Otogenic intracranial hypertension. Otitic hydrocephalus.

Otogenic intracranial hypertension is a rare complication of suppurative otitis media. Two patients with the typical features of the disease are presented. An historical review of the literature on the subject and a discussion of the differential diagnosis have been carried out.

Transtympanic electrocochleography during glycerol dehydration.

Thirteen patients with Meniere's disorder were tested using transtympanic electrocochleography during glycerol dehydration. The most common finding was a decrease in the negative summating potential and this appeared to be a more sensitive indicator of changes occurring in the cochlea than pure tone audiometry and speech discrimination. A pathophysiological explanation for this observation is offered and the possibility of using this decrease in the negative summating potential as a pointer to the prognosis of endolymphatic sac surgery is discussed.

Experimental intrarenal reflux and blood pressure.

The effect on the blood pressure of experimental vesico-ureteric reflux was investigated in adult female Wistar rats. In 6 rats, reflux with isotonic saline produced a transient rise in systemic blood pressure followed by a fall, with return to normal within 2 min (mean BP readings: 121-130-93 mmHg). In 6 rats during water diuresis, reflux with distilled water produced similar changes (114-120-79 mmHg).

Transtympanic electrocochleography in patients with syphilis and hearing loss.

Transtympanic electrocochleography was carried out on 18 syphilitic patients (30 ears were tested) most of whom were suffering from the late onset congenital form of the disease. A diphasic action potential with a large negative summating potential on the descending limb was found in 77.7% of ears; the cochlear microphonic potential was always of small amplitude.

Otoadmittance measurements in patients with rheumatoid arthritis.

Analysis of middle ear function has for many years been accomplished by acoustic impedance measurements and this has proved of great clinical value. The vectors which contribute to impedance are functions of mass, stiffness and resistance of the system and information about these components may be obtained by use of the otoadmittance meter. The shape of the tympanogram may be altered both by pathologies which change the relative magnitude of the vectors and by variation in the probe tone frequency.

S-carboxymethylcysteine in the treatment of glue ear: a double blind trial.

A double blind trial was carried out comparing S-carboxymethylcysteine (S-CMC; Mucodyne, Berk Pharmaceuticals) with inert placebo in the treatment of glue ear in fifty-two children who had not previously undergone surgery for the condition. The results, analysed after three months of treatment failed to demonstrate a significant reduction in the number of children receiving S-CMC who eventually required surgery for the condition.

Anaesthesia of the tympanic membrane using iontophoresis.

Experience is described of the use of iontophoresis of 2% lignocaine to achieve effective tympanic membrane anaesthesia. The main uses are for outpatient myringotomy and transtympanic electrocochleography. Complete anaesthesia of the drum has been obtained in all cases, and those patients who had previously had these procedures carried out without anaesthetic, or with surface 'anaesthesia' only, all stated a marked preference for iontophoresis.

Clinical electrocochleography in the diagnosis and management of Meneère's disorder.

Patients with a fluctuating hearing loss, episodic vertigo and tinnitus with no known aetiological cause were investigated as cases of Menière's disorder. Transtympanic electrocochleography was found to be helpful in reaching the diagnosis of an inner ear disorder. In 65% of the patients, a large DC potential was recorded which caused an apparent widening of the summating potential/action potential (SP/AP) waveform.

Profound bilateral sensorineural hearing loss during gentamicin therapy.

A case of profound bilateral sensorineural deafness occurring during gentamicin therapy is presented. Considerable recovery of the hearing in the right ear was observed but the left ear remained "dead". Electrocochleography confirmed the end-organ nature of the damage.

The deformity produced by a palsy of the marginal mandibular branch of the facial nerve.

It is a common misconception that damage to the marginal mandibular branch of the facial nerve causes drooping of the corner of the mouth. In fact the opposite is true, as a consideration of the anatomy confirms.

Tubulo-vascular relationships in the developing kidney.

The postnatal development of the tubulo-vascular relationships in the kidney was studied in 60 rats. The kidney is relatively immature at birth and only the juxtamedullary glomeruli are present. As their loops of Henle develop they grow down into the medulla around the previously developed collecting ducts, forming tubulovascular 'units' around whose periphery the shorter loops of the more peripheral glomeruli grow down.

The styloid process syndrome: aetiological factors and surgical management.

The literature on the syndromes associated with the styloid process is reviewed. The anatomy and embryology of the styloid apparatus are then discussed in relation to the development of these conditions; attention is drawn to the significance of elongation of the process. Eighty styloids measured at post-mortem examination enabled a mean length to be determined as well as a range of normals.

The structure of the pelvis in the immature human kidney.

Examination of the renal pelvis of late fetal and neonatal kidneys shows that in about one quarter of the calyces examined the arrangement is similat to that in the rat, the outer medulla being separated from the calyceal cavity by a very thin epithelium. It is suggested that this presents a vulnerable area through which intrarenal damage can occur as a result of vesico-ureteric reflux in the immature kidney.

The role of vesico-ureteric (V-U) reflux in the pathogenesis of kidney scars in the rat.

In Wistar rats V-U reflux with distilled water and sterile saline of varying osmolar strength produces scars in the perihilar region of the kidneys in 80% of animals. Using Indian ink as a marker, rupture of the forniceal epithelium regularly followed V-U reflux. Intrapelvic pressure rose to 120 mm Hg during the reflux procedure.

The venous drainage of the accessory reproductive organs of the rat with special reference to prostatic metabolism.

The venous drainage of the testis, epididymis, prostate and bladder was studied in live and recently dead rats. New evidence for a previously suggested direct venous connection between the epididymis and the prostate is presented, and a mechanism for blood flow from the deferential vein into the prostatic venous plexus under conditions of raised central venous pressure is described. The studies have also revealed discrepancies among previous reports which might be resolved by a simplified nomenclature.

The effects of changes of water balance on the renal pelvic epithelium of the rat.

The effects of changes of water balance on the renal pelvic epithelium of the rat. The fine structure of the various epithelia which line the renal pelvis was investigated in five hydropenic rats and five rats undergoing a water diuresis. In the former, the thin epithelium which covers the outer medulla showed dilated intercellular spaces and an increased number of cytoplasmic vacuoles whereas the intercellular spaces were tightly closed and there were few vacuoles in the diuretic rats.