Faculty Bibliography

A direct and simple operation of transfer of the anterior belly of the digastric muscle with its attached tendon is presented. It was carried out in 36 patients, with three minor complications. It has proved effective in paralysis of the mandibular division of the facial nerve as a primary or secondary procedure. In ablative resections where this branch of the nerve is intentionally sacrificed, it is advised to do the muscle and tendon transfer as part of the primary operation. In aesthetic operations or where the status of the nerve (post-operatively) is not specifically know, it is advised to wait for spontaneous return for an interval of 3 to 6 months. If the improvement is not satisfactory, then this technique may be considered

Experience with 81 gas computed tomography (CT) cisternography procedures in 79 patients in searching for acoustic neuroma is reported. Twenty-one tumors, four exclusively intracanalicular, were demonstrated after standard contrast-enhanced CT was negative. Fifty-five examinations were negative; four were inconclusive. The high resolution scanner with digital localization and reconstruction zoom capability greatly improved image detail. In nine of the 12 normal patients examined with it, the intracanalicular bundle was demonstrated. Substitution of carbon dioxide for air greatly reduced the morbidity of acute post-spinal tap headache. The procedure takes 30--45 min and can be performed on an outpatient basis. It is recommended as the procedure of choice when standard CT is negative in subjects clinically suspected of having acoustic neuroma

Administration of cyclosporin A, a new selective immunosuppressive agent, to mice infected with Schistosoma mansoni resulted in a significant reduction in the number of mature and immature male and, to a greater extent, female worms. With lower, subeffective, doses a reduction in hemoglobinase activity and protein content of female schistosomes is produced. Evidence available so far suggests that the antischistosomal effects of cyclosporin A are mediated through a stimulation of host mechanisms directed against the parasite.

Regulations from the Occupational Safety and Health Administration require the performance of audiometric tests on workers exposed to potentially hazardous noise levels. These tests are frequently performed by Occupational Hearing Conservationists who have taken a 20-hour course based on recommendations of the Council for Accreditation in Occupational Hearing Conservation. Unless audiograms performed by such personnel are promptly reviewed and appropriate referral to specialists made, significant and potentially life-threatening otic disease may go undetected. This paper reports a series of workers with acoustic tumors initially detected by an Occupational Hearing Conservation Program. It is dangerous to assume that the hearing loss and tinnitus reported by noise-exposed workers is necessarily the result of workplace noise exposure.

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.

The history of a 2,900 g infant who had no stridor at birth and developed subglottic stenosis is presented in detail. The laryngeal lumen, which accepted a 3 mm endotracheal tube at one day of age, diminished to total occlusion at 15 months of age. There was an 8-day intubation and tracheotomy at nine months. At 19 months the patient expired from associated cardiac problems; the larynx was obtained at autopsy and was serially sectioned in the horizontal plane. A series (Imm-Tracer) of 12 sections through the stenotic area is presented. It demonstrates gross distortion of the cricoid cartilage with ossification extending into the right paraglottic larynx.