A case complicated by paralysis of the third, fourth and sixth cranial nerves after vidian neurectomy is reported. Some probable causes of these complications are discussed. Corticosteroids were found to be effective for the treatment of these complications in the present case.
Audiograms of forty-four fresh cases of sudden deafness that visited our hospital within 7 days of the onset of the initial symptoms were studied. The following observations were made. 1. Many of the cases that showed a recovery exceeding 30 dB in average threshold of the entire frequency range were found to have visited the hospital on the day or the next day of onset of the disease. This would indicate that the treatment should be started within a day or two of the onset of the disease to obtain better results. In many of the cases that showed no or minimal improvement in spite of various treatment, hearing acuity of the opposite ear had also been found to be impaired. This observation may help one to foresee the prognosis of hearing disturbance in some cases. 2. In some cases pure tone threshold improved dramatically around the tenth day of the disease. 3. Many of the cases associated with vertigo did not show any improvement of hearing up to 30 dB level. 4. The conservative treatment has been given with emphasis being placed on hospitalization and rest. Recovery rate has been 43% in the present series. The author stresses the importance of establishing a certain objective standard for expression of the degree of improvement of this disease.
Thirteen ears in 11 cases with long-standing cochlear tinnitus have been treated with transtympanic injection with 1 cc of 4% Xylocaine solution which would cause anesthesia of the inner ear. Of the 13 ears tinnitus disappeared in 3 ears and markedly improved in 4 other ears. Anesthesia of the inner ear was probably effective in the treatment of cochlear tinnitus. This effect might have been due to abolishment of abnormal excitation of the hair cell or blockage of a vicious circle. The true evaluation of this method requires further observation of longer duration but the absence of untoward side effect may encourage otolaryngologists in trying this method for the treatment of those cases which have been resistant to any type of conservative measures.
Three cases of reticulum-cell sarcoma originating in the soft tissue of the face are reported. These tumors are relatively rare but have some particular features: 1) The appearance of the tumor is a diffuse swelling with indistinct border and the tumor is firm and invasive with or without regional lymphnode swelling. 2) Tumor itself is more sensitive to radiotherapy than chemotherapy such as VCR, BLM and others. 3) Some of them develop to a generalized type in a short period or after repetition of recurrence, they become very resistant to treatment.
Auditory acuity of aged people living in different environments is tested and compared The first group consists of the aged people who live together with one's family and are still engaged in one's occupation. The second group contains those who live in an institute for older people in cities and the third group consists of aged people living in an institute in the quiet country side separated from social and business activities. Overall results showed hearing acuity of those living in the normal household is well preserved for their ages. This was followed by hearing of those who live in the urban area and the worst was hearing of those who were separated from normal social activities. Preservation of hearing in aged people was found to be partly dependent upon the maintenance of function of auditory activities. Those who do not use auditory function in daily life are likely to aquire presbyacusis much readly as compared to those who constantly use the auditory function in daily life.