A four-year experience in a Vestibular Clinic led the author to the unconventional opinion that the ENG does not often make a significant contribution in the routine evaluation of patients with vertigo or dizziness. A good history by the doctor is usually enough to make a diagnosis. Audiometry and office ice calorics are done routinely. More sophisticated tests are done if judged necessary.

Around 10 per cent of the 300 consecutive cases seen at the clinic had no diagnosis. An ENG on these did not prove to be of help in making a diagnosis or getting closer to one.

This paper is an invitation to good clinical and synthetic judgement in days when more and more responsibility is delegated to sophisticated equipment.

The removal of the uvula for minor pharyngeal lesions is unusual in Western otorhinolaryngological practice. However, uvulectomy is a common procedure for ‘throat problems’ in Nirgeria and some other African countries by traditional surgeons. This is because it is believed that the elongated uvula is the root cause of all throat problems. These traditional surgeons are usually barbers by profession and only practice surgery on a part-time basis. Most of their patients do well but some have to be rushed to the hospital with severe post-operative bleeding. Attention of Europeans and other foreign otolaryngologists who may find themselves practising in any part of Arica is hereby drawn to the procedure.

The over-all distribution of the pre-operative bacteria of 806 ears and the post-operative bacteria of 109 post-operatively moist or discharging ears correlated very well, the only clear difference being the detection of diphtheroid bacilli more often post-operatively than pre-operatively.

When comparing the pre- and post-operative bacteriology of 109 post-operatively infected chronic ears which had undergone radical surgery and obliteration with Palva flaps (and which were drawn from a group of 806 ears originally operated on and followed yearly for 5–14 years) it was noticed that Pseudomonas aeruginosa and Proteus sp were cultured more often post-operatively than pre-operatively in the same ears. Statistically, other bacteria were not found to be significantly present in the same ears.

Transcranial attenuation for bone conduction as a function of frequency (0.25 to 4 kHz.) was measured on a group of unilaterally deaf (n 15) and a group of normal (n = 35) ears. The results indicate a positive mean attenuation for all frequencies with a peak value of 13 db. for both groups at 2 kHz. Inter-subject variability was extremely large. This is considered to be a result of variability in skull bone thickness.

Diminution of vision arising from head injuries involving the optic foramen can be treated by transethmoidal decompression of the optic froamen can be treated by transethomidal decompression of the optic nerve. Early surgery is associated with good recovery of function. In this paper, the surgical procedure is discussed, with the results in 10 cases.