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.

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The results of turbinate reduction surgery carried out on 307 patients are reviewed. This is a retrospective study over 16 years. The results of submucosal diathermy with and without outfracture, partial inferior turbinectomy and linear cautery were all equally disappointing in the long term. At 1 month postoperatively the overall success rate, as defined by patient satisfaction, was 82%, but this declined steadily with time to 60% at 3 months, 54% at 1 year and 41 % at 1–16 years. There was no significant difference found in the success rates between methods of turbinate reduction used. These findings are compared with more optimistic reports in the literature and their relevance to current surgical practice is discussed.

A series of 17 parotid glands were obtained by radical parotidectomy. Between 1 and 11 lymph nodes were found in them. Superficial parotidectomy only leaves an average of 1 node in the deep parotid. There is a 1 in 4 chance of there being no nodes left. There were no nodes easily accessible immediately under the deep part of the parotid gland. There seems to be a discrepancy between the number of nodes found in a radical surgical specimen and serial sections of the area. This suggests a significant number may be left in the skin flap. The place of excision of this skin is discussed.

One hundred and three patients with an oral squamous carcinoma were studied in an attempt to determine the clinical factors which affect survival. The 5 yr actuarial survival of the whole group of patients was 55%. Although survival depended on clinical staging, in those patients with no palpable nodes on presentation the tumour size did not affect survival. The most significant factor determining survival was the presence of palpable lymph nodes on presentation. Palpable nodes were more likely in patients with large tumours than those with small tumours. On the basis of these findings a modification of the TNM classification is suggested giving more weight to the presence of cervical nodes than in the present staging system.