37 patients who had been operated upon for trigger thumb, all below 15 years of age, have been reviewed. 75% of the affected thumbs were on the dominant hand and 25% have bow-stringing of 1-2 mm. without any complaints. All had good results. Unlike other authors, we found that operation done after the third year of age gave full correction of the flexion contracture.

The larynx of old persons has frequently been examined. However, a perusal of the literature reveals that no two physicians agree in their findings as far as the muscles of this organ are concerned. Kofler 1 mentioned slight atrophy of the muscles, without giving further details, and Imhofer 2 found that the lipoid pigment usually situated around the nuclei of the sarcolemma increased in amount in old persons. Segre 3 found simple atrophy of the adductor and the abductor muscles, characterized by an increase of the nuclei of the sarcolemma and an increase in both the collagenous and the elastic fibers. This atrophy was least marked in the interarytenoid and the vocal muscles. In contrast, Imhofer 4 did not observe an increase in elastic fibers. The cricothyroid muscles showed hypertrophy in the cases of Segre,3 which was considered compensatory, because of the atrophy of the adductor muscles. Carnevale Ricci5 described essentially the same conditions as Segre3 except for the lack of compensatory hypertrophy of the cricothyroid muscles and, in addition, observed fatty degeneration of the laryngeal muscles.Because the changes found in the laryngeal muscles are not sufficient to explain the gross changes of the senile larynx and the characteristic

The following case of carcinoma of the nasopharynx presents several features interesting not only to the otolaryngologist but also to the neurologist, the ophthalmologist, the roentgenologist and the pathologist. It is presented because of its value to both the clinician and the pathologist in that an attempt has been made to explain clinical symptoms from a complete study at autopsy.Of further interest was the intracranial extension of the tumor with marked destruction of bone, metastasis to the liver and an apparent implantation of tumor cells by contact from the growth in the nasopharynx to an ulcer on the nasal surface of the soft palate. This ulcer approximated and was irritated by the tumor in the nasopharynx on phonation and swallowing.That malignant tumors of the nasopharynx are not uncommon is evidenced by the abundance of literature on the subject, many authors reporting fairly large series of cases. It was our good fortune to study more minutely the pathologic anatomy of a case which we had observed clinically and in which we were allowed unrestricted material for autopsy. Trotter1 stressed the nasopharynx "a region rich in pathologic interest and subject to the growth of numerous tumours, which are by no means infrequent and are of great diagnostic importance." He directed attention to that class of growth which produces little or no projection into the nasopharynx and is therefore dismissed as having little diagnostic interest and to the tumor which projects into the nasopharynx and gives rise to obvious symptoms. He particularly stressed the importance of recognizing the former and stated that "diagnosis is entirely dependent upon recognition of the symptoms of infiltration of the naso-pharyngeal wall. . . . The strictly anatomical distribution of the symptoms is always a striking feature." He emphasized a triad of symptoms which should focus attention to such lesions of the nasopharynx, viz. :Read at the Sectional Meeting of the

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