Spontaneous cerebrospinal otorrhoea is a rare complication of a cholesteatoma. The histological findings in a temporal bone from such a case are reported. The cholesteatoma had eroded deeply through the vestibule into the internal auditory meatus.

Eight hundred and seventy-nine patients with Bell's Palsy were seen over a 10-year period. There was a distinct female preponderance and the peak incidence occurred in the second to fourth decades. There did not appear to be an increased incidence of either hypertension or diabetes but there was a definite increased risk during pregnancy. Half of the patients had an incomplete palsy and they all recovered within a few weeks of onset. Those patients with complete palsy but without evidence of degeneration also all recovered but took longer to do so. If degeneration was evident the chance of recovery was only 50 per cent. Steroids did not appear to influence the outcome of Bell's Palsy.

Topical nasal phenylpropanolamine in a 2.5 per cent solution (PPA) was used in an evaluation of the possible development of tachyphylaxis and of possible effects on the mucociliary system after one week of treatment in healthy humans. The tendency of PPA to produce tachyphylaxis was evaluated by rhi-nomanometrie measurements of nasal airway resistance after repeated dose-response provocations. The mucociliary transport time was tested with the saccharine-dye test. No reduced dose-response effect or change in mucociliary transport time was found with PPA, thus indicating that one week of treatment does not contribute to such adverse effects.

Closure of the nostril in atrophic rhinitis is a simple operation. Opening the obturated nose by excising the obturator membrane very often causes stenosis. A new and effective method for opening the nostrils, by meant of flaps, is suggested.

Computed tomography is replacing contrast radiography as the method of choice in evaluating congenital posterior choanal atresia. Careful preparation of the patient, however, is necessary prior to the examination in order to obtain the maximum of information pre-operatively.

We present patients with inadequate preparation and illustrate their misleading scans. The proper method of examination is discussed, with a review of the literature; it is essential to remove nasal secretions by suction and instil vasoconstrictor nose drops, shortly before scanning.

A head and neck oncology service serving the Islington and Haringey District was organized in 1985. It is based at the Whittington and Royal Northern Hospitals and is conducted in conjunction with the combined clinic of the Head and Neck Oncology Group at the Royal Ear Hospital (University College Hospital). This paper presents a surgery of the first year's experience during which 29 new cases of head and neck cancer were seem.

Serum immunoglobulin E levels were estimated in 50 patients with head and neck cancer and in 25 controls. Mean serum IgE value was significantly higher in patients with various sites of cancer in the head and neck region other than carcinoma of the tonsil. The levels increased with advancement in the stage of cancer. There was, however, no difference in mean serum IgE value with respect to the character of the lesion, to the histopathological type of growth or to radiotherapy.

In patients with carcinoma of the tonsil, the mean serum IgE concentration was significantly lowered.

Eleven children with infantile autism or autistic-like conditions were examined with oculomotor tests and with auditory brainstem response audiometry. Measurements of voluntary, horizontal non-predictable saccades showed that the eye motor function was abnormal in six (55 per cent) of the eleven patients. The saccades were hypometric in all six instances and the saccadic velocity was reduced in four instances. The abnormalities observed are consistent with brain dysfunction, in most cases probably indicating ponto-cerebellar involvement. In five instances ABR was found to be abnormal which indicates brainstem dysfunction. Oculomotor dysfunction and/or ABR abnormality was observed in eight (73 per cent) of the patients studied.

Motor nerve conduction studies were carried out on the ipsilateral and contralateral ulnar nerves (arm and forearm segments) in 20 patients presenting with unilateral acute Bell's palsy. In seven of these cases (35%), there was motor conduction delay in one or more segments of the ulnar nerve. The present study confirms the hypothesis that Bell's palsy has a viral or autoimmune aetiology resulting in a generalized polyneuropathy or mononeuritis multiplex. Paralysis is clinically more manifest in the facial nerve than other motor nerves; this is because of the peculiar anatomical course of the facial nerve inside a bony canal.

Two cases are reported confirming and demonstrating the relationship between spinal puncture or injection and VIIIth nerve function as a result of intracranial pressure changes.

Non-Hodgkin's lymphoma of the larynx is uncommon and when it occurs presents as a non-ulcerating supraglottic mass with a predilection for the ventricle. No case of the lymphoplasmacytic variety occurring in the larynx has been reported in the literature to date. We present such a case with distant leisons in the soft palate and nasal cavity, mimicking nasal polyps.