bluuebunny/crossref_metadata_2025 huggingface dataset:
Perilymph Displacement by Cerebrospinal Fluid in the Cochlea
Authors: Moscovitch D. H. , Gannon R. P. , Laszlo C. A.
Published: October 2014

On histological examination, the cochlear aqueduct of guinea pigs has a large open lumen, unlike the tissue-filled periotic duct of primates. Hence, the guinea pig's large patent periotic duct appears capable of accommodating a bulk flow of cerebrospinal fluid from the subarachnoid space into the scala tympani if an egress for this fluid was provided by experimentally perforating the cochlea. In order to measure this flow the cochlea in anesthetized guinea pigs was surgically exposed and a single opening was drilled in the basal turn of the scala tympani. All of the displaced perilymph was collected in a calibrated, silicone-coated micropipette sealed into this hole, and; was measured directly by recording the advance of the meniscus in the micropipette. The displacement rates were typically 0.8 to 1 μliter/min, but could be temporarily increased by short periods of respiratory depression and changes in body orientation. From a consideration of anatomical and hydrodynamic relationships, it is concluded that a major source of the fluid which displaces perilymph in the opened guinea pig cochlea is cerebrospinal fluid which enters the scala tympani via the cochlear aqueduct. These results indicate that if a single opening is made into the cochlea at the apex, all of the perilymph in scala tympani (8.0 utters) would be displaced in approximately 10 min. Furthermore, these results have important implications for the technique of intracochlear injection used to study the effects of ions and drugs on the cochlea, because the continuous displacement of perilymph from the opened cochlea consequently removes the test substance previously injected into the scala tympani.
Static Lung Volumes in Singers
Authors: Gould Wilbur J. , Okamura Hiroshi
Published: October 2014

It has long been assumed that the superior vocal ability of the trained professional singer arose from a higher than average breathing capacity and consequent above-normal ventilatory efficiency. However, until now, it has not been clear whether this presumed superior pulmonary capacity and breathing efficiency arose from training, from heredity, or from other factors. To clarify the role of training (and by inference that of other factors also) upon the capacity for singing, various indices reflecting static lung volumes, as distinguished from dynamic parameters measured during the act of singing, in trained professional singers, students of voice and subjects with no vocal training, were compared. Results indicated that contrary to reports by others, there were no significant differences in the total lung capacity (TLC) of the trained professional singer and that of the other two groups when allowances were made for age and sex; but when the ability to mobilize or utilize TLC was compared, it was found that the trained singer was much better able to do this than either of the other two groups. Specifically, it was found that the ratio of the residual lung volume (RV) (the amount of air remaining in the lungs at the end of a total voluntary expiration) to TLC was lower in the trained singer than in the students of voice, and that these students, in turn, had a lower RV/TLC ratio than the untrained subjects. These findings, therefore, suggest that the increased singing ability of the trained professional singer arises in large part from the ability to increase breathing efficiency by reducing the residual lung volume and, further, that this ability tends to improve with length of vocal training.
Improved Middle Ear Inflating Device
Authors: Mathes W. T.
Published: October 2014

This paper introduces to otologists and pediatricians a simple device useful for inflating the Eustachian tubes and middle ear spaces. The device allows compressed air from a toy balloon to be propelled into the middle ear spaces during the act of swallowing. Its primary value is assisting in clearing the “fluid car” problem and maintaining a middle ear space in postoperative tympanoplasties.
Cancer of the Lacrimal Sac
Authors: Schenck Nicholas L. , Ogura Joseph H. , Pratt Lindsay L.
Published: October 2014

Tumors of the lacrimal sac are rare, and are discussed primarily in the ophthalmological literature. The otolaryngologist, however, often performs the definitive surgery and must, therefore, be familiar with this disease. The lacrimal apparatus secretes and then drains lubricating fluid from the eye. This report focuses on the drainage mechanism which is anatomically and functionally a single structure composed of the canaliculi, the lacrimal sac, and the nasolacrimal duct. By 1963, 184 lacrimal sac tumors had been reported in the world literature. We have collected an additional 21 patients from the literature. This brings the total malignant tumors to 125, of which 74 were of epithelial origin. One sarcoma and four poorly differentiated epidermoid tumors treated in our department are presented in detail. The diagnosis is often evasive though the history of mass and epiphora is typical. Conservative treatment for dacryocystitis only temporizes. Work-up should include external and slitlamp examination, complete rhinological evaluation, sinus x-rays, tomograms of the bony lacrimal sac area, and dacryocystograms. Biopsy gives pathological confirmation. The largest group is epidermoid carcinoma, mostly of the poorly differentiated nonkeratinizing type. The treatment for benign lesions is local excision. Preoperative irradiation is indicated for epidermoid carcinoma, followed by wide local excision. Radical maxillectomy may be reserved for recurrences, and neck dissection for palpable nodes may be helpful. Mesenchymal tumors respond best to radiotherapy. Death in lacrimal sac cancer results from metastases, most often to the neck and lung. Five year survival rates appear to be slightly greater than 50%.
Mucociliary Function during Experimentally Induced Rhinovirus Infection in Man
Authors: Sakakura Yasuo , Sasaki Yasuhito , Togo Yasushi , Wagner Henry N. , Hornick Richard B. , Schwartz Andrew R. , Proctor Donald F.
Published: October 2014

