Archives of Otolaryngology

SHAMBAUGH, GEORGE E.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030123002pmid: 5947872

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract AN ARTICLE with this catchy title in The Journal of the American Medical Association (196:985 [June 13] 1966) by K. R. Boucot et al concerns a study of 6,137 men 45 years of age or older who volunteered to report twice each year for x-ray examination of the chest and to answer questions concerning smoking habits and respiratory symptoms. The prevalence of cough increased with age and with increasing degrees of smoking. During the nine- to ten-year follow-up of these patients 150 histologically confirmed bronchogenic carcinomas occurred; 66 were present on the initial examination and 84 developed subsequently. The study was concerned with the latter group of new lung cancers that developed while the men were under observation. No lung cancer developed among the 805 nonsmokers. Of the 520 occasional cigarette smokers (less than one-half pack per day), 1% developed lung cancer. Among the 964 heavy cigarette smokers, 3%

SHAMBAUGH, GEORGE E.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030123001

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract THE Archives is pleased to print a reply by Professor von Bekesy in response to the three articles by Professor Mygind that appeared in the November, December, and January issues. Believing that science and truth are best advanced by free and untrammeled discussion and controversey, we are especially pleased that Dr. Bekesy in this reply has so clearly explained the mode of action of shearing forces.

von BEKESY, GEORG

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030124003pmid: 5947873

Abstract THREE hearing theories have been proposed since 1961. One was based on the resonance of the pillars of the organ of Corti, one on the movements of the Hensen cells, and one on the movement of the tectorial membrane. Two of them were not published, but the third, the most assuming one, was published in this journal.1-3 All of them had the aim of explaining pitch resolution by mechanical stimulus localization along the organ of Corti and used comparative anatomy as a tool to eliminate unwanted difficulties. All three dealt with shearing forces and tried to dismiss them. They all forgot to mention how the vibrating stapes foot plate transmits its vibrations without too much energy loss to the pillars of the organ of Corti, the Hensen cells, or the tectorial membrane. And none of the theories contained new experiments but instead were constructed in the library. Since this References 1. Mygind, S.H.: Functional Mechanism of the Labyrinthine Epithelium , Arch Otolaryng 82:452-461, 1965.Crossref 2. Mygind, S.H.: Functional Mechanism of the Labyrinthine Epithelium , Arch Otolaryng 82:579-590, 1965.Crossref 3. Mygind, S.H.: Functional Mechanism of the Labyrinthine Epithelium , Arch Otolaryng 83:29-35, 1966.Crossref 4. Meissner, G.: Untersuchungen über den Tastsinn , Z Rationel Med 7:92-118, 1859. 5. Bekesy, G. von: Über die Vibrationsempfindung , Akustische Z 5:316-334, 1939. 6. Ranke, O.F.; Keidel, W.D.; and Weschke, H.G.: Das Hören bei Verschluss des Runden Fensters , Z Laryng Rhinol Otol 31:467-475, 1952. 7. Sand, A.: The Mechanism of the Lateral Sense Organs of Fishes , Proc Roy Soc 123:472-495, 1937.Crossref 8. Duvall, A.J., and Tonndorf, J.: Vital Staining of the Cochlea in Guinea Pigs , Laryngoscope 72:892-901, 1962.Crossref 9. Tonndorf, J.: Personal communication to the author, January 1965. 10. Tonndorf, J.; Duvall, A.J.; and Reneau, J.P.: Permeability of Intracochlear Membranes to Various Vital Stains , Ann Otol 72:809-841, 1962. 11. Tonndorf, J.; Duvall, A.J.; and Reneau, J.P.: Cochlea Anatomy in Three-Dimensional Representations, presented before the American Academy of Ophthalmology and Otolaryngology, 1964.

NAKAMURA, SHIRO;SANDO, ISAMU

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030133004pmid: 5916474

Abstract WITH THE development of modern techniques in oto-microsurgery, such congenital malformations of the structures in the tympanic cavity as deformities or absence of the ossicles have often been found. Recently, one case of bilateral congenital absence of the oval windows has been described by Fernandez.1 In the literature hitherto, only eight other cases of this rare anomaly have been reported; three of these were reported by Hough2 in 1958, one briefly mentioned in an article by Livingstone3 in 1958, one each by Tabor4 and Beickert5 in 1961, and two by Pou6 in 1963. Of these cases, two reported by Livingstone and Fernandez revealed the absence of the round window. It is the purpose of this paper to report other cases of congenital absence of the oval window recently encountered in our clinic. Report of Cases Case 1.—History.—This 17-year-old boy was referred References 1. Fernandez, A.O.: Congenital Absence of the Oval Window , Laryngoscope 74:186, 1964.Crossref 2. Hough, J.V.: Malformation and Anatomical Variations Seen in the Middle Ear During the Operation for Mobilization of the Stapes , Laryngoscope 66:1337, 1958.Crossref 3. Livingstone, G.: The Establishment of Sound Conduction in Congenital Deformity of the External Ear , J Laryng 73:231, 1958.Crossref 4. Tabor, J.R.: Absence of the Oval Window , Arch Otolaryng 74:55, 1961.Crossref 5. Beickert, P.: Structure of the Sound-Conduction Chain in the Absence of Stapes and Oval Window: Congenital Anomalies , HNO 9:313-316 ( (Oct) ) 1961. 6. Pou, J.W.: Congenital Absence of the Oval Window , Laryngoscope 73:384, 1963.Crossref 7. Anson, B.J.: Branchial Sources of the Auditory Ossicles in Man , Arch Otolaryng 76:200, 1962.Crossref 8. Bast, T., and Anson, B.J.: The Temporal Bone and the Ear , Springfield, Ill: Charles C Thomas, Publisher, 1949. 9. House, H.P.: Differential Diagnosis Between Otosclerosis and Congenital Footplate Fixation , Ann Otolaryng 67:848, 1958. 10. Tonndorf, J.: Closure of the Cochlear Window: Its Effect Upon Air- and Bone-Conduction , Ann Otolaryng 71:1, 1962. 11. Ranke, O.: Die Schalleitung im Mittel, Ohr , Klin Laryng 37:366, 1958.

