Faculty Bibliography

This study investigates the controversy regarding the influence of age on the acoustic reflex threshold for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators between Jerger et al. [Mono. Contemp. Audiol. 1 (1978)] and Jerger [J. Acoust. Soc. Am. 66 (1979)] on the one hand and Silman [J. Acoust. Soc. Am. 66 (1979)] and others on the other. The acoustic reflex thresholds for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators were evaluated under two measurement conditions. Seventy-two normal-hearing ears were drawn from 72 subjects ranging in age from 20-69 years. The results revealed that age was correlated with the acoustic reflex threshold for BBN activator but not for any of the tonal activators; the correlation was stronger under the 1-dB than under the 5-dB measurement condition. Also, the mean acoustic reflex thresholds for broadband noise activator were essentially similar to those reported by Jerger et al. (1978) but differed from those obtained in this study under the 1-dB measurement condition.

In 17 cases of sinusitis-induced subdural empyema, all but 5 occurred in boys or men aged 13 to 33 years. Clinical features were headaches and fever (14 patients), nuchal rigidity (10), and seizures (8). Seven patients had periorbital cellulitis, and 15 had radiographic clouding of at least one sinus. Only five patients had a history of sinusitis. CT identified the empyema accurately in seven patients but failed in two patients who developed subdural empyema while being treated for sinusitis-induced cerebritis. Ten patients had specific bacteriologic etiologies determined by culture of empyema, blood, or sinuses.

One hundred thirty-six cases of subglottic hemangioma in infants have been reported in the English -language literature; four additional cases are reported here. The clinical presentations, diagnostic work-ups, treatments, and outcomes are analyzed. Twenty-one patients died, 17 of whom underwent autopsy. The histology of the laryngeal pathology from seven of these patients was reviewed by the authors. Possible correlation between the pathological findings and the clinical presentation is made. Approaches to diagnosis and treatment are suggested based on these findings.

The objective of this study was to explore the hypothesis (Van De Water, 1976) that differentiating sensory receptors of the inner ear may attract ingrowing neurites of the statoacoustic (VIIIn) ganglion by chemotaxis. Co-cultured embryonic inner ears which shared a single VIIIn ganglion were grown "in vitro" to the equivalent of 20 days gestation and then processed histologically to show both cytodifferentiation of sensory structures and the presence of neural elements. Specimens of both 11- and 12.5-day-old co-cultured otocysts showed that VIIIn ganglion neurites grew into sensory receptors of both(+) with and (-) without ganglion inner ear explants. Fourteen-day-old co-cultured inner ears revealed that only the (+) ganglion inner ear explants received VIIIn ganglion neurites into the sensory areas, and that neurites were not attracted into the (-) ganglion explants. The results were found to support the hypothesis of a limited period of chemotaxis as being a possible mechanism for the establishment of the pattern of innervation of inner ear sensory receptors by its VIIIn ganglion.

In a study of the MMPI personality types of hospitalized men and women alcoholics, the Neurotic and Classic types had the characteristics of reactive alcoholism, and the Psychopathic, Schizoform A and Schizoform B types had the characteristics of essential alcoholism. Demographic variables and treatment prognosis also varied according to MMPI personality types.

A sublabial approach to the nasal cavity, paranasal sinuses and the nasopharynx degloving the middle third of the face has been described. Its major advantages over the other approaches have been compared and the usefulness of this approach has been stressed. The incidence of complications from this approach has been described and found to be acceptable.

A multiinstitutional study to define the impact of total treatment programs involving radical neck dissection (RND) and modified neck dissection (MND) on patients' permanent disability was undertaken. A total of 243 patient responses were included in the study. Comparative analyses between the treatment groups show no advantage of one surgical operation over the other in returning patients to their pretreatment employment status. Radiation therapy was identified as adding significantly to the patient's permanent disability.

Adenocarcinoma arising from the mucosa of the middle ear is a rare tumor. This report adds four new cases to the 13 cases that have been previously reported in the literature. These neoplasms tend to have a rather slow growth pattern and have an infrequent incidence of distant metastases. The observations that local recurrence is the major problem with adenocarcinoma of the middle ear suggest that aggressive locoregional treatment should be strongly considered.