Scanning electron microscopy is commonly used to study the normal or pathologically altered cochlear epithelium. It is especially useful for the study of ototoxicity in humans or animals. A cochlear microdissection technique in the guinea pig is presented which permits examination of the whole membranous cochlea with little artefactual damage to the sensory structures under study.

Vitamin D (calciferol) dehciency has recently been claimed to cause cochlear hearing-loss (Brookes and Morrison, 1981; Brookes, 1983, 1984). In view of the therapeutic and pathophysiological implications of this finding, a confirmatory study was undertaken in the Department of Neuro-otology at The Royal National Throat, Nose and Ear Hospital.

Screening of 112 consecutive new referrals revealed 32 patients with biochemical abnormalities compatible with vitamin D deficiency. Of these, 26 agreed to serum vitamin D assay and normal values were obtained in all of these cases. This study does not support the claim that vitamin D deficiency is a cause of hearing-loss.

Intravenous lidocaine is known to have an effect on the auditory system in that it is useful for suppressing tinnitus, albeit temporarily. We have used intravenously administered lidocaine as one of the treatment modalities for refractory, disturbing, tinnitus. Its effects on the vestibulo-ocular system were determined by elec-tronystagmography performed before and immediately after injecting lidocaine: smooth pendular stimulus tracking was unaffected; spontaneous and positional nystagmus tended to be suppressed; directional preponderance was reduced or reversed; and the difference between the nystagmus responses in the two directions during the pendular rotation chair test was also reduced or reversed. These changes in the caloric and rotation tests were statistically significant. Lidocaine also appeared to have altered the balance between the two sides in the vestibulo-spinal system as indicated by the results of the stepping test during craniocorpography. The results lend support to the hypothesis that intravenous lidocaine acts at the level of the central nervous system rather than at the periphery.

Atresia of the posterior nasal choanae is an unusual congenital condition. The embryological explanation is uncertain, that felt to be the most probable being presented here. Bilateral choanal atresia tends to be associated with neonatal airways obstruction and steps to be taken in its diagnosis and management are outlined. The definitive treatment of the condition is surgical excision, by either a trans-nasal or a trans-palatal approach. The conclusions arrived at as to the most effective method of management of these cases from a personal series of fourteen cases are detailed. A preference for the trans-nasal surgical approach is indicated and surgical details for this method are given, some aspects of which have not been previously reported.

Alter a bnet review ot the history or laryngeal photography, a simple and inexpensive method as used at the ENT Clinic of Ljubljana is described.

The equipment consists of a standard 35 mm Olympus OM-1 camera attached to the Olympus OME-J operating microscope and an Olympus T-32 flash unit connected via a large bore flexible light cable to a specially designed laryngoscope.

With the equipment described excellent photographs can be obtained even in inexperienced hands without interference with endoscopic procedures.

In children, acute epiglottitis is rapidly fatal due to airway obstruction by swollen supraglottic structures, but the oedema is short-lived. Therefore, in many centres short-term endotracheal intubation has replaced tracheostomy as the method of choice for relieving the obstruction.

We have tried both methods in 15 children over a period of three years under conditions of limited material and human resources. Tracheostomy was found to be safer. It was concluded that it is better to have a live healthy child with a small scar in the neck than a dead child without a scar.

There are a number of patients with unresectable recurrent carcinoma of the head and neck who continue to lead a relatively functional life despite advanced local disease. For these patients bleeding from tumor represents a devastating complication that can abruptly terminate the course of an otherwise chronic disease, albeit a uniformly fatal one. The technique we describe renders a relatively safe and effective treatment that seems to control this problem.

We report on our experience with three patients whose tumor bleeding was controlled by permanent intra-arterial embolization with Ivalon, a polyvinyl alcohol-based foam. The technique, indications, and complications are discussed.

Twenty-three cases of malignant tongue tumours in patients aged 15 to 30 are reported. Treatment and prognosis in the 18 for which follow-up information is available are discussed. The disease appears to be very similar to that in older subjects except for a greater incidence of neck node metastases. Close follow-up after primary treatment is essential since there is a high possibility of recurrent disease but which may respond well to salvage surgery if identified early. A greater awareness of the occurrence of tongue cancer in young adults is also necessary.