SADE, JACOB

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030139005pmid: 4161699

Abstract THE NORMAL lining of the middle ear is considered by most authorities as consisting of nonciliated, flat or cuboidal cells,1-3 and is thought to lack mucus-secreting elements.4-13 However, Polvogt4 states that cilia pass at times from the eustachian tube into the tympanum. Kolmer and Mellendorff12 saw cilia in the hypotympanum. Buch and Jorgensen13 as well as Lawson14 state that the tympanic cavity may be ciliated "in places." Maximov and Bloom15 state "near the opening of the auditory tube and tympanic membrane, it is (the epithelium) cuboidal or columnar and provided with cilia. The existence of glands is generally denied." Senturia16 described cilia in the tympanic cavity of dogs as well as goblet cells near the tube. Since it is known that lipoidal17,18 and fluorescent19 materials, licopodium seeds,20 starch, etc,21 are cleared rapidly from the middle ear through the eustachian tube into the nasopharynx, the assumption that cilia are absent or References 1. Friedman, I.: The Pathology of Secretory Otitis Media , Proc Roy Soc Med 56:695-699, 1963. 2. Schwarzbard, A.: The Reappraisal of the Clinical and Morphological Classification of the Tympanic Spaces and the Eustachian Tube , Ann Otol 67:241-247, 1958. 3. Wolff, D.: The Auditory Eustachian Tube , Laryngoscope 51:3-11, 1943. 4. Polvogt, L., and Babb, D.C.: Histologic Studies of the Eustachian Tube of Individuals With Good Hearing , Laryngoscope 50:671-675, 1940.Crossref 5. Semenov, H.: Some Observations of the Histopathology of Inflammation in the Eustachian Tube and the Middle Ear , Trans Amer Laryng 42:563-597, 1936. 6. Ojala, L.: Contribution to the Physiology and Pathology of Mastoid Air Cell Formation , Acta Otolaryng , (suppl 86) . 7. Suehs, O.W.: Secretory Otitis Media , Laryngoscope 62:933-1027, 1952.Crossref 8. Lowy, K.: Zur Pathologic des Sekretorischen Mittelohrkatarrhs , Mschr Ohrenheilk 72:40-46, 1938. 9. Bendek, G.A.: Histopathology of Transudatory Secretory Otitis Media , Arch Otolaryng 78:33-38, 1963.Crossref 10. Zollner, F.: Anatomie, Physiologie, Pathologie und Klinik der Ohrtrompete , Berlin: Springer-Verlag, 1942. 11. Friedman, I.: The Comparative Pathology of Otitis Media Experimental and Human , J Laryng Otol 69:588-601, 1955.Crossref 12. Kolmer, W., and Mellendorff, M.V.: Handbuch der mikroskopische Anatomie des Menchen, 1927. 13. Buch, M.H., and Jorgensen, M.B.: Eustachian Tube and Middle Ear , Arch Otolaryng 79:472-480, 1964.Crossref 14. Lawson, L.J.: Secretory Otitis Media , Arch Otolaryng 6:346-352, 1927.Crossref 15. Maximov, A.A., and Bloom, W.: A Textbook of Histology , Philadelphia: W. B. Saunders Co., 1944. 16. Senturia, B.H.; Carr, C.H.; and Ahlvim, R.C.: Middle Ear Effusions: Pathologic Changes of the Mucoperiosteum in the Experimental Animal , Ann Otol 71:632-648, 1962. 17. Terracol, J.; Carone, A.; and Gnerrier, J.: La Trompe d'Eustache , Masson et Cie, 1949. 18. Compere, W.E., Jr.: Tympanic Cavity Clearance Studies , Trans Amer Acad Ophthal 62:444-454, 1958. 19. Rogers, L.; Kirschner, F.; and Proud, G.O.: The Evaluation of Eustachian Tubal Function by Fluorescent Dye Studies , Laryngoscope 72:456-467, 1962.Crossref 20. Sate, I.: Experimentelle Untersuchengen uber die Flimmer-bewegungen in der Tuba eustachii , Zbl Hals Nas Ohrenheilk 31:687, 1939. 21. Holmgren, G.: Recherche experimentale sur la fonction de la trompe d'eustache , Acta Otolaryng 20:381-387, 1934.Crossref 22. Proetz, A.W.: Essays on the Applied Physiology of the Nose , St. Louis: Annals Publishing Company, 1947. 23. Hilding, A.C.: Ciliary Streaming in the Bronchial Tree and the Time Element in Carcinogenesis , New Eng J Med 256:634-640, 1957.Crossref 24. Ross, E.L., and Rawson, R.W.: Absorption From Middle Ear , Arch Otolaryng 22:312, 1935.Crossref 25. Berthick, E., and Proud, G.O.: Experimental Absorption of Fluids From the Middle Ear , Arch Otolaryng 81:237-242, 1965.Crossref 26. Flory, H.W.: Lectures on General Pathology , Philadelphia: W. B. Saunders Co., 1959. 27. Aschan, G.: The Anatomy of the Eustachian Tube With Regard to Its Function , Acta Soc Med Upsal 40:131-149, 1955. 28. Farrier, J.B.: Histopathologic Considerations in Treatment of the Eustachian Tube , Arch Otolaryng 37:607, 1943. 29. Sade, J.: To be published. 30. Senturia, B.H.; Carr, C.A.; and Bauman, E.S.: Middle Ear Effusions: Courses and Treatment , Trans Amer Acad Ophthal 64:60-72, 1960. 31. Gessert, C.F.; Bauman, E.S.; and Senturia, B.H.: The Action of Enzymes on Human Middle Ear Effusions , Ann Otol 69:936-956, 1960. 32. Friedman, I.: The Pathology of Otitis Media , Rep Inst Laryng Otol 7/8:221-236, 1957-1958. 33. Senturia, B.H.: Secretory Otitis Media , Proc Roy Soc Med 56:687-706, 1963.

GUILFORD, FREDERICK R.;SHORTREED, ROBERT;HALPERT, BELA

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030146006pmid: 5330022

Abstract CORTICAL iORTICAL BONE and cartilage are being used in man to reconstruct the ossicular chain when one or more of its components are absent or not suitable for repositioning.1-5 In order to investigate the viability of bone and cartilage so implanted, autogenous osseous tissue and cartilage were placed into the bullae of dogs. The contents of the bullae were removed for microscopic study three months or longer following implantation. Materials and Methods Eight mongrel dogs each weighing about 7 kg were used. Two operations were performed on each animal, one on the left and one on the right side, with a one-month interval between the two procedures. In one half of the animals the initial operation was on the right side and in the other on the left. Under intravenous sodium pentobarbital (Nembutal) anesthesia, an incision was made over the costochondral junction of the left lower rib cage, and References 1. Hall, A., and Rytzner, C.: Vitality of Autotransplanted Ossicles , Acta Otolaryng , (suppl 158) , pp 335-340, 1960. 2. Zollner, F.: " Stapedectomy: Reconstruction With Vein Graft and Bone Strut ," in Schuknecht, H. F. (ed.): Otosclerosis , Henry Ford Hospital International Symposium, Boston: Little, Brown & Co., 1962, pp 603-609. 3. Jansen, C.: Cartilage-Tympanoplasty , Laryngoscope 73:1288-1302 ( (Oct) ) 1963.Crossref 4. Stengl, T.A., and Hohmann, A.: Experimental Incus Transposition , Arch Otolaryng 80:72-79 ( (July) ) 1964.Crossref 5. Guilford, F.R.: Repositioning of the Incus , Laryngoscope 75:236-242 ( (Feb) ) 1965.Crossref

HOUSE, WILLIAM F.;PATTERSON, MACK E.;LINTHICUM, FRED H.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030150007pmid: 5947874

Abstract MANY TECHNIQUES have been used in an attempt to restore hearing in cases in which the ossicular tissue has been totally destroyed by chronic ear disease. Unfortunately, good hearing results have been very difficult to obtain for these patients. Methods Wullstein's Type IV Technique.—In the Wullstein type IV procedure the oval window is exteriorized and the round window protected by a skin graft. When successful, this technique still results in a residual 30 db bone air gap. Since these cases seldom have more than a 40 to 45 db bone air gap initially, the degree of hearing improvement is only 10 or 15 db in most instances.1Prosthetic Techniques.—Various prosthetic devices have been used to form a columella between the stapes footplate and the tympanic membrane graft. These techniques include polyethylene tubing with the lateral end flared or covered with wire mesh. Extrusion of these devices occurred References 1. Wullstein, H.: "Die Tympanoplastik als Gehorverbessernde Operation bei Otitis Media Chronica und ihre Resultate," in Proceedings of the Fifth International Congress of Otolaryngology, Rhinology, and Laryngology, 1953, p 104. 2. Sheehy, J.L.: Ossicular Problems in Tympanoplasty , Arch Otolaryng 81:115-122, 1965.Crossref 3. Bassett, C.A., et al: Bibliography of Bone Transplantation , Plast Reconstr Surg (Transplantation Bull) 2:668-679 ( (Sept) ) 1964. 4. Brooks, D.B., et al: Immunologic Factors in Homogeneous Bone Transplantation , J Bone Joint Surg 45-A:1617-1626 ( (Dec) ) 1963. 5. Kley, W., and Draf, W.: Histologische Untersuchungen uber Autotransplantierte Gehorknochelchen und Knochenstuckchen im Mittelohr Beim Menchen , Acta Otolaryng 59:593 ( (June) ) 1965.Crossref 6. Swanson, A.B., et al: Seven Years' Experience With Irradiated Bone Graft Material , Surg Gynec Obstet 117:573-577 ( (Nov) ) 1963.

