The incudostapedial articulation in Down's syndrome (trisomy 21): a temporal bone study.

Hypothesis: Anomaly in the incudostapedial articulation (IS) may be responsible for persistent conductive hearing loss (HL) in Down's syndrome (DS) patients. Our goal was to perform a detailed histopathologic assessment of the role of the IS joint in the conductive HL.

Background: In addition to other disabilities, 38% to 78% of patients with Down's syndrome (Trisomy 21) have CHL, some of which are persistent despite maximum treatment.

The pathogenesis of acquired cholesteatoma of the human middle ear: support for the migration hypothesis.

Hypothesis: That acquired cholesteatoma of the human middle ear and mastoid process can be caused by migration of squamous epithelium from the tympanic membrane.

Objective: To provide histologic evidence in humans of the potential for medial epithelial migration toward the middle ear.

Background: The origin of cholesteatomas of the middle ear complex of humans is still not clearly understood.

The incudostapedial articulation: new concepts.

Hypothesis: To study the detailed anatomy of the incudostapedial joint (ISJ).

Background: Detailed study of the anatomy of the ISJ has been surprisingly neglected and continues to be controversial.

Methods: We studied the joint in 86 temporal bones from 51 subjects, aged 12 to 104 years, by light microscopy and three-dimensional images of computer-based reconstructions.

Sensorineural hearing loss in patients with inflammatory bowel disease.

Objective: The study aimed to discuss the association between sensorineural hearing loss (SNHL) and inflammatory bowel disease (IBD).

Methods: We reviewed cases of patients with known IBD seen in an otolaryngology practice with documentation of all otologic data including age of onset, family history of otologic problems, exposure to noise, audiometric findings, and so on.

Results: Of 38 patients with a history of IBD, 22 had documented SNHL.

Asymmetric agenesis of the mastoid antrum in a neonate.

The authors report a case of asymmetric development of the mastoid antrum in a neonate. The lack of mastoid development most likely represents a congenital maldevelopment. Agenesis of the mastoid antrum has surgical implications, as failure to recognize its absence can result in disorientation during surgery, with potential to injure adjacent structures.

Schwannoma of the nasal cavity.

Schwannomas are benign peripheral nerve sheath tumors that occur throughout the body. They may present as either solitary or multiple masses. They rarely occur in the nasal cavity.

Anomalies of the ear in the Pierre Robin triad.

Objectives: The Pierre Robin triad (PRT) consists of micrognathia-retrognathia, glossoptosis, and an oval or cleft palate. The goal of this study was to identify patterns of similarity to and differences from the two previous temporal bone studies of the PRT.

Methods: Seven children with the PRT (ages, 45 minutes to 2 years; gestational ages, 41 to 43 weeks) were studied.

Fixation of the stapes footplate in children: a clinical and temporal bone histopathologic study.

Objective: To clarify the anatomic characteristics, cause, and surgical outcomes relating to fixation of the stapes footplate in children.

Study Design: Retrospective case review and four-center histopathologic study of temporal bones.

Setting: Tertiary referral center.

Sensorineural hearing loss, early greying, and essential tremor: a new hereditary syndrome?

Objective: To present a syndrome composed of sensorineural hearing loss, early greying of scalp hair, and adult-onset essential tremor.

Study Design: Retrospective chart review.

Setting: Tertiary care academic hospital.

The deafness of Ludwig van Beethoven: an immunopathy.

Objective: To analyze and discuss the deafness of Ludwig van Beethoven (1770-1827) and to offer a logical theory for its etiology.

Method: The study will carefully review the composer's symptoms as described in his letters to friends and acquaintances and also will review a large body of source material, particularly publications by his contemporaries, some of which were generously loaned by Beethoven-Haus, Bonn, Germany, where necessary translations were made directly from the original German. We will also study publications on Inflammatory Bowel Disease (IBD) and its associated extraintestinal manifestations and personal discussions with experienced gastroenterologists.

Hearing loss in steelband musicians.

Objective: To determine the difference in hearing between a group of steelband musicians (pannists) and a control group.

Design, Settings, And Subjects: We conducted a controlled cross-sectional pilot study consisting of 29 steelpan players and 30 control subjects from a steelpan orchestra (steelband) in the Otolaryngology Department of the Eric Williams Medical Sciences Complex.

Results: Significantly more steelpan players had a hearing loss than the control subjects at 3000 Hz, 4000 Hz, and 6000 Hz ( P < 0.

Alternative therapies in the management of headache and facial pain.

Complementary therapies are now becoming the rule rather than the exception in the management of headache and facial pain. It is incumbent on physicians to be aware of and to have a working knowledge of these increasingly popular modalities.

Classification of headache and facial pain.

It is important for us as otolaryngologists to identify our critical role in diagnosing and treating the subset of patients that suffers from headaches. It is equally important for the layperson and the medical community to recognize the importance of a multidisciplinary team approach in the management of headache and facial pain. Despite its limitations, classification provides us with a starting point from which scientists, clinicians, and patients can begin to determine the success of diagnostic and therapeutic strategies.

3-D reconstruction of the vestibular endorgans in pediatric temporal bones.

We investigated the vestibular endorgans in three children using 3-D reconstructions from histological sections. The right temporal bone of a newborn child without peripheral vestibular pathology was used as reference model and the temporal bones from a child with Goldenhar syndrome and a child with Pierre Robin sequence with known peripheral vestibular pathology were studied. All five temporal bones were prepared by the celloidin technique and sectioned at 20 microm.

External auditory canal duplication anomalies associated with congenital aural atresia.

Maldevelopment of the first branchial cleft can produce a broad spectrum of anomalies in its derivative structure, the external auditory canal (EAC). Failure of the cleft to develop normally can result in either the absence of a normally patent EAC (atresia, or stenosis) or a duplication anomaly (cyst, sinus, or fistula). Despite their common origins, the coexistence of these anatomical abnormalities is quite unusual.

Ante mortem ruptures of the endolymphatic membranes in children: real finding or artifact?

We undertook this study to determine whether or not ante mortem ruptures of the endolymphatic membranes occurred naturally in the infantile labyrinth, what were the most frequent locations and to assess the statistical correlation of an earlier finding of bulging of Reissner's membrane in pediatric temporal bones. We examined 128 temporal bones from 80 children between the ages of newborn to 12 years with an average age of 15.4 months.

The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth.

Objectives: Deposits of basophilic material on the cupulae of the semicircular ducts have been described in adult human temporal bones, and such deposits have been implicated in the clinical phenomenon of benign paroxysmal positional vertigo (BPPV). Although relatively rare, BPPV has been reported to occur in children. The goal of this study was to evaluate the occurrence of cupular deposits in pediatric material.