Malignant External Otitis (MEO) and Acute External Otitis (AEO) are clinically very similar in their beginnings. It is important to differentiate between them very early. Bone scanning is the best diagnostic tool. Eight cases of AEO and MEO are herewith presented.

The diagnostic criteria of malignant external otitis (MEO) have been reviewed. They were divided into two categories: obligatory and occasional. The obligatory criteria are: pain, edema, exudate, granulations, microabscess (when operated), positive bone scan or failure of local treatment often more than 1 week, and possibly pseudomonas in culture. The occasional criteria are diabetes, cranial nerve involvement, positive radiograph, debilitating condition and old age. All of the obligatory criteria must be present in order to establish the diagnosis. The presence of occasional criteria alone does not establish it. The importance of Tc99 scan in detecting osteomyelitis is stressed. When bone scan is not available, a trial of 1–3 weeks of local treatment is suggested. Failure to respond to such treatment may assist in making the diagnosis of MEO.

To assess the prevalence of otitis media in Tanzania a study was made of 3772 patients attending for the first time the ENT out-patient department of Muhimbili Medical Centre, University Hospital of Dar es Salaam. Otitis media in one form or another was present in 524 patients (14 per cent). The majority reported a long history of ear discharge.

Hearing loss was a major complaint and was often found to be between 40–60 dB. H.L. Most patients admitted previous treatment, but otoscopy had rarely been performed. The medical profession in Tanzania cannot possibly deal with the large number of cases of chronic otitis media.

With the recent introduction of otorhinolaryngology into the curriculum of the medical school of Tanzania it seems advisable to include otology in the programme for primary health workers.

Thirty-four Menière patients (43 ears) were treated in an underpressure chamber. Békésy audiometry and impedance audiometry were performed immediately before and after the exposure to underpressure. A hearing gain of more than 10 dB. was found in 19 per cent of the ears (8/43). In five ears this improvement lasted for a few days. Only one patient (2 per cent) reported a relief of tinnitus. In 9 out of the 30 patients (30 per cent) with recent vertiginous attacks a positive subjective effect on the vertigo was obtained.

Total glossectomy is the most crippling of all oral cavity resections. Speech problems are unavoidable and post-operative aspiration is often severe. Two patients are presented who have had tongue reconstructions following near-total glossectomies. In each case a quilted, split-skin grafted pectoralis major muscle flap was used. The speech and swallowing results of these two patients are compared with two patients who underwent a hemiglossectomy and total glossectomy respectively without tongue reconstruction. Only if the suprahyoid and extrinsic tongue muscles are preserved can an active oral phase of swallowing and usable speech be regained by tongue reconstruction.

A laryngeal polyp caused a life-threatening airway obstruction in a 3-year-old child. This condition required an emergency tracheotomy, which was performed without previous intubation. The histological picture indicated the diagnosis of a teleangiectatic granuloma. No other case of solitary laryngeal polyp causing upper airway obstruction in a child has been previously reported.