bluuebunny/crossref_metadata_2025 huggingface dataset:
Remission of Superior Oblique Myokymia after Microvascular Decompression
Authors: Scharwey Kerstin , Krzizok Thomas , Samii Madjijd , Rosahl Steffen K. , Kaufmann Herbert
Published: April 2003

Superior oblique myokymia (SOM) is an ocular motility disorder characterized by oscillopsia, vertical or torsional diplopia, sometimes combined with pressure sensation. Although the pathophysiological basis is unclear, isolated case reports have documented its association with intracranial pathological processes. We present a case of SOM associated with a vascular compression of the fourth nerve at the root exit zone. Following microneurosurgical decompression, SOM completely resolved and paralysis of the fourth nerve occurred. This was less disturbing.
Expression of Fibroblast Growth Factor Receptor in Adult Mouse Utricle Damaged by Streptomycin Sulfate
Authors: Yamashita Hiroshi , Gondo Toshikazu , Ishihara Tokuhiro , Takahashi Masahiro
Published: April 2003

The expression of fibroblast growth factor (FGF) receptor was investigated in adult mouse utricles damaged by streptomycin sulfate using confocal laser scanning microscopy (CLSM). The nerve endings in the mouse utricles could be detected by the immunoreactivity of neurofilament by CLSM. In the utricles of control adult mice, little expression of FGF receptor could be detected by a method of double staining for FGF receptor and neurofilament immunoreactivities. However, the expression of FGF immunoreactivity increased in the nerve endings of the damaged utricles. This result suggests that FGF is probably related to the synaptic plasticity in the adult mouse utricles.
Studies of Cochlear Blood Flow in Guinea Pigs with Endolymphatic Hydrops
Authors: Yazawa Yoshiro , Kitano Hiroya , Suzuki Mikio , Tanaka Hirosi , Kitajima Kazutomo
Published: April 2003

Laser Doppler flowmetry was used to assess cochlear blood flow (CoBF) in guinea pigs with experimental endolymphatic hydrops following intravenous infusion of 5 types of drugs: 50% glycerol, 70% isosorbide, 20% mannitol, 7% sodium bicarbonate, and 1% diphenidol. The magnitude of the CoBF changes following infusion tended to be smaller in the hydropic ears than in the normal control ears. A significant reduction in CoBF changes was observed in hydropic ears infused with isosorbide and sodium bicarbonate. These results suggest that the cochlear microvascular sensitivity to various stimuli such as drug infusion is reduced in hydropic ears. This may result from atrophy of the stria vascularis which is often observed in the hydropic ears of guinea pigs. Thus it seems likely that the same reaction occurs in the inner ear of patients with Ménière’s disease in whom atrophy of the stria vascularis is also presumed to exist in conjunction with extensive endolymphatic hydrops. Therefore, it seems probable that the function of the microvasculature of the stria vascularis is impaired in the inner ear of patients with Ménière’s disease, resulting in the slow progressive deterioration of the inner ear with time.
Haemophilus influenzae and Streptococcus pyogenes Group A Challenge Induce a Th1 Type of Cytokine Response in Cells Obtained from Tonsillar Hypertrophy and Recurrent Tonsillitis
Authors: Ågren Karin , Brauner Annelie , Andersson Jan
Published: April 2003

We have previously shown that tonsil tissue both from children with tonsillar hypertrophy and recurrent tonsillitis is colonized and invaded by Haemophilus influenzae and Streptococcus pyogenes group A. In order to evaluate if these bacteria are involved in the immunopathogenesis of these two conditions, tonsillar cells from both groups were stimulated in vitro with intact, heat-inactivated H. influenzae or S. pyogenes A. The immunoreactivity was evaluated by assessing the induction of cytokine production (IL-1α, IL-1β, TNF-α, IL-6, IL-8, IL-2, IFN-γ, IL-4, TNF-β and IL-10), which was detected at the single-cell level. All cytokines studied except IL-4 were induced in both groups after stimulation with H. influenzae or S. pyogenes A. The dominating cytokines were IL-1β, IFN-γ and TNF-β. No major differences in the cytokine pattern or number of cytokine-producing cells were noticed between the two patient cohorts after H. influenzae stimulation. Activation by S. pyogenes A bacteria gave rise to higher frequencies of IFN-γ- and TNF-β-synthesizing cells in the recurrent tonsillitis group. The incidence of CD4-, CD8-positive T cells and CD40-positive B cells was comparable between the two groups while the MAC-387-positive macrophages were significantly higher in the recurrent tonsillitis groups. In conclusion, a Th1 type of cytokine response was found in both groups following stimulation with H. influenzae or S. pyogenes A.
Pathological Features of Healing of a Ruptured Human Round Window Membrane
Authors: Sone Michihiko
Published: April 2003

Pathology of a round window membrane rupture was demonstrated in a human temporal bone from a case in which labyrinthotomy had been performed through the round window membrane. Proliferation of mesothelial cells was seen in the inner layer of the membrane, and it appeared to be reinforced from the inside by these reactive cells. The middle layer of the membrane was thickened by increased collagen and elastin. The pathologic changes which take place during healing of the ruptured round window membrane are discussed.
Chondrosarcoma of the Temporal Bone and Otosclerosis
Authors: Ramírez-Camacho R. , Pinilla M. , Ramón y Cajal S. , Berrocal J.R. García , Vicente J.
Published: April 2003

