Tympanograms were done on 120 patients with adenoid hyperplasia, chronic sinusitis and chronic tonsillitis to measure the middle-ear pressure as a parameter to eustachian tube function. The results were compared with those obtained in 50 normal subjects. The statistical significance of the mean values of middle-ear pressure is very highly significant in patients with adenoid hyperplasia, significant in chronic sinusitis group and insignificant in patients with chronic tonsillitis, as compared to the normal control group. Hence, eustachian tube dysfunction is maximum in patients with obstructing adenoids, less in chronic sinusitis and least in chronic tonsillitis.

A double-blind placebo controlled trial of Mucodyne (carbocisteine, Berk Pharmaceuticals), Actifed (triprolidine HCI and pseudoephedrine HCI, Wellcome) and combined Mucodyne and Actifed in the treatment of middle-ear effusions is reported. The trial was undertaken to assess whether either preparation, alone or in Combination, would reduce the number of children requiring surgical treatment for this condition. No statistical difference between the various groups in avoiding surgical treatment with Mucodyne was associated with a significantly greater number of ears restored to a normal appearance and middle ear function as measured by tympanometry. All patients relapsing after surgery belonged to the groups receiving placebo, Actifed or the combination of Mucodyne and Actifed prior to the operation.

An unusual case history of a patient with an acoustic neurinoma is reported. The patient had a two-year history of unilateral sensori-neural hearing impairment, normal radiological appearance of the internal acoustic meatus at tomography and on CT a grossly calcified tumour in the cerebello-pontine angle, indicating pathology other than an neurinoma. Vertebral angiography was normal, and at surgery a grossly calcified tumour was found, while microscopy revealed a typical neurinoma pattern. The tumour had to be removed in two stages, both via the translabyrinthine approach, with a satisfactory post-operative condition, including near-normal facial function. It is concluded that dense calcifications in tumours in the cerebello-pontine angle do not necessarily exclude a neurinoma, and vertebral angiography is therefore not indicated routinely. However, such findings do predict difficulties at surgery.

This case report illustrates an unusual hazard of underwater sports: vagal neuropathology secondary to early poliomyelitis which resulted in residual palato-pharyngeal paresis. Gag and swallowing reflexes appeared to function adequately but in fact were not normal. When stressed, during water aspiration, they were inadequate, resulting in great risk to the underwater enthusiast. A history of early viral myelitis must be considered as a potential hazard in underwater sports.