Three hundred and ten patients were examined by otoscopy. Age, sex, social class and use of cotton buds for-aural toilet were recorded. The incidence of visually occlusive wax plugs in the external auditory canals was not significantly different between users and non-users of cotton buds, either in children or in adults.

Patch testing of ten patients who had been treated with gentamicin-hydrocortisone ear drops for active chronic suppurative otitis media showed evidence of contact sensitivity in five. Positive skin tests correlated with failure to respond to treatment.

This paper presents the results of a pilot study of vaccination in thirteen patients with chronically infected mastoid cavities or central perforations of the tympanic membrane. In each patient Pseudomonas aeruginosa was repeatedly cultured from the ear and a long list of medical and surgical treatments had been tried, without success, to control the infection. The clinical, bacteriological and immunological responses were monitored over a six-month period.

The results are extremely encouraging. Eight patients' ears became dry for the first time in many years. However, three months after vaccination three ears had become reinfected.

All of the patients except one had a good immunological response to vaccination, with many-fold increases in the total serum immunoglobulin G, A and M levels.

There is much controversial evidence that children gain weight to a significant extent following tonsillectomy, usually associated with a general improvement in health. One hundred and nine consecutive children undergoing tonsillectomy in Dundee for recurrent tonsillitis had their weights recorded pre-operatively, and twelve months after surgery were re-weighed and a symptom chart completed. The results showed the patients were generally not underweight before surgery as their median weight was on the 55th. percentile. Most parents reported an improvement in their child's appetite with a reduction in the number of sore throats after surgery. Their weights following surgery had increased by an average of 20 per cent over what would normally have been expected, but this increase in weight was not confined to underweight children, but to the entire group.

In this retrospective study of parotid tumours. 57 patients with pleomorphic adenomas were treated with superficial parotidectomy and 33 patients with limited excision. The follow-up period has been 4–14 years. When the operation was superficial parotidectomy, recurrences occurred in 8.7 per cent compared to 6 per cent in cases of limited excision. Side-effects such as permanent weakness of the facial nerve or postoperative gustatory sweating were also more common when superficial parotidectomy was performed. The post-operative results observed suggest that limited excision under magnification is more favourable than superficial parotidectomy in the treatment of pleomorphic adenomas.

Three cases of embryonal rhabdomyosarcoma in the middle ear and mastoid in children are presented. Diagnosis was confirmed by histopathology. A multidisciplinary approach employing surgery, chemotherapy and radiation therapy is the method of choice in the management of this rare and highly lethal condition.

An extensive lateral sinus thrombosis secondary to silent otitis media, in a patient with a nephrotic syndrome, is presented. The thrombotic process progressed asymptomatically until the occlusion of the superior vena cava. Removal of the intractable pathology within the mastoid and administration of appropriate antibiotic therapy, prevented the further propagation of the life-threatening condition.

The relative efficacy of Cocaine and Lignocaine as local anaesthetic agents in the nose were compared. Twenty-five patients undergoing bilateral intra-nasal antroscopy under local anaesthetic were used as their own controls when one nasal cavity was anaesthetised with Cocaine and the other with Lignocaine. On 56 per cent of occasions the patients experienced no difference in the level of discomfort. However, on 36 per cent of occasions Cocaine was noted to give better subjective anaesthesia as compared with 8 per cent of occasions when Lignocaine was superior.