In conjunction with a controlled study of the effect of vitamin C on susceptibility to experimentally induced rhinovirus infections in man, we have conducted a study of nasal mucociliary function in the subjects volunteering for the study. In the 21 volunteers an average mucociliary flow rate (measured by the Quinlan tagged particle technique) of 7.5 mm/min was found in those with normal nasal morphology and 4.0 mm/min in those with abnormal nasal morphology. The rates decreased during infection in both groups but at different times after induction of infection. Ascorbic acid had no effect on either susceptibility to induced rhinovirus infection or mucociliary transport.
Circadian and Interpersonal Variability of Iga in Nasal Secretions
Authors: Hughes E. C. , Johnson R. L.
Published: October 2014

Secretory immunoglobulin-A (IgA) in nasal mucus exerts a major protective function for the respiratory tract, and low amounts of IgA are reported to correlate with susceptibility to disease. Therefore, a study has been made of the variability in amount of IgA present in human nasal mucosa. Subjects' IgA production has been found to vary substantially during the day and to reach very low values from time to time. Subjects sampled themselves by a nasal wash procedure. The samples were analyzed for IgA and for total soluble protein Because the total protein is relatively constant, use of the ratio of these two quantities reduces the effect of sampling differences and gives a better measure of IgA production. Samples were collected five and six times daily in November and March. The results were similar with no seasonal effect. A three- to four-fold change was found in the IgA production of most subjects during an average day. The peak usually appeared between midnight and 8:00 a.m., with a broad low period during the afternoon, displaying a typical circadian cycle. The greatest number of low-value samples appeared in the period between 2:00 and 5:00 p.m. Subjects differed in their average level of IgA production. Most subjects had periods of consecutive low samples, often showing that their IgA production was low for four or more hours. All subjects had some periods of low IgA production. Some were consistently low, and these reported having a higher incidence of respiratory disease than average. These low periods and the variation between subjects may be important as to the susceptibility to respiratory disease. The method of determination is well worked out. It is recommended that physicians utilize this analysis to help diagnose the patient with frequent respiratory sickness, including those of the bronchial mucosa, sinus and middle ear. The present study shows that a serial observation of four samples over the day would be best for finding a hypo condition. However, if only one sample can be taken, the later part of the afternoon is the best time in order to discover the deficiency, if any. The existence of a circadian cycle suggests possible control by the adrenal hormone system which has a similar cycle. If confirmed by further research this finding would point to a study of methods of treatment to increase IgA production.
The Sequential Bithermal Binaural Caloric Test: I. A Statistical Analysis of Normal Subject Responses
Authors: Custer David D. , Black Franklin O. , Hemenway William G. , Thornby John I.
Published: October 2014

Statistical analysis of bithermal binaural caloric test results gave a statistically significant response difference between ears for right-handed normal subjects. There were no significant response differences due to temperature of stimulation or due to the interaction between temperature of stimulation and ear stimulated. Of the four different orders of stimulation tested, all were statistically equivalent. Because intrasubject variance from a statistical analysis of normal subject responses was evidently much smaller than percentage based variance, the use of absolute differences or confidence intervals for determination of normal limits should yield more precise normal criteria than percentage based comparisons allow.
Tectorial Reticulum of the Labyrinthine Endings of Vertebrates
Authors: Wever Ernest Glen
Published: October 2014

A special layer of tectorial tissue, usually in the form of a fibrous network, that was first discovered in the macular and crista endings of the frog's labyrinth, has now been identified in these endings in representatives of all the other vertebrates, and therefore is considered to be a universal feature of the labyrinthine sense organs. This tectorial layer is located between the otolithic and cellular layers and is clearly distinct from both of these. In properly fixed and prepared material this structure is easily seen in the macular endings, where the difference in tissue composition between it and the otolithic ground substance can be demonstrated by selective staining. The primary function of this tectorial reticulum is the stimulation of the hair cells. It makes all the connections to the ciliary tufts of these cells, and is instrumental in conveying to them the differential motions produced by the overlying otolithic or cupular masses. Still further functions of this tectorial layer are suggested. There is reason to believe that it assists the sensitivity of the vestibular organs by converting pressure changes into shearing forces that are well distributed over the sensory surface, and involve a broad area of the hair cells in concerted action. It seems clear also that this structure has a protective function in transmitting the forces from the overlying masses of the ending indirectly through the flexible strands of its network rather than by direct connections that might be disruptive when stimulation is excessive. This layer may also provide elastic restorative forces that bring the ending back to an equilibrium condition after each stimulation.
Effects of Tobacco on the Ear
Authors: Greenberg S. Donald , Dickey J. Rayner , Neely J. Gail
Published: October 2014

