The author reviews and discusses the major theories on the development of aural cholesteatoma. 1. Cholesteatoma developing at the PSQ This is a type of cholesteatoma described by Harbermann (1888) as a kind of secondary cholesteatomas following necrotizing otitis at the PSQ area. Some however, regard this as a type of primary cholesteatoma developing due to retraction of the tympanic membrane (Tumarkin 1961). The author considers that the cholesteatoma in the PSQ is, most likely, cholesteatoma of primary type. 2. Immingration theory The authors examined the canal skins and eardrums of the several cases of attic type cholesteatoma in children but failed to confirm the immigration of the basal cells into the granulation tissue. In animial experiments using rabbits, in which the author obliterated the eustachian tube papillary immigration of the basal cells was seen only in ears with perforation of the eardrum, and retraction cholesteatoma only in ears without perforation. The author concluded that negative pressure and inflammation in the middle ear would precipitate the growth of the eipthelial cells of the pars flaccida, and then subsequent retraction will give rise to formation of cholesteatoma.
We examined CAMP and CGMP to evaluate the effects of acupuncture. Serum CAMP and GMP were measured, before and after stimulation, with radioimmunoassay. Both sides Tsu-San-Li were punctured for 15 minutes with 30 gauge Chinese needles, which were electrically stimulated by Chinese made GT-6805 with the setting of 1 Hz, power index 1. In normal subjects (8 males and 16 females) serum CAMP and CGMP was 20.77±2.368 pmol/ml and 13.02±1.496 pmol/ml respectively. A/G ratio was 1.609±0.217. Other normal subjects (8 males and 6 females) received acupuncture. Before stimulation CAMP was 22.95±7.607 pmol/ml, CGMP was 17.60±4.106 pmol/ml and A/G ratio was 1.326±0.432. After stimulation CAMP was 19.21±3.762 pmol/ml, CGMP was 19.92±0.454 pmol/ml and A/G ratio was 1.049±0.344. After simulation CAMP was significantly decreased, but those in low levels were increased and those in high levels were decreased. Effect of acupuncture on CGMP was not significant. After stimulation A/G ratio was decreased.
The tympanostomy tube was introduced as a treatment of chronic serous otitis media by B. W. Armstrong in 1954. Although the concept of the use of the ventilation tube in the tympanic membrane has been widely accepted as an uncomplicated minor procedure, some complications do occur. The most common complication following insertion of tympanostomy tubes is ear discharge, a distressing problem for both the patient and the physician. From November 1979 to January 1981, we placed tympanostomy tubes in 442 ears, of which 26 ears were troubled with ear discharge. We examined the background of otorrhea in these 26 ears, taking notice of nasal conditions, bacterial changes and clinical courses. Based on the results thus obtained, we then prepared a manual dealing with the treatment of the otorrhea.
Diseases of the paranasal sinuses affect the function of the eye in various ways because of the proximity of the two orgns. The authors have shown previously that disturbance in convergence could often be corrected by surgical treatments of the diseases of the paranasal sinuses. Another two such cases are reported here, in which disturbance in convergence has been corrected by intranasal sinusectomy in cases with severe chronic sinuistis.
The authors described various methods of the use of homograft nasal septal cartilage as ossicular replacements in type III and type IV tympanoplasties and concluded from a long-term experience that the cartilage is a very useful and reliable material as ossicular replacement since the cartilege is pliable to fashioning, durable with minimal later distortions and absorption.