We found no significant difference in outcome between patients packed with TAO and BIPP. Packing with TAO is therefore a suitable alternative to BIPP gauze ear dressing following myringoplasty.

The aim of this study was to assess the value of rigid endoscopy in patients presenting with globus symptoms. We conducted a retrospective analysis of 250 patients who underwent rigid endoscopy for globus symptoms over a 12-month period. In 217 patients (86.8 per cent) the examination of the larynx, pharynx and upper oesophagus was entirely normal. Abnormal findings included cricopharyngeal spasm in 12 patients (4.8 per cent), reflux in 11 (4.4 per cent), pharyngitis in two (0.8 per cent), web in two (0.8 per cent), and retention cyst in three (1.2 per cent). The 95 per cent confidence interval (CI) for the mean number of persons with malignancy based on the Poisson distribution is 0 and 3.7 (0 and 14.8 as rates per 1000). The relationship between the clinical diagnosis and endoscopic findings was examined using the chi-square test, with a p value of 0.0001. These results suggest that patients presenting with globus sensation are unlikely to harbour neoplastic lesions and therefore rigid endoscopy may well be an inappropriate investigation in this group. The risks, costs and discomfort associated with this intervention can often be avoided.

This retrospective study examined 33 patients with Wegener's granuloma seen between 1990 and 1999 in the Ayrshire and Arran region of Scotland. There was an estimated annual incidence of 10/million/year. The diagnosis in this series was based on the presence of one or more of the following: a positive histology, a positive c-ANCA or a typical clinical course. Twenty-eight patients were diagnosed based on either a positive histology and/or c-ANCA, whereas the remaining five were diagnosed based on the clinical course. c-ANCA was positive in 79.3% but correlated poorly with disease activity. Nasal biopsies were positive in 40%, whereas 94% of renal biopsies were positive, thereby making nasal biopsies unreliable in the diagnosis. Significantly elevated levels of erythrocyte sedimentation rate (ESR) averaging 77 mm/h were found in 32 patients at diagnosis. This showed fluctuation with disease activity. Thirteen patients died, 12 within 5 years. The best prognostic indicator statistically was age.

Both the skin-prick test and the nasal smear eosinophilia showed correlation with the clinical history, although the skin-prick test was more sensitive. No statistically significant correlation was demonstrable between the two tests.

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