Taking cognizance of the embryology and newer diagnostic techniques, the trans-palatal route is strongly recommended as the optimal surgical procedure for the management of choanal atresia. It should be performed as soon as general anesthesia can be safely administered. In selected instances, but particularly when a patient is at increased surgical risk, necessitating surgical brevity, the endonasal puncture technique should be considered as the initial procedure. Parents must be appraised of the potential for subsequent growth deficiencies, mental retardation, and crossbite.

Serum immunoglobulin (IgG, IgA and IgM) levels were determined in patients with chronic tonsillitis before and one month after tonsillectomy. The preoperative levels of serum IgG, IgA and IgM were significantly higher when compared with the controls. The increase may be due to repeated antigenic stimulation. The post-operative levels for the three immunoglobulins were decreased; however, a significant reduction was observed for IgG only where the mean value was comparable with the control group. The data confirm that tonsillectomy does not disturb the humoral immune system of the body.

The authors have treated 44 patients with posterior chronic acid laryngitis. Biopsy was performed in all patients. Characteristic changes typical of the hyperregenerative or atrophic phase of reflux oesophagitis were identified in all specimens. Gastric hypersecretion was proven in all but two patients. The aetio-logic factors of acid posterior laryngitis are gastro-oesophageal reflux, with friction of both vocal processes during phonation and vocal abuse. The preferred therapy is removal of circumscribed lesions with a suitable medical regimen.

Immunohistochemical staining for keratin proteins may be useful as a diagnostic parameter in head and neck neoplasms. Our study evaluates the keratin antibody staining properties of normal tissues as well as neoplastic and non-neoplastic head and neck lesions from surgical procedures performed on 100 patients. The results indicate that the anti-keratin antibody technique can be helpful in several areas of head and neck pathology.