PAPARELLA, MICHAEL M.;LIM, JONG JAI;SUGIURA, SHIGERU;BOLZ, ARTHUR

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030156008pmid: 5947875

Abstract SEVERE sensorineural deafness after stapedectomy is still a problem in otosclerosis surgery. Permanent cochlear losses may occur immediately after surgery or may have a delayed onset of weeks or months following an initial good result. It is especially difficult to understand the profound delayed cochlear loss which can sometimes follow an uncomplicated stapedectomy. The incidence of this complication varies somewhat according to the different reports as well as, probably, to interpretation of cases which qualify for selection. An incidence of 2.6% has been reported by Schuknecht,1 2.4% by House,2 and 2.5% by Portmann.3 Cochlear lesions may occur twice as often in stapedectomy revisions (not mobilization) and three times as often in fenestration revisions,4 so that apparently the more often the inner ear is opened in otosclerosis surgery the greater the possibility of developing irreversible pathological cochlear changes. Shambaugh and Takahara5 have evaluated both early and References 1. Schuknecht, H.F.: Sensorineural Hearing Loss Following Stapedectomy , Acta Otolaryng 54:336-348, 1962.Crossref 2. House, H.P.: " Experiences With Stapes Surgery ," in Otosclerosis , Boston: Little, Brown & Co., 1962, pp 447-456. 3. Portmann, M.: " Interposition: Surgical Procedure for Stapes Ankylosis ," in Otosclerosis , Boston: Little, Brown and Co., 1962, pp 429-445. 4. Shambaugh, G.E., Jr.: " Cochlear Pathology Following Fenestration and Stapes Surgery ," in Otosclerosis , Boston: Little, Brown and Co., 1962, pp 269-278. 5. Shambaugh, G.E., Jr., and Takahara, S.A.: Clinical and Experimental Study on the Effect of Fenestration on the Labyrinthine Contents , Acta Otolaryng , (suppl 123) , 1955. 6. Hohmann, A.: " Inner Ear Reactions to Stapes Surgery (Animal Experiments) ," in Otosclerosis , Boston: Little, Brown & Co., 1962, pp 305-317. 7. Paparella, M.M.: Unpublished data. 8. Paparella, M.M., and Saunders, W.H.: Unpublished data. 9. Paparella, M.M.: Experimental Tympanoplasty in the Squirrel Monkey, Proceedings of the VIII International Congress of Otolaryngology, Tokyo, October 1965, to be published. 10. Kimura, R., and Perlman, H.B.: Arterial Obstruction of the Labyrinth: I. Cochlear Changes , Ann Otol 67:5-24, 1958. 11. Paparella, M.M.: Acoustic Trauma From the Bone Cutting Bur , Laryngoscope 72:116-126, 1962.Crossref 12. Paparella, M.M.: A High-Frequency Microvibrator (Bioacoustical Effects) , Arch Otolaryng 74:220-228, 1961.Crossref 13. Paparella. M.M.: The Effect of Trauma in Causing Cochlear Losses After Stapedectomy , Acta Otolaryng , to be published. 14. Bellucci, R.J., and Wolf, D.: Tissue Reaction Following Reconstruction of the Oval Window in Experimental Animals , Ann Otol 69:517-539, 1960. 15. Bellucci, R.J., and Wolf, D.: Experimental Stapedectomy With Collagen Sponge Implant , Laryngoscope 74:668-688, 1964.Crossref 16. Colman, B.H.: Experimental Stapedectomy: The Internal Ear Changes , J Laryng 76:411-428, 1962.Crossref 17. Rosenberg, E.F.: " The Pathology of Rheumatoid Arthritis ," in Hollander et al (eds): Arthritis Philadelphia: Lea and Febiger, 1953, pp 130-147. 18. Collins, D.H.: The Pathology of Articular and Spinal Diseases , Baltimore: Williams & Wilkins Co., 1949, pp 179-205. 19. Mellors, R.C., et al: Cellular Origin of Rheumatoid Factor , J Exp Med 110:875-886, 1959.Crossref 20. Rich, A.R.: Hypersensitivity in Disease With Special Reference to Periarteritis Nodosa, Rheumatic Fever, Disseminated Lupus Erythematosis and Rheumatoid Arthritis , Harvey Lect 1946-1947, pp 106-147. 21. McKeown, E.F.: Experimental Serum Carditis and Its Relationship to Rheumatic Fever , J Path Bact 59:547-555, 1947.Crossref 22. More, R.H., and McLean, C.R.: Lesions of Hypersensitivity Induced in Rabbits by Massive Injection of Horse Serum , Amer J Path 25:413-446, 1949. 23. More, R.H., and Movat, H.Z.: Character and Significance of the Cellular Response in the Collagen Diseases and Experimental Hypersensitivity , Lab Invest 8:873-880 ( (No. 4) ) 1959. 24. Hopps, H.C., and Wissler, R.W.: The Experimental Production of Generalized Arteritis and Periarteritis (Periarteritis Nodosa) , J Lab Clin Med 31:939-957, 1946. 25. Robbins, S.L.: " Hypersensitivity and the Collagen Diseases ," in Textbook of Pathology With Clinical Application , Philadelphia: W. B. Saunders Co., 1962, pp 345-360. 26. Pappenheimer, A.M., and Freund, J.: " Induction of Delayed Hypersensitivity to Protein Antigens ," in Cellular and Humoral Aspects of the Hypersensitivity States , New York: Hoeber Medical book division of Harper & Row, Publishers, Inc., 1959, pp 67-88. 27. Lawrence, H.S.: " The Transfer of Hypersensitivity of the Delayed Type in Man ," in Cellular and Humoral Aspects of the Hypersensitivity States , New York: Hoeber Medical book division of Harper & Row, Publishers, Inc., 1959, pp 279-318.

REDDY, JOHN;SATALOFF, JOSEPH;LIU, JUNG-CHING

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030167009pmid: 5947876

Abstract HISTOPATHOLOGICAL changes following human stapes surgery have been reported by several investigators.1-7 Lindsay1 reported bilateral stapes mobilization with early re-ankylosis and osteogenesis in the area of the annular ligament. Baron and Lindsay2 reported a successful case of fat graft, and Schuknecht et al3 observed a fat connective tissue graft that was converted to connective tissue. Shea et al4 reported a vein graft with its elastic layer unchanged for 21 months postoperatively. The vein was covered on the vestibular surface by flat endothelium and on the middle ear surface by connective tissue and flat epithelium continuous with the mucoepithelium of the middle ear. There is evidence that vein graft repair takes place in three months according to Shea et al.4 House5 reported calcification in the vein graft, and Ezquerro6 observed the vein graft remains as vein for at least 2½ years. Harris References 1. Lindsay, J.: Histopathological Changes Following Fenestration and Stapes Mobilization , Trans Amer Acad Ophthal 63:187, 1959. 2. Baron, S., and Lindsay, J.: Stapedectomy With Fat Graft and Polyethylene Strut: A Case Report , Arch Otolaryng 80:128, 1964.Crossref 3. Schuknecht, H., et al: Stapedectomy: Postmortem Studies , Arch Otolaryng 79:437, 1964.Crossref 4. Shea, J.; Schiff, M.; and Burn, H.: " The Permanence of the Human Vein Graft in Fenestration of the Oval Window ," in Otosclerosis , Boston: Little, Brown and Co., 1961. 5. House, H.: Early and Late Complications of Stapes Surgery , Arch Otolaryng 78:606, 1963.Crossref 6. Ezquerro, C.: Vein Graft in Otology , Arch Otolaryng 79:188, 1964.Crossref 7. Harris, I., and Weiss, L.: Granulomatous Complications of Oval Window Fat Grafts , Laryngoscope 72:870, 1962. 8. Belluci, R., and Wolff, D.: Tissue Reactions Following Reconstruction of the Oval Window in Experimental Animals , Ann Otol 69:517, 1960. 9. Hayden, R., and McGee, H.: Traumatized Oval Window Fat Grafts , Arch Otolaryng 81:243, 1965.Crossref 10. Rutledge, L., et al: Experimental Fat Grafts and Teflon Pistons in Cats , Arch Otolaryng 81:570, 1965.Crossref 11. Reddy, J., and Igarashi, M.: Prosthetic Devices in the Middle Ear of Cats , J Laryng 78:675, 1964.Crossref 12. Hohmann, A.: " Inner Ear Reactions to Stapes Surgery (Animal Experiment) ," in Otosclerosis , Boston: Little, Brown and Co., 1961. 13. Paparella, M.: Acoustic Trauma From Bone Cutting Bur , Laryngoscope 72:116, 1962.Crossref 14. Williams, S.; McNeil, R.; and Schuknecht, H.: The Effects of Graft Manipulation Following Stapedectomy in the Cat , J Laryng 78:1090, 1964.Crossref 15. Benitez, J., and Schuknecht, H.: Otosclerosis: A Human Temporal Bone Report , Laryngoscope 72:1, 1962.Crossref 16. Linthicum, F.: The Effect of Surgical Trauma in Otosclerosis , Laryngoscope 75:35, 1965.Crossref

