The anatomy of the arterial supply of the inferior turbinate was studied by dissection and serial histological sections. The arrangement was found to be constant, with a single main descending branch of the sphenopalatine artery entering its substance from above, 1–1.5 cm from its posterior border. This artery branches as it passes forwards within the turbinate, remaining close to the bone. As these pass anteriorly they give rise to arterial arcades which remain close to or within the bone, with the main artery increasing in diameter. The implications of these findings are discussed in a surgical context.

Results of standard audiometry and tympanometry were compared with the Welch Allyn ‘Audioscope’ and ‘Microtymp’, in the diagnosis of secretory otitis media, in 100 children.Standard pure tone audiometry had a specificity of 92 per cent and sensitivity of 51.6 per cent. The Welch Allyn ‘Audioscope’ a specificity of 84.2 per cent and sensitivity of 57.5 per cent; standard tympanometry a specificity of 71 per cent and sensitivity of 88 per cent; the Welch Allyn ‘Microtymp’ a specificity of 63 per cent and sensitivity of 90 per cent.In view of cost, portability, and speed of testing the Welch Allyn instruments would be particularly suitable for community screening.Pure tone audiometry with a pass threshold of 25 dB, at 2 and 4 kHz is a poor indicator of effusion.

Sinus radiographs have been carried out on 240 new cases of childhood otitis media with effusion (OME). When the films were suggestive of infection, maxillary sinus washouts were carried out as part of the surgical treatment. Abnormal X-rays were obtained in 28 per cent of the study group, but only 16 cases (seven per cent) of sinus infection were confirmed on antral lavage. In those with positive washouts, there was an apparent relationship between the findings in the maxillary sinuses and middle ears of the same side in some of the cases. There was also evidence of improvement of the middle ear disease when the sinus infection was successfully treated. It does not appear that sinus infection is an important cause of OME, though it may be relevant in a small number of cases.

A prospective study of otitis media with effusion (OME) in both adults and children has been carried out. 75 new adult patients were seen during a 4-year period. Of these, 13 had associated diseases which could reasonably be considered to have been a cause of their effusion. Over a 2-year period, 192 new children with OME were seen. There was a significantly higher incidence of previous otalgia and/or aural discharge in the children as compared to the adults (P less than or equal to 0.001). The adults had significantly more serous effusions than the children (P less than or equal to 0.001), but both mucoid and serous effusions occurred in both groups. Similar rates of spontaneous resolution were observed in the 2 groups. Within the adult group, patients with a history of upper respiratory infection at the onset of hearing loss were significantly more likely to have spontaneous resolution of their effusion (P less than or equal to 0.02).

Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Nasal sarcoidosis commonly affects the mucosa of the septum and the inferior turbinates. These patients may present with nasal discharge, crusting, obstruction, epistaxis or anosmia. We present an unusual case of nasal sarcoidosis involving the ethmoid sinus causing recurrent eyelid swelling and discuss its management.