Chondrosarcoma constitutes 6% of all primary bone tumors and 11% of malignant primary bone tumors. Nevertheless, in a review of the tumor registry of the University of Michigan covering a period of 50 years, there were only 3 cases involving the temporal bone. A case of a woman with a chondrosarcoma of the temporal bone that was partially resected by means of an infratemporal approach at the skull base is presented. This patient had previously undergone surgical treatment for otosclerosis of the other ear. Several considerations regarding survival factors in this type of tumor are dealt with in terms of the histological features, therapeutic options and anatomic location. The possibility that this lesion may originate from the persistence of the cartilaginous inclusions that some authors consider to be involved in the origin of otosclerosis is discussed.
Calcium Mobilization in Isolated Epithelial Cells of the Endolymphatic Sac
Authors: Arishige Shuso , Takumida Masaya , Yajin Koji
Published: April 2003

Endolymphatic sac epithelial cells were isolated from the endolymphatic sac of the guinea pig by enzymatic and mechanical dissociation. The intracellular free calcium ion concentrations ([Ca2+]i) of the isolated cells were determined using the Ca2+-sensitive dye fura-2. The isolated cells were classified into two types, i.e. light and dark cells. In the resting state, [Ca2+]i in the cells was variable in both types of cells. In the presence of 200 µM ATP, there was a rapid rise in [Ca2+]i. These findings suggest that endolymphatic sac epithelial cells may have receptor-mediated Ca channels which may play an important role for a nerve-mediated local feedback system of the endolymphatic sac to regulate homeostasis of endolymph volume, pressure and electrolyte balance.
Vestibular Function and Cochlear Implant
Authors: Rossi Giovanni , Solero Paolo , Rolando Marco , Bisetti Massimo Spadola
Published: April 2003

The authors illustrate their personal experience relating to 32 patients, aged between 12 and 74 years, undergoing cochlear implant, in whom vestibular reflexes were evaluated before and after surgery. This series did not include cases of areflexia, but only 1 case of reduced vestibular reflexia consequently to surgery. In this case, owing to the probable intervention of central compensation processes, labyrinthine hyporeflexia never became clinically significant. These personal results enable the authors to affirm that preoperative vestibular reflexes do not offer elements able to influence the choice of the ear in which to perform the cochlear implant. In the series of patients reported by the authors, a cochleostomy by removal of the floor of the round window niche, following the suggestions of O’Leary et al., always headed the electrode implant. This contrivance may reduce or eliminate the negative effects on vestibular receptors indirectly caused by the consequent and inevitable alteration of perilymph pressure produced by the implant.
Advances in the Use of Glass-Ionomeric Cement
Authors: Weber B.P. , Philipps B. , Strauchmann B. , Lenarz T.
Published: April 2003

An experimentally developed technique for microapplication of low-viscosity glass ionomeric cement (see part 1) was tested in animals over a 6-month period. The cement was used to firmly connect gold with titanium and gold with middle ear ossicles in 22 adult foxhounds. After a 6-month period of acoustic stimulation via parts of an implantable hearing aid, the finely applied glass-ionomeric cement was integrated in situ, stable and caused no adverse reactions. The microapplication technique used proved to be easy, effective and provided long-term stability.
Clonal Expansion of T-Cell Receptor Beta Gene Segment in the Retrocochlear Lesions of EAE Mice
Authors: Cheng Kuang-Chuan , Lee Kyung Mi , Yoo Tai-June
Published: April 2003

It has been reported that the T cell receptor Vβ8.2 (TcrbV8.2) gene segment is predominantly expressed in encephalomyelitic T cells responding to myelin basic protein (MBP) in experimental allergic encephalomyelitis (EAE) mice. We have demonstrated retrocochlear hearing loss in EAE mice in previous studies. Administration of a monoclonal antibody specific to the T cell receptor Vβ8 (TcrbV8) subfamily prevented both this type of hearing loss and the central nerve disease. In this study, we examined the role of the TcrbV8.2 gene segment in the retrocochlear lesions of EAE mice. A clonal expression of T cell receptor beta chain gene segment (TcrbV8.2-TcrbD2-TcrbJ2.7) was identified in the retrocochlear lesions. The TcrbV8.2 gene segment appears to recombine only with TcrbJ2.1 (32.1%) and TcrbJ2.7 (67.9%) gene segments. The TcrbJ2.7 gene segment has also been previously identified as the dominant TcrbJ gene in the lymph nodes of EAE mice. Only TcrbD2, with a length of 4 amino acids, was observed recombining with these TcrbV8.2 sequences. G and C nucleotides are predominantly expressed at the N regions between the V-D and D-J junctions. This dominant TcrbV gene segment (TcrbV8.2-TcrbD2-TcrbJ2.7) observed in the retrocochlear lesions has been identified in the MBP-specific T cells from the lymph nodes of EAE mice. These results suggest that a small subset of antigen-specific T cells migrate to, and expand at, the retrocochlear lesions, which leads to hearing loss.
Time Course of Eye Nystagmus and Body Movement after Peripheral Vestibular Lesions in Guinea Pigs
Authors: Thompson G.C. , Ross C.D. , Britton B.H.
Published: April 2003

Body movement of guinea pigs was measured using a force platform at various times before and after unilateral end organ ablation and before and after sham surgery. Both spontaneous and drop-evoked movement patterns differed in the same animal after vestibular ablation and from control animals that received sham lesions. Whereas measures of eye nystagmus disappeared by 48 h postablation, measures of body movement indicated persistent differences even at 72 h. We conclude that the force platform can differentiate between movement patterns of normal and vestibular-lesioned animals and, in fact, measures a vestibular deficiency that is independent of eye nystagmus. The force platform appears to be a useful addition to evaluate vestibular deficits as well as to detect any benefits of pharmacological or surgical therapies.
A Second Primary Squamous Cell Carcinoma Arising in a Radial Forearm Flap Used for Reconstruction of the Hypopharynx
Authors: Sakamoto Masayuki , Nibu Ken-ichi , Sugasawa Masashi , Nakatsuka Takashi , Harii Kiyonori , Ichimura Keiichi
Published: April 2003

