Fifty children aged between five and eight years of age who have had proven otitis media with effusion have been retrospectively assessed. Twenty-five children who had attended the Casualty Department with head injuries, who have had X-radiography of their skulls as part of their investigation, acted as controls. All the children in this group were selected because they had no otological history.

The 50 Children comprising the retrospective survey were split into two groups: Group 1, with recurrent secretory otitis media requiring surgical intervention on more than three occasions; Group 2, comprising 25 children who had had up to three surgical interventions.

All the children had PA X-radiography of their skulls in order to demonstrate the bony nasal septum. In Group 1, a septal deformity was found to be sited at the middle third of the bony septum at the vomero-ethmoid suture. In Group 2, the deformity was found to involve the whole of the middle third of the bony septum, plus portions of the upper and lower thirds of the bony septum.

In the control group, in whom there was no history of otological disease, there was no deformity sited at the middle third of the bony septum.

Dematoplasty for the treatment of epistaxis caused by HHT has become well established. A modification of Saunders's (1960) original dermatoplastic technique is described, which permits the nasolabial incision to be avoided.

This retrospective study of the long-term effect on epistaxis caused by HHT demonstrates, in contrast to those with a short period of observation, that epistaxis can be partially controlled by means of dermatoplasty and, further, that it is impossible to eliminate completely the need for blood transfusion.

In two of the patients it was found that newly formed telangiectases had occurred in the transplant 15 and 18 years post-operatively.

The case is described of an eight-year-old Nigerian boy who died from olfactory neuroblastoma which presented with nasal obstruction and epistaxis. Autopsy showed intracranial extension of the tumour into the frontal lobe, and histology revealed undifferentiated neuroblasts, forming rosette in some areas and producing tangled neurofibrils in others. The histogenesis of the tumour and its diagnosis are briefly discussed.