The purpose of this paper is to show that satisfactory results following mastoidectomy can be obtained for the problem of chronic serous otitis. The success of the simple mastoid operation or mastoidectomy with facial recess approach and the subsequent increased aeration of the mastoidantral-attic-middle-ear complex is to be suggested when the repeated use of myringotomy tubes alone is not the answer to chronic serous otitis. It is chronic negative pressure due to eustachian tube dysfunction that leads to irreversible mastoid disease.

Seven cases of mastoidectomy for chronic serous otitis media are presented. All cases had adequate conservative medical and surgical treatment over a period of years for chronic serous otitis before mastoidectomy was considered. The clinical history, as well as lateral mastoid X-ray, was used in diagnosing irreversible mastoid disease.

Laryngeal tuberculosis is now an uncommon disease in the United Kingdom. A series of ten cases is reported. In contrast to the pre-chemotherapy era, when the disease was associated with advanced cavitated pulmonary tuberculosis and was highly infectious, it now presents in a manner similar to laryngeal carcinoma except that painful dysphagia is a prominent symptom. All such patients should have a chest X-ray carried out as part of their initial investigation. Sputum is almost always positive for tubercle bacilli on direct films. Direct laryngoscopy and biopsy are necessary if a carcinoma is suspected.

The change of pattern of the disease may be due to the fact that the larynx now usually becomes involved by haematogenous spread rather than by direct spread along the airways. Laryngeal tuberculosis is now no more infectious than pulmonary tuberculosis, and responds well to antituberculous chemotherapy. Symptoms resolve completely within three weeks if corticosteroids are given in combination.