A prospective trial of hearing aid provision was undertaken to define factors which might be used to allow hearing aids to be fitted optimally. Patients referred for the provision of a hearing aid were studied prospectively at each of five visits when they were questioned by means of a proforma. Fifty-six patients completed the trial and gave adequate responses for analysis. No audiometric or symptomatic criteria were found to be of use in predicting the final choice of hearing aid combination. It may be that initial sequential monaural aiding leads to a higher uptake of binaural aids in the long term. Patients valued multiple visits to the clinic and sequential trials of monaural aiding, the majority felt that binaural aids should be tried.

The course of the posterior ampullary (singular) nerve has been studied in 30 preserved human temporal bones. In 17 dissections (57%), the nerve was readily accessible in the floor of the round window niche without undue risk to the round window membrane or the ampulla of the posterior semicircular canal. In 5 bones (16%), the nerve was closely related to the round window membrane and could not have been approached without significant risk of damage to the membrane. In 8 (27%), the nerve ran more or less directly medially to the internal auditory meatus without entering the round window niche. The ampulla of the posterior semicircular canal would therefore have been at risk if the nerve were approached surgically.

1991) Clin. Otolaryngol. 16, 305-308 Surgical anatomy of the singular nerveThe course of the posterior ampullary (singular) nerve has been studied in 30 preserved human temporal bones. In 17 dissections (57%), the nerve was readily accessible in the floor of the round window niche without undue risk to the round window membrane or the ampulla of the posterior semicircular canal. In 5 bones (l6%), the nerve was closely related to the round window membrane and could not have been approached without significant risk of damage to the membrane. In 8 (27%0), the nerve ran more or less directly medially to the internal auditory meatus without entering the round window niche. The ampulla of the posterior semicircular canal would therefore have been at risk if the nerve were approached surgically.

Two children aged three and seven years presented to the department of Otolaryngology with total dysphagia following the accidental swallowing of a steel ball bearing and a plastic ball. These rare spherical foreign bodies were removed successfully by oesophagoscopy under general anaesthesia using an innovative method involving a balloon angiographic catheter.