ELPERN, BARRY S.;ELBROND, OLE

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030172010pmid: 5947877

Abstract IN TYMPANOPLASTY, it is sometimes necessary to deal with absence of the malleus head in conjunction with other ossicle defects, especially following cholesteatoma in the attic. It may also be necessary in some cases to remove a malleus head which has become fixated to the epitympanic wall. These conditions raise the question of whether absence of the malleus head limits the degree of hearing restoration which may be expected from tympanoplasty. The available literature would suggest that this might be so. Bekesy1 has described the counterbalance function of the malleus head and the way in which the absence of this structure upsets the coincidence of the center of gravity and the axis of rotation of the ossicle chain, causing stress on the eardrum which interferes with its normal mode of vibration. A quantified estimate of the effect of this interference has been reported by Lawrence,2 who measured References 1. Von Bekesy, G.: Experiments in Hearing , New York: McGraw-Hill Book Co., Inc., 1960, pp 102, 181, 201. 2. Lawrence, M.: Acoustic Effects of Middle Ear Substitution , Trans Amer Acad Ophthal Otolaryng 64:235-247, 1960. 3. Andersen, H.C., et al: Experimental Studies on Sound Transmission in the Human Ear , Acta Otolaryng 54:511-520, 1962.Crossref 4. Andersen, H.C., et al: Experimental Studies on Sound Transmission in the Human Ear , Acta Otolaryng 56:307-317, 1963.Crossref 5. Andersen, H.C., et al: Experimental Studies on Sound Transmission in the Human Ear , Acta Otolaryng , (suppl 183) , p 11, 1963. 6. Andersen, H.C., et al: Experimental Studies on Sound Transmission in the Human Ear , Acta Otolaryng , (suppl 188) , p 280, 1964. 7. Andersen, H.C., et al: Experimental Studies on Sound Transmission in the Human Ear , Acta Otolaryng 57:231-235, 1964.Crossref 8. Andersen, H.C., et al: Experimental Studies on Sound Transmission in the Human Ear , Acta Otolaryng 60:223, 1965.Crossref 9. Elbrond, O., and Elpern, B.S.: Reconstruction of Ossicular Chain in Incus Defects , Arch Otolaryng 82:603-608, 1965.Crossref

NEERGAARD, EJLER B.;RASMUSSEN, POUL E.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030175011pmid: 5947878

Abstract WHEN a normal ear is exposed to a loud sound, the stapedius muscle in each ear will contract. This stapedius muscle reflex may be detected by a range or different procedures: (1) electromyographic registration by means of electrodes in the muscle or tendon; (2) optical detection by direct inspection of the eardrum or structures visible through a perforation in the eardrum; (3) measurement of changes in the sound transmission of the middle ear by recording of cochlear microphonics or recording of sound pressure in the external ear canal when sound is applied to the skull; (4) registration of changes in the acoustic impedance of the ear; (5) detection of variations in air pressure in the ear canal caused by eardrum movements. Investigation of the latency of the stapedius muscle reflex may also be performed by most of the above-mentioned procedures. This latency is defined as the time interval between the References 1. Perlman, H.B., and Case, T.J.: Latent Period of the Crossed Stapedius Reflex in Man , Ann Otol 48:663,1939. 2. Fisch, U., and Schulthess, G.: Electromyographic Studies on the Human Stapedial Muscle , Acta Otolaryng 56:287, 1963.Crossref 3. Djupesland, G.: Electromyography of the Tympanic Muscles in Man , Int Audiol 4:34, 1965.Crossref 4. Kobrak, H.G.: Experimental Observations on Sound Conduction in the Middle and Inner Ear , Ann Otol 62:748, 1953. 5. Kawata, S.: Judgement of Recruitment by Means of Measuring the Retraction Grade of the Tympanic Membrane , Acta Otolaryng 49:517, 1958.Crossref 6. Metz, O.: The Acoustic Impedance Measured in Normal and Pathological Ears , Acta Otolaryng , (suppl 63) , 1946. 7. Jepsen, O.: Studies on the Acoustic Stapedius Reflex in Man, thesis, Universitetsforlaget, Aarhus, 1955. 8. Jepsen, O.: " Middle-Ear Muscle Reflexes in Man ," in Jerger (ed.): Modern Developments in Audiology , New York, London: Academic Press, 1963. 9. Thomsen, K.A.: Employment of Impedance Measurements in Otologic and Otoneurologic Diagnostics , Acta Otolaryng 45:159, 1955.Crossref 10. Zwislocki, J.: Some Impedance Measurements on Normal and Pathological Ears , J Acoust Soc Amer 29:1312, 1957.Crossref 11. Moller, A.R.: Intra-aural Muscle Contraction in Man, Examined by Measuring Acoustic Impedance of the Ear , Laryngoscope 68:48, 1958. 12. Terkildsen, K., and Nielsen, S.S.: An Electroacoustic Impedance Measuring Bridge for Clinical Use , Arch Otolaryng 72:339, 1960.Crossref 13. Klockhoff, I.: Midddle Ear Muscle Reflexes in Man , Acta Otolaryng , (suppl 164) , 1961. 14. Neergaard, E.B.; Rasmussen, P.E.; and Jepsen, O.: Measurement of Acoustic Impedance by a New Principle, Cross-Coupling , Int Audiol 4:20, 1965.Crossref 15. Metz, O.: Studies on the Contraction of the Tympanic Muscles as Indicated by Changes in the Impedance of the Ear , Acta Otolaryng 39:397, 1951.Crossref 16. Terkildsen, K.: The Intra-aural Muscle Reflexes in Normal Persons and in Workers Exposed to Intense Industrial Noise , Acta Otolaryng 52:384, 1960.Crossref 17. Mendelson, E.S.: A Sensitive Method for Registration of Human Intratympanic Muscle Reflexes , J Appl Physiol 11:499, 1957. 18. Mendelson, E.S.: Improved Method for Studying Tympanic Reflexes in Man , J Acoust Soc Amer 33:146, 1961.Crossref 19. Terkildsen, K.: Movements of the Eardrum Following Intra-aural Muscle Reflexes , Arch Otolaryng 66:484, 1957.Crossref 20. Weiss, H.S., et al: The Normal Human Intra-aural Muscle Reflex in Response to Sound , Acta Otolaryng 55:505, 1962.Crossref 21. Holst, H.E.; Ingelstedt, S.; and Örtegren, U.: Eardrum Movements Following Stimulation of the Middle Ear Muscles , Acta Otolaryng , (suppl 182) , p 73, 1963. 22. Terkildsen, K., and Thomsen, K.A.: The Influence of Pressure Variations on the Impedance of the Human Eardrum , J Laryng 73:409, 1959.Crossref 23. Salomon, G., and Starr, A.: Electromyography of Middle Ear Muscles in Man During Motor Activities , Acta Neurol 39:161, 1963.Crossref 24. Mangold, E.: Willkürliche Kontraktionen des Tensor Tympani und die graphische Registrierung von Druckschwankungen im äusseren Gehörgang , Pflüger Arch Ges Physiol 149:539, 1913.Crossref

KOSSOFF, G.;KHAN, A. E.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030183012pmid: 5947879

