Sequelae to secretory otitis are described on the basis of epidemiological studies and clinical series of secretory otitis as well as histopathological studies of normal and pathological temporal bones. The sequelae comprise attic retractions of varying degree, tympanosclerotic and atrophic changes of pars tensa, reduced pneumatization of the mastoid air cells, changes of the middle ear mucosa, and sensorineural hearing loss.
The effect of MS-antigen on the nasal mucous membrane, when administered in the form of aerosol, was evaluated in respect to ciliary movement and morphological changes. The experiment was conducted in vivo (nasal mucous membrane from mature domestic rabbits) and in vitro (the mucous membrane of nasal septum of mature domestic rabbits). The results were as follows: 1) The solution of MS-antigen in the concentration of 60mg/ml had no significant injurious effect on the nasal mucous membrane, so it was considered that it could be used clinically in the form of aerosol. 2) MS-antigen, in a concentration of 20mg/ml, showed a ciliary movement activation effect.
This report discusses normal findings obtained in the optokinetic nystagmus test. Optokinetic nystagmus was provoked with isometric acceleration (±4°/sec2). The optokinetic stimulation drum was started at 0°/sec and accelerated to 160°/sec. After this level of stimulation having been reached, the drum was decelerated to 0°/sec. Optokinetic nsytagmus thus induced was recorded on the ENG at paper speeds of 1 mm/sec and 0.5 cm/sec. The former record was analyzed by a qualitative procedure, and the latter by a quantitative procedure. Optokinetic nystagmus test findings were analyzed in 50 normal subjects. As a result, it was revealed that the maximum eye speed of the slow component of nystagmus was 94.0°±16.5°/sec and the total number of nystagmus was 218.0±23.4. A more objective evaluation can be made of optokinetic nystagmus test results by analyzing not only qualitative findings such as OKP (Optokinetic Nystagmus Pattern) but also quantitative findings. It is therefore recommended that the evaluation of optokinetic nystagnius test results be based on both qualitative and quantitative findings.
Relationship between hypertrophy of adenoid and ventilatory function of the enstachian tube in cases of otitis media with effusion (OME) was investigated. 1. There was no significant difference in tubal opening pressure and positive pressure equilibrasion function whether the eustachian tube was compressed by adenoid or not, endoscopically. 2. There was no significant difference in tubal opening pressure measured in the operation room before and just after adenoidectomy. 3. In six months' observation, there was no significant difference in tubal opening pressure between adenoidectomized and non-adenoidectomizedgroup, while incomplete positive pressure equilibration function was more frequently observed in non-adenoidectomized group. It was concluded that adenoid did not affect the passage of eustachian tube, but a slight effect on tubal active ventilatory function was suggested.
There were sixteen cases of neurilemmoma in the head and neck, which were observed at Kanazawa University Hospital from 1973 to 1985. In ou r series, the tumor was distributed as follows: nasal cavity, 4 cases; pharynx, 4 cases; pnrotid gland, 2 cases; oral cavity, 2 cases; mastoid, 1 case; auditory canal, 1 case; upper neck, 1 case and epiglottis, 1 case. All cases were treated with surgical excision. In a case of pharynx, part of the tumor remained because the capsule was indistinguishable, and has recurred after 5 years. In the histological findings, uncapsulated tumors were found in the cases of the nasal cavity and epiglottis. Some cases of the nasal cavity have lacked the capsule on the surface of the tumor facing to open space. Two tumors of the pharynx and upper neck had their origin from sympathetic nerve in the parapharyngeal space. According to CT scan, tumors arising from the sympathetic nerve had appeared in the anterior part of parapharyngeal space or posterior part (carotid sheath) of it. Thus we supposed that neurilemmoma arised from the sympathetic nerve would be classified into three groups; pharyngeal type which corresponds to pharyngeal tumor, carotid sheath type which corresponds to upper neck tumor and mixed type which extends to both region. It is significant to foreknow the relation of carotid and jugular vein to tumor, especially in the carotid sheath type, preoperatively. For this reason, CT scan with contrast enhancement would be prefered.
In recent practice, the authors experienced five cases of deafness following meningitis. Analysis of these cases with reference to foreign literature has led the authors to point out several features which could be stressed. Deafness following meningitis, while it is frequently encountered in children, occurs also in adults particularly of middle and advanced ages. Peripheral vestibular disturbance often appears to accompany deafness. Deafness is usually bilateral and can often be quite severe, but it sometimes shows asymmetrical involvement. In some cases, word discrimination becomes poor compared with the results of pure tone audiometry. This mightindicate possibly the concomitant retrocochlear lesion in addition to the lesion in the cochleawhich is usually due to labyrinthitis. Finally, possible administration of ototoxic drugs for the treatment of meningitis should be considered.
Cisplatin was administered intravenously or intraperitoneally to patients with gynecological malignant tumors, and investigated its effect on the auditory organ. The results were as follows. 1. Auditory acuity was deteriorated by 20 dB or more in 26.1% of the total, 22.2% of patients given intravenous doses and 28.6% of patient given intraperitoneal doses. Deterioration of 25 dB or more occurred in 17.4%, 11.1% and 21.4% respectively. 2. Hearing disorder developed at an average dose of 190 mg. 3. Intravenous administration caused hearing disorder at lower doses than in intraperitoneal administration. 4. In patients under the age of 60 years, intraperitoneal administration was safer. 5. With regard to frequency, hearing was most frequently disturbed at 8 kHz. 6. No vestibular disturbance was found.
Two cases of laryngeal tuberculosis are presented here, and clinical tendencies of the disease in the last two decades are statistically analysed. In recent years, laryngeal tuberculosis is observed less frequently because of the advance in chemotherapy., while the feature of the disease has changed as it did in tuberculosis of other organs. The characteristic feature of the disease in recent years are as follows: (1) The patient's age is higher. (2) Hoarseness is more frequently complained than dysphagia and pharyngeal pain. (3) Granulomatous lesion is more frequently found than other types of lesion, for example infiltrative lesion. Hence it is important to make the differential diagnosis of laryngeal tuberculosis from carcinoma. To diagnose the disease early, it is important to pay attention to patient's general conditions, laryngoscopic findings, chest X-ray, and sputum examination. Finally biopsy is necessary to make the definite diagnosis.
The immunofluorescence method (IF) has the advantage of being a relatively simple procedure, and useful for rapid diagnosis of many viralinfections. The Epstein-Barr virus (EBV) serological test by the use of IF is also useful for the diagnosis of nasopharyngeal carcinoma. The indirect IF has been used to detect EBV-specific antigens. Authors devised a combination method between routine IF and Evans Blue staining. The method is often useful for comparison of cell morphology and the site of EBV-specific antigens. In addition, the use of Pro-Tex ® as a mounting medium can preserve a marked loss of immunofluorescence.