An animal model has been devised to allow trainees in nasal and sinus endoscopy to develop basic instrument handling and psychomotor skills, without risk to patients.The sheep's head obtained from the abattoir was modified slightly to simulate more closely the human situation. The model permits nasendoscopy, foreign body removal, septoplasty, turbinate reduction, frontal and maxillary sinoscopy, antrostomy and an epistaxis exercise. To date the tissues have been used freshly thawed, and must be used on the day of preparation.

A 70-year-old woman with an upper respiratory infection sustained an orbital floor fracture after vigorous nose blowing. The injury was complicated by orbital emphysema and cellulitis. CT scanning confirmed orbital floor fracture and associated orbital soft tissue herniation into the maxillary antrum. A follow-up sinus endoscopy three months later showed a healed periosteum and mucosa, but continued orbital herniation. As the patient's symptoms had largely resolved, repair was averted. Follow-up after nine months showed no recurrence of orbital swelling. The case presented illustrates a rare complication of vigorous nose blowing, coupled with thinning of the sinus walls seen in aging.

A series of surgical simulation exercises has been developed using an animal model to allow trainees to practise basic instrument handling and develop psychomotor skills in bronchoscopy, without risk to patients. A pig model was found to be most suitable. After suitable preparation the model can be used for diagnostic and therapeutic exercises in bronchoscopy, including lavage, biopsy and the removal of various foreign bodies. The model is a safe, inexpensive and convenient means of bronchoscopic training for otolaryngology trainees. For the trained specialist who has to remove bronchial foreign bodies infrequently, the model is a useful way of maintaining skills.

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Using a modified respiratory spirometer, we set out to determine whether the nasal peak flow rate, or a new parameter the naso-oral 1 second index (the ratio between the nasal forced inspiratory '1 second' volume and the oral forced inspiratory '1 second' volume) correlated with anterior rhinomanometry and visual analogue scores. Ten patients undergoing nasal surgery for nasal obstruction were recruited into the study. The naso-oral 1 second index consistently correlated better than the nasal peak flow rate with anterior rhinomanometry. The naso-oral index also correlated better than nasal peak flow with visual analogue scores. Correlation was best demonstrated when assessing the benefit gained by patients from surgery. The naso-oral index is a potentially useful clinical parameter, and correlates acceptably well both with visual analogue scores and anterior rhinomanometry.