The origin of the cholesteatoma matrix remains controversial although most investigators favor the hypothesis of epidermal migration from a perforated tympanic membrane. The metaplasia theory of the histogenesis of cholesteatoma is rarely considered relevant today. This study demonstrated that following repetitive exposures to a potent irritant such as tobacco tar, stratified squamous epithelial metaplasia can occur in the aural bulla of the cat. The investigation included six cats with indwelling polyethylene tubes surgically inserted into both aural bullae. In each cat the left bullae served as a control and 0.2 ml of tobacco tar from a cigarette smoking machine was instilled at weekly intervals into the right bullae. The animals were sacrificed in sequence at weekly intervals one week following the instillations so that the first animal had two weeks exposure and the sixth, seven weeks. In addition to metaplastic stratified squamous epihelium, goblet cell metaplasia was also seen.
The Nasopulmonary Reflex in the Awake Animal
Authors: Whicker James H. , Kern Eugene B.
Published: October 2014

Changes in pulmonary resistance and compliance, secondary to excitation of a nasopulmonary reflex, were studied in awake and anesthetized dogs. Resistance increased in all dogs after stimulation of the nasal mucosa. Because the direction and magnitude of compliance changes varied widely in both awake and anesthetized dogs, no predictable pattern could be established. A physiologic as well as an anatomic alliance links the upper and lower parts of the respiratory tract. The pathophysiologic significance of this relationship must be determined.
Esophageal Stenosis in Benign Mucous Membrane Pemphigoid
Authors: Minkin Wilfred , Seliger Gustave , Auerbach Robert
Published: October 2014

A patient is reported who had benign mucous membrane pemphoid (BMMP) with life-threatening esophageal stenosis. Esophageal involvement is an uncommon, but not rare, manifestation of BMMP. Blisters and erosions eventually lead to web-like adhesions and finally stricture. At least three deaths directly attributable to esophageal involvement have been reported.
Surgical Therapy of Dysphonia Plica Ventricularis
Authors: Kosokovic F. , Lenarcic-Cepelja I.
Published: October 2014

The authors report their experience in the use of surgery for the treatment of dysphonia plica ventricularis, the vocal disorder which results when enlargement of the ventricular folds impairs true vocal cord apposition. Diagnosis was made by means of microlaryngoscopy under local anesthesia applying neuroleptic drugs. Surgery was reserved for those patients whose mucosal hypertrophy did not respond to medications, psychotherapy and persistent speech exercises. The surgical technique employed consisted of grasping the central portion of the ventricular fold, pulling it medially, and excising the triangular portion of mucosa thus exposed. The underlying vocal cord was used as a point of reference for the excision. The raw surface was observed to reepithelialize rapidly. Cortisone inhalations were administered postoperatively in order to decrease the chance of scar formation. The 25 patients treated in this manner have done well during the one to four year follow-up period.
Value of Rotational Tests in the Diagnosis of Vestibular Disease
Authors: McClure Joseph A. , Lycett Paul , Johnson Walter H.
Published: October 2014

Caloric irrigation of the external ear canal represents an inadequate vestibular stimulus because the method is not physiologic and the canal irrigation and the heat transfer to the inner ear cannot be well controlled. In rotational testing an accurate acceleration profile can be applied with an appropriate rotating device. A test procedure is presently being used, which consists of constant acceleration at 3°/sec2 for 50 seconds, hold at constant velocity for 240 seconds, followed by a similar deceleration (equivalent to acceleration in the revelse direction) and hold. On-line data reduction of the nystagmus response is accomplished automatically using a simple analog technique. This technique provides a concise presentation (on a standard size sheet of paper) of the total slow phase eye displacement resulting from the primary and secondary responses and enables comparison of the results for both directions of acceleration. Experience with the routine use of rotational testing in a vestibular clinic and the significance of various paterns of response with special emphasis on vestibular adaptation function are discussed.
Circumferential Tympano - Mastoid Access the Sinus Tympani Area
Authors: Goodhill Victor
Published: October 2014

Primary emphasis is on the juxtaposition of the antero-posterior view of the surgeon as a complement to the standard postero-anterior view. This antero-posterior view permits greater latitude in dealing with lesions of the sinus tympani cellular system. Although this new visualization approach may entirely obviate the surgical-anatomical necessity for the posterior tympanotomy-facial recess bone dissections in many cases, it may be useful to combine both in some cases. A circumferential 270° surgical approach to the temporal bone is described. It allows for circumnavigation of the tympano-mastoid area, for specific surgical access requirements.
Viral Disease of the Labyrinth: I Review of the Literature and Discussion of the Role of Cytomegalovirus in Congenital Deafness
Authors: Strauss Melvin , Davis Gustave L.
Published: October 2014

Review of the literature concerning the histopathology of viral induced deafness indicates two general patterns of viral infection of the inner ear: 1) An endolymphatic labyrinthitis secondary to viremia via the stria vascularis is described in rubella, mumps, rubeola, and cytomegalovirus. 2) A perilymphatic infection secondary to meningeal, perineural, or endoneural spread is seen in varicella-zoster. Pathologic changes of degeneration and atrophy are due to inflammation and seem to be constant no matter if the infection is prenatal or postnatal. Two published reports of prenatal and perinatal cytomegalovirus infection show endolymphatic labyrinthitis similar to that casued by the other viruses. Subsequent clinical studies indicate the presence of hearing loss in mildly symptomatic and/or asymptomatic children with cytomegalovirus infections. Cytomegalovirus infection may prove to be the most significant cause of congenital and/or viral induced deafness in the future as the number of children infected with rubella, rubeola, and mumps decreases due to the use of appropriate vaccines.
The Early Development of the Larynx in Staged Human Embryos
Authors: O'Rahilly Ronan , Tucker John A.
Published: October 2014

