Electrocochleography plays an important role in the diagnosis of hearing disorders. In Meniere's disease, the value of negative summating potential (SP) relative to the action potential (AP) is known to be much larger than in normal hearing and other sensorineural hearing loss. However, since it is unknown whether or not the finding of dominant negative SP (DNSP) is characteristic in Meniere's disease, its practical value for differentiation of Meniere's disease remaines uncertain.
In this paper, for each disease accompanied by dizziness and or hearing disorders, the proportion of cases with DNSP was determined. Acoustic click (105dB SPL, 125msec. intervals) were used as stimuli, and the output of the cochlea was picked up by a silver-ball electrode placed on the surface of the ear drum. The amplified responses were taken 1024 times averaged and read out on an oscillograph. Materials included 160 patients with dizziness and/or hearing disturbances, including 91 with Meniere's disease, 7 with cochlear Meniere's disease, 13 with vestibular Meniere's disease, 1 with luetic labyrinthitis, 7 with sudden deafness, 14 with sensorineural hearing loss, 12 with dizziness and so on. DNSP was frequently observed in Meniere's disease(67%), cochlear Meniere's disease (100%), and sudden deafness(28%), in which endolymphatic hydrops were at least partially suspected. In other diseases accompanied by dizziness and/or hearing disturbances, DNSP was rare. Therefore, DNSP is considered to indicate certain groups of disease with endolymphatic hydrops. Meniere's disease of a shorter duration revesled DNSP less often. DNSP showed a tendency to remain after the acute stage had passed, i. e. in the stage of remission.

View full abstract

Auditory brain-stem responses (ABRs) from six patients with degenerative disease of the brain-stem (spinocerebellar degeneration 3; neuro-Behcet 2; multiple sclerosis 1) were recorded. These cases were suspected of having wide and relatively severe damage to the brain-stem. By neurotological examination and X-ray findings (CT scan), the lesions were comparable to those of a brain-stem tumor case in which only wave I of the ABR was recordable. The latencies of the wave I and V of cases studied were within the normal range. The amplitude of the ABR showed no remarkable changes. From these data we conclude that in some degenerative diseases of the brain stem the ABR appears normal.

View full abstract

Hyperacusis in 52 patients was investigated concerning etiology.
Time relationship between stapedial muscle paralysis and hyperacusis were examined in 9 cases of hyperacusis due to facial palsy. The relationship proved to be unstable in most cases.
Similar results were obtained in the study of another 50 patients with this palsy.
In 18 cases of unilateral hyperacusis without hearing impairment due to various etiology, except facial palsy, stapedial reflexes were analyzed bilaterally. Stapedial reflexes in normal ears occurring by sound stimulation to the ears with hyperacusis proved to have a larger amplitude than reflexes in the opposite ears in 9 cases (50%). We regard this result as one of the clues to the enbodiment of hyperacusis.

View full abstract

A new technique was demonstrated in chronic otitis media with inflammatory stenosis of eustachian tube. Bone exposure of the eustachian tube and of peritubal air cells was followed by implantation of silicon in this space. Postoperative care was taken to ensure wound healing in the same way as is carried out for conservative radical mastoidectomy.
At the second operation, eustachian tube and anterior tympanum was found to be reconstructed with an intact mucous membrane.
Middle ear space can be easily rebuilt with tragal cartilage.

View full abstract

Fifty-five patients who were suspected to have a tumor invasion in the pterygopalatine fossa, pterygoid fossa, infratemporal fossa, lateral and posterior pharyngeal wall were examined using EMI Scanner 1010. A line joining the lower edge of the orbit to the uppermost part of the external auditory canal (Reid's base line) is adopted as a base and cuts were obtained below and above this line. The place examined in the present study was included in the slices from 1 to 4cm below the base line. Soft tissues in the pterygopalatine fossa and its vicinity are grossly divided into two parts, namely the high density and the low density area. The former mainly represents muscles like the lateral pterygoid or the medial pterygoid muscles and the latter indicates the fatty soft tissues locating among muscles and bones. In addition to the destruction of the bone and the deformity of the air filled cavity, changes in the soft tissues are very important to determine the presence or absence of the tumor invasion. Although the tumor, in general, has an almost same density as the muscles, the extension of the tumor can be demonstrated by the loss of the low density area and the deformity of the muscle shadow. CT scan revealed a tumor invasion in the pterygopalatine fossa and its vicinity in 18 out of 25 cases of maxillary carcinoma and these findings were confirmed by surgery. CT scan is most usefull for determination of the size and location of the tumor and we propose that findings on CT scan should be taken into consideration when attempting to determine TNM classification of tumors.

View full abstract

Two patients with primary malignant melanoma originating in the nose and paranasal sinus were treated with combined cryosurgery and immunotherapy using a new immunopotentiator consisting of the cell-wall skeleton of Nocardia rubra (N-CWS).
The first was a 45 year old man with complaints of left nasal obstruction and nasal discharge. Initially, BCG immunotherapy by local injection to the nasal tumor was carried out, but following the second injection, the patient went into a state of shock. The combined treatment with cryosurgery and immunotherapy using N-CWS was then begun.
One month after the treatment, the nasal tumor was reduced considerably, and almost disappeared in two months. There are no signs of metastasis or local recurrence.
The second case was a 71 year old woman who complained of swelling and pain in the left upper jaw. She had been given ⁶⁰Co irradiation, but it was not effective.
The same combined therapy mentioned above was begun, but she was discharged three weeks later as she and her family rejected further therapy.
There is no evidence of metastasis of the tumor in this patient 8 months after the treatment. Thus, the combined therapy with cryosurgery and immunotherapy using N-CWS, a new immunopotentiator, shows promise for either operable or inoperable patients with a malignant melanoma in the upper respiratory tract.

View full abstract

Effects of isoproterenol were clinically studied on 37 patients with vertigo and these effects were assessed two weeks later by subjective and objective parameters. Isoproterenol proved effective for those with a peripheral vertigo, but was less effective for those with a vertigo of a central origin. Of the subjective parameters, vertigo sensation, nausea and/or vomiting, and headache and/or “heavy head feeling” were prominently improved in the peripheral vertigo groups. On the other hand, the effects on tinnitus and shoulder stiffness were limited, and hearing impairment was not improved. Objective parameters such as found in the postural reflex test (Mann's test), stepping test, writing test, spontaneous nystagmus test, positional and positioning nystagmus test, and caloric test were also improved in the peripheral groups. Palpitation which occurred in two patients was transient and slight and disappeared simultaneously with the cessation of the administration.

View full abstract