A 63-year-old man had undergone hypopharyngectomy for hypopharyngeal carcinoma in 1985. A free radial forearm flap was used for reconstruction of the pharynx. Ten years after the surgery, a second primary squamous cell carcinoma occurred in the neopharynx. Persistent exposure to alcohol, saliva and foodstuffs was considered as a possible cause of second primary carcinoma. Long-term follow-up is indicated in patients undergoing reconstruction using cutaneous or musculocutaneous flaps.
Localisation of Ecto-5{LC2}’- Nucleotidase and Divalent Cation-Activated Ecto-ATPase in Chronic Tonsillitis
Authors: Avramović Verica , Vlahović Predrag , Savić Vojin , Stanković Milan
Published: April 2003

The histochemical localisation of two ecto-enzymes, 5′-nucleotidase (5′-NT) and Mg2+-ATPase, was investigated in hyperplastic and recurrent tonsillitis. Detection of enzymes was performed on frozen sections using the classical lead nitrate method. Activity of 5′-NT was demonstrated particularly in the cells of lymphoid follicles and in the basal layer of the surface tonsillar epithelium. There was no difference in localisation of 5′-NT between hyperplastic and recurrent tonsillitis, whereas a stronger reaction in follicular mantle zones was observed in recurrent tonsillitis compared to hyperplastic tonsillitis. Mg2+-ATPase activity was mainly associated with the cells lining the tonsillar crypt, with the interfollicular areas and blood vessels. In recurrent tonsillitis only half of the studied follicular germinal centres expressed Mg2+-ATPase activity, compared to hyperplastic tonsillitis. The similar localisation of 5′-NT and ecto-ATPase in both types of chronic tonsillitis suggests that in inflamed tonsils expression of investigated enzymes probably does not depend on the type of chronic tonsillitis.
Ciliary Beat Frequency, Olfaction and Endoscopic Sinus Surgery
Authors: Abdel-Hak Balegh , Gunkel Andreas , Kanonier Georg , Schrott-Fischer Anneliese , Ulmer Hanno , Thumfart Walter
Published: April 2003

We assessed prospectively changes in olfaction and ciliary beat frequency (CBF) after functional endoscopic sinus surgery (FESS) in 70 patients with chronic sinusitis. CBF was measured by the microscopic-photometry technique 2, 4 and 6 months after FESS. Olfaction was evaluated by the Erlangener Smell Identification Test. Preoperative CBF was markedly reduced due to the infectious process. CBF was significantly improved (p < 0.001), reaching normal values 6 months postoperatively despite the endoscopic examination revealing normal nasal mucosa at around 3 months. The pattern of improvement of CBF was linear being more rapid between months 4 and 6. After operation olfactory-impaired patients were improved subjectively and objectively (p < 0.001 and p = 0.003). We conclude that impaired olfactory ability and CBF are significantly improved after FESS, and FESS demands longer postoperative follow-up periods for at least 6 months even if the clinical evaluations were normal.
Bilateral Facial Nerve Palsy: Four Case Reports
Authors: Arias Gloria , Nogués Julio , Mañós Manuel , Amilibia Emilio , Dicenta Manuel
Published: April 2003

Bilateral facial nerve palsy is relatively uncommon and may occur in association with a variety of neurological, infectious, neoplastic or degenerative disorders. Presentation is made of 4 cases of bilateral facial diplegia due to a refractory anemia with excess of blasts, a Lyme disease and a tuberculoid leprosy. In one of these patients the cause of bilateral seventh-nerve palsy was unknown (Bell’s palsy). Facial palsy returned to normal after treatment with steroids in 3 patients. The patient with myelodysplastic syndrome did not show any improvement and died 6 months after diagnosis.
Artificial Petrous Bone Produced by Stereolithography for Microsurgical Dissecting Exercises
Authors: Begall Klaus , Vorwerk Ulrich
Published: April 2003

Training in microsurgery of the middle ear requires dissecting to be carried out on petrous bone. Human petrous bone structures are not available in adequate quantity to permit extensive practicing. Using synthetic resins, true reproductions of petrous bone can be obtained by means of a stereolithographic method, yielding structures of the petrous part which are highly similar to human bone. Digital data sets are obtained from spiral CT scans, and transferred to CAD systems such that, using stereolithography, petrous bone facsimiles are produced on the parametric model. Any number of such models of an original can be produced. Thus, identical structures can be made available for a wide range of uses. Exercises conducted on artificial petrous bone so produced are equivalent to those carried out on human structures, in terms of material properties and visualisation of anatomic details.
Possible Involvement of Free Radicals in Lipopolysaccharide-Induced Labyrinthitis in the Guinea Pig: A Morphological and Functional Investigation
Authors: Takumida Masaya , Anniko Matti , Popa Raul
Published: April 2003

Intratympanic injection of bacterial lipopolysaccharide impaired caloric responses and caused severe and widespread morphological damage to vestibular end organs and the endolymphatic sac in the guinea pig. These effects could be blocked with N-nitro-L-arginine methylester, a competitive inhibitor of nitric oxide synthase, with superoxide dismutase, an O2 scavenger, with dexamethasone, and with ebselen, a scavenger of peroxynitrite. These observations indicate that enhanced nitric oxide and superoxide production, resulting in formation of peroxynitrite, is probably an important factor responsible for the pathological damage to vestibuli. If this is so, we may have found a way to study vestibular pathogenesis in inner ear disease.
Cochlear Microphonic Potentials in Patients with Vestibular Schwannomas
Authors: Noguchi Yoshihiro , Komatsuzaki Atsushi , Nishida Hiroaki
Published: April 2003

