Otolaryngology最新文献

The effects of nitrogen mustard on the electrical potentials of the inner ear were studied, and the results were correlated with the histopathologic findings which have been reported in nitrogen mustard ototoxicity. The endocochlear DC potential (EP) decreased rapidly after an injection of nitrogen mustard (NM). The amplitude of the cochlear microphonics potential (CM) diminished rapidly, and no substantial recoveries were observed. No significant changes in the magnitude of the negative potential of organ of Corti (NPOC) were observed. A large negative summating potential (SP) was recorded even when the amplitude of the CM had diminished.

Human subjects were exposed to an octave-band noise for 24 hours. Temporary threshold shifts increased for the first eight hours of exposure and then were asymptotic. While threshold shifts were largest at about one-half octave above the center frequency of the noise, a second maximum was observed at higher test frequencies. The exact frequency of this second maximum decreased from 7.0 kHz, for a noise centered at 2.0 kHz, to 5.5 kHz for a noise centered at 0.5 kHz. This result could be caused by the travelling wave pattern along the cochlear partition or to the production of distortion products.

Caloric testing plays a prominent role in evaluating the vestibular system. A unilateral reduced vestibular response (RVR) is a common abnormality and is consistent with peripheral vestibular pathology. An erroneous interpretation of RVR may be made due to the following circumstances: laboratory technique, the influence of directional preponderance (DP) on monothermal tests (MT), unilateral hyperactivity, or pseudocaloric (PC) nystagmus. These errors in interpretation may be avoided by (1) repeating any single irrigation that is significantly different from the other three, to rule out laboratory technical error; (2) performing bithermal (BT) testing exists, to eliminate the effects of directional preponderance; (3) observing that a right/left (R/L) difference is not due to unilateral hyperactivity, by noting absolute slow phase (SP) velocity; and (4) by demonstrating bidirectional sensitivity of the cupula before concluding that residual caloric function exists instead of no function.

A malignant fibrous histiocytoma from the maxillary sinus of a 51-year-old woman was treated surgically with adjuvant chemotherapy and radiation. The maxillary sinus is an unusual site for this rare and controversial neoplasm, as a review of the literature shows.

The otolaryngologist has a reference frame for congenital stridor that rarely includes diagnosis of a bronchogenic cyst. The life-threatening potential of this lesion makes consideration and recognition imperative. Representing less than 5% of the mediastinal childhood masses in the infant, respiratory distress most often initiates diagnostic studies leading to identification and extirpation. The case presentation highlights the clinical course. The diagnostic hallmark of this case was the delayed onset of stridor with subsequent progression. Thereafter, a chest film and barium swallow suggested the diagnosis. In newborns, however, such cysts may not be evident on routine chest films and, nonetheless, cause significant respiratory distress from airway compression. Surgical extirpation should be affected as soon as possible after the diagnosis is entertained in order to insure against a sudden respiratory death.

Rabies is a rare, fatal viral infection, usually transmitted by the bite of an infected animal. Some 30,000 Americans are immunized annually, however, so public health considerations are common. The development of a new vaccine, grown in human diploid cell culture, is discussed. It appears to have high antigenicity with no serious morbidity. A case of a patient with fatal rabies who had fever, delirium, dysphagia, and cervical and pectoral subcutaneous emphysema is presented.