Magnetic resonance imaging of paranasal sinus tumors for craniofacial resection.

Computerized tomography (CT) has been shown to be 78% accurate with respect to anatomic extent of tumor when correlated with operative findings and histology in patients undergoing craniofacial resection. To determine whether preoperative evaluation could be improved by the combination of CT and magnetic resonance imaging (MRI), 26 patients with tumor of the paranasal sinuses had undergone MRI before surgery in addition to CT. Ten patients also received Gadolinium-DTPA as a contrast-enhancement agent during MRI.

Objective assessment of nasal obstruction.

Attempts to find objective tests to assess nasal obstruction have a long history. The physiologic and pathologic fluctuations that occur within the nose over short periods of time have hampered these efforts, and all presently available techniques have significant drawbacks. The most commonly used is active rhinomanometry, and relatively recent standardization has led to the popularization of the anterior method.

The vessels of the stria vascularis: quantitative comparison of three rodent species.

The stria vascularis (SV) was quantitatively compared in three species commonly used in auditory research: guinea pig, mouse and gerbil. Measurements were obtained for surface area, cross-sectional area, length, width and thickness of SV. Surface area and length were proportional to the overall size of the cochlea in each species, but there was no significant difference between species in mean cross-sectional area.

Head and neck surgery in the elderly: a maturing problem.

The number of elderly patients requiring oncologic head and neck surgery is increasing as this proportion of the population continues to grow. To establish the specific problems and relative risks, 100 patients, 70 years of age and over have been examined to determine post-operative mortality and morbidity. Results do not show these to be significantly increased in the elderly and support an aggressive approach to head and neck cancer management in these patients.

Evaluation of a computer interview system for use with neuro-otology patients.

The effectiveness, feasibility and credibility of a computer assessment package was evaluated in a group of 60 neuro-otological outpatients. The computer system was compared with a standard questionnaire and used to elicit basic neuro-otological information prior to clinical interview. The majority of patients (81%) preferred computer assessment.

A comparison of initial and permanent surface changes to guinea pig hair cells after acoustic overstimulation.

Groups of pigmented guinea pigs were exposed unilaterally to a 15 kHz pure tone at 133 dB SPL for 7.5 min. The inner ears of one group were examined by light microscopy to count damaged hair cells 3 weeks after exposure.

Gentamicin alters membrane structure as shown by freeze-fracture of liposomes.

Freeze-fracture has been used to examine the effects of gentamicin on membrane structure in liposomes of different anionic phospholipids combined with a neutral phospholipid, phosphatidylcholine. The molar ratios of neutral: anionic lipid were 1:1 (high anionic lipid ratio) and 4:1 (low anionic lipid) and the liposomes were incubated with 0.1 mM (low) and 1 mM (high) gentamicin.

The effects of different fixations on the distribution and numbers of mast cells in patients with nasal polyps.

Mast cells in rats have been categorized into mucosal and connective tissue mast cells by properties which include their fixation characteristics and their distribution in tissues. There are a number of factors which make this classification unsatisfactory including the variability of fixation, intensity of background staining and the application of animal studies to man. Seasonal allergic reactions in the nose of man occur both in the surface metachromatic cells and in those within the epithelium; the latter are presumed to be mucosal mast cells.

Synergistic interactions of gentamicin and pure tones causing cochlear hair cell loss in pigmented guinea pigs.

The effects of single and repeated combinations of gentamicin and sound on Preyer reflex and cochlear hair cells in pigmented guinea pigs have been examined. Gentamicin at 50 mg/kg for 10 days and an 8 kHz pure tone (116 dB for 60 min) cause little or no hair cell loss when given alone. In combination, hair cell loss occurs with the gentamicin and sound acting synergistically.

Craniofacial resection for tumors of the nasal cavity and paranasal sinuses.

The combined approach for resection of tumors of the nose and paranasal sinuses is well established. The technique has been considerably modified, resulting in an operation that combines good access, sound oncologic resection with excellent cosmesis, and a low postoperative morbidity rate for conditions that have been associated hitherto with an extremely poor prognosis. A 9 year experience with 92 patients is presented.

Cognitive variables in tinnitus annoyance.

Two new questionnaires were devised to investigate dimensions of complaint about tinnitus. Following a factor analysis of data provided by a sample of tinnitus patients who were administered the first questionnaire, the second questionnaire was developed. This included questions concerning coping attitudes and beliefs about tinnitus.

'Otology at the crossroads' (the second Morell MacKenzie address).

It is an honour for an otological surgeon to be asked to deliver the second Sir Morell MacKenzie address. Thank you for the invitation and for that honour. Exactly 100 years ago MacKenzie, with Norris Wolfenden, founded 'The Journal of Laryngology and Rhinology'.

A new rapid component in the cochlear response to brief electrical efferent stimulation: CM and otoacoustic observations.

