The problem of measuring the nasal airway is discussed, and the previous literature has been reviewed. A simple method of measuring the airway and the degree of nasal obstruction has been proposed.

This report has provided a brief survey of the Tinnitus Clinic population as it appeared near the end of 1981, when 1806 patients had been seen. That number is probably sufficient to provide satisfactory statistical reliability for the observations cited here. It should be mentioned that the Tinnitus Clinic has continued to accumulate cases, at the approximate rate of 30 per month, and at this writing the total number of patients seen to date is over 2300.

The data obtained from the first 1806 patients were collected under conditions that were not as homogeneous as those prevailing now, in that standardized testing equipment was not available until January 1979, and testing techniques were continuing to be revised even after that time. In addition a major revision of the patient questionnaires was undertaken late in 1981, with the result that much more detailed information is being obtained than was formerly possible using the old questionnaire format. Thus, we can anticipate that the next such survey of the Tinnitus Clinic population will offer considerably expanded and more detailed types of observations than those presented here.

Fifty-six individuals with acromegaly referred for pituitary surgery were studied to determine any relationship between acromegaly and sensorineural or conductive hearing loss. Compared to a matched population control sample, no significant difference between the acromegalics and controls has been found, either for air conduction or for bone conduction. The differences between these findings and those published previously are discussed, and reasons proposed to explain the discrepancies.

Bilateral stapedectomy was performed in 122 cases of bilateral otosclerosis at Ulleval Hospital between 1960 and 1978. Ninety-six patients (192 ears), or 79 per cent, were re-examined in 1980. The long-term results showed that the air/bone gap was closed to within 10 db. in 142 ears (74 per cent). Twenty-four patients (25 per cent) used a hearing aid at the time of the examination, mainly because of presbyacusis.

Deafness or serious sensori-neural loss ascribed to the operation was found in 21 ears (11 per cent). Immediate deafness occurred in three ears (1.5 per cent), and in seven ears (3.7 percent) the patient became deaf later. Eleven ears (5.8 per cent) had marked sensori-neural losses, but with some speech comprehension. None of the patients had bilateral deafness, but one patient was deaf in one ear, with a sensori-neural loss of 80 db. in the other.

Eleven patients (13 ears) who had undergone previous stapediolysis or crurotomy, were treated as a separate group, and their results were compared with those obtained in the other patients.

We have also tried to find out if there is any difference between the long-term results of surgery in the first and in the second ear.

The previous use of ventilation tubes has been investigated retrospectively in a series of children whose ears had been operated on. Within a six-year period, 49 ears had a cholesteatoma documented, and in 14 of these a tube had been used. During the same period, 64 ears were operated on for chronic otitis media without cholesteatoma, and of these only three ears had been treated with a tube. This difference is statistically significant (p = 0.0004). A final conclusion is not possible from this information and more research is needed, but the study indicates the importance of a long-term follow-up of children who have been treated with ventilation tubes.

Taking cognizance of the embryology and newer diagnostic techniques, the trans-palatal route is strongly recommended as the optimal surgical procedure for the management of choanal atresia. It should be performed as soon as general anesthesia can be safely administered. In selected instances, but particularly when a patient is at increased surgical risk, necessitating surgical brevity, the endonasal puncture technique should be considered as the initial procedure. Parents must be appraised of the potential for subsequent growth deficiencies, mental retardation, and crossbite.

The relationship of tinnitus to pain is examined and a theoretical case made out for the possible use of acupuncture in the treatment of tinnitus. A double-blind cross-over controlled trial is described. The use of Visual Analogue Scales (V.A.S.) is discussed in this context. 35 per cent of patients described some benefit from the active treatment only, although we were unable to demonstrate this objectively. Statistical analysis of the group as a whole revealed no significant differences between placebo and active acupuncture treatment.

An open radical mastoid cavity presents a handicap to the patient If elimination of the cavity appears desirable, one should use an operative technique which does not incur the risk of a cholesteatoma redeveloping. In our experience obliteration of the cavity with non-resorbable methacrylate Sulfix-6 is the best way to achieve this. The arguments in favour of this view are presented and the operative technique is described.