We evaluated the cochlear function of 44 patients with unilateral vestibular schwannomas by measuring cochlear microphonic potentials (CM) in electrocochleography. We used short tone bursts with 0.5-, 1-, 2-, and 4-kHz frequencies as acoustic stimuli to evoke CMs, and determined CM detection thresholds. The CM detection thresholds in vestibular schwannomas ranged from normal to no response. Cochlear dysfunction was seen in 35 (79.5%) of the 44 cases; these patients had higher CM detection thresholds than normal subjects. Although a significant correlation was found between mean hearing level (0.5–4 kHz) and mean CM detection threshold (0.5–4 kHz), 20 patients had lower CM detection thresholds than were found using audiometry. This suggests that there is an additional retrocochlear component responsible for this hearing loss.
Titanium and Glass-Ionomer Cement as Ossicular Replacement Materials: Biocompatibility Results after Implantation in the Rabbit
Authors: Schwager Konrad , Geyer G.
Published: April 2003

The middle ear poses unique challenges when finding suitable materials for ossicular reconstruction, primarily because of its link to the external environment via the eustachian tube, which leads to a greater potential for exposure to infectious agents. In this animal study, the biocompatibilities of titanium and glass-ionomer cement were assessed in the middle ear of the rabbit after being implanted as total ossicular replacement prostheses (TORPs) or as free pins. Animals were sacrified after 28, 84, 168, 336, or 504 days or 2 years, and a cutting saw technique was used to prepare slides for light microscopy. Slides were examined for mucosal coverage and any sign of foreign body reaction. Both materials showed good acceptance in the middle ear. After 28 days, the TORPs were covered by middle ear mucosa. As expected, it took a longer time (up to 504 days) to cover the free implants. An interesting finding was the growth of new bone on both the surface of the titanium implants and the glass-ionomer prostheses. The results of this animal study indicate that both titanium and glass-ionomer cement are favorable materials for ossicular replacement prostheses.
The Effect of Epstein-Barr Virus Gene BHRF1 Expression on Radioresistance of Nasopharyngeal Carcinoma Cells
Authors: Huang H. , Pan X.H. , Zhou J.H. , Yu L. , Kong X.T. , Zhou S.M. , Li Z.J. , Fu Q. , Sun X.Y.
Published: April 2003

In order to investigate the effect of the expression of Epstein-Barr virus gene BHRF1 on the apoptotic resistance of nasopharyngeal carcinoma cells to radiation, a highly expressing vector for BHRF1 was constructed and transfected into the nasopharyngeal carcinoma cell line CNE2. Then, the biologic alterations of the cells were tested after 60Co radiation. The results showed that, in the BHRF1-expressing cells, the apoptotic index was far lower than in the control groups after 60Co radiation, and cells recovered faster from the radiation, with a higher cell-proliferative rate, stronger ability of colony formation and tumor development in nude mice than that in the control groups. Given the functional homology of BHRF1 with bcl-2, our data indicate that BHRF1 expression could prohibit nasopharyngeal carcinoma cellular apoptosis caused by radiation and in this way contribute to oncogenic transformation.
Lectin Expression during Wound Healing of the Rabbit Sinus Mucosa: A Study of Regenerating Epithelium and Early Polyp Formation
Authors: Otori Nobuyoshi , Carlsöö Bengt , Stierna Pontus
Published: April 2003

Lectin expression during wound healing of the rabbit sinus mucosa was examined. Positive UEA-I staining was evident on squamous or cuboidal as well as columnar regenerating epithelial cells (RE cells). PNA staining of columnar RE cells first became evident after neuraminidase treatment, while squamous or cuboidal RE cells stained positively with PNA alone. Fucosylation within RE cells thus occurred from a relatively early period, and sialylation followed at later stages. Ingrowing epithelial cells of early polyp formation stained negatively with UEA-I, indicating that unfucosylated RE cells may represent aberrant cellular behavior. We concluded that these patterns of lectin staining indicate a functional maturation as well as an integration of regenerating mucosa.
Can Short-Latency Vestibulospinal Reflexes in Lower Leg Muscles Be Elicited by Tapping the Head?
Authors: Iida Masahiro , Bötzel Kai , Dieterich Marianne , Krafczyk Siegbert , Brandt Thomas , Hitouji Kayoko , Igarashi Makoto , Sakai Makoto
Published: April 2003

A gentle tap on the forehead evoked short-latency motor responses in the sternocleidomastoid muscle, which may be vestibulocollic reflexes with characteristics similar to those elicited by clicks. We tested this paradigm in subjects standing upright, in order to determine the differential effects of taps on the forehead on the patterns and latencies of spinal stretch and vestibulospinal reflexes, which are important for postural control. Taps on the forehead elicited short-latency inhibitory electromyographic responses in both gastrocnemius muscles with a mean latency of 48.3 ± 3.1 ms (onset) to 98.3 ± 6.3 ms (end). Taps on the sternum elicited similar responses from the gastrocnemius muscles, indicating that vestibular stimulation is not essential for eliciting these responses. Both responses may play a role in predetermining the strategy for correcting body perturbations. The actual reflex is probably elicited by somatosensory input from the neck, which converges with vestibular input for the multisensory control of posture.
A New Stapedotomy Prosthesis: Preliminary Report
Authors: Velegrakis George A. , Papadakis Chariton E. , Prokopakis Emmanuel P. , Helidonis Emmanuel S.
Published: April 2003

