Total en bloc removal is the ideal surgical treatment for glomus jugulare tumours. Efforts to accomplish this have been made periodically since shortly after this tumour was first identified in the early 1940s. A method of removal using a combined approach through the neck and temporal bone is described here. This method is preceded by pre-operative irradiation therapy and on occasion by embolization. The early results obtained using this method in 19 patients are reported.

A four-year experience in a Vestibular Clinic led the author to the unconventional opinion that the ENG does not often make a significant contribution in the routine evaluation of patients with vertigo or dizziness. A good history by the doctor is usually enough to make a diagnosis. Audiometry and office ice calorics are done routinely. More sophisticated tests are done if judged necessary.

Around 10 per cent of the 300 consecutive cases seen at the clinic had no diagnosis. An ENG on these did not prove to be of help in making a diagnosis or getting closer to one.

This paper is an invitation to good clinical and synthetic judgement in days when more and more responsibility is delegated to sophisticated equipment.

Mucocoeles, mucopyocoeles and empyemas of the sphenoid sinus are rare, but potentially dangerous. Their occurrence is accompanied by a multitude of clinical symptoms and signs, which confuse the diagnosis and may lead to its mismanagement. The treatment of this condition is surgical and in its early states essentially simple.

At Groote Schuur Hospital over a 6-year period (1972–1977) 6 patients with mucocoeles, mucopyocoeles or abscesses of the sphenoid sinuses have been seen. Their clinical presentation, radiological findings and surgical treatment are described and discussed. Correctly managed this condition should completely resolve; however, there is a mortality associated with delay or misdiagnosis.