Brain stem auditory evoked potentials (BAEP) and the blink reflex (BR) were recorded from 50 patients with a wide spectrum of multiple sclerosis, to determine whether the combination of the two tests of brain stem function would yield a higher rate of abnormality than each test performed alone. Sixty-four per cent of patients had a BAEP abnormality and fifty-two per cent had an abnormal BR, but when the results were combined, seventy-six per cent were abnormal. The blink reflex was abnormal in all patients with symptoms suggestive of trigemino-facial pathology.

The beneficial effect of intravenous corticosteroids in preventing traumatic laryngeal edema is controversial. Between 1968 and 1971, a controlled clinical study was conducted, at the American University of Beirut Medical Center, of 70 children who underwent bronchoscopy for removal of foreign bodies from the tracheobronchial tree.

The patients were divided into two randomized groups; one group was given intravenous dexamethasone while the second was kept as a control. The length of hospitalization and the development of complications attributable to tracheobronchial edema were compared. Intravenous corticosteroids do not seem to reduce the incidence of post-bronchoscopy laryngeal edema.

Difficult intubations are more common in otolaryngological practice than any other branch of medicine or surgery. The majority of these are predictable. It is the unexpected intubational failure, usually in a patient undergoing treatment for an unrelated problem, that results in tragedy. In this paper the indications for fibre optic guided intubation are discussed, and the technique described and illustrated in a case of pharyngeal obstruction secondary to an epiglottic cyst. It is suggested that our expertise to operate within the upper airway should be exploited to the advantage of our patients, and of our anaesthetic and surgical colleagues.

A 36-year-old male with a primary chondroid is presented. This tumour arose from the base of the temporal bone and extended to the mastoid cavity. It involved the facial nerve and was adherent to the internal jugular vein and internal carotid artery. The tumour was excised and the patient has been carefully followed up for 10 years. He has shown no evidence of local recurrence, intracranial extension of the residual tumour and distant metastasis.

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.

With the introduction of the flexible fibreoptic nasopharyngo-laryngoscope, we have a sophisticated instrument for examination of the nasopharynx and larynx. It is also useful for obtaining biopsies from the nasopharynx and has many advantages over other methods. The most important is that it is possible to take biopsies from selected sites under direct visualization and the biopsy results are therefore more reliable.

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.

The clinical aspects of mycobacterial infection of the head and neck are considered as presenting in patients at a cancer hospital over the last 15 years. Some difficulties in diagonsis with respect to the evalution of tuberculosis in this region are discussed.

A total of 32 patients with evidence of infection were identified. Twenty-six of these with cervical lymphadenopathy are considered as a group; their clinical features and diagonsis are summarized and a note made of the recent change in the macroscopic quality of the notes removed.

Six cases are given particular attention; two with laryngeal, two with nasal or adenodial infection and two with atypical mycobacterial infection diagnosed on clinical grounds.

Total lactate dehydrogenase (LDH) activity and isoenzyme pattern were studied in tumore tissue from eight patients with maxillary adenocarcinoma, chronic inflammatory mucosa from 12 patients, normal maxillary mucosa from 12 patients, and an experimental lung adenocarcinoma and normal lung tissue from 12 mice.

An increase in the total LDH activity and cathodic shift in LDH isoenzyme pattern was found in human maxillary adenocarcinoma as compared to normal and inflammatory mucosa. The inflammatory mucosa showed an increase in the total LDH activity and a normal isoenzyme pattern. The LDH alterations in the total LDH activity and a normal isoenzyme pattern. The LDH alterations in the experimental lung adenocarcinoma in mice were similar to those in the human tumours but they were much more marked.