Our study describes a newly designed stapedotomy prosthesis which consists of two components: (1) a platinum ribbon, and (2) a Teflon shaft. The first innovation is a flattened ‘tab’ on the posterior aspect of the platinum ribbon. The second innovation concerns the dual diameter cylinder-like shaft. Our prosthesis was implanted into 25 individuals, who underwent stapedotomy for stapes fixation, and the results are shown and discussed. Our innovations offer a proper and safe insertion of the prosthesis into the oval window associated with excellent manipulation and handling. At the same time, maximum visualization of the surgical field is achieved, while the stepped-down design of the shaft prevents the prosthesis protruding into the vestibule.
Blink Reflex Excitability Recovery Curves in Patients with Dysfunctions after Facial Nerve Palsy
Authors: Nakamura Katsuhiko , Kashima Kenji , Koike Yasuo
Published: April 2003

The blink reflex excitability recovery curves were studied in 12 patients with postparalytic facial dysfunctions (PPFD) and 12 healthy control subjects. The inhibitory effects of the conditioning stimuli on the ipsilateral R2 and contralateral R2 responses observed in control subjects were significantly less in patients with PPFD. The enhanced recovery of the R2 responses was similar on the affected side and unaffected side in the patients. These results indicate that patients with PPFD have an increased excitability of central interneurons which mediate the R2 pathway. It is suggested that not only changes in the peripheral facial nerve but also changes in the central nervous system may contribute to the onset of PPFD.
Stenosis of the Internal AuditoryCanal with VIIth and VIIIth Cranial Nerve Dysfunctions
Authors: Nakamura Katsuhiko , Koda Junji , Koike Yasuo
Published: April 2003

We report the case of a 37-year-old woman with a history of long-standing right-sided sensorineural hearing loss who presented with an acute onset of vertigo and ipsilateral facial palsy. A computed tomographic scan study showed a stenosis of the right internal auditory canal (IAC). Neither generalized skeletal disease nor bony tumors, which may cause the IAC stenosis, were evident. The IAC stenosis found in this patient may be due to congenital malformation. Inflammation, compression or ischemia in the stenosed IAC may have resulted in the vertigo and facial palsy. This is the only case that we are aware of in which IAC stenosis is accompanied by vertigo and facial palsy.
Otoneurosyphilis Masquerading as Neurofibromatosis Type II
Authors: Ahmad Ijaz , Lee W.C.
Published: April 2003

We present a case report of a 75-year-old patient with bilateral sensorineural hearing loss, vertigo and progressive neurological deficits. MRI scans showed multiple intracranial lesions. In the light of positive serological tests for syphilis, these unusual radiological features might represent gummatous lesions which were in keeping with a diagnosis of tertiary syphilis with otological and neurological involvement. The patient was treated with Bicillin and corticosteroids with initial improvement, but succumbed rapidly with multiple neurological deficits. The radiological differential diagnosis included neurofibromatosis type II in this case, which illustrates that neurosyphilis can mimic other neurological diseases. The literature on neurosyphilis is reviewed.
Large Vestibular Aqueduct Syndrome
Authors: Walsh R.M. , Ayshford C.A. , Chavda S.V. , Proops D.W.
Published: April 2003

A large vestibular aqueduct is one of the commonest radiological abnormalities of the inner ear. A case of acute profound unilateral sensorineural hearing loss and balance disturbance following minor head trauma in the presence of an abnormally enlarged vestibular aqueduct is described. The significance of a diagnosis of large vestibular aqueduct syndrome, in the presence of serviceable hearing, is that it identifies patients who should refrain from activities that increase intracranial pressure to prevent hearing loss.
Methicillin-Resistant Staphylococcus aureus Neck Infections Resulting in a Delayed Abscess and a Tracheo-Oesophageal Fistula
Authors: Ahmad Ijaz , Lee W.C.
Published: April 2003

We describe 2 cases of methicillin-resistant Staphylococcus aureus neck infections resulting in a deep neck abscess in one and formation of a tracheo-oesophageal fistula in the other. Predisposing factors, preventive measures and the principles of management are discussed. The role of carrier detection and rational use of antibiotics are highlighted.
Evaluation of Second-Ear Stapedotomy with the Glasgow Benefit Plot
Authors: de Bruijn A.J.G. , Tange R.A. , Dreschler W.A.
Published: April 2003

This study reports the evaluation of the results after 72 stapedotomies in patients with bilateral otosclerosis. All pre- and postoperative audiological data, together with all relevant information of the operations, were stored in a data base and analyzed retrospectively. The Glasgow benefit plot (GBP) is a useful method to evaluate the hearing results of each individual ear after stapes surgery in a more functional way rather than from a technical standpoint. Therefore, it has been used to assess the benefit obtained after second-ear stapedotomy. From the results it appears that a second operation on the contralateral side increases the chances of achieving at least one ‘normal’-hearing ear, and it makes symmetrical ‘normal’ hearing possible in the majority of the cases.
Auditory Brainstem Response and Neuropathology in a Case of Systemic T-Cell Lymphoma with Intracranial Metastasis
Authors: Naito Rie , Hayashida Tetsuro , Mochizuki Mamoru , Kojima Hideaki , Kaga Kimitaka
Published: April 2003

A 58-year-old male with systemic T-cell lymphoma involving the brainstem eccentrically, showed varying abnormal auditory brainstem responses (ABRs). The initial ABR demonstrated a prolonged V wave peak latency and an I-V IPL on admission. Four months later, all waves were absent bilaterally. Neuropathological examination at autopsy revealed that most of the nuclei and tracts associated with the auditory system were destroyed by lymphoid cell infiltration. It suggested that in the early stages of this disease, lymphoid cells could have involved the lower brainstem and, subsequently, in the advanced stages invaded the inferior colliculus.
Neurothekeoma, a Rare Tumour of the Tongue
Authors: Breuer T. , Koester M. , Weidenbecher M. , Steininger H.
Published: April 2003

