The CO2 laser is being used in several otolaryngology departments around the world. Clinical experience has shown that it is a unique surgical tool in the management of benign and in some malignant lesions of the larynx. Until now, little has been written about its indications in patients with carcinomas of the larynx. The purpose of this paper is to present our experience with 58 patients with various premalignant and malignant lesions of the larynx in which the CO2 laser was employed as a curative or palliative debulking procedure.

Singer and Blom's endoscopic technique, using a single valved silicone prosthesis, constituted a dramatic advance in speech rehabilitation following total laryngectomy. Since 1980, we have developed a silicone biflanged prosthesis that overcomes some of the inconveniences of previous prostheses. Insertion via the mouth and the oesophagus, or as a primary procedure during total laryngectomy is easily done with the use of specially developed instruments. The success rate in 36 patients in which the voice button was inserted at the time of total laryngectomy was 86.2%.

Six cases of pathologically confirmed cochleovestibular lesions due to typhoid fever are presented- The lesions occurred between the second and third weeks of the disease (5 of 6 cases), in the left ear more commonly than in the right (4 of 6 cases), and in females more often than in males (5 of 6 cases). Some of the lesions were reversible. Factors believed to be significant for development of these lesions include host susceptibility, endotoxins, arteritis, and ischemia.

A technique is introduced for vocal cord mobilization in which a tunnel is made through the inner perichondrium of the thyroid car tilage and a medical grade silicone is placed from the upper part of the thyroid cartilage and pulled out over the cricothyroid membrane. This technique was performed on six dogs, and results were compared to those of a modified laryngoplasty performed on another six dogs. The technique was refined on 20 cadavers and finally performed on five adult patients with more than I year of vocal cord paralysis. Results of this technique suggest that it constitutes a good alternative to Teflon injection; morbidity was minimal.KEY WORDS -Silastic implant, vocal cord paralysis.

\s=b\The transseptal approach is the most logical and adequate technique to reach the sella turcica and adjacent structures.