Basis and some diagnostic implications of electrocochleography.

Electrocochleography (ECoG) involves the recording of electrical responses to sound from the vicinity of the cochlea. The technique, as we practice it, utilizes a trans-tympanic recording needle situated on the promontory of the middle ear. Filtered clicks in the frequency range between 500 and 8,000 Hz are presented to the ear under test at a rate of 10/sec. Repetitive clicks of a given frequency are first presented at high intensity and the responses summed (averaged) in a computer. The click is systematically lowered in intensity, and an average is collected at each level until the normal dynamic range of hearing has been explored. Two major electrical indices are present in the recording: these are 1. the whole-nerve action potential (AP) derived from the first-order auditory neurons, and 2. the cochlear microphonic (CM) derived from the hair cells. Inspection of the whole nerve AP as intensity is lowered allows the estimation of the response threshold, which correlates well with behavioral threshold. Inspection of the relation between the CM and the AP allows qualitative differentiation to be made between pathology arising in the hair cell (sensory) and in the nerve (neural).     

Treatment of otogenic intracranial complications. Therapeutic and diagnostic difficulties

The article presents the results of clinical, laboratory, CT and MRT examination and treatment of patients with otogenic intracranial complications (OIC) hospitalized to ENT clinics for the last 10 years. The statistics show that the number of OIC patients tends to decrease for the last 40 years. This may be explained by perfection of specialized ENT service in backcountry rural districts. It is emphasized that use of antibiotics and other anti-inflammatory drugs before hospitalization changes a clinical OIC picture and complicates early diagnosis especially the diagnosis of cerebral and cerebellar abscesses.     

Christ-Siemens-Touraine syndrome. Therapeutic case review

The Christ-Siemens-Touraine syndrome, or anhidrotic ectodermal dysplasia, presents three principal signs: anhidrosis or hypohidrosis, hypotrichosis and anodontia or hypodontia. This syndrome is of particular interest to stomatologists and orthodontists because of the particular therapeutic problems raised by the anodontia and associated skeletal anomalies. A case is reported in which the principal clinical sign was anodontia, and the various therapeutic options currently available are discussed.     

Radiobiologic research for head and neck cancer therapy. Therapeutic implications

Hypoxic cell sensitizers, particle therapy, hyperthermia, and combinations of chemotherapy and radiotherapy have potential to increase the therapeutic ratio in future clinical radiotherapy treatment regimens. The biologic bases of these investigations are beginning to appear as avenues of clinical investigation.     

Sicca syndrome … diagnostic perplexities.

Patients presenting with xerostomia and other signs of Sjogren's syndrome pose diagnostic problems. Many other underlying diseases cause these symptoms and a systematic evaluation is necessary to make an accurate diagnostic assessment. There are immunological tests and histological studies which help make them distinctive and are herein outlined. Patients with this information presenting with sicca syndrome, therefore, can be more accurately assessed and have better treatment regimens instituted. The “sicca syndrome,” which is a disorder discussed primarily in the rheumatology literature, is rarely a topic in the otolaryngology literature, although there are often presenting symptoms of this problem in the head and neck. This paper reviews this problem, discusses the confusion regarding terminology, and outlines a practical method of diagnosis for the clinician.     

Adenotonsillectomy in children with von Willebrand's disease: how and when. A case report with review of the literature

A 5 year-old boy aspirated a metal spring accidentally. The right bronchial foreign body was removed by threading the alligator of a biopsy forceps through the lumen of the spring while opening its jaws distally. This case illustrates that a foreign body with a central lumen in a child can be successfully removed using a flexible bronchoscope, thus obviating the need for general anesthesia and rigid bronchoscopy.     

Acquired aphasia without deafness in childhood--the Landau-Kleffner syndrome

A young boy presented with loss of speech and behaviour disturbance and was thought to be deaf. He was subsequently found to have the Landau-Kleffner syndrome (LKS), or acquired aphasia with epilepsy. Children with this disorder commonly present to an audiology or ENT clinic. Early recognition is important to initiate supportive, speech and educational care.     

Acquired immune deficiency syndrome (AIDS) presenting as a nasal septal perforation.

Patients infected with the Human Immunodeficiency Virus (HIV) and those with AIDS may present with many head and neck manifestations. We report a case of an undiagnosed HIV positive male who presented with symptoms due to a nasal septal perforation, and rapidly developed AIDS. The histopathology of the perforation margins revealed active chronic inflammation with no evidence of neoplasia or granuloma. No viral or fungal infection was demonstrable on immunological testing and fungal stain. This is the first reported case of a patient developing AIDS presenting with a nasal septal perforation.