Modern photo-endoscopic techniques for examination of the nasopharynx (author's transl)]

Advances in electrotechniques and optics in the last years have led to the use of fiberoptic endoscopes in the examination of the nasopharynx. A modified photo-endoscopic method is reported, utilizing a Hopkins' lens system which is introduced intraorally. A robot-reflex camera with variable optics and focal distance is used for photographic documentation of nasopharyngeal findings. The efficiency of the method is demonstrated by selected clinical examples.     

Sialorrhea. Value of isotopic examination (author's transl)]

Three types of sialorrhea can be distinguished: -- deglutition disorders, especially in patients with Parkinson's disease and those with anxiety, -- ptyalomania, -- primary hypersecretion at rest. Functional scintigraphic studies enable a physiological approach to be made, and this tends to group together, under the name of primary hypersecretion at rest, various clinical manifestations occurring in two main groups: -- elderly women complaining of a bitter taste in the mouth, -- plethoric men with large salivary glands. The scintigraphic recording apperances of secretion at rest, which occurs early and without obvious food stimuli, are also noted in other clinical types. It remains to be demonstrated whether they have a common physiopathological basis arising from disorders of the normal sensitivity of the buccal cavity.     

Fundamental frequency analysis - a contribution to the objective examination of the speaking and singing voice (author's transl)]

The applicability of a newly developed fundamental frequency analyzer to diagnosis in phoniatrics is reviewed. During routine voice examination, the analyzer allows a quick and accurate measurement of fundamental frequency and sound level of the speaking voice, and of vocal range and maximum phonation time. By computing fundamental frequency histograms, the median fundamental frequency and the total pitch range can be better determined and compared. Objective studies of certain technical faculties of the singing voice, which usually are estimated subjectively by the speech therapist, may now be done by means of this analyzer. Several examples demonstrate the differences between correct and incorrect phonation. These studies compare the pitch perturbations during the crescendo and decrescendo of a swell-tone, and show typical traces of staccato, thrill and yodel. Conclusions of the study indicate that fundamental frequency analysis is a valuable supplemental method for objective voice examination.     

Electron microscopic examination on cytogenesis of juvenile nasopharyngeal angiofibromas (author's transl)]

After the electron miscroscopic examination of tissue samples of juvenile nasopharyngeal angiofibromas obtained from 9 male patients ranging in their age from 7-24 years the problems of cytogenesis and classification are discussed. Besides it is tried to correlate particular morphological findings to certain clinical phenomenons. The vascular component of juvenile nasopharyngeal angiofibromas shows a clear proliferation of the vascular wall cells. Particularly, proliferating pericytes, cells withous peculiar characteristics ("undifferentiated" cells) and cells in various stages of differentiation are to be emphasized. Obviously, vascular wall cells emigrate into the surrounding tissue and transform themselves into small fibroblasts. The second component of juvenil nasopharyngeal angiofibromas is represented by stromal fibroblasts with several cytological variations. Only activated "classical" fibroblasts and fibroblasts with histocyte-like features reveal the nuclear pattern unique for these growths which is characterized by the combination of protrusions of nuclear membrane with formation of nuclear "blebs" and of dense intranuclear granules. Cells with these nuclear characteristics were considered as preexisting fibroblasts. Thus juvenile nasopharyngeal angiofibromas are formed by the proliferation of two tissue components, namely by the proliferation of vascular wall cells and stromal fibroblasts, and can be conceived as reactive hyperplasias. The swelling body-like and organoid appearance, cytological pecularities, characteristic topographic relations (localization and supplying vessesl) and the sex-dependent occurrence speak for a tumor-like hyperplasia of a rudimentary organ unknown till now.     

Atresia of the ear (author's transl)]

The results of operations for congenital deformities of the external and middle ear throughout a 10-year period, 1962-1972, are presented. 38 ears were operated upon, of which 26 obtained an average hearing gain of 25 dB. In 12 ears no improvement was obtained, and no ear became worse. Among the 15 patients with bilateral deformities 11 obtained a postoperative hearing in one or both ears of 40 dB or better, in average 30 dB.     

