Disease of the apex of the petrous temporal bone, while rarely encountered, can present a unique challenge to the otologist. Lesions tend to be advanced at presentation, as massive bony erosion can remain asymptomatic. When symptoms occur, they reflect involvement of the neurovascular contents of the temporal bone. The earliest clinical features, such as headache, facial numbness and middle-ear effusion, do not immediately suggest the site or gravity of the underlying pathology. Anterior extension of disease may produce ophthalmoplegia and diplopia whilst posterior spread involves the lower cranial nerves, within the internal auditory canal, jugular foramen and hypoglossal canal.

A staging system is suggested for carcinomas of the external and middle ear, based on a personal series of 47 patients. Statistical analysis showed that the proposed system was a valid method of identifying significant predictor factors. Other significant predictors of survival were histology, lymph node metastases, and the patients' general condition. Stage-for-stage there was no significant difference in survival between tumours of the external and middle ear.

Fifty-seven patients who had sustained nasal fractures during childhood were divided into three groups, according to the age at which the fracture had taken place. These three groups were based on the normal periods of development of the nose. They were compared with regard to possible sequelae after fracture. The results are discussed and an example from each group is shown.

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.

Conventional histological studies of stapes footplates from patients with osteogenesis imperfecta revealed, in nine out of 15 stapes examined, an otospongiotic-like lesion. Although the morphology of the stapedial lesion was comparable to the early otosclerotic focus, a greater structural disorganization and larger resorption spaces in osteogenesis imperfecta distinguished the two conditions. The histopathology of the stapes was related to the morphology of cortical and trabecular bone from the iliac crest. Various degrees of immature, osteogenic bony tissue were found in the iliac crest, showing no resemblance to the otospongiotic-like focus in the footplate. Even though the histologic appearance of the stapes footplates differed from the findings in peripheral bone, the present study indicates that the stapedial lesion in osteogenesis imperfecta is most likely a manifestation of the generalized bone and connective tissue disorder. The study further supports the view that osteogenesis imperfecta and otosclerosis are of different aetiology.

A totally deaf with a multiple-channel cochler prosthesis obtained open-set speech discrimation using the telephone. CID Everyday Sentences were presented by telephone to the patient. Who repeated an average of 21 percent when a repeat of the sentences was permitted. This result is consistent with the patient's reports of telephone usage.

Otoconial material was obtained from a number of vertebrates to determine the CaC03 polymorph present. Otoconia and otoliths from bony fish, amphibians, and reptiles are primarily aragonitic; those from birds and mammals are calcitic. This paper summarizes data from all other investigators as well as presenting new data, particularly pertaining to reptiles. The significance, if any, of the relationship between taxonomic group and carbonate polymorph remains an intriguing question.

Abstract A series of myringoplasties is presented and those cases that did not heal perfect are discussed.

In order to evaluate whether some changes in the technique could further improve the results, another series incorporating these changes was operated after and the results are presented. Differences in healing and post-operative hearing between the two groups of patients are evaluated.