Twenty-five patients with bilateral nasal obstruction due to hypertrophy of the inferior turbinates were entered into a prospective study to compare the efficacy and the associated complications of total inferior turbinectomy and concho-antropexy. We found no significant statistical difference in the efficacy of these procedures in relieving nasal obstruction and discharge (>0.5). Total inferior turbinectomy was associated with more postoperative pain (p<0.05) and with long-term dryness and crusting (p<0.05) which were statistically significant. This is the first trial where concho-antropexy and total inferior turbinectomy are compared.

Two established methods (active posterior and passive anterior rhinomanometry) and 2 new methods (peak nasal inspiratory flow rate and apparent nasal volume) were used in 12 volunteers to assess the patency of the nasal airways under each of 4 conditions (baseline, post-exercise, nasal histamine and nasal cocaine). All methods showed the congestant effect of histamine but the peak nasal inspiratory flow and apparent nasal volume techniques were more sensitive to the 'decongesting' manoeuvres, (exercise and cocaine). Useful objective quantitative data on the patency of the nasal airways and its changes in response to stimuli can be obtained by simple, cheap and readily available techniques. Subjective sensation is a poor guide to the state of patency of the nasal airways.

The results of a retrospective study of the effect and outcome of middle ear ventilation by Goode's tubes are presented. 83 ears from 50 patients were analyzed both as a group and in age-related sub-groups over a mean follow-up period of 1.83 years. The mean period of ventilation by Goode's tubes before removal or extrusion was 18.4 months. The tubes became infected in 70.4% and were spontaneously extruded in 44.9% of patients. Permanent perforation of the tympanic membrane ensued in 47.5% of patients and significantly more often in those aged between 10 and 20 years (P less than 0.002). Patients aged less than 10 years were significantly less likely to develop a retraction of their tympanic membranes after removal of the Goode's tube than those older (P less than 0.02). No significant relationship was found between the development of these complications and the period of ventilation, past experience of otitis media, consistency of effusion, degree of tympanosclerosis or the preoperative presence of tympanic retraction.

This study compares the efficacy of submucosal diathermy and cryotherapy in the treatment of nasal obstruction caused by engorged inferior turbinates. Subjectively they are equally effective but cryotherapy has the advantage that it can be performed under local anaesthetic and does not require hospitalization. Rhinomanometry suggests that cryotherapy causes more destruction of the submucosal vascular plexus than submucosal diathermy. Scanning electron microscopy 6 weeks postoperatively demonstrates that both treatment modalities cause widespread damage to the mucociliary epithelium.