Abstract ULTRASONIC irradiation of the semicircular canals for treatment of vestibular disturbances was first described by Arslan1 in 1953. Although the equipment originally used by Arslan has been superseded by more efficient generators,2-4 the original method of applying the irradiation to the surgically exposed semicircular canal has not been changed. The main developments have been in the design of more suitable applicators and clinical evaluation of the results of the irradiation, which have established that ultrasonic irradiation abolishes vertigo attacks in a large percentage of cases, while preserving hearing in the affected ear. As the surgical procedure is relatively simple and the new generators are reliable and simple to operate, the technique is becoming accepted by many otologists as the choice method of treating vestibular disturbances which do not respond to standard chemotherapy. The CAL Generator The CAL ultrasonic generator (Fig 1), designed to overcome the disadvantages of the References 1. Arslan, M.: "Treatment of Meniere's Syndrome by Direct Application of Ultrasound to the Vestibular System," in Proceedings, Fifth International Congress, Otorhinolaryngology, Amsterdam, 1953, p 429. 2. Kossoff, G.: Physical Instrumentation for Application of Ultrasound in Vestibular Disturbances, Commonwealth Acoustic Laboratories Report No. 20, Sydney, Australia. 3. James, J.A., et al: New 3-Megacycle Generator for Destruction of Vestibular End Organ , Acta Otolaryng 56:148, 1963.Crossref 4. Sjoberg, A., et al: Treatment of Meniere's Disease by Ultrasonic Irradiation , Acta Otolaryng , (suppl 178) , 1963. 5. Kossoff, G.: Design of the CAL Ultrasonic Generator for the Treatment of Meniere's Disease , IEEE Trans Sonics Ultrasonics SU-11:95, 1964.Crossref 6. Basek, M., and Epanchin, V.N.: New Ultrasonic Generator for Treating Meniere's Disease , Arch Otolaryng 80:271, 1964.Crossref 7. Kossoff, G., et al: The Use of the CAL Ultrasonic Generator in Meniere's Disease , J Laryng 78:245, 1964.Crossref 8. Arslan, M.: Prime applicazioni del metodo di distruzione ultrasonica dell'ipofisi per via transetmoidale , Min Otorinolaring 15:1-2, 1965. 9. Bullen, M.A., et al: A Physical Survey of the Ultrasonic Treatment of Meniere's disease , Ultrasonics 1:2, 1963.Crossref 10. Savetsley, L., and Altmann, F.: The Treatment of Meniere's Disease With Ultrasound , Arch Otolaryng 77:181, 1963.Crossref 11. Arslan, M.: Ultrasonic Destruction of the Vestibular Receptors in Severe Meniere's Disease , Laryngoscope 74:1262, 1964.Crossref 12. Giencarlo, H., et al: Vestibular Changes Following Ultrasonic Irradiation , Arch Otolaryng 82:365, 1965.Crossref 13. Bell, E.: Action of Ultrasound on Adult and Embryonic Organ Systems , Amer J Phys Med 37:184, 1958. 14. Hughes, D.E.: Ultrasonic Energy , Urbana, Ill, University of Illinois Press, 1965. 15. Hughes, D.E., and Chou, J.T.Y.: The Biochemistry of the Inner Ear and the Consequences of Treatment by Ultrasound , Acta Otolaryng , (suppl 192) , p 200, 1963. 16. Dohlman, G.F.: Secretion and Absorption of Endolymph , Ann Otol 73:708, 1964.

HARPMAN, J. A.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030191013pmid: 5947880

Abstract THE MAIN interest of the case report presented here is that it describes an operative procedure for dealing with neoplasms involving the cribriform plate. These neoplasms are especially important since olfactory neuroepitheliomas—which are but slightly radiosensitive—are being recognized more frequently. Report of a Case A 53-year-old man—an office worker—presented with swelling of the nasal bridge of about six weeks' duration. He had had right epistaxis three weeks previously. Fig 1 shows his external appearance. The upper part of the nasal septum was widened and appeared "granulomatous." The Wassermann reaction was negative; the erythrocyte sedimentation rate showed a 22-mm fall in the first hour; sinus x-ray films showed no obvious lesion; the blood count was normal; x-ray film showed the chest was clear. A biopsy of the septal lesion (Fig 2) was histologically interpreted by two pathologists as adamantinoma, by a third as squamous cell epithelioma, and by a fourth

BELTAOS, EFSTATHIOS;MAURER, WILLIAM J.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030195014pmid: 5947881

Abstract ONCOCYTOMAS are rare tumors occurring mostly in the parotid gland. Of the 25 reported cases, 20 arose in the parotid gland, two in the submaxillary gland, two in the palate, and one in the larynx (Table). The purpose of this paper is to record an additional case of oncocytoma of the submaxillary salivary gland. Report of a Case A 42-year-old white man had been aware of a nontender, firm mass in the left side of his neck for about eight months. On physical examination a 2×1.5×1 cm nodule was palpable in the submaxillary region, 2 cm anterior to the angle of the mandible. It was not fixed to the skin or to the deep structures of the neck and was thought to be an enlarged lymph node. The nodule was removed easily and the postoperative course was uneventful. Follow-up examination, after eight months, showed no References 1. Hamperl, H.: Beiträge Zur normalen und pathologischen Histologie men schlicher Speicheldrüsen , Z Mikr Anat Forsch 27:1-55, 1931. 2. Schaffer, J.: Beiträge zur Histologie menschlicher Organe: IV. Zunge, V. Mundhöhle-Schlundkopf, VI. Oesophagus, VII. Cardia , Sitzungsb Kaiserl Akad Math Naturwiss Cl , part 3, 106:353-455, 1897. 3. Hamperl, H.: Uber das Vorkommen von Onkocyten im verschiedenen Organen und ihren Geschwülsten , Virchow Arch Path Anat 298:327-375, 1936.Crossref 4. Stout, A.P.: Cellular Origin of Bronchial Adenoma , Arch Path 35:803-807, 1943. 5. Nohteri, H.: A Case of Laryngeal Cyst Composed of Oncocytes and the Appearance of Oncocytes in Mucous Membrane of the Nose and Larynx , Acta Path Microbiol Scand 23:473-483, 1946.Crossref 6. McFarland, J.: Adenoma of the Salivary Glands , Amer J Med Sci 174:362-378, 1927.Crossref 7. Gruenfeld, G.E., and Jorstad, L.H.: Adenoma of the Parotid Salivary Gland: Onkocytic Tumor , Amer J Cancer 26:571-575, 1936. 8. Steinhardt, G.: Über besondere Zellen in den alternden Mundspeicheldrüsen (Onkocyten) und ihre Beziehungen zu den Adenolymphomen und Adenomen , Virchow Arch Path Anat 289:624-635, 1933.Crossref 9. Ahlbom, H.E.: Mucous and Salivary Gland Tumors , Acta Radiol , (suppl 23) , pp 1-452, 1935. 10. Skorpil, F.: Über das Speicheldrüsenadenom , Virchow Arch Path Anat 306:714-736, 1940.Crossref 11. Stohr, F., and Risak, E.: Zur Klinik und anatomie der Parotisgeschwulste , Arch Klin Chir 143:609-648, 1926. 12. Ackerman, L.V.: Oncocytoma of the Parotid Gland , Arch Path 36:508-511, 1943. 13. McFarland, J.: The Histopathologic Prognosis of Salivary Gland Mixed Tumors , Amer J Med Sci 203:502-519, 1942.Crossref 14. Huckel, R.: Eine ungewöhnliche Adenomform der Parotis , Verh Deutsch Ges Path 25:342-347, 1930. 15. Lloyd, O.C.: Salivary Adenoma and Adenolymphoma , J Path Bact 58:699-710, 1946.Crossref 16. Stump, D.J.: Onkocytic Adenoma of the Salivary Glands , Arch Path 48:287-296, 1949. 17. Christopherson, W.M.: Oncocytoma of the Parotid Gland , Arch Path 48:96-98, 1949. 18. Meza-Chavez, L.: Oxyphilic Granular Cell Adenoma of the Parotid Gland (Oncocytoma) , Amer J Path 25:523-548, 1949. 19. Greenberg, S.D., and Haley, M.D.: Oncocytoma (Oxyphil-Cell Adenoma) of the Parotid Gland , Amer J Clin Path 27:321-327, 1957. 20. Geist, D.C.: Oxyphilic Granular Cell Adenoma of the Parotid Gland: Report of a Case , Amer Surg 24:735-737, 1958. 21. Schafer, E.L.; Gruet, M.; and Jackson, A.S.: Oncocytic-Cell Adenoma of the Parotid Gland , Amer J Surg 91:272-278, 1956.Crossref 22. Loiacono, F.: Osservazioni sull' oncocitoma salivare , Minerva Chir 17:1059-1061 ( (Nov 15) ) 1962. 23. Coppo, E.; D'Agostino, G.; and Perrino, A.: Tumori rari del tessuto salivare , Annali Laring 61:475-485 ( (Aug) ) 1962. 24. DuPlay, M.: Adenoma de la glande sous-maxillaire , Arch Gen Med 1:601-603, 1875. 25. Capo, O.A.: Oxyphilic Adenoma (Oncocytoma) of the Larynx , Arch Otolaryng 82:42, 1965.Crossref

