Many consider that the compliance of the middle ear as measured from the tympanogram can be helpful in diagnosing otosclerosis. To test this assertion, the compliance in 34 individuals with surgically proven otosclerosis was compared with the compliance in 34 age and sex matched, normal controls, randomly selected from the population. Though the mean compliance was different in the two groups, there was considerable overlap in the range of values which severely limits the practical usefulness of tympanometry.

If the level of compliance is taken at which a false negative diagnosis would be made in 10 per cent of otosclerotic ears, a false positive diagnosis of otosclerosis would be made in 88 per cent of normal ears. If the level of compliance is taken at which a false positive diagnosis of otosclerosis would be made in 10 per cent of normal ears, 72 per cent of ears with otosclerosis would be considered normal.

It is concluded that tympanometry will not help to arrive at a diagnosis of otosclerosis.

The Cologne-Diiren research group has developed a new extracochlear eight-channel electrode system. The first observations on six cases have shown encouraging psychoacoustic results.

The role of the Carbon Dioxide laser in the performance of laryngeal microsurgery is discussed with reference to its advantages over conventional techniques. The need to excise lesions rather than to vaporise them is stressed and additional instrumentation is described.

The entire larynx is usually sacrificed in the process of surgical treatment of T3 glottic carcinoma, trans-glottic carcinoma and pyriform sinus carcinoma, with consequent loss of speech. Most of the uninvolved, cancer-free part of the larynx is discarded for no good reason.

According to the surgical principles of oncology, a tumour should be removed with clear margins, but this does not necessarily mean that the whole organ has to be extirpated. In a recently applied surgical procedure, the small tumour-free part of the larynx is fashioned into an innervated myo-mucosal valved shunt joining trachea and pharynx. This neoglottis allows expiration into the pharynx in speech production but it also contracts during swallowing to avoid aspiration. The first four consecutive cases in which this procedure has been carried out with complete success are presented.

We report a case of a lipoma arising in the middle ear of a 64-year-old woman and extending down the eustachian tube to cause acute airways obstruction. The lipoma arose coinciden-tally after a stapedectomy operation and caused apparent late failure of the operation. A review of the literature revealed no similar cases.