In the year 1955 Zöilner has described the pathogenesis, diagnosis and special surgical management of “Paukensklerese”. Since then tympanosclerosis has attracted great attention from otologists concerned with improvements of hearing through reconstructive microsurgery of the middle ear. Although extensive studies and clinical observations of tympanosclerosis have been carried out, there are still unsolved problems relating the origin and the cause of the grotesque calcified masses in the middle ear space. For an attempt to clarify the pathogenesis of this disease Zöilner has carried out extensive studies on the subjects applying modern techniques and powerful scientific instrument such as X-ray microanalysis in electromicroscope. Deposition of calcium phosphate apatites in cytoplasmic elements of degenerating cells and in the ground substance of the sclerotic focus were closely related to the progress of the diseases. Prick test or intracutaneous test revealed that the patients are more prone to allergic than the control. Hyperparathyroidism caused experimentally in guinea pig accelerated deposition of calcium in tympanic cavity. Total protein and electrolyte (potassium, calcium, sodium, chloride) in serum were found to be normal by applying various tests and tuberculin test and antistreptolysin test were negative. Relationship of the tympnosclerosis with the autoimmune diseases have being under investigation. The precise site of an ossicular fixation could readily be determined with careful microscopic examination and palpation. Hyaline tissue in the ossicular chain had been successfully microdissected. Where hyaline is removed reflxation will ready occur. This is minimized by placing paraffin wax between the apposing bone surface where mucous membrane has been removed. Fixation by hyaline limited to the stapedius tendon is easily corrected simply by resecting the focus. Stapes effodation or stapedectemy in staged operation is recommended in cases of calcified fixation on oval window niche or entire tympanic cavity.
Etiology of congenital deformity may be found in heredity, irradiation, infection, endocrine dysfunction, ingestion of some chemical substances, malnutrition of mother, stress and mechanical effects during delivery. Other factors may also be responsible for production of deformity. The author studied the teratogenic effect of emotional stress in rats. Experimental Method: Adult Winster rats weighing about 200 grs. were used. Two female rats were kept in a box with a male rat. After confirming pregnancy female rats were sacrificed at different periods of pregnancy. The rats were divided into the following groups: 19-day sacrifice group: Control Group Ao. represents a group for control, Bo. represents a group treated with trypan blue.; 1% solution of trypan blue was injected 1 cc/100 gr. body weight, on the 8th day of pregnancy. Co. includes a group which received 40, 000 IU. of vitamine A subcutaneously per 100 gr. Stress Group As. represents a group subjected to emotional stress. Bs. indicates a group in which stress was given after injection with trypan blue. Cs. represents a group in which stress was given after vitamine A injection. Stress Group As. represents a group subjected to emotional stress. Bs. indicates a group in which stress was given after injection with trypan blue. Cs. represents a group in which stress was given after vitamine A injection. of body weight on the 8th day of pregnancy. 15-day sacrifice group: Do. is a group for control. Ds. includes those in which emotional stress was given. Ds. indicates a group which received both stress and vitamine A injection. The stress was given by means of repeated flashes of light, loud noise and electric current for 6 hours a day from the 9th day to 15th day of pregnancy. A half of the animals were sacrificed on the 15th day and the others on the 19th day of pregnancy in order to examine the fetuses and placentas. The mother rats were also examined for numbers of eosinophiles and change in body weight during pregnancy. Hypophysis and adrenal glands were weighed and examined histolo gically after they were sacrificed. Results: 1. As. group showed a decrease in number of eosinophiles, however, no macroscopic or microscopic anomaly was found. Fetal death has significantly increased in comparison with Ao. group. 2. Anomaly in Bs. group was found in 3.7% of the population, which was not a significant increase as compared with the control group. significant difference was observed between trypan blue and stress in the production of deformities. 3. Co. group included deformity in 29.1% and Cs. group 69.1%, both of which were significantly increased. This fact may indicate an augmentative effect when vitamine A and stress combined. No significant difference was noted in the number of fetal death. The most frequent deformity was cleft palats, followed by deformity of the auricle, eye, micrognathia, separation of the mandible and separation of the tongue. 4. Histological examination confirmed the macroscopic observation. 5. Histological examination of the placenta revealed more congestion in stress groups. 6. Weight of the hypophysis and the adrenal glands showed similar changes in the stress group. Histological examination of Ds. group showed increased congestion of the hypophysis while of adrenal gland in Cs. group revealed thickening of the adrenal cortex. 7. The author concluded that emotional stress given in certain condition can produce deformity in fetuses.
Since 1963 the authors used intra-arterial infusion of anti-cancer drugs as preoperative treatment for head and neck malignancies. The authors observed in many cases that steady retraction of tumors was arrested after a certain doses of the infusion. The authors studied local blood vessels finding significant changes after the arterial infusion of certain doses, which might have been one of the causes of the observed inefficiency in the treatment. They observed blood vessels in the lingual papillae by means of Ultropak and found marked changes of the arterioles after arterial infusion of Bleomycin. Such changes of the blood vessels often accompanied by stomatitis. The authors suggested that these changes of the blood vessel could be prevented by simultaneous infusion of reduced glutathione (GSH).
Ventricular pneumocephalus was found in a 38-year-old male with cholesteatoma of the middle ear when he developed acute meningitis. The ventricular pneumncephalus became a intracerebral pneumocephalus in about 30 days. Radical mastoidectomy revealed a bone defect at the roof of the antrum exposing the dura mater and a fistula extending into the brain tissue. A pathway into the intracranium at the antrum is considered to be very rare. Culture of the otorrhea did not reveal any gas-producing microorganisms. Granulation tissues were found extending from the orifice of Eustachian tube to the aditus ad antrum. The authors discussed the etiology of the pneumocephalus.
The authors report two cases of mixed tumor of the palate. The first case was a 51-year-old male who had a silent tumor of the soft palate for one year, that was found to be partially malignant. The patient was treated by Bleomycin and 5-Fluorouracil after surgical removal of the tumor. The second case was a 52-year-old male who had a giant tumor that almost occupied the oral cavity, and that was considered to have occurred in the right hard palate about 26 years ago. The tumor was 7×6×5.5 cm in size and weighed 70 grams.
This is a report of a case of primary tuberculosis of the palatine tonsil occurring in a 38-year-old female, a house wife, whose initial complaints were sore throat and painful swallowing. It was initially thought to be simple tonsillitis because there was no ulceration or erosion and only slight inflammation. She was treated with antibiotics but symptoms did not subside. We suspected malignant tumor of the palatine tonsil and started irradiation of 60Co, however, biopsy revealed tuberculous granulation of the tonsil. We used anti-tubercular chemoagents SM, PAS, INAH for about two months, followed by tonsillectomy. The postoperative course was uneventful. Very few cases of primary tuberculosis of the palatine tonsil are found in the literature. We cosidered that this was a case of direct infection of the tonsil from foods such as milk.