GACEK, RICHARD R.;ZONIS, RICHARD

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030200015pmid: 5330023

Abstract PROTECTION of the carotid artery following radical neck dissection is a major concern of the head and neck surgeon, especially in those patients in whom impaired wound healing is anticipated. These include debilitated patients, those with prior irradiation, and those with preoperative infection or orocutaneous fistula. The various methods currently employed for covering the carotid artery, with the advantages and disadvantages of each, have been reviewed by Conley.1 Each is applicable in certain situations, depending on the mobility of the artery and the portion one desires to protect. However, no one method has proven satisfactory in all situations. Transposition of the levator scapulae muscle was first advocated by Staley in 1961.2 A modification of this method was demonstrated by Schweitzer in 19623 where the muscle was pedicled superiorly and sutured over the carotid bulb. Pedicles from the scalene muscles could then be used to cover the remainder References 1. Conley, J.J.: Carotid Artery Protection , Arch Otolaryng 75:60-65, 1962.Crossref 2. Staley, C.J.: A Muscle Cover for the Carotid Artery After Radical Neck Dissection , Amer J Surg 102:815-817, 1961.Crossref 3. Schweitzer, R.J.: Use of Muscle Flaps for Protection of Carotid Artery After Radical Neck Dissection , Ann Surg 156:811-818, 1962.Crossref 4. Gray's Anatomy , ed 26, Philadelphia: Lea & Febiger, 1954, p 655.

BAKER, ROBINSON;CHERRY, JERRIE;LOTT, STEWART;BISCHOFBERGER, WILLY B.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030203016pmid: 5947882

Abstract CARCINOMA of the maxillary sinus accounts for approximately 5% of malignancies involving the respiratory system. The disease is not common and frequently not diagnosed in its early stages of development. The delay in diagnosis can be attributed to several factors: (1) small lesions are hidden in a bony enclosure and (2) the initial symptoms are usually those of chronic sinusitis. The treatment of malignant tumors in this anatomical area has been controversial. Further advances in therapy are dependent upon earlier diagnosis and a synthesis of experience from a number of institutions in the management of this relatively rare disease. This study analyzes the treatment of carcinoma of the maxillary sinus at The Johns Hopkins Hospital. All records of patients with primary carcinoma of the maxillary sinus between 1952 and 1962 were reviewed. Satisfactory clinical data was obtained on 25 patients. A histologic diagnosis was established in all instances. All patients References 1. Sisson, G.; Johnson, E.N.; and Amiti, C.S.: Cancer of the Maxillary Sinus , Ann Otol 72:1050, 1963. 2. Jesse, R.H.: Preoperative Versus Postoperative Radiation in the Treatment of Squamous Carcinoma of the Paranasal Sinuses , Amer J Surg 110:552, 1965.Crossref 3. Frazell, E.L., and Lewis, J.S.: Cancer of the Nasal Cavity and Accessory Sinuses , Cancer 16:1293, 1963.Crossref 4. Spratt, J.S., and Mercado, R.: Therapy and Staging in Advanced Cancer of the Maxillary Antrum , Amer J Surg 110:502, 1965.Crossref 5. McGregor, I.A.: The Temporal Flap in Facial Covers: A Method of Repair , Trans Third Int Cong Plastic Surg 66:1096, 1963.

DICKINSON, JOHN T.;CIPCIC, JOSEPH;ARENA, SEBASTIAN

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030207017pmid: 5330024

Abstract THE CARE of acute facial injuries is no longer limited to reducing fractures and closing lacerations. Greater recognition is now given the desirability and necessity of utilizing plastic reconstructive procedures in the primary repair of facial injuries. Application of such surgical techniques at the time of initial repair can be of inestimable value in total rehabilitation of the patient. Best results in both esthetic and functional restoration can be achieved by judicious use of such plastic reconstructive procedures as: (1) dermabrasion; (2) relaxation incisions, Z-plasties, and local flaps; (3) skin grafts; (4) immediate reconstruction of a severed parotid duct and lacerated facial nerve; and (5) immediate application of other tissue grafts and/or artificial implants. The well-trained otolaryngologist is ideally suited for the correction of facial injuries because of his superior knowledge of the anatomy, physiology, and pathological problems related to the tissues involved. With the same skill he employs in

PROUD, G. O.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030219018pmid: 5947883

Abstract THE OTORHINOLARYNGOLOGIST is embarking upon a new adventure, for certain new surgical procedures have come into his hands. Among these are the translabyrinthine approach for removal of tumors of the internal auditory meatus and middle cranial fossa exploration. The adventure promises to be a challenging one, but the ability to perform the operative maneuvers per se does not equip him for the full responsibility which is his. The neurologists and neurosurgeons as well as the internists have come to rely upon the otolaryngologist's audiologic and labyrinthine tests in the overall localization and diagnosis of many central nervous system lesions. With these thoughts in mind the following material was prepared with the realization that the known facts are so numerous and the specialty of otoneurology so young and rapidly changing that it is completely impossible to include everything that is known about the subject. It is hoped, however, that the work References 1. Crosby, E.C.; Humphrey, T.; and Lauer, E.W.: Correlative Anatomy of the Nervous System , New York: Macmillan Co., 1962, pp 149-158. 2. Spiegel, E.A., and Sommer, I.: Neurology of the Ear, Nose and Throat , New York: Grune & Stratton, Inc., 1944. 3. Heath, S.R.: Rail-Walking Performance as Related to Mental Age and Etiological Type Among the Mentally Retarded , Amer J Psych 55:240-247.Crossref 4. Scala, N.P., and Spiegel, E.A.: The Mechanism of Optokinetic Nystagmus , Trans Amer Acad Ophthal 43:277-299, 1938. 5. Smith, J.L., and Cogan, D.G.: Optokinetic Nystagmus: A Test for Parietal Lobe Lesions , Amer J Ophthal 48:187-193 ( (Aug) ) 1959. 6. Crosby, E.C.: Nystagmus as a Sign of Central Nervous System Involvement , Ann Otol 62:1117, 1953. 7. Cawthorne, T.: Positional Nystagmus , Ann Otol 63:481-490, 1954. 8. Nylen, C.O.: The Posture Test , Acta Otolaryng (suppl 109) , pp 125-130, 1953. 9. Hallpike, C.S.: The Caloric Tests , J Laryng Otol 70:15-28 ( (Jan) ) 1956.Crossref

SHAMBAUGH, GEORGE E.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030226019

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract I T IS far from easy to retrace here the life of the creator of "fenestration." Maurice Sourdille was a man with a lively, creative intelligence, a complex character with boundless energy. The fact that his name will remain as one of the greatest in our field is simple to explain: it was he who, for the first time, succeeded in permanently restoring hearing to an otosclerosed patient after an operation on the semicircular external canal. This achievement, simple as it seems, required constant and systematic effort during the 12 years following the end of World War I. It is true that others had already used various surgical processes to improve hearing, but before him no one had succeeded in restoring a social and permanent audition by the opening of the posterior labyrinth. It was only by unremitting toil that he obtained this result. It was due to his extraordinary