Neurothekeomas are benign tumours mostly arising in the face and upper limbs predominantly in young women. Histologically they can be classified as cellular or myxoid, and complete surgical resection is the treatment of choice. In this case of a neurothekeoma located in the anterior tongue of a child, cryotherapy was used as the treatment modality, in order to avoid a greater loss of tongue function.
Basaloid Squamous Cell Carcinoma of Oral Cavity and Oropharynx
Authors: Altavilla Giuseppe , Mannarà Giacinto M. , Rinaldo Alessandra , Ferlito Alfio
Published: April 2003

Basaloid squamous cell carcinoma is a variant of squamous cell carcinoma with distinctive histological and immunohistochemical characteristics and aggressive behaviour involving predominantly the upper aerodigestive tract. We describe the clinicopathological findings, along with immunohistochemical investigations, in 5 new cases with carcinoma localized in oral cavity and oropharynx.
Long-Term Stability between Click-Evoked Otoacoustic Emissions and Distortion Product Otoacoustic Emissions in Guinea Pigs: A Comparison
Authors: Hoshino Michitaka , Ueda Hiromi , Nakata Seiichi
Published: April 2003

This study examines the long-term stability of otoacoustic emissions (OAEs), and we selected click-evoked otoacoustic emissions (CEOAEs) and distortion product otoacoustic emissions (DPOAEs) from several types of OAEs. We then compared these methods for the long-term monitoring of inner ear functions. Over a period of 8 weeks, we measured CEOAEs and DPOAEs in guinea pigs (n = 8) every week and analyzed the changes in the total echo power of CEOAE, the echo power of frequency bands of CEOAE and the DPOAE level (f2/f1 = 1.2). We considered as ‘stable’ parameters those that showed small changes or of which the p value was close to 1.0. Good p values of CEOAEs were obtained over the 2- to 3-kHz range; better p values of DPOAEs were obtained over the 2- to 8-kHz range. Thus, DPOAEs afforded the extended frequency information achievable with CEOAEs. According to our results, DPOAEs were superior to CEOAEs as parameters of long-term stability because they showed fewer changes in level at each frequency.
Prognostic Value of Multiple-Frequency Tympanometry in Acute Otitis media
Authors: Vlachou Stamatia , Ferekidis Eleftherios , Tsakanikos Michael , Apostolopoulos Nicholas , Adamopoulos Georgios
Published: April 2003

Multiple-frequency tympanometry (MFT) and conventional 226-Hz tympanometry were performed in 86 ears of children affected by acute otitis media (AOM) after therapy. In a 3-month follow-up period, the recurrence rate of AOM and persistence of middle-ear effusion in these children were evaluated in comparison with the early results of the two methods, as well as the relation of MFT findings to the possibility of development of AOM sequelae. It seems that abnormal resonant frequency values and recordings by MFT right after an episode of AOM indicate persistence of changes in the mass and stiffness balance of the middle ear, not demonstrated by conventional tympanometry, that could be responsible for a higher probability of AOM sequelae.
Toward Three-Dimensional Analysis of Cochlear Structure
Authors: Steele Charles R.
Published: April 2003

Recent results from a three-dimensional model of the cochlea are summarized. The features include physically realistic values of basilar membrane stiffness, mass, and fluid viscosity. The simple ‘feed-forward’ principle for the active process yields results in qualitative agreement with recent mesurements in the cochlea. The limitation is a simplified representation of the organ of Corti, with two degrees of freedom representing the motion of the pectinate and arcuate zones of the basilar membrane. However, the inner sulcus fluid flow is included. The new feature presented in this paper is an approach to treat all the structural detail of the organ of Corti, with the sole input to the calculation in a form easily understood by anyone familiar with the cochlea. Specific results are shown for the Pakistani water buffalo, since a fairly complete anatomical description of this cochlea is available. The static stiffness from the calculation, based on only the anatomy and known values for the protein elastic moduli, are in remarkable agreement with recent measurements in the gerbil cochlea. Only preliminary results for the dynamic response with inviscid fluid are reported. Of interest, however, are the propagation modes related to significant fluid displacement and pressure in the different compartments of the organ of Corti.
Observations on Simultaneous Perilymphatic Motions and Cochlear Microphonics Suppression
Authors: Haberland E.-J. , Neumann H.J.
Published: April 2003

Very low frequencies interfere in the intact cochlea with higher frequencies and suppress these depending on the vibration phase of the low-frequency sound. Physiological functions of the body, mediated, for example, by the eardrum or perilymph coupling with the cerebrospinal fluid, cause a low-frequency pressure modulation of the perilymph, which generates a synchronous perilymphatic motion resulting from the unevenly distributed compliances in the cochlea. This slow streaming causes a displacement of the entire basilar membrane, with as a consequence a postponement of the operating point of the mechanoelectrical transducer as a result of the pressure drop in the helicotrema and the narrow apical cochlear turn. In this contribution, interference phenomena are described, which are caused by spontaneous contractions of the tensor tympani muscle and by respiration-synchronous perilymphatic flow. These two test signals have trapezoidal and triangular impulse functions. In both cases, as suppression pattern of the cochlear microphonics level-time function, the second derivative of the pressure-time function was observed. The suppression is found to lie between 1 and 2 dB. It depends on the level of the suppressed sound and shows a compressive nonlinearity.
3D-Finite Element Modelof the Human Cochlea Including Fluid-Structure Couplings
Authors: Böhnke Frank , Arnold Wolfgang
Published: April 2003

