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The origin of acute periorbital swelling is not always evident. Careful attention to the history, physical findings in the nose and adjacent areas and X-ray appearances should lead to a correct diagnosis in each case. Infections of the frontal, ethmoid and maxillary sinuses, the tear sac and nasal vestibule as well as fractures of the nasal and zygomatic bones account for most of the cases.

Since 1972 we have been cautiously exploring the use of CO2 laser in the management of carefully selected cases of localized carcinoma of the oral cavity. At the present time our experience is based on the treatment of 57 patients with cancer of the oral cavity. The CO2 laser has been found to be an indispensable tool in the transoral management of T1 carcinomas, multiple superficial carcinoma, extensive leukoplakia and verrucous carcinoma. The laser allows precise excision of the lesion and involved mucosa and provides an excellent specimen for histologic verification of the margins. The morbidity of laser excision is minimal, so that a tracheotomy is not needed and patients can almost always be discharged on the following day. (Follow-up data on those patients at risk for 30 months indicate excellent control rates.)

The early postoperative hypopharyngeal anatomy of 37 consecutive patients undergoing total laryngectomy at the Boston Veteran's Administration Hospital between July 1977 and April 1980 was studied by barium swallow radiographs and correlated with the technique of closure. The "pseudoepiglottis," a structure radiographically resembling a normal epiglottis, was seen arising from the anterior hypopharynx near the base of the tongue in 21 of 28 evaluable patients. It occurred in all patients with vertical closures vs. 67% of patients with a "T" shaped closure. The average length in the "T" closure group was 9.6 mm (range 0-35) vs. 18.4 mm (6-40) in the vertical group, a statistically significant difference (p less than 0.05). Radiologic strictures occurred in 39% of all patients, dysphagia in 29%, fistulae in 18%, and sinus tracts in 14%. All complications occurred more frequently in the vertical closure group. Patients who received preoperative cis-platinum bleomycin chemotherapy and postoperative irradiation had 50% dysphagia and 67% stricture rates. The average ratio of the width of the retropharyngeal space to that of C4 was 0.48 in stricture patients vs. 0.29 in non-stricture patients (statistically significant at the p less than 0.01 level). This ratio taken in the early postoperative period may help predict which patients will develop strictures.

In 1954 a review of the subject of dorsal sympathectomy in labyrinthine disease was promised by the late Leighton F. Johnson, M. D., 1 but because of his untimely death this was not possible for him. The cases which he treated have been followed, and to their number others, who were treated in like manner, have been added. A review of the results is now possible. The champion of this form of treatment of Meniere's disease and allied conditions was Passe; the final summary of Passe's work, 2 which was published posthumously, showed that he obtained an approximately 60% favorable response to this type of treatment. In 1954 Lewis 3 reported his results in 17 cases of Meniere's disease subject to incapacitating attacks of vertigo. In 7 of the 17 cases he obtained satisfactory control of the attacks. The remaining 10 cases were either failures or received insufficient benefit from