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030231020

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Home Study Courses.—The 1966-1967 home study courses in the basic sciences relating to ophthalmology and otolaryngology will begin Sept 1, 1966, and cover a period of ten months. These courses, which are offered as a part of the educational program of the American Academy of Ophthalmology and Otolaryngology, are designed to stimulate reading in the basic sciences and can be used as a supplement to residency training or as a refresher course of directed reading for the physician in practice. Detailed information and application forms may be secured from the Executive Secretary-Treasurer of the American Academy of Ophthalmology and Otolaryngology, W. L. Benedict, MD, 15 Second St SW, Rochester, Minn 55901. Enrollment must be completed before Aug 15, 1966. Guy Boyden Memorial Lecture.—The Guy Boyden Memorial Lecture will be presented by Mr. Ronald G. Macbeth of the Department of Otolaryngology, Radcliffe Infirmary, Oxford, England, on Tuesday, Sept 6,

SATALOFF, JOSEPH

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030232021

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract PATHOLOGIC QUIZ CASE 1 J. R. CHANDLER, MD, MIAMI, FLA A 28-year-old white man noticed intermittent bilateral frontal headaches for three weeks prior to the appearance of a small lump just above the inner aspect of his right eye. The headaches continued as the small lump became slightly larger. There was no impairment of vision or diplopia. There were no nasal symptoms.Examination revealed a firm, rounded, nontender mass approximately 2 cm in diameter just above the medial canthus of the right eye. There wasslight diplopia on upward gaze. There was some slight bit of mucopurulent material in the right middle meatus and a small bit of dried blood in the middle meatus on posterior rhinoscopic examination. X-ray studies revealed a density of the right frontal and ethmoid sinuses with no associated bone destruction.After aspiration biopsy resulted in a tentative diagnosis, the lesion was excised by means of

PUTNEY, F. JOHNSON

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030236022pmid: 5330026

Abstract ELECTRON microscopy upon tissue obtained at the time of bronchoscopy demonstrated changes in the intercellular structure of the cell walls and membrane, particularly in patients with chronic bronchitis.1 The changes in bronchitis were those of degree only, and no absolute difference between normal bronchial mucosa and that of bronchitis could be demonstrated. Several observations were made on the bronchitic tissue, and the most marked was a great reduction in the amount of pellicular structure. Several other alterations of intercellular structure were less marked. Experimentally, in dogs anticancer drugs introduced intrabronchially in the tumor zone were absorbed into the local blood and lymphatic circulations, reducing the possibility of drug toxicity that occurs from systemic administration.2 Since the high concentration in a cancer-containing bronchus may destroy fixed and free-floating malignant cells before, during, and after manipulation the use of chemotherapeutic agents through the bronchoscope may prove to be an adjunct References 1. Brinkman, G.L., and Watson, J.H.L.: Electron Microscopy of Human Bronchial Mucosa , JAMA 192:760 ( (May 31) ) 1965.Crossref 2. Cole, D.R., et al: Intraluminal Cancer Chemotherapy Adjuvant to Pulmonary Resection , J Surg Res 5:105 ( (March) ) 1965.Crossref 3. Steinman, E.P.: The Horizontal or Side-To-Side Movements of the Tracheal Bifurcation , Arch Otolaryng 81:232 ( (March) ) 1965.Crossref 4. Ramirez-R.J.; Kieffer, R.F., Jr.; and Ball, W.C.: Bronchopulmonary Lavage in Man , Ann Intern Med 63:819 ( (Nov) ) 1965.Crossref 5. Atkins, J.P.: Tracheal Reaction Following the Use of Cuffed Tracheotomy Tubes , Ann Otol 73:1124 ( (Dec) ) 1964. 6. Zhdanova, M.P.: Capillary Hemangioma of Trachea , Zh Ushn Nos Gorl Bolez 1:77, 1964. 7. Harley, H.R.S., et al: Fatal Cerebral Anoxia Following the Use of Lignocaine Spray for Bronchoscopy , Brit J Anesth 37:61 ( (Jan) ) 1965.Crossref 8. Mikhok, D., et al: Perforation of Bronchi , Vestn Otorhinolaring 4:83, 1964. 9. Brennan, M.T., and Putney, F.J.: Bronchial Perforation During Bronchoscopy , Ann Otol 73:1108 ( (Dec) ) 1964. 10. Silbiger, M.L., and Kushner, L.N.: Tracheobronchial Perforation: Its Diagnosis and Treatment , Radiology 85:242 ( (Aug) ) 1965.Crossref 11. Anderson, H.A.; Fontana, R.S.; and Harrison, E.G., Jr.: Transbronchoscopic Lung Biopsy in Diffuse Pulmonary Disease , Dis Chest 48:187 ( (Aug) ) 1965.Crossref 12. Fearon, B., et al: The Idiopathic Respiratory Distress Syndrome in the Newborn , Ann Otol 73:1082 ( (Dec) ) 1964. 13. Caldarola, V.T., et al: Benign Tumors and Tumor-Like Conditions of the Trachea and Bronchi , Ann Otol 73:1042 ( (Dec) ) 1964. 14. Lisa, J.R.; Trinidad, S.; and Rosenblatt, M.B.: Site of Origin, Histogenesis, and Cytostructure of Bronchogenic Carcinoma , Amer J Clin Path 44:375 ( (Oct) ) 1965. 15. Hattori, S., et al: Cytologic Diagnosis of Early Lung Cancer , Dis Chest 48:123 ( (Aug) ) 1965.Crossref 16. Casella, R.R.; Ellis, F.H., Jr.; and Brown, A.L., Jr.: Fine Structure Changes in Achalasia of the Esophagus , Amer J Path 46:279 ( (Feb) ) 1965. 17. Lund, W.S.: The Function of the Cricopharyngeal Sphincter During Swallowing , Acta Otolaryng 59:497 ( (May) ) 1965.Crossref 18. Grimes, O.F.: Cavernous Hemangioma of the Esophagus , Dis Chest 48:380 ( (Oct) ) 1965.Crossref 19. Carter, R., and Hinshaw, D.B.: Use of the Esophagoscope in the Diagnosis of Rupture of the Esophagus , Surg Gynec Obstet 120:1304 ( (June) ) 1965. 20. Gibson, R.: Removal of Intramural Foreign Body From Esophagus Using Roper-Hall Foreign Body Locator , J Laryng 79:23 ( (Jan) ) 1965.Crossref 21. Luborsky, F.E.; Drummond, B.J.; and Penta, A.A.: Recent Advances in the Removal of Magnetic Foreign Bodies From the Esophagus, Stomach and Duodenum With Controllable Permanent Magnets , Amer J Roentgen 92:1021 ( (Nov) ) 1964. 22. Fifer, W.R.; Woellner, R.C.; and Gordon, S.S.: Mediastinal Histoplasmosis , Dis Chest 47:518 ( (May) ) 1965.Crossref 23. Mossberg, S.M.: Lower Esophageal Ring Successfully Treated by Pneumatic Dilatation , Gastroenterology 48:118 ( (Jan) ) 1965. 24. Conn, H.O.; Smith, H.W.; and Brodoff, M.: Observer Variation in the Endoscopic Diagnosis of Esophageal Varices , New Eng J Med 272:830 ( (April 22) ) 1965.Crossref 25. Ottenjann, R., and Heckel, M.: Selective Endoscopic Gastric Biopsy in Cases of Giant Mucosal Folds , Deutsch Med Wschr 90:1510 ( (Aug 27) ) 1965.Crossref 26. Adams, C.L., and Enerson, D.M.: Obstruction of a Mousseau-Barbin Tube From Prolapsed Esophageal Mucosa , J Thorac Cardiov Surg 49:259 ( (Feb) ) 1965. 27. Sohn, D.; Valensi, Q.; and Bryk, D.: Hepatoma Metastasizing to the Esophagus , JAMA 194:910 ( (Nov 22) ) 1965.Crossref

CLEMIS, JACK D.;C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030240023

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This concise book has reader appeal, not only for the laryngologist and speech therapist, but also for the patient with a speech disorder and for the professional voice user. In this book the author teaches how to make your voice pleasing and clear, how to speak with resonance and melody, and how to speak at the right pitch and range with ease. "The same procedure for making the voice pleasant will keep the voice healthy and aid in preventing nodules, polyps, ulcers, and vocal cord thickening."

