A questionnaire on medical treatment of childhood secretory otitis was posted to all Consultant Otologists in the Thames Regions of the National Health Service. Questions dealt with indications for medical management, choice of treatment, and indications for omitting medical therapy in favour of immediate surgery, or giving no treatment at all. 86 questionnaires were completed. 81.4 per cent of respondents used medical treatment, but there was no consensus as to the drug or combination preferred. Oral decongestant preparations were the most popular. 87.1 per cent of users of medical therapy sometimes omitted it in favour of immediate surgery, most commonly because previous treatment by another practitioner appeared a failure. 63.1 per cent of all respondents left some cases completely untreated. The views of experienced otologists on the treatment of ‘glue ear’ vary widely, and there is no acceptable evidence to support any method of medical therapy. Large-scale trials are needed to clarify the position.

Auditory Brainstem Evoked Potentials (ABEP) were recorded from 29 adults and children, accidentally exposed to lead through food until approximately a year prior to this study. ABEP were recorded in response to 75 dBHL click presented at rates of 10/sec. and 55/sec. Average values were calculated for peak latency and for interpeak latency differences. Average values of the effect of increasing stimulus rate were calculated as well. Similar values were calculated for normative child and adult control groups.

IPLD (I-III) showed the most significant and recurring results, with longer intervals in lead-exposed children compared with their control group. Increasing stimulus rate, on the other hand, affected the adult lead-exposed subjects more than the children. These results may imply an impairment of the auditory system with azonal and myelin involvement. ABEP is suggested as a sensitive detector of subclinical lead exposure effects on the nervous system.

We reviewed clinical findings in 740 patients over age 65 who consulted the Otological Medical Group, Inc., during a one-year period for dizziness. A thorough neurotologic evaluation is indicated in every such case to determine the specific cause of dizziness. In 21 per cent of these patients, a specific cause of dizziness was found. In the remaining 79 per cent, the diagnosis of primary dysequilibrium of ageing (presbyastasis) was made.

We classified dysequilibrium of ageing (presbyastasis) according to the character, time course, and precipitating factors of dizziness. Two clinical types were described: constant and unclassified. The histological finding in the temporal bones of four cases with dysequilibrium of ageing were reviewed. Pathological changes other than those in the peripheral vestibular system seem to be responsible for dysequilibrium of ageing.

In the present series, about three-fourths of the patients had a daily dose of nicotinic acid to produce flushing of the skin. In 16 per cent, the dizziness was minor, requiring no special treatment. In the remaining 9 per cent with incapacitating vertigo, a vasodilator regimen, antivertiginous drugs, and Cawthorne's vestibular exercises were prescribed.