Dematoplasty for the treatment of epistaxis caused by HHT has become well established. A modification of Saunders's (1960) original dermatoplastic technique is described, which permits the nasolabial incision to be avoided.

This retrospective study of the long-term effect on epistaxis caused by HHT demonstrates, in contrast to those with a short period of observation, that epistaxis can be partially controlled by means of dermatoplasty and, further, that it is impossible to eliminate completely the need for blood transfusion.

In two of the patients it was found that newly formed telangiectases had occurred in the transplant 15 and 18 years post-operatively.

Experience with flunarizine, a selective calcium-entry blocker, in the treatment of dizziness is reviewed. Clinical efficacy was predicted in pharmacological studies both in rabbits and humans: torsion swing or caloric induced nystagmus were significantly suppressed by flunarizine. Open therapeutic findings, using clinical and electronystagmographic or audiographic assessments as well, showed that flunarizine is of benefit to patients with vertigo of labyrinthine as well as of cerebrovascular origin. These results were confirmed in double-blind controlled trials. Flunarizine, either started with a loading dose gradually decreased thereafter, or given at a fixed 10 mg. dose schedule was proven to produce rapid improvement of dizziness and unsteadiness and to be tolerated very well.

A survey was conducted of deaf children in the Glasgow area diagnosed between 1965 and 1979 to assess the relative incidences of the known aetiological factors. This took the form of a review of case records supplemented by the use of questionnaires. The results showed small variations from earlier published figures but were broadly similar. The effectiveness of rubella and anti-Rhesus immunization were also evaluated. It was found that more than half of all cases of profound deafness in childhood are acquired rather than inherited and are therefore potentially preventable

In a controlled investigation of 22 patients with hereditary haemorrhagic telangiectasia, an evaluation has been carried out of the connective tissue content of muco-substances prior to and after treatment with oral oestrogen (oestradiol valerate 4 mg. daily). The clinical condition of the patients, all of whom had haemorrhagic anaemia, was evaluated by the frequency of epistaxis and by blood analyses. No effect of treatment could be demonstrated by means of histochemical, clinical or laboratory methods.

A six-year-old female with congenital bilateral choanal atresia was examined by CT (computed tomography) and contrast radiography. CT clearly demonstrated the existence of choanal atresia, and differentiated osseous stenosis from membranous stenosis in the choanae. CT may be the first choice of radiological examination for the pre-operative diagnosis of congenital choanal atresia.

This five-year survey of ear disease in a London population of 10,000 is considered to be a valid description of the incidence of ear disease presenting in a general practice community, since all patients were examined and diagnosed either by the author or by the district hospital Ear, Nose and Throat Department. The results agreed generally with the findings of the National Morbidity Surveys, but a more comprehensive range of ear disease is described. There is general agreement, between this and other surveys in the United Kingdom and the United States, that the most common ear diseases presenting in general practice populations are acute suppurative otitis media and impacted wax, followed by presbyacusis, secretory otitis media, chronic suppurative otitis media, vertigo and traumatic deafness due to noise, blast or head injury. However, the incidence of these and other diseases differs greatly in many countries throughout the world and some aetiological factors are suggested.

The evidence in this paper points to the continuing need for the investigation of the incidence and aetiology of some ear diseases in many parts of the world.

The results of unilateral immediate tonsillectomy, as the routine treatment of peritonsillar abscess, were studies in 47 patients with no previous history of serious tonsillitis. The follow-up was carried out between three and four years after operation.

The incidence of tonsillitis in the contralateral tonsil remained unchanged and peritonsillar abscess did not occur in that tonsil. Symptoms of pharyngitis, periodic or chronic, were present in three patients only. This was found to be significantly lower than that found in the literature in a similar group of patients in whom bilateral immediate tonsillectomy had been performed.

The results are discussed and the authors recommend unilateral immediate tonsillectomy in cases of peritonsillar abscess in all patients with no previous history of serious tonsillitis, as this apparently prevents the troublesome side-effects of chronic pharyngitis.

Nearly 70 percent of contemporary ENT consultants perform adenoidectomy as a routine when removing the tonsils. It has been stated in the literature that adenoid and tonsillar hypertrophy tend to co-exist and so a study was set up to investigate this hypothesis, with the possible that it may be of diagnostic importance. A series of 45 children admitted for the operations of tonsillectomy and adenoidectomy was investigated. No correlation was found between adenoid weight and tonsil weight. In view of this, it was concluded that tonsil and adenoid hypertrophy do not necessarily co-exist and that tonsil size cannot be used to predict adenoid size.