The fate of 32 Per-Lee ventilation tubes inserted by a single surgeon for secretory otitis media in children and adults is analysed over a 15-year period. There were no extrusions and 25 tubes were still functional at the time of the survey. The total ventilation time achieved by the 32 tubes was over 157 years. Seven tubes were removed on account of either obstruction or infection. Spontaneous healing of the tympanic membrane was uncertain following removal of the tube and a considerable degree of scarring was inevitable. Hearing improvement occurred while the tube was functioning and there were no cases of hearing deterioration. It is concluded that the Per-Lee tube is a suitable prosthesis for long-term middle-ear ventilation.

Nasal mucus clearance (N.M.C.) varies with geographical conditions. Studies on the evaluation of this important function have so far been done only in the western part of the world, but now the normal values of N.M.C. in India have been established by measuring the transportation of saccharine crystals through the nose. This has been compared with the values obtained in various diseases of the nasal and lower respiratory tracts, thus establishing the prognostic and diagnostic importance of measuring the nasal mucus clearance.

A prospective survey of 60 patients requiring manipulation under anaesthetic for nasal fractures has been carried out using pre- and post-operative photographs in conjunction with a standardized proforma. The results are presented and discussed.

Primate intrinsic laryngeal muscles studied consisted of Type I and Type II fibres. Type II fibres were larger than Type I fibres. The coefficient of variance of these muscles suggested that the fibre-size variation was similar in all of these muscles. Denervation resulted in shrinking of Type II fibres at two weeks in all the muscles, while at four weeks the thyroarytenoid showed an inflammatory reaction and far greater reduction in size than the other muscles. At eight weeks, however, all the muscles were fibrosed. We conclude that laryngeal muscles begin to show evidence of denervation at two weeks and are fibrosed in eight weeks. The thyroarytenoid muscle showed inflammatory degeneration, while the posterior cricoarytenoid and cricothyroid muscles showed classical changes of denervation. These findings should have clinical significance in the timing of reinnervation procedures.

The present study aims at an assessment of hepato-splenomegaly in infectious mononucleosis (IM). In 29 patients admitted to the ENT department with IM, based on the typical clinical and laboratory findings, including a positive mononucleosis test in most cases, the size of the liver and spleen was estimated by ultrasonic scanning on days 1, 3, 5, 10, 20, 30, 90 and 120 after admission. A control group of eight patients with peritonsillar abscess was included for comparison. The results showed that all patients had an enlarged spleen (mean enlargement: 50–60 per cent) but only a few were palpable. Half of the patients had enlargement of the liver (5–20 per cent), which was palpable in only 8 per cent. There was no correlation between the size of the spleen and that of the liver, not between the changes in the size of these organs. There was no enlargement of the liver or spleen in the control group. No correlation was found between the size, or changes in the size, of the organs and blood values such as lactatdehydrogenase and aspartatamino-transferase. There is, however, a striking parallelism between the curves for these parameters, which might indicate that the organs as well as the blood tests return to normal within 28 days. If this holds true, our warning to abstain from physical exercise and alcoholic intake may be limited to a period of about 1 month.

Serum phosphohexose isomerase (PHI) levels were estimated in 28 patients with head and neck cancer. The mean value was significantly higher when compared to the controls. There was no difference in mean PHI value with respect to the character of the lesion or with the histopathological type of growth. The activity was increased with the advancement of the stage of cancer.

With radiotherapy, a gradual and significant decrease in serum PHI activity was observed.

The apparent tendency of juvenile nasopharyngeal angiofibroma to involute with age has been known for many years but firm evidence of this has been lacking. This case report uses computerized tomography to provide the first documented evidence of this involution.

Since 1897 a total of 37 cases of extracardiac rhabdomyomas of the fetal type have been reported in the literature. Only two of these were localized in the larynx. We report an additional case of extracardiac rhabdomyoma localized in the larynx, and the pertinent literature is discussed. Although rare, its existence should be kept in mind in the differential diagnosis of laryngeal tumours.

The presenting features and management of three cases of chondroma and one of chondrosarcoma in different head and neck sites are described. The rarity of this tumour is emphasized by a brief review of the literature. The fact that all the above cases presented within two years to one District General Hospital makes this series very unusual indeed.