence. The two patients presented in this paper were aged fifteen and seven respectively, with almost iddentical lesions and with very similar x-rays. A clinical picture of each patient is given, following a brief description of fibrous dysplasia. Special emphasis has been placed on the treatment which is necessarily surgical. In both cases extensive radical surgery of the lesion was performed using a combined craniofacial approach. Finally, a brief evaluation is made of these two cases.

The long-term follow-up of eight patients with established subglottic stenosis managed with a composite hyoid-sternohyoid graft is reported. Four of these patients were children. All but one of the patients were extubated within four months of surgery. The reconstructed airway is shown to grow with age and re-stenosis has not occurred. Apart from post-operative granulation tissue at the repair site, the major complication has been a breathy voice in two children due to overwidening of the larynx.

In children, acute epiglottitis is rapidly fatal due to airway obstruction by swollen supraglottic structures, but the oedema is short-lived. Therefore, in many centres short-term endotracheal intubation has replaced tracheostomy as the method of choice for relieving the obstruction.

We have tried both methods in 15 children over a period of three years under conditions of limited material and human resources. Tracheostomy was found to be safer. It was concluded that it is better to have a live healthy child with a small scar in the neck than a dead child without a scar.

The clinical presentation and management of craniocervical chordomas in the Mersey Region between 1974 and 1984 are presented, and compared to those in previously published series. A review of the current modalities of treatment is also discussed.