The propagation of acoustic waves in the inner ear in vivo could not be quantified completely yet. This is in particular true in conjunction with the micromechanical structures of the organ of Corti, though these data are important for the explanation and discussion of clinical measurements like otoacoustic emissions and auditory brainstem responses. To access these problems a three-dimensional mechanical model of the cochlea including the fluid-structure couplings is developed and evaluated numerically by finite elements. Although the complex cochlear partition is covered by passive mechanical elements, the results fit early experiments (1928), which studied the wave propagation in the cochlea with fresh human cadavers [G. von Békésy: Experiments in Hearing. New York, McGraw-Hill, 1960]. Additionally it is now easy to calculate the mechanical input impedance of the cochlea. These results agree with recent experiments [S.N. Merchant et al.: Hear Res 1996;97:30–45].
Surgical Anatomy of the Facial Nerve in Chinese Mastoids
Authors: Low W.K.
Published: April 2003

Since racial differences in mastoid morphology exist, there may be racial differences in the surgical anatomy of the facial nerve in the mastoid. Thirty Chinese adult temporal bones were dissected. The facial nerve in the mastoid coursed vertically (60.0%), anteriorly (33.3%) and posteriorly (6.7%) in the sagittal plane. In the coronal plane, it coursed vertically (46.7%) and laterally (53.3%). The chorda tympani was found to have extratemporal origin in 53.3% and for the rest, the distance of its origin from the stylomastoid foramen averaged 3.17 mm (range 0.5–6.0 mm). The mean dimension of the extended facial recess was 4.40 mm (range 3.0–6.0 mm). The facial nerve was at a mean of 3.15 mm (range 2.0–5.0 mm) posterior to the most posterior point of the tympanic annulus and partially crossed the tympanic annulus from medial to lateral at this point. In conclusion, the typical surgical anatomy of the mastoid facial nerve as described in the Western literature may not apply to the Chinese.
Neurotological Evaluation of Vertical Semicircular Canal Function in Inner Ear Malformation
Authors: Sasaki Osamu , Otsuka Akihiro , Asawa Shiro , Sakaguchi Masanori , Ishiyama Tetsuya , Ezawa Susumu , Taguchi Kiichiro
Published: April 2003

A 9-year-old boy with inner ear malformation complained of slight deafness and unsteadiness. CT revealed a normal cochlea despite enlargement of the lateral semicircular canals. The vertical semicircular canals developed more or less normally. The caloric test showed complete canal paresis bilaterally; however, a horizontal rotational stimulus elicited a vestibulo-ocular response, which showed only rightward and downward nystagmus, and their maximal slow-phase velocities were low. In addition, the examination of the vertical semicircular canal function using the head-tilted rotation test revealed a more active response, and the maximal slow-phase velocities were higher than those of a standard horizontal rotational test. These results suggest that the function of the vertical semicircular canal was well preserved and that it may have perceived the horizontal acceleration instead of the lateral semicircular canal.
Inner Ear Malformations: Mondini’s Dysplasia
Authors: Arellano B. , Ramírez-Camacho R. , Trinidad A. , Vicente J.
Published: April 2003

Advances in imaging techniques are enabling the detection of increasing numbers of inner ear malformations. Mondini’s dysplasia, whether alone or in association with other malformations, is one of those most frequently encountered. We report 4 cases of Mondini’s dysplasia treated by us, discussing recent embryological and genetic findings.
Immunohistochemical Localization of Proliferating Cells and Epidermal Growth Factor Receptors in Mouse Olfactory Epithelium
Authors: Ohta Yasushi , Ichimura Keiichi
Published: April 2003

We investigated age-related changes in proliferating cells and epidermal growth factor receptors (EGFRs) in mouse olfactory epithelium using an immunohistochemical method with the antiproliferating cell nuclear antigen (PCNA) antibody and the antihuman EGFRs antibody. Many PCNA-positive cells occurred in the surface and basal layers of the olfactory epithelium in the embryonal and neonatal mice. However, only some PCNA-positive cells occurred in the basal layer of adult mice, and only a few presented in the basal layer of aged mice. EGFRs were observed in all layers of the olfactory epithelium at the embryonal and neonatal stages, but were not identified in the olfactory epithelium at the adult or aged stages. We believe that a decrease in EGFRs in the olfactory epithelium induces the inhibition of cell proliferation, with the resultant atrophy of the olfactory epithelium.
Effectiveness and Utility of Chemical Labyrinthectomy with Streptomycin Using Osmotic Pump
Authors: Shimogori Hiroaki , Yamashita Hiroshi
Published: April 2003

To investigate the utility of osmotic pumps, labyrinthectomy was performed surgically (surgical group) or chemically with 30% streptomycin sulfate (SM) using osmotic pumps (SM group) in guinea pigs. After treatment, no statistical difference was observed in the frequency of spontaneous nystagmus and the degree of yaw head tilt between the groups. These data indicate the reliability and efficacy of osmotic pumps, and it might be possible to make guinea pig models using osmotic pumps to predict various grades of damage in the vestibular periphery of humans.
Side Effects after Surgical Treatment of Snoring
Authors: Hagert Britt , Wikblad Karin , Ödkvist Lars , Wahren Lis Karin
Published: April 2003

