Archives of oto-rhino-laryngology最新文献

Scanning electron microscopic examinations were carried out on the perilymphatic space bordering the round window in guinea pigs. A number of small vessels were found crossing free through the lumen of the scala tympani in this area. The larger number (5-10) of these capillaries are suspended between the bony cochlear wall and the terminal net of fibrocytes which covers the cochlear opening of the cochlear aqueduct and spreads onto the basal third of the round window membrane. Other capillaries (3-5) cross the lumen of the scala tympani from the outer cochlear wall to the modiolus. All of these capillaries have a thin endothelium and a very thin pericytic covering. These findings suggest that the capillaries crossing the perilymphatic space may give rise to a different chemical composition of the perilymph bordering the round window in comparison with the more upper parts of the scala tympani.

An 18-year-old man with an ulceration of his right tonsil and cervical lymphadenopathy was examined. The patient also had a papular eruption in his face, chest, abdomen, and upper extremities. There were no signs of genital involvement. Routine serological tests for syphilis were reactive and histological findings of a cervical lymph node biopsy were characteristic for syphilitic lymphadenitis. Spirochetes were also identified in the tissue sections. A diagnosis of secondary syphilis of the tonsil with cervical syphilitic lymphadenitis was made. In recent years, the number of new cases of syphilis has increased in Japan. Since the oral cavity is the most common extragenital site of syphilis, clinicians should bear in mind that oral lesions from an unknown cause might possibly be syphilitic.

Ca2(+)-ATPase activity was studied ultra-cytochemically in the middle ear mucosa of the guinea pig. On electron microscopic examination, the most intense reaction was found on the microvilli. Reaction products were also observed on the cilia and around and between the secretory granules on the apical side of the cells in their secretory phase. The basolateral membranes contained few reaction products, while very little or no activity was found on the basal membrane.

The authors report their preliminary findings in a prospective study on the possible effects of different risk conditions present at birth on language acquisition and cognition. A multifactorial test was used to test normal children for normative values. This test was then administered to 186 at-risk babies and controls at 18 months of age. A noticeable difference in overall performance was observed only for preterm babies having an appropriate weight for their gestational age. However, significant results will only be available after evaluations are repeated when the children are 36 months old.

Laryngeal framework surgery for improving or changing the voice is a challenging development in phoniatric surgery. Basically two categories can be distinguished: (1) attempted medialization of the vocal fold, as for the treatment of paralytic dysphonias (arytenoid rotation technique and Isshiki's type I thyroplasty); (2) adjustment of the vocal fold's tension to produce changes in vocal pitch, as for the treatment of transsexuals or mutational dysphonia (cricothyroid approximation, Isshiki's type III thyroplasty and LeJeune's anterior commissure laryngoplasty). Both types of surgery are best performed with the patient under local anesthesia so that fine tuning of the voice is possible by monitoring the voice during the surgical procedure. The techniques of arytenoid rotation and Isshiki's type I thyroplasty are described in detail and the result of a combination of these procedures is illustrated by a case history of an aphonic patient with unilateral vagus nerve paralysis and subsequent severe incomplete glottal closure during phonation. In addition, the results achieved in several other patients are presented. Our current experience with laryngoplastic surgery and its variations is such that endolaryngeal Teflon or collagen injections are no longer used in our department. To date, we have seen no complications from the laryngoplasties and the voice results have been excellent.

Since 1950 many animal radiotracer experiments have been performed to study inner ear kinetics. For the most part in these studies, radionuclides were applied systemically, following which a discontinuous probing of inner ear fluids or of inner ear tissues was done. Two techniques have been developed in the Section for Experimental Otorhinolaryngology of the University of Würzburg. These have been adapted to the direct and continuous measurements of inner ear efflux kinetics for several hour periods. For this purpose, only a tiny amount of radiotracer need be applied directly to the inner ear. Experiments were done on the anesthetized guinea pig as an animal model. In the first technique, a collimator-detector system is focused precisely on the cochlea, which had been quickly resealed after application of the radionuclide bolus via two small holes in the basal turn of the cochlea. The second technique makes use of a perilymph cycling system, whereby a small outer volume includes a microcuvette with a so-called artificial round window. By this latter cycling technique, perilymph clearance kinetics of all kinds of radiotracers--with the exception of tritium labelled ones--can be measured. Calculations from clearance kinetics show that quite small particles with particle weights up to 100, such as the chlorine anion and the potassium cation, as well as urea, glycerol, pyruvate, and lactate, exhibit perilymphatic half-lives varying from 45 to 60 min. These half-live data are plausible in regard to cochlear blood flow measured previously via an independent technique developed by Angelborg et al.(ABSTRACT TRUNCATED AT 250 WORDS)

Verrucous carcinoma of the larynx is quite distinct from well-differentiated squamous cell carcinoma has a characteristic morphology and specific clinical behavior. It accounts for approximately 1%-2% of all laryngeal carcinomas. However, difficulties are encountered clinically in separating verrucous carcinomas from keratoses, verruca vulgaris and squamous cell carcinomas with a verrucous appearance. Between 1962 and 1982, 1504 patients with squamous cell carcinomas of the larynx were diagnosed and treated by staff physicians in the Department of Otolaryngology--Head and Neck Surgery, Washington University in St. Louis. Fifteen of these patients (1%) had verrucous carcinomas. These cases were studied in order to clarify any diagnostic problems, trace the biologic behavior of the tumors and report the results of the treatment used. Of these 15 patients, we were able to follow up 8. The latter had been treated only with surgery and none of them had received radiotherapy. One death occurred, but the patient died of other causes and remained free of cancer. Reports in the literature describe a high rate of recurrence of verrucous carcinomas following radiotherapy with occasional anaplastic transformation of tumors. No patients in our series developed a metastasis in the neck, indicating that neck dissection is not justified for patients with these neoplasms even though clinically enlarged neck nodes may be present.

The cochlear blood flow of normal adult guinea pigs was measured by a laser Doppler flowmeter. The validity of this flowmeter was ascertained by its specificity for blood flow and its sensitivity to blood flow changes. Angiotensin II was infused into the animals and asphyxia was induced. The responses of the cochlear blood flow showed a close correlation with those of the systolic blood pressure. These results suggest a passive aspect in the physiology of cochlear blood circulation. On the other hand, there was a negative correlation between the responses of auricular skin blood flow and those of systolic blood pressure to a certain dose range of angiotensin II. To clarify the specific details of inner ear blood flow, further studies of the hemodynamics of the inner ear blood circulation should be continued under various experimental conditions.

Twenty cases of intrapetrous lesions were studied by a 1.5 T magnetic resonance (MR) unit. In all cases, comparisons were made between MR, CT and clinical findings. Our present material included 9 cholesteatomas, 1 cholesterol cyst, 3 primary epidermoid carcinomas, 2 metastatic neoplasms, 1 glomus jugulare tumor and 4 facial neurinomas. Gadolinium was injected in 7 cases and seemed to be the best method for studying the intrapetrous tumors. MR permitted accurate topographic study and assessment of tumoral extension, as well as a ready demonstration of tumor vascularity. The present findings also showed that MR is not capable of defining small bony detail or calcifications.