Foreign bodies and alkali burns in the trachea and esophagus are potentially fatal. Some camera batteries contain 45% potassium hydroxide electrolyte which can leak and cause liquification necrosis upon tissue contact. This report describes a case of an alkali battery foreign body in the esophagus with a subsequent fatal course which was masked by steroid therapy. A discussion of corrosive burns of the esophagus, their etiology, clinical course and pathology is presented.

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The diagnosis of rhinitis medicamentosa was made in 130 patients seen over a 10 year period from July 1967 to June 1977. There was an incidence of 1% in our otolaryngological practice. Patients had been taking the causal medication for an average of 21.4 months. There were 73 males and 57 females with the peak incidence in young and middle-age adults. The primary offending medications were decongestant nasal sprays in 85 patients, decongestant drops in 33, and a combination of these drugs in 12 patients. The major reasons for self-medication were 1. deviated nasal septum in 40 patients, 2. an acute upper respiratory infection in 33, 3. allergy in 18, 4. miscellaneous causes in 24 and 5. unknown in 15 patients. The initial management in addition to avoidance of the medication consisted of systemic antibiotics, decongestants, antihistamines, and sedatives depending on the severity of the rhinitis and the presence of secondary infection. Later treatment consisted of correction of the deviated septums, allergic management, and supportive care. Eight patients were considered to have complications of the disease by development of chronic ethmoiditis and nasal polyposis. The pharmacologic properties of the causal agents are thoroughly reviewed as they relate to the pathogenesis of this disease. It is felt that the ready commercial availability and limited clinical value of the topical nasal sprays and drops represents a certain risk to all patients using them.

Sudden sensorineural hearing loss is a well recognized phenomenon in otologic practice with both viral and vascular etiologies being supported. However, sudden hearing loss as a complication of non‐otologic surgical procedure is a seldom reported and rare phenomenon. Five cases of unilateral sudden sensorineural hearing loss which are time related and probably causally related to non‐otologic surgery are presented. Two cases underwent open heart surgery and support previous reports of hearing loss secondary to cardiopulmonary bypass procedures. Three noncardiac cases are also reviewed. None of these patients had prior otologic disease which would predispose to a sudden hearing loss, and no intraoperative or postoperative complication was specifically noted as a cause of the hearing loss. The literature is reviewed and attention is drawn to the problem. We wish to encourage further reports and to recommend early identification and treatment in those cases related to cardiopulmonary bypass.

A retrospective study was conducted of 696 patients with squamous cell carcinoma of the head and neck seen over a 10-year period. Special focus was placed on secondary esophageal primaries in this group in an effort to define the role of esophagoscopy in the management of these patients. Second primary esophageal lesions were infrequently encountered (17 of 696, or 2.4% of the patients). Diagnostic accuracy of the esophagogram in a series of patients with index head and neck tumors and in a separate series of patients with index esophageal lesions was found to be high (98 + %). Based upon this study, we do not feel that esophagoscopy is always indicated as part of the initial workup for all head and neck cancer patients. Rather, we consider the barium swallow esophagogram to be a relatively safe and acceptably accurate alternative in most cases, with esophagoscopy reserved for specific indications.