At the present time, viral laryngotracheobronchitis. (LTB), and bacterial epiglottitis account for the majority of cases of acute infectious upper airway obstruction in children. This airway obstruction may become life-threatening and require relief either by tracheotomy or by nasotracheal intubation. Recently the trend has been away from tracheotomy and towards intubation. Three cases are reported in this paper, in which intubation by experienced anaesthetists proved impossible, and a life-saving tracheotomy was immediately performed by the otolaryngologist in attondance.

It is recommended that an experienced otolaryngologist should always be present at the time of intubation, should it prove impossible, and the child require emergency tracheotomy to secure the airway.

The drooling that accompanies motor neurone disorders adds to the burden of an individual already severely handicapped socially. Control of this problem can be achieved by a number of measures, such as the surgical repositioning of the salivary gland ducts and by use of medical or surgical means of reducing salivary production.

Nineteen patients aged 5 to 9 years, with excessive drooling as a result of perinatal brain damage, have been treated surgically at Groote Schuur Hospital, Cape Town, by bilateral tympanic neurectomies, unilateral chorda tympani nerve section and contralateral submandibular gland excision. In all 19, salivary flow was reduced and the drooling problem significantly improved. No post-operative complications occurred.

Mucocoeles of the maxillary antrum extensie enough to cause local bone destruction appear to be extremely rare. Such a case is reported with the appropriate pathological and radiological findings. Perusal of the literature suggests that this condition, unlike mucocoeles arising in other sinuses, may closely mimic a carcinoma and all authors stress the necessity for Caldwell-Luc surgery to be certain of the diagnosis. Som and Shugar (1980) describe features visible on CT scanning which may help to differentiate between mucocoeles, pyocoeles and carcinomata. In spite of the relatively high incidence of cysts of the antrum, it is thought unlikely that mucocoeles in this location would arise from such a cyst; indeed it is likely that all mucocoeles arise from blockage of the outflow tract of the appropriate sinus. There is a high incidence of maxillary sinus mucocoele in Japan following Caldwell-Luc surgery (Hasegawa et al., 1979). Noyek and Zizmor (1976) suggest that compartmentalization of the autrum after operation may leave islands of mucosa without drainage; such a collection my give rise to a mucocoele.

The success rate of eighth nerve section in abolishing tinnitus is disappointing and the results generally unpredictable. A comparison of the effects of a bolus intravenous injection of lidocaine with the effects of nerve section is reported: it presents some evidence that the response to lidocaine may be of value in selecting patients for nerve section, and further it may shed some light on the site of action of lidocaine in suppressing tinnitus.

The design and use of the levator scapulae flap is reviewed. Particular attention is paid to the blood flow. A description is given of how this flap may be employed to repair smaller defects of the mouth and pharynx. It is used in association with split skin. The use of such a technique is compared to musculo-cutaneous flaps, with particular reference to the skin blood flow.

In a number of Danish ENT departments, X-ray examination of the paranasal sinuses has been a routine procedure in cases of servere epistaxis of uncertain genesis two to four weeks after its treatment has been completed. The object has been to rule out cancer of the nose and/or paranasal sinsues. In the present study, the value of this procedure was assessed.

Involvement of the temporal bone by eosinophilic granuloma is rare. Four cases are presented here and the pertinant literature is reviewed.

This disease must be kept in mind by the otolaryngologist because of the diagnostic and therapeutic problems that may arise.

Direct injection of methyl-prednisolone sodium succinate is suggested as a treatment of eosinophilic granuloma in the temporal bone.

Abstract In microsurgery of the middle ear using argon laser, heat is produced on the sensorineural structures adjacent to the irradiated bones.

Thermal gradients following laser applications have been measured by means of special thermocouples.

The footplate was perforated by a 50 msec. ray applied both at 380 m Watt and at 460 m Watt. The maximum temperature increase registered in the labyrinthine spaces was respectively 2oc. and 3.5oC.

Coagulation of the promontory mucosa was performed using 100 msec. impulses at 200 m Watt. At the end of a series of 12 applications the temperature increase at the level of the basal coil was 1.4oc.

From the above results the authors conclude the no damage is induced during laser microsurgery and that, considering the power and time values relative to impulses, the use of laser in routine clinical practice should be relatively safe.

In the preceeding report (Jackson, 1985) the author produced evidence which brought into question the widely held view that, in abolishing tinnitus, lidocaine was acting ‘centrally’. This present investigation is another approach to attempt to narrow the site of action of lidocaine in abolishing tinnitus.

During a four-year period, patients suffering from strictly unilateral tinnitus which was referred to, and therefore apparently arising from, an ipsilateral ‘dead’ ear, underwent electrocochleography. Additionally, the subjective effect on the tinnitus of a bolus injection of lidocaine was recorded. Nine patients were available for this study, which appears to show a correlation of the results of the elec-trocochleogram and the effects of the lidocaine injection, although the numbers are small.

An accurate, reliable, inexpensive and safe method for the examiniation of the upper aero-digestive tract is described. Its efficacy is evaluated retrospectively on 250 patients over an 18-month period.