A case of squamous cell carcinoma of the tongue was complicated by post operative hyponatraemia. The criteria for the syndrome of inappropriate secretion of anti diuretic hormone, [ADH] (SIADH) were met but the patient remained hyponatraemic despite adequate treatment. The patient had previously received radical external radiotherapy to the neck and was found to be profoundly hypothyroid. Correction of the hypothyroid state led to clinical and biochemical recovery. The frequency of post-irradiation hypothyroidism and the possible mechanisms of hypothyroid-induced hyponatraemia are discussed

A significant decrease in the pH of saliva has been detected in patients with recurrent aphthous ulcers (RAU). The decreae in pH was more prominent at night than between meals, and some persistent decrease was noticed even after recovery. The total proteins of saliva in RAU were also significantly decreased.

These findings were similar to those observed in patients complaining of petic ulcers, so it is recommended that patients with RAU should be treated with antacids as well as anticholinergic drugs, and that the possibility of concomitant peptic ulceration should also be investigated.

Twenty-six cases of patients presenting with benign laryngeal lesions treated by laser excision were compared with age and sex matched controls treated by conventional surgery. There was no statistically significant difference post-operatively between the groups in analgesic requirement, length of hospital stay, voice quality or laryngoscopic appearance.

The results of sinus aspiration in 100 children were analysed retrospectively. There was no correlation between a positive aspiration and the patients' symptoms, signs or previous radiograph.

Formaldehyde-induced fluorescence and electron microscopy have been used to show the sympathetic innervation of the vocal cord in the guinea pig. The topographical distribution and morphology of the sympathetic fibres and endings are commented upon.

This study compared nasopharyngeal sepsis with under-aeration ear disease. Nasopharyngeal sepsis was assessed by culture taken directly from the surface of removed adenoid tissue. 156 cases were studied; 100 showed varying degrees of middle-ear under-aeration and 56 had no active ear disease or history of it. In addition, an assessment of post-nasal obstruction was made and this too was compared with middle-ear status.

The conclusions suggested that, whilst normal ears can exist in the presence of accepted nasal pathogens, diseased ears are rarely seen in the absence of nasal sepsis. The degree of post-nasal obstruction seemed irrelevant.

The commonest nasopharyngeal pathogen was Haemophilus influenzae and when found alone this had a particularly detrimental affect on middle-ear aeration, causing a significant incidence of mucoid middle-ear effusion in this group.

A prospective study was undertaken of 75 patients complaining of epistaxis who presented to an Accident and Emergency Department.

The patients were placed into four groups according to their presenting features, and various forms of appropriate management applied.

It was found that in the group that had ceased bleeding on presentation, whether or not a bleeding point was visible, there was no benefit obtained by treatment. If the nose was still bleeding on presentation, and the bleeding point was visible, successful management could be obtained by cauterising the bleeding point. This is a treatment that could be carried out by either the General Practitioner or the Accident Department. If the nose was actively bleeding, and the bleeding point could not be seen, then even initially successful treatment by the Accident Department was usually found to be ineffective within forty-eight hours. It is suggested that this group should be referred to an ENT unit on presentation.

Recent research, stimulated by the growing awareness of the sleep apnea syndrome, has shown that nasal breathing plays a major role in the regulation of respiration in sleep. These observations are not new; they confirm century-old clinical findings on the importance of nasal breathing in sleep. The earliest account of the deleterious effects of mouth breathing in sleep was made by Lemnious Levinus towards the end of the sixteenth century. Two hundred years later, Catlin dedicated an entire book to the superiority of nasal breathing over mouth breathing in sleep; and in the late 1800's, Cline, Wells, Griffin and others showed that obstructed nasal breathing causes sleep disorders.

Over the 27-year period from 1954–1981, 51 patients with non-Hodgkin's lymphoma arising in the tonsil were treated at the Regional Radiotherapy Centre, Mount Vernon Hospital. The original biopsy material was reviewed in each case and reclassified using the British National Lymphoma Investigation criteria. Grade 2 non-Hodgkin's lymphoma was reported in 80 per cent of cases. Ninety per cent of patients presented in stages IE or HE and were treated with radical local radiotherapy. A 5-year survival of 51 per cent was achieved and a 5-year relapse-free survival of 35 per cent. Stage IE patients had a statistically significant survival advantage compared to stage HE. Sixty-one per cent of patients relapsed, of whom 74 per cent died from active lymphoma. The abdomen was the most frequent site for relapse with involvement of both nodal and extranodal sites.

Attention is drawn to the problems of surgical resection by partial laryngectomy after full therapeutic dosage of telecobalt irradiation. Material is presented from two treatment centres to indicate trends in surgical treatment and the complications experienced. Results will be given which confirm a reasonable expectation of cure and functional conservation by vertical partial laryngectomy for recurrence of glottic cancer after irradiation. The results of treatment of recurrent supraglottic cancer by horizontal partial laryngectomy gave more cause for concern in terms of complications and survival. In conclusion an attempt is made, based on the quoted experience, to define the position of conservation surgery in two centres for laryngeal cancer in the United Kingdom.

Total glossectomy is the most crippling of all oral cavity resections. Speech problems are unavoidable and post-operative aspiration is often severe. Two patients are presented who have had tongue reconstructions following near-total glossectomies. In each case a quilted, split-skin grafted pectoralis major muscle flap was used. The speech and swallowing results of these two patients are compared with two patients who underwent a hemiglossectomy and total glossectomy respectively without tongue reconstruction. Only if the suprahyoid and extrinsic tongue muscles are preserved can an active oral phase of swallowing and usable speech be regained by tongue reconstruction.