The aim of this study was to investigate the aetiology of acquired atresia and stenosis of the external auditory meatus and to present our results for surgical management. Over an 18-year period (from 1986 to 2004), data were collected prospectively from patient cohorts in Dundee and Edinburgh. Stenosis of the auditory meatus was due to chronic otitis externa in 64 per cent of cases, compared with 37 per cent of cases with acquired atresia; the latter had instead a history of chronic suppurative otitis media in 43 per cent. Surgical treatment of canal stenosis with meatoplasty alone achieved a widely patent ear canal in 80 per cent of cases, with 78 per cent of ears remaining free of discharge. Cases of acquired atresia treated with simple surgical excision of the soft tissue plug experienced a 100 per cent failure rate. The additional use of a split skin graft achieved a patent meatus in 70 per cent of cases, with hearing improvement in 79 per cent. However, the ear canal remained unstable and late recurrence was observed.

Currently, there is no consensus on how outcomes of cholesteatoma surgery are reported. The authors recommend that these should be long-term data (5 yr or longer), using survival analyses for recidivistic rate and cutoff analyses for postoperative otorrhea and hearing outcome.

Duphenix first described gustatory sweating in 1757. The underlying pathogenesis was not appreciated until 1923, when Lucja Frey, a Polish neurologist, observed the phenomenon in a Polish soldier with an infected bullet wound in the parotid gland and suggested that the auriculo-temporal nerve played a role. Lucja Frey was born in Lwów, Poland, in 1889 and began her medical studies in Lwów before moving to Warsaw to work as a neurologist. She amassed a total of 43 publications on various neurological topics over her career. Unfortunately, during the Second World War she was enlisted into the Lwów ghetto, where she worked until her death in 1943. We present the history of Frey's syndrome, particularly the life of Lucja Frey and the syndrome she described.

Implementation of the European Working Time Directive and the Modernising Medical Careers initiative will mean junior surgeons must be trained in fewer hours over a shorter period. For this reason, junior surgeon training opportunities must be optimized. We undertook a departmental audit to identify where opportunities to train senior house officers (SHOs) in theatre were being lost, so that appropriate timetable changes could be made in order to optimize exposure to suitable surgical cases. During the first audit cycle, the SHOs followed their existing timetable and theatre attendance was monitored prospectively over a two-week period. Only 30 per cent of theatre sessions were attended and case participation was only 27 per cent. Simple timetable changes were made to maximize SHO theatre attendance, and a second prospective two-week audit was undertaken. The new rota yielded 46 per cent theatre attendance and 48 per cent case participation.