The audiometric configurations of a randomly selected group of 360 patients with clinical Meniere's disease were analysed in conjunction with their clinical manifestations. Although 78.6% of the patients had an abnormal pure-tone audiogram in the opposite ear from that which was initially diagnosed as Meniere's disease, based on the entire clinical picture, the disease was found to be definitely bilateral in 32% of the patients. A peaking audiogram type was found to be most common, occurring in about half of the involved ears. In approximately half of those with bilateral disease the second ear became involved within two years of onset of involvement of the first ear, and in another 27% the second ear became involved after a period of 5 years or more. These observations stress the importance of conservation in managing Meniere's disease, especially when considering surgical intervention for intractable disease, with the hope of retaining or restoring labyrinthine function.

The data on 281 patients who underwent surgical therapy for laryngeal carcinoma from 1976 through 1984 were reviewed, revealing 16 patients who presented with an impending obstruction of the airway that was treated by an "emergency" laryngectomy. A review of the patients in our series did not reveal any serious complications from the procedure and it has allowed effective management of these advanced neoplasms. In addition, 10 patients who developed peristomal recurrences were reviewed. Preoperative factors such as location of lesion, antecedent surgery, and previous radiation therapy were assessed and compared to the patients who underwent "emergency" laryngectomy in an attempt to further define risk factors involved in peristomal recurrence. A strong association with subglottic extension was noted. Also associated in this review was antecedent full-course radiation therapy.

The potential of low morbidity associated with the use of the sternocleidomastoid branch, along with the potential for delivering a vascularized muscle pedicle to the temporal bone region, makes selective use of this procedure a valuable addition to the multiple reconstruction options for the paralyzed face.