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Acoustic rhinometry is a new technique which evaluates nasal obstruction by analysing reflections of a sound pulse introduced via the nostrils. The technique is rapid, reproducible, non-invasive and requires minimal cooperation from the subject. Unlike rhinomanometry it does not require airflow. A graph of nasal cross-sectional area as a function of distance from the nostril is produced, from which several area and volume estimates of the nasal cavity can be derived. The reliability of the method is greatest in the anterior nasal cavity, which is the site of the nasal valve. We have applied the technique to the study of normal nasal physiology in adults and children and to a range of pathological conditions. The role of acoustic rhinometry in diagnosis is somewhat limited compared to nasal endoscopy, but it is useful for nasal challenge and for quantifying nasal obstruction. Monitoring of medical and surgical therapy is a more promising application. In future, acoustic rhinometry is likely to be of particular help in evaluating childhood nasal obstruction, as it is well tolerated by children as young as 3 years old-a group of patients to whom objective tests have hitherto been difficult to apply.

The natural history of intranasal antrostomy is poorly understood despite the popularity of the procedure. Researches have been conducted to examine this and in particular to establish factors which might be responsible for closure. A complete appraisal of the anatomy of the inferior meatus has been undertaken to determine factors which limit the dimensions of an antrostomy. Retrospective and prospective studies have been performed on patients undergoing the operation to assess patency and size. The results of these studies demonstrate that initial size is important in determining long-term patency in adults, and if an antrostomy is open at one year it usually remains open in the long-term unless infection supervenes; in children, however, antrostomies appear to close more rapidly.