NEUROLEPTANALGESIA is described for its use in the management of otolaryngologic cases undergoing elective surgery. 100 cases have been reviewed extensively. The advantages and possible problems are outlined. It seems to be a highly satisfactory alternative to conventional general anesthetic techniques for most ear, nose and throat procedures and operations, where quiescence rather than anesthesia is required. The absence of direct myocardial depression and a marked decrease in operative and post-operative morbidity constitute the principal advantages.

In two patients with Wegener's granulomatosis, treatment-resistant serous otitis media was followed by unilateral facial nerve palsy. Later both patients developed uraemia due to extracapillary glomerulonephritis. In one of them, who was treated with prednisone and cyclophosphamide, renal function improved, while in the other patient it remained impaired. Both patients suffered lasting hearing impairment in spite of general improvement during the course of the disease. The facial nerve palsy improved slightly in one, while no improvement was seen in the other.

The possibility of Wegener's granulomatosis or other autoimmune collagen diseases should be considered in cases of treatment-resistant serous otitis media. Early diagnosis and treatment can possibly save the patient from the lifethreatening consequences of these diseases.