The purpose of this study was to show that the pathological changes in the tympanic cavity of the preliminary report were not made by electron beam irradiation. According to the electron iso dose curve, when the pharyngal orifice of the auditory tube was irradiated with the same condition as the prelimimary study, the tympanic cavity would be suffered from the dispersed beam at a dose of less than 200 rad. We conducted three experiments to know the histopathological effects of electron bean irradiation to the tympanic cavity with dose of 200 rad. Guinea pigs, with intact tympanic membrane and normal Preyer reflex were used. 1) One of the temporal bones of the guinea pig was irradiated with electron beam at a dose of 200 red. 2) One of the temporal bones of the guinea pig was irradiated with electron beam at a dose of 2, 000 rad. Electron iso dose curve showed that the other site of the temporal bones would be irradiated at a dose of less than 200 rad. We observed the pathological findings of the nonirradiated site. 3) Non-irradiated guinea pigs. 1 M, and 2 M after irradiation, animals were sacrificed and serial sections of the middle ear were made. Histopathological findings of the tympanic cavityty were as follows. 1) No remarkable changes were observed in the tympanic cavity. 2) In the irradiated site of the temporal bones, dillatation and proliferation of blood vessels, and slight round cell infiltration were detected within the submucosa. Mucosal epithelium showed no discernible alterations. The tympanic cavity was filled with acidophilic effusion, containing only a few cells, such as lymphocytes, macrophages, and fibrin. Neutrophilic cells were also sparsely found in the effusion. In the non-irradiated site of the temporal bones, histopathological findings were almost normal. 3) The tympanic cavity showed no discernible changes. Histopathological findings of the auditory tube were as follows. 1) A few inflammatory cell infiltration, and slight proliferation of the fibroblasts within the submucosa were observed, around the pharyngeal orifice. Mucosal epithelium showed no remarkable changes. The lumen of the tube was filled with thick mucoid substance secreted from the tubal glands, containing only a few inflammatory cells. In the group 2, and 3, localization and severity of changes were almost same as in the group 1. Those changes were recognized as the physiological response against an ordinary infection. In summary, the present study revealed that the electron beam irradiation at a dose of 200 rad to the tympanic cavity caused no discernible alterations. And those findings suggested that in the preliminary report the histopathological changes in the tympanic cavity were induced not by irradiation but by the experimental tubal insufficiency.
Since 1980, we have been using the Crib-OGram at the Japanese Red Cross Medical Center to screen babies who were at risk for hearing loss. In 1983 the shorter Crib-O-Gram (S-COG) without Interstimulus Intervals (ISI) was introduced. This report researches the comparison of results from the S-COG without ISI to results from the original Crid-O-Gram with NI (L-COG). Average screening time with the S-COG was 37 minutes, and 1 hour 52 minutes with the L-COG. Screening scores were not significantly different between the two groups. Second screening scores were significantly higher than the first one (P<0.01), which was conducted the previous day. And when comparing the first and second screening scores, the S-COG's scores were significantly higher than those of the L-COG (P<0.01).
A 36-year-old female had hemifacial spasm and paresis for one year. CT-scan revealed a largemiddle cranial fossa mass which destroyed partially the root of the internal acoustic meatus. The patient showed no trigeminal signs and symptoms. On surgery, a trigeminal neurinoma was confirmed. Differential diagnosis is discussed.
A case of von Rceklinghausen's disease has been observed for 6 years. The patient was a 22-year-old male. He visited the otolaryngology clinic with complaints of bilateral hearing loss, right facial palsy, right ophthalmoplegia, gait disturbance, and bilateral muscle atrophy of the extremities. Swelling was noted in the right neck and pharyngo-laryngeal area. Café au lait spots were noticed. The bilateral hearing loss was caused by bilateral acoustic neurinomas, which were confirmed by CT-scan examintion. The hearing loss gradually progressed. The patient was young and had tumors in many cranial nerves, therefore the treatment should have been performed very carefully.
Glomus jugulare tumor is of rare occurrence among Japanese. The authors report three cases, all of which had been treated by operation. However, two of the three cases recurred in several years. The two cases that recurred were tumors adhering to the jugular bulb where the separation caused considerable bleeding during the initial surgery. The key factor in surgery would be that whether the surgeon know exactly the relation of the tumor to the jugular bulb prior to surgery. In case where the adhesions are too close to the jugular bulb the tumor would have to be removed by infratemporal fossa approach and ligating the internal jugular vein prior to the separation by for a complete removal of tumor without being complicated with recurrence.