More than 15 serially sectioned human embryos from stage 8 to stage 15 were examined, together with relevant reconstructions and photographs. Their lengths ranged from 1 to 7 mm, and their ages from 18 to 33 postovulatory days. The necessity of employing a recognized staging system is stressed. The foregut appears either late in stage 8 or during stage 9. The median pharyngeal groove that appears during stage 9 presages the first indication of the respiratory system and includes the future larynx. The laryngotracheal sulcus begins to be circumscribed at stage 10 and a caudal expansion represents the pulmonary primordium. The tracheoesophageal septum appears at stage 12. The right and left lung buds become definite by stage 13. The hypopharyngeal eminence, arytenoid swellings, and epithelial lamina of the larynx are detectable at stage 14. Vestibulotracheal and pharyngotracheal canals are distinguishable at stage 15. Hence, from the first appearance of the foregut at about 19 days, the larynx has developed into a recognizable organ two weeks later, namely, by 33 days.
Cutaneous Vascular Anatomy of Pectoral Skin Flaps
Authors: Calcaterra Thomas C. , Cherney Edward F. , Saffouri Mohammed
Published: October 2014

The need for nondelayed skin flaps from the chest for postoperative reconstruction and repair has increased considerably since the advent of combined irradiation and surgical therapy for treatment of cancer of the head and neck. Survival of these pedicled flaps is of paramount concern to the surgeon, as flap necrosis can be catastrophic for the patient. Many parameters have been evaluated to predict flap viability, but recent studies strongly suggest that the arterial blood supply of the pedicle is the most important factor in the success of immediate transposition. A study was performed in 19 cadavers to delineate the cutaneous vascular anatomy of the chest in order to determine precisely where the perforating vessels of the thorax and shoulders supply the pedicle region of medially-based and laterally-based pectoral flaps. On the basis of this study, modification of the design of these flaps is recommended.
Effect of Denervation of Nasal Mucosa on Pulmonary Mechanics
Authors: Whicker James H. , Kern Eugene B.
Published: October 2014

Eight dogs underwent denervation of the nasal mucosa by bilateral surgical interruption of the caudal nasal nerve, major palatine nerves, nerve branches traversing the pterygopalatine ganglion, and ethmoid nerve. Determinations of pulmonary resistance and compliance immediately before denervation and 1 hour, 24 hours, and 7 days after denervation did not demonstrate a tonic nasal influence on pulmonary mechanics. Changes within the range of normal did occur in the immediate period after denervation. Because pulmonary resistance and compliance approached control values by the seventh day after denervation, these variations are probably the result of atelectasis and pooling of mucus within the bronchi, secondary to prolonged general anesthesia. Thus, pulmonary mechanics probably are not significantly altered after denervation of the nasal mucosa.
Malignant Hyperpyrexia during General Anesthesia
Authors: Maisel Robert H. , Sessions Donald G. , Miller Robert N.
Published: October 2014

Malignant hyperpyrexia during general anesthesia requires emergency treatment. The hyperthermic trait is due to an inborn error of metabolism with variably expressed autosomal dominant inheritance, as well as a sporadic incidence. Volatile inhalant anesthetic agents are thought to produce abnormal calcium ion release in susceptible individuals. Resultant enzyme activation and oxidative phosphorylation then cause hypermetabolism and produce fever to 108° and higher. Combined morbidity and mortality of the syndrome is still in excess of 75%. A treatment protocol based on the presently understood pathophysiology of the disease is described. It includes parenteral delivery of procaine, corticosteroids and Thorazine® as well as routine support measures. Herald signs of this syndrome, such as abnormal anesthetic induction with masseter muscle spasm suggest curtailing the operation or obtaining full consultation.
Obstructive Lesions of the Trachea
Authors: Grillo Hermes C.
Published: October 2014

Over 100 patients with obstructing lesions of the trachea have undergone resection and end-to-end reconstruction in the past decade. Eighty-four of these had lesions of inflammatory origin and 16 were neoplastic. Their symptoms were primarily airway obstruction. Postintubation lesions of the trachea occur most commonly at the level of inflatable cuffs used to obtain a seal during ventilatory therapy and next most commonly at the level of tracheal stomas in similar patients. Their etiology is chiefly cicatrization following deep ulceration due to pressure necrosis at one of the two sites. Additional lesions may also occur at other levels. The most common primary neoplasm of the trachea was squamous cell carcinoma; the second most common was adenoid cystic carcinoma. Autopsy studies indicated that approximately one-half of the trachea might be resected and primary reconstruction done if certain principles of anatomic mobilization were followed, dependent on the level of the lesion and its extent. Upper tracheal lesions are approached clinically anteriorly through a cervicomediastinal approach with or without division of the upper sternum. In all but extreme cases direct approximation can be done. On a rare occasion, a laryngeal release procedure will provide additional mobility. Tumors of the lower half of the trachea are approached through a high transthoracic incision with appropriate hilar mobilization in addition to cervical flexion for devolvement of the cervical trachea into the mediastinum. In the first 100 consecutive cases, 73 of the 84 patients with benign stricture had a good or excellent result on morphologic and clinical grounds. Four were satisfactory, four represented failures or poor results and there were three deaths. Only one-third of 29 patients with primary neoplasms of the trachea were reconstructable when first seen. Others were suitable for radiation treatment only, no treatment or laryngotrachiectomy. Eleven patients underwent end-to-end reconstruction. There was one operative death, one late recurrence and the other nine are living without known disease from 1 to 11 years postoperatively.
Iatrogenic Injury to the Hypopharynx and Cervical Esophagus: An Autopsy Study
Authors: Wolff Allan P. , Kessler Stephen
Published: October 2014