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030240025

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This book is written for the speech therapist, physician, and teacher by an author highly qualified by reason of her extensive clinical background. Her working classifications are simple, functional, consistent with accepted neurological concepts, and of proved value in treatment and prognosis. The text covers "The Development of Speech in the Community," "Delayed Speech Development," "Defective Articulation," "Stammering," "Speech Disorders in Twins," and "Lateral Dominence and Speech."

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030240026

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract The author's aim in writing this concise paperback on the psychosocial aspects of speech is to supplement existing major texts on the subject.

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030240024

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Increasing information from phoneticians, acoustic physicists, psychologists, educationalists, and laryngologists as well as modern electronic instruments such as the spectrograph, sonograph, myograph, image intensifier, and high-speed cineradiograph prompted the updating of this basic textbook first written in 1956. It is intended as a practical textbook on diagnosis and treatment of disorders of the voice. It is an excellent book, well-organized, well-written, and concise in manner, that will command otolaryngologic appeal.

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030241028

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Lipreading, speech rehabilitation, language learning, speech conservation, hearing aid use, and auditory training are processes concerned with aural habilitation and rehabilitation. The aim of auditory training is to assist the hearing handicapped in making better use of the hearing he possesses. The purpose of this book is to provide some structure to that area of aural rehabilitation referred to as auditory training.

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030241027

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This book, first written in 1944, has achieved international acceptance, and the sixth edition represents only a part of Miss Morley's generous contributions to the field of speech. Improved techniques and earlier surgery have resulted in speech therapy changing from a hopeless struggle against insufferable odds to achieve speech which was at least intelligible, to that of postoperative assessment of speech which is developing gradually but surely toward the normal. Today, by the age of 4, most children have attained normal articulation, and speech therapy is required only in those few who have failed to do so. In the sixth edition there has been substantial revision (in sections on orthodontic treatment and on damage to growth due to early surgery), reorganization (of much of the accumulated material), and addition (of information concerning palatopharyngeal competence, pressure tests, orifice measurements, lateral radiography, and cineradiography). The text is structured to include normal and

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030241029

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In 1949, Luchsinger and Arnold published the first German edition of Lehrbuch der Stimm-und Sprachheilkunde and ten years later a larger more complete volume was printed. The present book is an extension and further development of this second edition consisting, in part, of the English translation, and, in part, many additions and rearrangements. Much credit is given to Dr. Evelyn Robe Finkbeiner who, together with Dr. Arnold, completed the work of translation. Extensive compressing, expanding, and remodeling justify the new title. The book is divided into two sections. In the first, Dr. Luchsinger describes the voice and its disturbances, and in the second, Dr. Arnold discusses speech and language and their disorders. Each section is organized into two parts, the first providing general and background information and the second, specific disorders. Striving for encyclopedic completeness, the authors have covered practically all known types of vocal and verbal disorders. Robert West

TRESLEY, IRA J.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030241031

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract The first edition of this book was published in 1951 and was a thorough and detailed study of surgical procedures involving the nose. It included reconstruction of war injuries and deformities from neoplastic, traumatic, radiation, congenital, and other causes. Each procedure is well illustrated both anatomically and surgically. Preoperative and postoperative photographs of patients showed the results of these procedures. The second edition is not a revision but a reprinting of the first edition, and the only addition is a chapter on the use of some of the new synthetics for implantation purposes. A description on the use of cartilage and bone is given. The synthetics described are Teflon, the silicones, and synthetic sponges. The principal sponge materials are silicone Etheron, and Ivalon. The properties and characteristics are listed with advantages and disadvantages. The author concludes that in our present state of knowledge it is probably best to consider an

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030241030

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This French author has carried on the work of her late husband, Dr. Gerard de Parrel, in the remedial education of the deaf. The book describes their methods for the treatment of speech disorders, strongly advocating the principles of (1) early ascertainment of the disorders; (2) immediate initiation of remedial treatment; (3) acceptance of the parents and family as playing key roles in helping the patient; (4) skilled counseling of parents; and (5) the continuity of the therapeutic program.

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030242033

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This textbook has for many years stood as a pillar in support of general medical education in this country. It was first written in 1941, with three main objectives in mind: "The correlation of pharmacology with related medical sciences, the reinterpretation of the actions and uses of drugs from the viewpoint of important advances in medicine and the placing of emphasis on the application of pharmacodynamics to therapeutics," and revisions in 1955 and 1965 have been guided by them. Doctors Goodman and Gilman have altered their roles in this volume from authors to editors, having invited 42 contributors to subtract from, change, and add to "segments of a unified text directed to medical students, internes, residents and practitioners." I have neither the authority nor the inclination to comment upon the contents of this text. Suffice it to say that Goodman and Gilman have steadfastly taught therapeutics to physicians in a

C., J.D.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030242032

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Indications for anticoagulants in otolaryngology may occur as infrequently as may an otolaryngologist's contact with the anticoagulated patient, yet this occurs with sufficient frequency as to demand an understanding of this area of medical therapeutics. In this text the author offers in a most concise, uncomplicated, and unbiased form, the information that a practitioner desires for practical use. The title of the book suggests a more limited scope than the text offers, and it was with pleasant surprise that I found an abundance of valuable medical information between its covers. Basic data on history, blood coagulation, chemistry, and laboratory controls are confined to bare and essential facts. Clinical topics include thrombosis, embolism, atherosclerosis, coronary artery disease, and other cardiopulmonary conditions, cerebral and peripheral vascular disease with carefully outlined indications, contraindications, and complications of anticoagulant therapy. At the same time, the author presents arguments for and against anticoagulation in areas where

SALINGER, SAMUEL

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030243034

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor: The following incident may be of interest to your readers. A woman in her mid-40's phoned me one sunny afternoon stating that she had just experienced a sudden attack of severe pain in the right ear while she was outdoors. She disclaimed having had any previous upper respiratory trouble or ear complaint or nausea or dizziness. However, she added that since the onset of the pain she was experiencing intermittent rumbling or rustling sounds in the ear. I was at a loss to explain this phenomenon and was inclined to dismiss it as a neuralgia in an emotional woman. Still, at her insistence that the pain was unbearable I agreed to meet her at the office in a few minutes. When I first looked into the ear I saw nothing abnormal except a tiny bright red spot on the postero-inferior quadrant which appeared like a small hematoma.

TALBOTT, JOHN H.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030243036

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor: The above letter has been modified in keeping with accepted rules of good taste. The paradox in the letter is obvious. Why should one accept the "traditional teaching" of the use of "we" when the author was singular? Only general rules are enforced by the copy editors in correcting manuscripts. If authors would spend only a small portion of their time in perusing "Advice to Authors" (JAMA190:113-136 [Oct 5] 1964), less mental trauma would follow. The Editorial Division attempts to prepare all copy in one style, ie, good style—not the same style.

FOWLER, EDMUND P.

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030243035

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor: Last month I called your attention to the fact that my paper, "Otosclerosis in Identical Twins," was not published as I wrote it, eg, all the "we's" were changed to "I's." Most of us were brought up to avoid the use of the first person singular and as a rule to use the editorial "we." This and other so-called editorial corrections are very annoying to many authors who express themselves far better than the correctors of their script. In my opinion the writer of a paper should be allowed to express himself in his own words so that the reader may obtain at least a partial picture of his personality. The way things are managed now it almost seems as though the paper had been written by an electric computer. Could you do something to stop the AMA from attempting to prepare all copy in one style?

1966 Archives of Otolaryngology

doi: 10.1001/archotol.1966.00760030244037