Faculty Bibliography

Eighteen healthy 8- to 11-year-old children with normal hearing and histories of recurrent middle ear effusion (MEE) before the age of 5 years were evaluated by a battery of audiologic, psychologic, language, and achievement tests. Each of these children was compared to a non-MEE sibling who was tested at the same age. None of the children had been diagnosed as learning disabled. Both groups tested in the bright normal range of verbal ability on the WISC-R. Paired comparison of sibling data revealed that the MEE subjects had deficits in verbal ability, auditory decoding, and spelling skills compared with control siblings. Significant strength in visual sequential memory in the MEE subjects suggests that the availability of compensatory strategies for auditory deficits in these subjects. Sex and/or birth order differences did not explain the differences observed between siblings.

Neuroepithelial suprastructures in abnormal human inner ears were studied by light microscopy, scanning electron microscopy, and x-ray diffraction. The most common abnormality was calcification, which selectively affected the gelatinous membranes (otoconial, cupular, and tectorial) and the secretory tissues (stria vascularis and utricular dark cells). The structures most frequently affected were the otoconial membranes. The minerals involved were apatite, octacalcium phosphate, and vaterite, replacing the normal layer of calcium carbonate in the form of calcite crystals. The first two of these substances were sometimes mixed with calcite. In the saccule such abnormal otoconial deposits were usually associated with a collapsed saccular wall. Formation of abnormal otoconia is characterized as primary (no pre-existing normal calcite otoconia) or secondary (formed after the destruction of normal otoconia). Such deposits probably depend upon an abnormal composition of the endolymph, especially upon an elevated concentration of phosphate ions. It is inferred that a normal endolymphatic microhomeostasis is necessary to maintain the functional state of the neuroepithelial suprastructures.

A rare lesion of the maxillary and ethmoid sinuses, an ossifying capillary hemangioma, is presented. The therapeutic options and our choice of embolization followed one day later by radical surgery under hypotensive, hypothermic anesthesia are discussed. The principles of therapy involved in this lesion apply to the management of any large vascular tumor of the head and neck

Review of the literature reveals 76 cases of fibrous histiocytoma of the deep structures of the head and neck. To this we have added 11 of our own cases, and analyzed the total group to determine clinical and histological features of a high risk population. Age, sex, presence of pain, location of tumor, size of tumor, and local invasion appear to be important clinical criteria. Bizarre giant cells, numerous and atypical mitoses, necrosis, and inflammation appear to be important histologic features. The treatment of choice is wide local excision. Chemotherapy appears to produce tumor regression.

Radical resection of the anterior portion of the oral cavity, including a portion of the tongue, floor of the mouth, mandible, and neck, has always been, and remains, a perplexing problem in immediate rehabilitation of the area of the oral cavity and mentum. In the past, these deformities were classified as "Andy Gump." Attempts at correction of this deformity are protracted and complex. The use of the pectoralis myocutaneous flap offers an improvement in the concept of mamagement in that it supplies a skin lining for the oral cavity and augments the chin and neck in a single-stage procedure that may be combined with the primary operation.

Eighteen healthy, normal hearing (PTA greater than or equal to 15dB, better ear), neurologically intact, 8 to 11-year-old children who had documented histories of middle ear effusion (MEE) before the age of five years were evaluated by a battery of audiological, psychological, language and achievement tests. Each was compared to his/her non-MEE sibling who was tested at the same age. All the children (n = 36) tested in the bright normal range of verbal ability (WISC-R) and none had been diagnosed previously as learning disabled. Paired comparison of sibling data revealed that the effusion subjects had deficits in verbal ability, auditory decoding and spelling skills when compared with their control siblings. Significant strength in visual sequential memory in the MEE subjects suggests the availability of compensatory strategies for auditory deficits. Data analysis on the basis of sex and/or birth order differences could not explain the differences between siblings.