This report presents a case where an open safety pin passed through the Esophagus and where Nature herself finally solved the problem by closing the pin, which was afterwards carried in the faecal stream and discharged from the body without any harm to the patient.

In a study to determine whether or not there is a familial or hereditary pre-disposition to develop secretory otitis media (SOM), the parents of 73 children with presistent SOM and 35 controls were examined clinically, and abnormalities of the tympanic membrane (TM) noted. Analysis of the findings suggests that heredity plays a large part in determining a child's likelihood of developing SOM.

The migration theory of cholesteatoma formation considers that stratified squamous epithelium from the external auditory meatus migrates into the middle ear, giving rise to cholesteatoma. To test the ability of squamous epithelium to migrate in this manner, 73 stains were placed in relation to 23 chronic perforations. In no instance did epithelium migrate into the middle ear cleft. The limitations of the migration theory are discussed.

In ears with minor conductive hearing loss of traumatic origin, it is sometimes possible to invert the deflection of the stapedial reflex by application of a small underpressure in the external auditory meatus of the injured ear (probe ear). This inversion can be explained by an ossicular discontinuity bridge by soft tissue.

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.

Submucous palatal fibrosis invariably leads to trismus due to fibrosis in the retromolar region. Medical lines of treatment are of no use in relieving the trismus once it is established. Various surgical methods, such as excision of fibrous tissue or excision of fibrous tissue with skin grafting, have been suggested, but none of them has been proved to give a lasting cure. We have made use of tongue flaps on either side in cases of trismus due to submucous palatal fibrosis in the retromolar region. Twentyfive cases have been operated upon with this technique and the results are quited encouraging. Regular follow-up for up to three years has shown good results without any complications.

During the 10-year period 1972–1981, 3,688 and 867 oesophagoscopies were performed at two ENT clinics of a university hospital and of a country hospital with an incidence of oesophageal perforation of 0.8 per cent and 1.1 per cent respectively.

Rigid instruments were used in all cases, most often in combination with dilatation of a benign stricture.

A 56-year-old woman presented with unilateral tinnitus and hearing loss for 18 months. A middle ear mass was detected clinically. At operation, the tumour was found to have eroded the stapes. The light and electron microscopic features of the tumour were those of a middle ear adenoma. This rare benign tumour has an excellent prognosis. Erosion of an ossicle has not been previously associated with this tumour.

Benign adenomatous tumours arising from middle ear mucosa are rare (Mills and Fechner, 1984). The term adenoma of middle ear was proposed by Hyams and Michales (1976), and their review of 20 cases emphasized the benign behaviour of these tumours. We report a case of middle ear adenoma in which ossicular erosion occurred.

The successful closure of a large pharyngo-cutaneous fistula by a bipedicled tubed flap is described. This procedure is technically simple and reliable. An advantage of this method is that both lining and covering are obtained in the same flap.