The occurrence of iatrogenic injury to the adult hypopharynx and cervical esophagus has been casually documented by direct surgical exploration, endoscopy, radiography and, occasionally, by autopsy. To provide meaningful knowledge about the incidence of injury, the nature of the lesions, the character of the offending instruments and those injury-prone patients, a consecutive autopsy series was performed, focusing upon the pathology of the hypopharynx and cervical esophagus. One hundred and forty-nine consecutive hypopharyngeal-cervical esophageal specimens were examined. Sixty-nine percent of the patients had metal instruments or soft, flexible tubing placed through their oral and nasal pharynges. Sixty percent of those instrumented showed injury. All instruments used were found to have caused injury, suction catheters being implicated for the first time. Specific groups were found to be injury-prone, the most susceptible being those with thrombocytopenia. Only two percent of all injuries were noted antimortem.
Granular Cell Myoblastoma of the Esophagus Incidence and Surgical Treatment
Authors: Farrell Kenneth H. , Devine Kenneth D. , Harrison Edgar G. , Olsen Arthur M.
Published: October 2014

Granular cell myoblastoma (Abrikossoff's tumor), although certainly a rare, almost always benign lesion, is being encountered with increasing frequency in areas of particular interest to the otolaryngologist or surgeon in the upper aerodigestive tract. Although such lesions have been found frequently in the oral cavity and larynx, only one case has been reported of such a lesion originating in the esophagus. The detailed clinical and pathologic findings of three additional patients with esophageal lesions are described. Conservative surgical removal of granular cell myoblastoma may be preferable to endoscopic dilatation.
Tracheography with the Experimental Contrast Agent Tantalum
Authors: Stitik Frederick P. , Proctor Donald F.
Published: October 2014

Before the use of tantalum powder, positive contrast studies of the trachea were performed with a viscous oily iodine suspension. Iodine in suspension is not very radiopaque, and is moderately toxic. The oily portion of the contrast media is viscous and tends to obstruct the airways. In patients with compromised airway diameters such as those with tracheal stenosis, a positive contrast study was often considered too dangerous to perform. At this time, operability and the type of surgery anticipated was based on radiologic studies with poor anatomical detail. Tantalum is a safe contrast agent which is exceptionally radiodense and nontoxic. A small amount of tantalum dust coats the airway, giving excellent detail without compromising the airway diameter. Radiographic studies demonstrate excellent anatomical detail and are obtained with little patient discomfort. There have been no complicaions. Thirty-two patients with suspected tracheal stenosis have been studied by a protocol utilizing powdered tantalum as the contrast agent. Seven were normal. Varying degrees of tracheal stenosis were found in 18 patients. Five had only tracheomalacia, eight patients had a combination of both stenosis and malaria. Tracheomalacia was discovered in three patients in whom it was not suspected clinically. Consequently we are performing cine examinations on all patients with suspected high airway obstruction. Certain technical details are crucial to the proper performance of this procedure. These, as well as the characteristic findings in each disease category, are presented.
Cancer of the Skin of the Nose
Authors: Conley John
Published: October 2014

In 456 cases of cancer of the skin of the nose there was an even distribution in the sexes with the highest incidence occurring in the fifth and sixth decades. Basal cell cancer comprised 87%, occurring predominantly on the ala, tip and root; squamous cell cancer, more common on the lateral borders and columella, occurred in 10.7% of the cases. Previous exposure to irradiation was the most pernicious etiological factor. Fifty-one percent had been previously treated inadequately and presented with a recurrence. Metastases developed in 0.25% of the basal cell cancers and in 18.5% of the squamous cell cancers. Nine percent had recurrence after definitive treatment. Treatment was predominantly surgical excision, but irradiation, electrodesiccation and combinations of these with chemosurgery were also used. One patient with basal cell, five with squamous cell and one with sweat gland tumor died as a result of carcinoma of the skin of the nose. Another small group, previously exposed to full face irradiation, became chronic producers of recurrent cancer of the skin of the face (and nose); eight of these patients died as a result of cancer of the skin of the face.
Bilateral Pseudocysts of the Auricle in a Female
Authors: Santos Vladimir B. , Polisar Ira A. , Ruffy Mauro L.
Published: October 2014