The onset and time course of cochlear response changes induced by brief electrical stimulation of medial fibres of the OCB have been studied in detail in guinea pig. Changes in both cochlear microphonic and otoacoustic responses begin within 10 ms of electrical excitation. The sensitive differential technique employed has allowed the use of very short and weak electrical stimulations.

Prostaglandin synthesis in the pathogenesis of fronto-ethmoidal mucoceles.

The fronto-ethmoidal mucocele is a rare condition capable of expansion and erosion of bone. Its etiology is attributed to obstruction of the fronto-nasal duct and inflammation. To elucidate the role of inflammation, mucocele fragments and fibroblasts cultured from them were examined in vitro to assess prostaglandin E2 synthesis.

The specific locomotive activity of tympanic membrane and cholesteatoma epithelium in tissue culture.

Human tympanic membrane and cholesteatomatous epithelium were grown in tissue culture. Outgrowth from the explants and colonies produced by subculture produced epithelium capable of rapid "en masse" migration. This phenomenon was not found in epithelium grown from other sites.

Characteristics of the membrane of the stereocilia and cell apex in cochlear hair cells.

Freeze-fracture has been used to examine the membrane of the cell apex and of the stereocilia in cochlear hair cells. The apical (non-stereociliary) membrane of inner hair cells (IHCs) exhibited a lower density of intramembrane particles (IMP) than that of the outer hair cells (OHCs) but in both cell types the apical membrane responded to the effects of filipin. The distribution of IMP and of filipin-induced membrane deformations was uniform over the apical membranes in both IHC and OHC, thus, providing no evidence for local membrane differentiation on the non-stereociliary part of the hair cell apex.

Species differences in the distribution of infracuticular F-actin in outer hair cells of the cochlea.

The distribution of filamentous actin (F-actin) in outer hair cells has been examined in several mammalian species using tetramethylrhodamine phalloidin, a specific marker for F-actin. The stereocilia and cuticular plates of the OHC in all species examined (pigmented guinea pig, hooded rat, chinchilla and squirrel monkey) contained F-actin; however, an infracuticular network of F-actin was present in OHC of the apical turns of the guinea pig cochlea but could not be identified in any other species examined.

Epithelial distribution in the human fetal larynx.

Scanning and transmission electron microscopy and light microscopy were used to study the distribution of squamous epithelium and ciliated respiratory type epithelium in ten midtrimester human fetal larynges. Particular attention was paid to the subglottic region, where previous studies have reported areas of squamous metaplasia in neonates, infants, and nonsmoking adults. Both types of epithelium were found in different proportions in the supraglottic, glottic, and subglottic regions.

Evolution of the epidermoid formation and its role in the development of the middle ear and tympanic membrane during the first trimester.

In a study of 20 ears from embryos and early fetuses, 16 contained structures recognizable as precursors of the epidermoid formation (EF). The earliest were small, but later they took the form of a long epithelial bud which emanated from the tip of the tubotympanic recess or Eustachian tube. At a later stage still the EF protruded into the lumen of the Eustachian tube.

Origin of congenital cholesteatoma from a normally occurring epidermoid rest in the developing middle ear.

The sites of involvement of congenital cholesteatoma, a lesion which has recently become more frequently recognized, are reviewed from literature sources. There is a propensity for its occurrence, especially when small, in the anterior superior part of the middle ear. The same situation is the precise location of an epidermoid cell rest, the epidermoid formation (EF).

Congenital ossicular abnormalities: a review of 68 cases.

Sixty-eight cases of congenital conductive hearing loss due to ossicular abnormalities were reviewed. The clinical and surgical details of each case were documented, and a classification was drawn up on the basis of the abnormalities encountered. Sixty-six percent of the cases were documented as middle ear anomalies in the absence of any other evidence of congenital disease.

A specialist institute looks to the future.

A specialized institute has unique problems relating to its responsibility for teaching, research and clinical care. In the 40 years of its existence it has played a considerable role in the development of the specialty in the United Kingdom, advancing knowledge in all fields--particularly head and neck oncology and audiological medicine. The threat to its associated specialist hospital and to its own future because of severe cuts may result in far-reaching decisions regarding its future role.

Inferior meatal antrostomy. Fundamental considerations of design and function.

The operation of inferior meatal antrostomy has emerged as the most popular surgical technique in the management of maxillary sinusitis though the surgical anatomy and natural history of the procedure are poorly understood. The anatomy of the inferior meatus determines surgical limitations and a retrospective study of 108 patients who have undergone antrostomy provides a basis for a prospective study in which the size of the antrostomy has been assessed in 65 patients pre- and post-operatively using direct measurement and serial photography. After initial circumferential healing within the first few weeks, the majority remain unchanged unless infection supervenes when complete closure may result.