Otosporin and Gentisone HC ear drops were inserted twice daily for 3 weeks into the external auditory meatuses of guinea pigs. An intraperitoneal injection of vincristine (1 mg/kg.) was given to each animal three hours before it was killed. Temporal bones and attached external auditory meatuses were dissected, tissues were fixed in 10 per cent buffered formalin, decalcified in EDTA, and embedded in JB4 plastic for sectioning at 4 μm. The proliferative activity in the epidermis of the bony meatus and in the lateral surface of the tympanic membrane was obtained by deriving the mitotic indices. After both types of ear drops there was a statistically significant reduction in mitotic indices, the values being about half the control values. The proliferative activity in the tympanic membrane was too low to permit statistical analysis, but no differences were apparent between the groups. The thicknesses of the epidermis and dermis of the bony canal, and of the tympanic membrane, were measured using a Kontron MOP-AM03 analyser. Although the dermis was thinner as a result of the administration of ear drops, both the epidermis of the bony meatus and that of the tympanic membrane were thicker, all these changes being statistically significant.

The ultrastructure of the normal human endolymphatic sac (ES) has been observed by transmission electron microscopy (TEM). The role of the epithelium, the various regions of the subepithelial space and the general anatomy of the ES in pressure regulation were morphologically studied to generate testable hypotheses of human ES function. Light microscopic (LM) and TEM evidence of pressure regulatory mechanisms by endolymph resorption, mechanical factors, and secretory activity are presented. These mechanisms may be useful in designing experimental studies of the ES, and in interpretation of retrospective LM and TEM studies of patients with Meniere's disease.

In the newer surgical procedures for fistula speech, finger occlusion of the tracheostoma is mandatory for speech production. This can be embarrassing as it draws attention to the patient's stoma. Finger occlusion is unhygienic and at times inconvenient. A new tracheostoma valve has been designed to eliminate the need for finger occlusion for speech. It has been evaluated clinically in nine laryngectomees, all of whom retained a good objective quality of speech similar to that obtained by finger occlusion. Vocal efficiency measurements with the valve are very encouraging. The valve is simple to use, of universal size, self-retaining, does not need any skin cleansing and obviates the need for skin adhesives to hold the valve in place.

Near-total laryngectomy with myo-mucosal valved neoglottis is the most recent of the various surgical procedures for speech rehabilitation. The site and mechanism of phonatory function of the neoglottis has been investigated in eight patients by means of electrolaryngography. Results demonstrate substantial similarity in the nature of function of the neoglottis when compared with the normal human glottis.

Serum aliesterase levels have been estimated in 38 patients with head and neck cancer. The mean value was significantly lower than in controls. The decrease in activity was greater in patients with ulcerative growths and it progressed with advancement in the stage of cancer.

With radiotherapy, a progressive and significant increase in serum aliesterase activity was observed. In patients with non-malignant growths the activity was comparable with that in controls.

Dissection of lymphatic nodes in the neck—whether radical or partial, functional or prophylactic—forms an integral part of the surgical management of cancer of the head and neck. Accurate orientation and fixation of the surgical specimen is a prerequisite for correct histopathological study of the extent of the disease and for a complete clinicopathological interpretation, which is of significant therapeutic and prognostic importance.

A laryngocele is an air-filled dilatation of the saccule of the larynx. An in fected laryngocele is called a laryngopyocele. Our experience with two cases of laryngopyoceles are presented. Only 29 cases of laryngopyoceles have so far been reported in the literature (Illum and Nehen, 1980).

Case one had a right-sided combined laryngopyocele and case two had a right-sided combined laryngopyocele and a left-sided combined laryngocele.

Both our cases had their lesions excised via an external approach, as described by Yarington and Frazer (1966), with case two having a bilateral excision.

Abstract A laryngectomized patient who developed massive subcutaneous emphysema, pneumothorax, pneumomediastinum, and esophageal fistual with a retroesophageal collection following the creation of a tracheo-esophageal fistuls for alaryngeal voice restoration is presented, together with its management. A review of the literature is made, and possible causes of the three complications are discussed.