Bilateral pseudocysts of the auricle have been described in a 20-year-old Puerto Rican female. No definite etiology has been established for this clinical entity at the present time. Biopsy of the anterior wall of the cyst from our patient showed histologic characteristics similar to those described by Engel.1 Combined technique using curettage, painting the inner surface of the cyst wall with 1% tincture of iodine and application of contour pressure dressings for several days resulted in uneventful healing in two weeks and restoration of the normal appearance of the auricles.
An Apparatus for Ultra-High-Speed Cinematography of the Vocal Cords
Authors: Hirano Minoru , Yoshida Yoshikazu , Matsushita Hideaki , Nakashima Tohru
Published: October 2014

In order to expand the studies of vocal cord vibration into greater varieties, normal and pathological, a photographic apparatus has been developed which meets the following needs: 1) Ultra high speed photographing can be done with any subject whose larynx is visualized under a laryngeal mirror; 2) The illumination is bright enough for high framing rates up to 10,000 frames per second and for color photographing; 3) The operation of the equipment is simple in order to obtain adequate films easily and consistently. The present paper describes the structure and the operation of the apparatus in detail.
Fine Structural Localization of Acetylcholinesterase in the Olfactory Mucosa in Guinea Pig and Rabbit
Authors: Nadol Joseph B. , DeLorenzo A. J. Darin
Published: October 2014

Using histochemical procedures for electron microscopy, acetylcholinesterase (AChE) activity was demonstrated in the olfactory mucosa of the guinea pig and rabbit. This activity was found in two specific locations, one intracellular and one extracellular. The intracellular localization was limited to the cisternae of whorls of smooth endoplasmic reticulum within the cytoplasm of supporting cells. The extracellular localization was limited to the intercellular space between the limiting membranes of the receptor dendrite and the supporting cell. A role for the ACh-AChE system in olfactory transduction is suggested, and comparison made with other receptor systems.
A Contribution to the Physiology of the Perilymph Part I: The Origins of Perilymph
Authors: Schnieder Ernst-August
Published: October 2014

Perilymph may as a first approximation be considered an ultrafiltrate of blood. Under quasi-stationary conditions there is a balance of concentrations of nonproteinbound low molecular weight substances in the blood and perilymph, the blood concentration being the governing factor. The rate of equilibration of such substances depends on the exchange rate of perilymph, which may be characterized by τ, the “cochlear half life.” In guinea pigs the mean cochlear half life is ten min, which means that half the perilymphatic volume (8 μl) is exchanged every ten min. It appears most probable that the cells of the organ of Corti (like all other epithelial organs) are metabolically supplied from their base, i.e., from the perilymph. The oxygen supply via the perilymph amounts to 0.1 nM/min, whereas the oxygen supply via the endolymph (equal τ assumed) would only be 1.6% of the perilymphatic supply. The glucose concentration of the perilymph does not constitute a limiting metabolic factor.
Unusual Ciliated Cell Group in the Utricle of a Cat
Authors: Hoshino Tomoyuki , Matsumoto Kenji
Published: October 2014

Using a scanning electron microscope, a group of ciliated cells was found in the area of the utricular macula of an adult cat. A cross section of the same specimen viewed with a transmission electron microscope revealed that the hairs observed had the characteristic inner structure of true cilia. As the same cell group was not found in either the contralateral ear of the same cat or in any of three other cats examined, the presence of these ciliated cells seems to be exceptional.
Attenuation Characteristics of Recreational Helmets
Authors: Bess Fred H. , Gale Denis W. , Aarni John D. , Redfield Nicholas P.
Published: October 2014

The noise levels of many off-the-road vehicles (ORVs) are potentially capable of causing damage to the human auditory mechanism. Most drivers of these machines refuse to wear ear protection because they contend that their helmets provide adequate attenuation. This study was designed to evaluate the attenuation of two typical recreational helmets. The results of this investigation indicated that recreational headgear alone is not sufficient protection from high noise levels. Drivers of ORVs should wear some form of ear protection in conjunction with their headgear until the noise levels of these machines are reduced.
Middle-Ear Mucosa in Newborn Infants
Authors: Bak-Pedersen K. , Tos Mirko
Published: October 2014

To ascertain whether the mucous glands constitute a normal or abnormal component of the mucous membrane in the osseous Eustachian tube and middle ear, 28 prematures and newborn infants were studied. The entire mucous membrane from the Eustachian tube and middle ear was removed and stained by the PAS-alcian blue whole mount method. No mucous glands were found in the osseous tube or middle ear, although the conditions for their formation were present, there being goblet cells and stratified columnar epithelium in the osseous tube and anterior part of the middle ear. Thus, the mucous glands do not form a normal component of the middle ear mucosa, although they may be demonstrated in ears which are clinically quite normal. Minor and short lasting catarrhal affections of the tubal and middle ear mucosa — Which occur in everyone during childhood or later without leaving any other sequelae in the middle ear — may lead to the formation of a few glands. As long as only a few glands are present, the production of mucus is negligible and does not entail clinical symptoms. In chronic middle ear diseases the density of glands is relatively high, and the mucus or mucus-admixed discharge occurring in these diseases is an active product of the mucous glands and goblet cells.
Chronic Intracochlear Electrode Implantation: Cochlear Pathology and Acoustic Nerve Survival
Authors: Schindler Robert A. , Merzenich Michael M.
Published: October 2014

