Abstract The auditory and vestibular sense-organs of the rabbit were examined for the presence of substance P(SP) by an immunohistochemical technique using a monoclonal SP-antibody. Between 30 and 40 per cent of the cells of the vestibular ganglia and about 50 per cent of the spiral ganglion cells innervating the extreme basal part of the cochlea showed SP-like immunoreactivity. The neural elements in the vestibular sensory epithelia, notably the calyx-formed nerve terminals of type 1 sensory cells of the maculae, also showed strong SP-like immunoreactivity. The findings suggest the possibility of a modulator or transmitter role for SP in the inner ear function.

Previous studies havd shown erythromycin to penetrate into both the middle-ear effusion and the adenoid tissue in children with Otitis Media with Effusion (OME). The levels obtained were similar to the plasma levels. Cultures in long-standing cases of OME have yielded respiratory pathogens—Haemophilus influenzae, streptococcus pneumoniae and Branhamella catarrhalis—in the nasopharynx in 79 per cent and in the middle-ear effusion in per cent.

In the present investigation a group of children with OME of more than three months' duration were given erythromycin (Abboticin®) in standard dosage for the last 10 days prior to scheduled operation (paracentesis or tympanostomy). Resolution was determined as normalization of the middle ear status, and this led to cancellation of surgery. The rate of resolution—12/26 (45 per cent)—was significantly higher than in a similar group of children not treated with erythromycin—11/72 (15 per cent). There are thus rational reasons for using erythromycin in OME, in many cases as an alternative to tympanostomy.

A postal survey of 100 members of the Association of Head and Neck Oncologists of Great Britain was conducted in the first 6 months of 1983. The sample consisted principally of Otolaryngologists (50 per cent), Radiotherapists (14 per cent), Medical Oncologists (10 per cent), Oral Surgeons (10 per cent) and Plastic Surgeons (10 per cent). More than 80 per cent of those who completed the questionnaire used chemotherapy for Head and Neck cancer (72 per cent used it for palliation, and 64 per cent as part of combined modality therapy). There was great variation in the chemotherapeutic regimens used by the various responders. Furthermore, most responders used more than one regimen. Methotrexate was the agent most frequently used. No specific regimen, either single-agent or multiple-agent, enjoyed universal acceptance, although the combination of Vincristine, Bleomycin and Methotrexate was popular. Chemotherapy was thought by most responders to have a useful but as yet undefined place in the management of Head and Neck cancer. This survey underlines the need for prospective, controlled, clinical trials into the efficacy of cytotoxic chemotherapy for Head and Neck cancer.