Histopathological studies of otosclerosis have been well documented by many anatomists and pathologists since the 19th Century, based on microscopic dissections of the temporal bones from Caucasian patients. The author attempts to describe the morphology and development of the normal human otic capsule for better understanding of histopathologic characteristics of otosclerosis. Otosclerosis is a primary disease of the osseous otic capsule which consists of one or more localized foci where there have been repeated resorption and remodeling of osseous tissue. The most common location for a focus is anterior to the vestibular window. The focus may gradually invade the annular ligament and stapes, causing bony ankylosis of the stapes and impairment of hearing (clinical otosclerosis). In other instances otosclerotic focus may become quiescent in the otic capsule without causing bony ankylosis of the stapes footplate (histologic otosclerosis). Histopathologically, four stages are generally recognized in the development and progression of the otosclerotic bone change: 1. Osteoclastic destruction of endochondral bone of the otic capsule and formation of perivascular spaces which contains vascular channels and fibrous tissue. 2. Formation of immature basophilic bone. 3. The remodeling process of resorption and new bone formation resulting in a more mature acidophilic lamellar bone. 4. Formation of a highly mineralized acidophilic bone which has a mosaic-like appearance at the quiescent stage of otosclerotic lesion. The author describes the general morphological features of otosclerosis by reviewing the literature and by presenting microphotographs of histologic otosclerosis obtained in a survey of the temporal bones from unselected Japanese ears, and clinical otosclerosis which had been collected from removed stapes footplates by stapedectomies from Japanese otosclerotic patients.
Several viral infections of the inner ear with clinical manifestations similar to those of sudden deafness have been known to occur for many years. Such inner ear infections include those of mumps, varicella-zoster and measles viruses. The author describes his thinking that such infections particularly those of mumps and measles maydevelop via hematogenic routes or viremia rather than cerebrospinal fluid routes that have been assumed to occur. Routes of varicella-zoster virus into the inner ear are proposed not necessarily the same with those of mumps and measles viruses, where rather latent infections or infection through the cranial nerves e. g.facial nerve should be taken into consideration.
A case of granuloma teleangiectaticum (pregnancy tumor) arising from the dorsal surface of the tongue is reported. A 38-year-old housewife, in the 38 th week of pregnancy, noted a small asymptomatic papule on the tongue without a known preceding trauma. One week later she noticed that the papule had grown rapidly and an episode of spontaneous bleeding of several minutes' duration. She then sought an otolaryngologic consultation at the hospital of National Defense Medical College on November 9, 1978. Oral examination revealed a reddish brown, painless, dome-shaped mass in the anterior dorsal surface of the tongue. A clinical diagnosis of pregnancy tumor was made. The patient was told that the tumor would regress spontaneously after delivery. However, the mass showed a rapid growth in approximately 7 days after delivery. A surgical excision was done under local anesthesia. Histological examination revealed a typical teleangiectatic granuloma arising from the tongue. The pertinent literature of the granuloma was briefly reviewed.
Contrary to the characterisitc slow growing of the tumor the authors report an acoustic neuroma with unusually rapid growth. The 41-year-old male was first seen at the Jikei University Hospital with a complaint of left hearing defect of one month's duration. Otoneurological examination showed left sensorineural hearing loss at lower frequency range, horizontal nystagmus and readily induced OKP. ETT showed slight saccadic patterns and caloric test left canal paresis. Radiological examination of the temporal bone revealed an obscure left internal auditory canal. Within 3 months of the initial visit the patient became ataxic in gait associated with further aggravation in hearing. Gaze nystagmus and OKP and ETT findings together with the above results were suggestive of central nervous system invasion of the tumor. The dimension of the tumor had been confirmed by CT scan prior to surgical intervention. Exposure of the internal auditory canal revealed a large acoustic tumor with cystic changes involving the V, VIII, IX, X and XI cranial nerves.
A rare case of mucocele developing in the sphenoid sinus is reported. The patient was a 63-year-old man who complained of right visual disorder and facial numbness for approximately 3 years prior to his admission. There was no history of nose surgery or trauma. Rhinoscopic examination showed a polypous mass enpacked in the ipsilateral middle nasal meatus. Plain films and tomograms of the paranasal sinuses revealed a round cystic shadow located in the sphenoid sinus and a radiolucency in the right ethmoid and maxillary sinuses. A clinical diagnosis of mucocele was made. The mucocele was surgically treated through both maxillary and ethmoid to establish an adequate drainage into the nasal cavity. Both maxillary and ethmoid sinuses were filled with cicatricial fibrous tissues, a part of which occluded the ostia of the sphenoid sinus. Occlusion of the ostium of the sinus by cicatricial fibrous tissues may have been a possible cause of the mucocele in the present case. The pertinent literature of this condition was briefly reviewed.
Histopathological changes are investigated in the tongue of the guinea pig after freezing for one and a half minuters at-60°C Atrophy of the muscle fibers and an increase in vascular permeability were found to have occurred immediately after cryosurgery. Approximately 24 hours after freezing, the stratified squamous cell epithelium covering the surface of the tongue had desquamated. The majority of the muscle fibers had atrophied and both inflammatory and cicatricial reactions were noted in the frozen lesion. Seven days after surgery, the treated lesion was completely replaced by scar tissues and subsequently was covered with newly formed squamous cell epithelium.