The temporal bones of ten cats implanted with intracochlear electrodes for three to 117 weeks were stained with hematoxylin and eosin and examined with light microscopy. The electrodes were embedded in Silastic® which was molded to fill the most basal 9 mm of the scala tympani. They were inserted directly into the scala through the round window. Among our observations were the following: 1) All or nearly all hair cells were lost in the basal coil during the first several weeks after implantation. Some, but not all, supporting cells were also lost. There was extensive hair cell loss in the middle and apical turns, although some hair cells were seen there in all examined cats. 2) There was evidence of degeneration of spiral ganglion cells in the basal cochlea in several animals, but most primary auditory neurons including (with two exceptions) most of those in the region directly over the electrode, survived implantation in every cat. The radial nerve fibers of the spiral ganglion cells also survived long-term implantation. The functional viability of remaining spiral ganglion cells was confirmed in acute neurophysiological experiments conducted just before the animals were sacrificed. 3) More severe degeneration was seen in two cats in which the electrode perforated the basilar partition. In these animals, there was loss of many spiral ganglion cells, and evidence of new bone growth in the region of the perforation. 4) The appearance of the stria vascularis and spiral ligament in some implanted animals paralleled their descriptions following occlusion of the cochlear vein. 5) Connective tissue formed around the electrode surfaces, apparently displacing perilymph and sealing the electrode into the scala tympani. There was no evidence of perilymph fistula in any animal. 6) There was little evidence of progressive degeneration of the organ of Corti or spiral ganglion from three to 34 weeks after implantation. Some of the implications and limitations of these findings are discussed.
Tomography in the Diagnosis of Petrositis
Authors: Parnell Francis W. , Brandenburg James H. , Swingle John D.
Published: October 2014

Coalescent petrositis is an uncommon condition and is now most commonly observed complicating chronic, antibiotic resistant ear infections. Tomography defines areas of bone destruction which are equivocal on conventional views. Four cases are presented which demonstrate accurate localization of the petrositis by tomography, providing preoperative assessment of the approach and extent of the necessary surgical procedure.
Quantitative Determination of Secretory Immunoglobulin a (SIgA) in Middle Ear Effusions
Authors: Mogi Goro , Honjo Shoichi , Maeda Shoichi , Yoshida Toyoharu , Watanabe Noritake
Published: October 2014

For the purpose of investigating the nature of middle ear effusion, quantitative analysis of secretory immunoglobulin A (SIgA) by radioactive single radial diffusion (RSRD) technique was performed on specimens of middle ear effusion and serum from the corresponding patient. Specimens consisted of 61 serous effusions (32 acute and 29 chronic type) and 29 mucoid effusions (9 acute and 20 chronic). The mean value of SIgA concentration in the serous effusions was 212.7 ± 13.5 μg/ml and that in sera from these patients was 27.0 ± 3.0 μg/ml. In the mucoid type the mean value of SIgA in effusions was 357.7 ± 13.2 μg/ml and that in sera was 24.3 ± 2.8 μg/ml. The difference in the mean value of SIgA concentration between the serous and mucoid types of effusions was statistically significant. The mean value of SIgA concentration in serous effusions was eight times that in sera from these patients and in mucoid effusions the SIgA value was approximately 14 times that in sera. The calculated percentage of SIgA in the total IgA of middle ear effusions was 11–12% in both the serous and mucoid categories. The percentage in sera was about 1%. Results of this study indicate that all middle ear effusions contain appreciable amounts of the secretory element, although the transudate from serum is the major component of effusion, and support an hypothesis that while serous middle ear effusions are a mixture of normal ear secretions bathing the membrane surface and transudates from serum, mucoid effusions are the result of enhanced epithelial secretory activity and transudates.
A Contribution to the Physiology of the Perilymph Part II: Cochlear and Cerebral Blood Flow
Authors: Schnieder Ernst-August
Published: October 2014

Cerebral blood flow exerts a controlling influence over cochlear blood flow. Cerebral blood flow (CBF) (and with it the cochlear blood flow) can be increased most efficaciously by increasing arterial pCO2. A marked influence on cochlear blood flow after intravenous injection of vasoactive substances is not to be expected.
The Concentration of Antibiotics in Sinus Secretions; Ampicillin, Cephradine and Erythromycinestolate
Authors: Axelsson A. , Brorson J.-E.
Published: October 2014

The ability of different antibiotics to penetrate into the diseased maxillary sinus was investigated. Patients with acute maxillary sinusitis with secretion were given ampicillin, cephradine or erythromycinestolate. Forty-four aspirated and 155 irrigated samples were assessed. Any correlations between the concentration of the antibiotic and clinical parameters such as interval last antibiotic dose, duration of therapy, radiological sinus state, sinus ostium patency and irrigation findings were also investigated. The highest concentration was achieved with ampicillin and the lowest with cephradine. In general no correlation between the concentration of antibiotics and the clinical parameters could be demonstrated. The apparent uncertain and individual ability of antibiotics to penetrate into the diseased sinus is discussed.
Experimental Middle Ear Effusions: An Immunofluorescent Study
Authors: Hussl Burkhard , Lim David
Published: October 2014

