FOUR cases of bilateral congenital choanal atresia are presented. Three of them (75 per cent) were shown by Electric Response Audiometry (ERA) tests to have, in addition, congenital nerve deafness; and two had other congenital anomalies. Thus, congenital nerve deafness should be considered as a possible congenital anomaly associated with choanal atresia. Early diagnosis and treatment of congenital choanal atresia can prevent death from asphyxia during the neonatal period, but after surgical correction of the atresia the possible existence of additional anomalies has to be determined and treated.

By the use of electric response audiometry we are able to detect sensorineural hearing loss during the neonatal period and can plan the rehabilitation of deaf infants.

Malignant melanoma may metastasize to any anatomic site via the hematogenous route. A patient is described in whom a metastasis developed in the left maxillary antrum and nasal cavity and who received successful palliative surgical and radiotherapeutic treatment.

Metastatic carcinoma involving the paranasal sinuses has been reported most frequently secondary to renal cell tumors, followed by carcinoma of the lung and breast (Jortay, 1971; Robinson, 1973; Friedmann and Osborn, 1965; Bernstein et al., 1966). These tumor deposits are often diagnosed in a setting of diffuse metastatic disease or discovered at post-mortem examination. A patient recently treated at Pondville Hospital had symptomatic metastatic melanoma involving the left maxillary antrum and nasal cavity. Following surgical treat-ment, palliative radiotherapy was successfully delivered on three occasions providing symptomatic relief over the subsequent 17 months prior to the patient's death.

SJÖGREN's syndrome is a presumably autoimmune disease with parthologic findings of lymphocytic infiltration of the involved structures. Although the salivary and lacrimal gl ands are the most commonly involved sites, extragl andular lymphoproliferation also occurs. Upper and lower respiratory tract lymphoproliferation is known, but only one case of Sjögren's disease of the larynx has been previously reported. We present a case of laryngeal involvement in which the gross pathologic appearance is different from that in the earlier case report. The otolaryngologist should consider Sjögren's disease in the differential diagnosis of diffuse laryngeal lesions.