Fifty-seven patients between the ages of zero and 16 years, treated for nasal fractures during childhood by means of closed reduction, have been subjected to follow-up examination after development of the nose has ceased. These patients have been compared to a control group of 50 persons without any known nasal trauma. No difference was found between the two groups with regard to functional complaints, but deviations of the osseous and cartilaginous pyramid, humps and sáddle formations, as well as spine formations and deviations of the septum, were particularly prevalent in the fracture group. Crista formation and angulation were found to be equally frequent in both groups. The findings are discussed.

Fifty-seven patients who had sustained nasal fractures during childhood were divided into three groups, according to the age at which the fracture had taken place. These three groups were based on the normal periods of development of the nose. They were compared with regard to possible sequelae after fracture. The results are discussed and an example from each group is shown.

An accurate, reliable, inexpensive and safe method for the examiniation of the upper aero-digestive tract is described. Its efficacy is evaluated retrospectively on 250 patients over an 18-month period.

Flexible fibreoptic rhinolaryngoscopy has been shown to be an accurate, reliable, inexpensive and safe method of examining the upper aero-digestive tract (Lancer and Moir, 1985).

The result of 338 consecutive examinations are reported.

Difficult intubations are more common in otolaryngological practice than any other branch of medicine or surgery. The majority of these are predictable. It is the unexpected intubational failure, usually in a patient undergoing treatment for an unrelated problem, that results in tragedy. In this paper the indications for fibre optic guided intubation are discussed, and the technique described and illustrated in a case of pharyngeal obstruction secondary to an epiglottic cyst. It is suggested that our expertise to operate within the upper airway should be exploited to the advantage of our patients, and of our anaesthetic and surgical colleagues.

With the introduction of the flexible fibreoptic nasopharyngo-laryngoscope, we have a sophisticated instrument for examination of the nasopharynx and larynx. It is also useful for obtaining biopsies from the nasopharynx and has many advantages over other methods. The most important is that it is possible to take biopsies from selected sites under direct visualization and the biopsy results are therefore more reliable.

Fibreoptic endoscopy has only recently become used as a diagnostic tool for the E.N.T. surgeon but it has not been widely used in the investigation of pharyngeal disease. During a two-year period at Warwick Hospital 53 patients have undergone flexible fibreoptic endoscopy using a gastroscope, with visualization of the pharynx. larynx and upper G.I. tract as far as the duodenum. This report describes the technique employed, details the endoscopic findings in 53 patients, and discusses the indications for the technique and the advantages that it holds for the E.N.T. surgeon in the diagnosis and management of pharyngeal disease.

Nasopharyngeal angiofibroma (NPA) is a highly vascular, infiltrative tumour that occurs exclusively in the nasopharynx of young males. It is of special interest on account of its serious complications, and the difficulties that are encountered at the time of treatment. Various surgical approaches have been mentioned for both naso- and extra-nasopharyngeal angiofibromas. But a massive extra-NPA involving the naso-spheno-oro-palato-maxillary-infratemporal region, orbit and cheek is difficult to treat adequately with any of the approaches so far described in the literature. In these cases, a more radical approach (constituting embolization and subsequent clamping or ligation of the external carotid artery followed by total maxillectomy) may be needed. These procedures will not only give a dry operative field but also adequate exposure to the different parts of the extension of the tumour, thereby facilitating complete removal without any risk of recurrence.