Immunological phenomena occurring in the mucosa of the middle ear and Eustachian tube were investigated following experimental tubal obstruction which produced middle ear effusions in squirrel monkeys. Although there are many variations among specimens, in general all classes of immunoglobulin-producing plasma cells have shown an increase in number and/or an increase in intensity of fluorescence. IgG and IgA-producing plasma cells were more prominent than those producing other immunoglobulins. Presence of IgA in the secretory epithelial cells of the Eustachian tube of normal monkeys further supports the concept that the middle ear and Eustachian tube in the monkey as in human are protected by an immunodefense system.
Localization of 99mTechnetium in the Region of the Nose in Sjögren's Syndrome
Authors: Jones Alfred E. , Larson Alvin L. , Powell Ralph D. , Johnston Gerald S. , Henkin Robert I.
Published: October 2014

Patients with Sjögren's syndrome accumulated abnormal amounts of 99mtechnetium pertechnetate in the region of the nose during isotopic salivary flow studies. It was concurrently and independently observed that many patients with Sjögren's syndrome had hyposmia and pathological changes in the nasal mucous membranes. Fourteen patients with Sjögren's syndrome were studied for the relationship of the above observations and the nasal accumulation of radionuclide was compared with a control group of 16 subjects. Eleven of 14 patients with Sjögren's syndrome (78%) had nasal accumulation of the radionuclide; 14 had hyposmia and 13 of 14 had chronic inflammation of the nasal mucous membrane. One of 16 controls (6%) localized radionuclide in the nasal region. Results suggest that hyposmia, inflammatory changes in the nasal mucous membrane, and nasal accumulation of 99mtechnetium pertechnetate are interrelated aspects of Sjögren's syndrome.
A Contribution to the Physiology of the Perilymph Part III: On the Origin of Noise-Induced Hearing Loss
Authors: Schnieder Ernst-August
Published: October 2014

After exposure to white noise (SPL > 90 dB) the cochlear half life (τ) is increased by 100%. After exposure to white noise (90 dB<SPL<105 dB) the concentration of lactate in the perilymph increases significantly, while the blood level remains constant. Both results are capable of supporting the hypothesis that exposure to noise of a critical intensity (which appears to lie beween 90 and 100 dB) reduces cochlear blood flow. This reduction in turn diminishes the exchange rate of perilymph and reduces the oxygen supply to the sensory cells. The subsequent hypoxidosis of the organ of Corti may cause metabolic breakdown in, and on prolonged exposure, degeneration of the sensory cells. Both results are further capable of supporting the hypothesis outlined in Part I, that perilymph is the medium of transport to and from the cells of the organ of Corti.
Experimental Facial Nerve Paralysis: Influence of Decompression
Authors: Greer James A. , Cody D. Thane R. , Lambert Edward H. , Weiland Louis H.
Published: October 2014

An experimental model was employed to establish an endotemporal bone facial nerve paralysis in cats. Twelve facial nerves were initially surgically decompressed— Both bony decompression and sheath decompression—to determine if any harm was done to the nerves by these procedures. Transient harm was found in 3 of the 12 nerves. After the course of the facial paralysis without any decompression was determined, 39 cats underwent either bony or sheath nerve decompression, both immediately after injury and after a delay. The cats were followed clinically and electrophysiologically; the nerve excitability test and the amplitude and latency of muscle response evoked by nerve stimulation were used to evaluate nerve function. While immediate postinjury bony decompression resulted in slightly earlier recovery times, immediate sheath splitting significantly lengthened recovery times and worsened the electrophysiologic test results. Histologic studies confirmed the clinical and electrophysiologic results anatomically. Delayed nerve decompression, either bony or sheath, was not associated with faster recovery rates.
Clinical Experience and Experimental Findings with Sodium Fluoride in Otosclerosis (Otospongiosis)
Authors: Causse Jean , Chevance L. G. , Shambaugh George E.
Published: October 2014

The functional results in 2091 cases are presented. Patients were divided into surgical and nonsurgical groups and the findings were correlated with the use of NaF. An experimental study of the perilymph in otospongiotic patients and a qualitative study of the enzymes is reported.
Effect of Chlorine Bleach on the Esophagus
Authors: Hook Carl T. , Lowry Louis D.
Published: October 2014

The stimulus for this review and study was the report of experimentally produced esophageal burns in animals secondary to Clorox® ingestion which was reported by previous investigators in Chicago. Twenty-six children have been admitted to Children's Memorial Hospital since 1969 with “bleach ingestion” as the diagnosis. All but six underwent esophagoscopy in compliance with a “Pediatrics-Otorhinolaryngology Study Protocol” in an attempt to diagnose esophageal burns. Chemical burn of the esophagus was found in only one case; however, the exact content of ingested material was not definitely identified. In the one case of chemical burn, treatment was performed per protocol, and the patient is free of symptoms of stricture eighteen months postingestion. None of the other twenty-five patients have returned for treatment of ingestion sequelae. A laboratory study was conducted which utilized cats to simulate Clorox® ingestion by children. The cats were sacrificed at varying periods of time following ingestion with gross and microscopic exam of each esophagus being performed. Results showed the potential of chlorine bleach to cause chemical burns and superficial ulceration, but no stricture or residual sequelae when ingested in a manner simulating physiologic swallowing. Appropriate conclusions were made in respect to treatment of future patients with the diagnosis of “bleach ingestion.”