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Twenty-five patients were re-evaluated six years after presenting with their first episode of otitis media with effusion. The average age at presentation was 6.2 years. Twenty-three were found on follow-up to have normal audiometry and tympanometry, and had improved or at least remained stable in school performance. Recurrences of acute middle ear disease were noted during follow-up in eight of the patients, specially among the six who had presented in the summer, and more frequently among the eight children who eventually had tympanostomy tubes placed. This study appears to support the concept that otherwise normal American children presenting with otitis media with effusion seem fairly uncommonly to develop severe, recurrent middle ear disease.

Of 55 patients who had received, in a previously reported double-blind study, either an antihistamine-adrenergic combination or a placebo for three months for serous otitis media, 48 were followed without drug therapy for an additional year. During the follow-up period no differences were detected between the patients who had initially been treated with drugs and those who had received the placebo, as detected by audiometry, tympanometry, parental concern about hearing loss (as detected by the parents themselves or by their children's teachers or primary health care providers), school performance, or recurrences of serous otitis media.

Pharyngomaxillary space abscess complicated by carotid artery erosion is now an uncommon disease. Two cases recently came under our care within a short period of time. The history of tonsillitis or other oropharyngeal infection followed by an enlarging tender neck mass with neurological involvement of cranial nerves IX through XII and the cervical sympathetic chain should alert one to the correct diagnosis. Treatment must be aggressive. A Mosher-type incision is most satisfactory, and the surgeon must be prepared to ligate the great vessels of the neck if any severe hemorrhage is encountered.