In a questionnaire study detailed side effects after snoring surgery were examined in 415 individuals 2–8 years after surgery. Three years later a new questionnaire was answered by those with side effects affecting taste, smell and voice (n = 74). At the first follow-up 255 had side effects of globus, regurgitation, taste, smell and voice. The globus was the most common (40%). In all spheres except the globus, a significant improvement was seen 3 years later. However, pharyngeal dryness and phlegm had a reported frequency of nearly 60%. No significant differences were seen between the uvulopalatopharyngoplasty and laser uvulopalatoplasty methods. Taste disturbances might be due to surgical damage to the nerves or oral dryness. The olfactory impairment present in 7 patients still needs to be explained.
Motor Potentials of Lower-Lip Mimetic Muscles and Distal Arm Muscles to Cortical Transcranial Magnetic Stimulation: The Possibility of One-Dimensional Separation of Two Cortical Representation Areas
Authors: Rödel R. , Laskawi R. , Markus H.
Published: April 2003

The cortical representation of the abductor pollicis brevis muscle (APB) was investigated by transcranial magnetic stimulation (TMS) along the interaural line on the head surface in 17 healthy subjects. Comparing amplitudes of motor evoked potentials (MEPs) with those obtained by cortical TMS of lower-lip muscles, we found a considerable overlap between the areas from which reproducible MEPs of APB and lower-lip muscles could be elicited. However, there was a statistically significant separation of the two areas, the APB area being placed more medially. With regard to short examination procedures it can be concluded that a separation between distal arm and facial muscles is possible not only by two-dimensional cortical mapping procedures, but also by one-dimensional cortical TMS.
Prognostic Factors of Chronic Rhinosinusitis under Long-Term Low-Dose Macrolide Therapy
Authors: Suzuki Hideaki , Ikeda Katsuhisa , Honma Rikako , Gotoh Satoru , Oshima Takeshi , Furukawa Masayuki , Takasaka Tomonori
Published: April 2003

We studied the immunological and histopathological factors that affect the prognosis of chronic rhinosinusitis under long-term low-dose macrolide therapy. Sixteen patients with chronic rhinosinusitis were given 200 mg clarithromycin or 150 mg roxithromycin orally once a day without other concurrent treatments for 2–3 months. Measurement of the serum IgE level, blood cell count and differential leukocyte count of the peripheral blood, cytological assessment of the nasal smear and computed tomographic (CT) scans of the paranasal sinuses were performed before treatment. The opacity of the sinuses was estimated and scored by the CT images. After treatment, anterior ethmoidal mucosa samples were collected, an infiltrated inflammatory cells, interferon (IFN)-γ-positive cells and interleukin (IL)-4-positive cells were examined histologically and immunohistochemically. The severity of nasal symptoms was scored before and after treatment, and the improvement rate of the score (symptomatic improvement rate) was calculated. Patients with normal levels of serum IgE (≤250 U/ml) showed a significantly higher symptomatic improvement rate than those with high levels of serum IgE (42.1 ± 11.2 vs. 4.9 ± 3.1%, p = 0.046). The symptomatic improvement rate was inversely correlated with the eosinophil counts in the peripheral blood (r = –0.51, p = 0.04), in the nasal smear (r = –0.54, p = 0.045) and in the sinus mucosa (r = –0.54, p = 0.02). Meanwhile, the CT score, the number of IFN-γ-positive cells and IL-4-positive cells in the sinus mucosa and neutrophil counts in the nasal smear and in the sinus mucosa failed to correlate with the symptomatic improvement rate. These results suggest that macrolide therapy is indicated for patients without atopy or smear/tissue/peripheral blood eosinophilia. On the contrary, the severity of the disease, Th1/Th2 dominance in the sinus mucosa and neutrophilia are unlikely to be prognostic factors of chronic rhinosinusitis under long-term low-dose marolide therapy.
Diagnostic Procedures for Detection of Lymph Node Metastases in Cancer of the Larynx
Authors: Kau Reinhardt J. , Alexiou Christoph , Stimmer Herbert , Arnold Wolfgang
Published: April 2003

Squamous cell carcinoma is the most common malignant neoplasm of the larynx. One of the most important influences on prognosis is the presence of metastases to the cervical lymph nodes. Accurate determination of lymph node involvement is therefore a prerequisite for individualized therapy in patients with squamous cell carcinoma of the larynx. Clinical palpation of the neck is not very accurate and the role of imaging techniques such as ultrasound, ultrasound-guided fine needle aspiration cytology, color Doppler ultrasound, computed tomography, magnetic resonance imaging and positron emission tomography is being applied in order to improve upon the results of clinical investigation alone. According to our investigations and review of the literature, the accuracy of computed tomography scanning (84.9%) and magnetic resonance imaging (85%) was superior to palpation (69.7%) and ultrasound (72.7%). Ultrasound-guided fine needle aspiration cytology showed an accuracy of 89% and was in the same range with positron emission tomography (90.5%).
Development of Monovalent Ions in the Endolymph in Mouse Cochlea
Authors: Yamasaki Masayuki , Komune Shizuo , Shimozono Masami , Matsuda Keiji , Haruta Atsushi
Published: April 2003

The present study was designed to clarify the chronological developmental process of monovalent ions (Na+, K+, Cl–) in the endolymph of the mouse in relation to the development of the endocochlear potential (EP). The EP and ionic concentrations were measured simultaneously with the ion-sensitive double-barreled microelectrodes from the scala media of the basal turn. The EP increased abruptly 7 days after birth (DAB) and reached approximately 80 mV 14 DAB. In the earliest postnatal days, the endolymphatic Na+ concentration was significantly higher than that in adult mice, however, the K+ and the Cl– concentrations were lower. The concentrations of all the monovalent ions in endolymph reached adult levels at 7 DAB when the EP was still under 20 mV. These data strongly suggest the presence of a different mechanism between the production of monovalent ions, especially of high K+ in the endolymph and that of EP.