Treatment of carcinoma of the epiglottis.

One hundred five cases of primary squamous cell carcinoma of the epiglottis were reviewed and the results of treatment compared. The cure rate by radiation therapy for epiglottic carcinomas, both suprahyoid and infrahyoid, was poorer than previously reported cure rates for all supraglottic carcinomas (p less than 0.01).

Ultrastructural histopathology in a case of human ototoxicity due to loop diuretics.

The temporal bones of a patient who suffered sudden deafness and ataxia after administration of both furosemide and ethacrynic acid, were prepared for light and electron microscopy. There was no loss of hair or supporting cells. However, some hair cells, in both the vestibular neuroepithelium and the organ of Corti, particularly in the basal turn, were more densely staining and more granular than normal.

Reciprocal synapses at the base of outer hair cells in the organ of corti of man.

Reciprocal synapses have been found between nerve terminals and the outer hair cells in the human organ of Corti. A single nerve ending of the nonvesiculated type may possess two types of synaptic specialization of opposite polarity. The first is typical of the "afferent" synapse with a presynaptic body in the hair cell and pre- and postsynaptic membrane thickening.

Histopathology of Pseudomonas osteomyelitis of the temporal bone starting as malignant external otitis.

Although the natural history and treatment of "malignant external otitis" have been well described, available histopathologic data are limited to three case reports. The histopathology in two additional cases, in which the disease process was advanced and uncontrolled, is presented to illustrate the unique progression of temporal bone osteomyelitis due to the Pseudomonas organism. In both cases the bony labyrinthine capsule demonstrated remarkable resistance to the osteomyelitic process even though the infection seemed to pass around the inner ear from all sides.

Carcinoid tumor of the middle ear.

A primary tumor of the middle ear with histologic, histochemical, and ultrastructural features of a neuroendocrine neoplasm is described. This neoplasm superficially resembles the so-called adenomatous tumor of the middle ear, and potential relationships and differences between these tumors are discussed. Although the histogenesis of the carcinoid tumor of the middle ear is not well understood, it most likely originates from pre-existing neuroendocrine cells or a primitive precursor cell.

Extracranial technique for temporal bone removal.

Usijng a specifically designed circular bone plug cutter, an extracranial technique to obtain temporal bones for histological study is described. This technique is useful in cases in which conventional autopsy of the head it not possible or desirable.

Electron microscopic findings in presbycusic degeneration of the basal turn of the human cochlea.

Three human temporal bones with presbycusis affecting the basal turn of the cochlea were studied by light and electron microscopy. Conditions in two ears examined by light microscopy were typical of primary neural degeneration, with a descending audiometric pattern, loss of cochlear neurons in the basal turn, and preservation of the organ of Corti. Ultrastructural analysis revealed normal hair cells and marked degenerative changes of the remaining neural fibers, expecially in the basal turn.

Treatment of syphilitic hearing loss. Combined penicillin and steroid therapy in 29 patients.

Twenty-nine patients with presumed syphilitic hearing loss, either congenital or acquired, were treated on one or more occasions according to a three-month protocol using penicillin and prednisone. Changes in hearing were carefully followed during treatment and for at least one year thereafter. Of 58 ears studied in 29 patients, 19 demonstrated significant partial improvement in hearing during treatment.

Intercellular fluid pathways in the organ of Corti of cat and man.

The intercellular junctions in the organ of Corti of cat and man were examined with the electron microscope. In contrast to the zone of tight junctions, or zonulae occludentes, which were present at the surface of cells lining the scala media, there was no tight junctional specialization among the cells of the tympanic lamina, perilymphatic lining cells of the scala vestibuli, basal processes of the supporting cells of the organ of Corti or cells of the spiral limbus and spiral ligament. These findings suggest the possibility of fluid continuity between the scala vestibuli and scala tympani all along the cochlear duct.

Hearing loss as a sequela of meningitis.

A retrospective study of 547 cases of meningitis was performed. Of these, 236 were bacterial, 304 were viral, and 7 were fungal in etiology. Of 110 survivors of bacterial meningitis over the age of 2 1/2 years, 23 or 21% suffered partial or complete sensorineural hearing loss.

Detection of syphilitic hearing loss.

Syphilis can cause sensorineural hearing loss that is potentially treatable. To determine the incidence of positive serological findings in patients with sensorineural hearing loss, the rapid plasma reagin card test (RPRCT) and the FTA-ABS test were performed in a study group composed of patients with sensorineural hearing loss of obscure origin. Of the 306 patients with sensorineural hearing loss, 20 (6.

Intercellular junctions in the organ of Corti.

The intercellular junctions between adjacent supporting cells and between apposed hair and supporting cells in the organ of Corti of cat and human were studied. At the endolymphatic surface, the intercellular space was closed by a series of tight junctions (zonula occludens), whereas there were no tight junctions at the basilar membrane surface of the neuroepithelium. Beneath the adlumenal zonula occludens between adjacent supporting cells, a zonula adherens (intermediate junction, "desmosone") was found.

Viral particles in nasopharyngeal carcinoma.

Lymphoepithelioma of the nasopharynx was identified in a 17-year-old Chinese male. The Epstein-Barr virus titer was 1:3200. Tissue from the tumor mass was prepared for electron microscopy.

Positive Hennebert's sign in Meniere's disease.

A positive Hennebert's sign was found in 24 of 81 (30%) of ears with Meniere's disease and in none of 22 cases of vestibular schwannoma or 100 normal controls. Negative pressure applied to the external auditory canal was the required stimulus in 14 of 24 (58%) ears. The character of induced eye motion was variable, although horizontal nystagmus was found in 22 of 24 (92%) ears.

Electron microscopic observations in a case of long-standing profound sensorineural deafness.

The ultrastructural pathology in an ear with long-standing profound deafness is presented. Endolymphatic hydrops was present, although there had been no vestibular symptoms. Although hair cells were absent, the intercellular junctional complex at the endolymphatic surface of the organ of Corti was maintained, suggesting "healing" by migration or proliferation of supporting cells to fill the empty spaces.

Pseudocellulitis of the orbit.

A case of retinoblastoma with secondary glaucoma, in which the initial clinical findings were indistinguishable from those of orbital cellulitis, is presented. Acute glaucoma, especially in childhood, may mimick suppurative disease of the orbit, and primary ocular pathology must be considered in evaluating apparent disease processes in other facial structures.

Tight and gap junctions in a vertebrate inner ear.

The auditory organ of the alligator lizard has been investigated with the transmission electron microscope using methods which distinguish between tight and gap junctions. There is a continuous zone of tight junctions located near the endolymphatic surface of the organ forming a boundary between the endolymph in scala media and the interstitial spaces between the cells. No such tight junctions were observed between the perilymph of scala tympani and the interstitial fluid within the organ.

Hearing loss of acquired syphilis: diagnosis confirmed by incudectomy.

Syphilis, both congenital and acquired, may cause sensori-neural hearing loss. Congenital syphilis presents in two forms: early (infantile), and late (tardive). Acquired syphilis, both secondary and tertiary, may cause deafness.

Vertigo of delayed onset after sudden deafness.

An entity of episodic true vertigo of delayed onset following sudden and profound sensorineural hearing loss is described. Data on 12 patients and three case reports are presented. The latency between sudden deafness and the onset of the vertigo varied from 1 to 68 years.