Cyst of the nostril (author's transl)]

Cysts at the edge of the nostril develop from the remains of the antero-inferior prolongation of the lacrimonasal duct, in approximately 98% of cases in the woman. It is a rare condition, the diagnosis of which is easy if the practitioner has ever seen a case. Its clinical appearance is, in fact, very uniform, characterised by the appearance and increase in size of the extra-osseous neoplasm, with extension into and under the nostril. Excision is easy and should be performed by a buccal approach.     

Myoblastoma of the larynx (author's transl)]

The case of a 35-year-old man in whom a broad-based tumour of the left vocal cord was found to be the cause of hoarseness of 4 months' duration is reported. The tumour was completely removed and proved to be a myoblastoma. Twelve months postoperatively there was no recurrence. Whether these are true neoplasms in all cases is still uncertain. Recurrence, multifocal origin and malignant change, factors which cannot be excluded, underline the need for the long-term follow-up.     

The child and the otolaryngologist (author's transl)]

Figments of imagination and previous experiences enter into each clinic room emotional situation, and the apprehensions of the child, the parent and the doctor must be anticipated and acknowledged. The possibility of conflict should thus diminish. Awareness of the child's reaction and consideration of this should be the basis of doctor-patient rapport rather than physician authority. This article discusses with several illustrations the special situation of the ENT specialist.     

Chordoma - a review and report of two cases (author's transl)]

Chordomas can be categorized into those of clival, cervical and sacrococcygeal origin. The clival chordomas are primarily discussed in this report. In defining pathological anatomy or histology, a differentiation of benign from malignant chordomas by histological means alone is impossible. A preoperative diagnosis is only possible if tumor grows into the nasopharynx and allows a tissue biopsy to be taken. These tumors are clinically malignant though strict anatomic criteria for malignancy such as nuclear polymorphia or atypia, mitoses and metastases are rarely observed. The therapeutic results of operation and radiation are compared. Each alone fails because of the high recurrence rate of the tumor so that their combination is preferred. Although the prognosis of this disease is poor, one of our patients who was treated with radiation and surgery had a survival time of 14 years.     

Local grafting as a simple method of treatment of pseudoarthrosis (author's transl)]

The authors present a new technique for the treatment of a pseudoarthrosis by local graft. The graft, taken from the basilar bone, is moved to the site of lost bone substance whilst retaining its internal muscular attachments. The result is very satisfactory and avoids the use of an iliac graft.     

Partial resection of the tongue (author's transl)]

An improved simplified technique is described for reducing the volume of the tongue by operation. A plastic support has been designed on which the tongue can be spread out symmetrically and fixed in position. Gallbladder forceps are applied to the base of the tongue to avoid hemorrhage. An initial incision is made through the whole thickness of the tongue down to the support, and a partial resectomy performed, followed by apposition of the wound edges. The results obtained with this procedure are far superior to those previously reported using other techniques: the operation takes less time and there is almost no loss of blood.     

Isolated amyloid of the larynx (author's transl)]

A laryngeal amyloid in a 45-year-old man was removed from the sinus of Morgagni via laryngofissure at the Ear, Nose, and Throat Department of the University of Teheran. Aspects of the amyloid are discussed with regard to the literature.     

Therapy of sudden deafness with O2/CO2 inhalation (author's transl)]

A total of 55 patients with sudden deafness have been treated in a prospective randomized study by inhalation with 95% O2 and 5% CO2 or intravenous infusion with papaverin and dextran. Five days after treatment, no significant difference could be found between both therapies. However, audiometric results obtained one year later show statistically better results for those patients who were managed by O2/CO2 inhalations and indicate that such therapy may improve the spontaneous rate of recovery inherent to sudden deafness.     

Echography of the paranasal sinuses (author's transl)]

Echography, combined with routine X-rays of the paranasal sinuses, has been used in more than 300 patients. The diagnosis was controlled by clinical examination, endoscopy and operation. The combination of the two techniques reduces the diagnostic error in paranasal sinus disease to 5%.     

Aquamat--a proven bathing aid for the laryngectomee (author's transl)]

A device to facilitate bathing by the laryngectomee is described. The Aquamat is made up of equipment routinely used in anaesthesia and underwater diving. An airway link is made between a watertight tracheostoma and the mouth such that the patient can breath between nose and trachea. Special precautions are necessary for swimming.