Middle ear mucosa and chronic ear disease. III. Enzyme studies of thick noncholesteatomous epithelium.

Thick mucosa removed from the promontory in cases with chronic otitis media showed prominent PAS-positive glands and epithelial secretory cells. Alcian blue positivity was less pronounced, contrary to the mucosa from glue ears. Enzyme activity in the epithelium and propria was comparable to that in glue ears, with some increase in alkaline phosphatase and some decrease in proprial lactate dehydrogenase and malate dehydrogenase activity. Removal of thick, permanently altered mucoas is recommended even in the absence of squamous epithelium. Steps should be taken to allow regrowth of thin, normal middle ear epithelium on the promontory.     

Pseudomonas vaccination in chronic ear disease

This paper presents the results of a pilot study of vaccination in thirteen patients with chronically infected mastoid cavities or central perforations of the tympanic membrane. In each patient Pseudomonas aeruginosa was repeatedly cultured from the ear and a long list of medical and surgical treatments had been tried, without success, to control the infection. The clinical, bacteriological and immunological responses were monitored over a six-month period. The results are extremely encouraging. Eight patients' ears became dry for the first time in many years. However, three months after vaccination three ears had become reinfected. All of the patients except one had a good immunological response to vaccination, with many-fold increases in the total serum immunoglobulin G, A and M levels.     

慢性鼻窦炎患者中耳功能的测定

目的 探讨慢性鼻窦炎对中耳功能的影响。 方法 对53例慢性鼻窦炎患者、10例健康成人做声阻抗和纯音测听。结果 (1)53例患者中,声阻抗鼓室导抗图A 型33例（62.26%）,As型4例（7.55%）,B型2例（3.77%）,C型14（26.42%）;正常听阈35例（66.04%）,轻度聋16例（30.19%）,中度聋2例（3.77%）;(2)As、B、C型异常导抗图、峰压值、同侧对侧镫骨肌反射、坡度在鼻窦炎各分型与对照组、各分型之间比较,30组比较中9组有统计学差异。静态声顺值无统计学差异;(3)听阈各频率中鼻窦炎各分型与对照组、各分型之间 进行比较,60组比较中47组有统计学差异。结论 随慢性鼻窦炎分型分期加重,异常导抗图、镫骨肌反射消失增多,峰压值偏向负压,坡度值增加;静态声顺值无或少变化;同时听力损伤加重。     

Middle ear involvement in children with chronic rheumatoid juvenile arthritis

In a selected sample of patients affected by juvenile rheumatoid arthritis (JRA) little is known about middle ear involvement, even though many synovial joints are affected. Multifrequency tympanometry was used to measure admittance, conductance, susceptance and phase angle at different probe frequencies and resonant frequencies. In all, 35 children with JRA and a control group (30 children) were studied. Findings showed that mean resonant frequency values in all children with JRA were greater than in the control children. The multifrequency tympanometry parameters measured in acute JRA subjects are not different from parameters of remission JRA subjects except for a change in the phase angle. The changes found are due to involvement of the incudomalleolar and incudostapedial joints. and incudostapedial joints.     

Middle ear and Eustachian tube lining in chronic otitis media*

By means of histological observations we have tried to find morphological data on which to classify non-suppurative and suppurative chronic otitis media. There was also evidence of pathophysiological features which may have direct influence upon the development and behaviour of chronic inflammations of the tympanic cleft, such as disorders of ventilation and reaction of the mucoperiosteal layer. Local defence mechanisms, the species and virulence of infection also play an important role. It appears that the Eustachian tube is a very effective mechanical and immunological barrier against ascending infection which may perhaps be assisted by antibiotic treatment. Certainly non-suppurative chronic otitis media is more frequent now than in pre-antibiotic days.     

Middle ear and eustachian tube lining in chronic otitis media.

By means of histological observations we have tried to find morphological data on which to classify non-suppurative and suppurative chronic otitis media. There was also evidence of pathophysiological features which may have direct influence upon the development and behaviour of chronic inflammations of the tympanic cleft, such as disorders of ventilation and reaction of the mucoperiosteal layer. Local defence mechanisms, the species and virulence of infection also play an important role. It appears that the Eustachian tube is a very effective mechanical and immunological barrier against ascending infection which may perhaps be assisted by antibiotic treatment. Certainly non-suppurative chronic otitis media is more frequent now than in pre-antibiotic days.     

Stapes fixation in chronic middle ear disease.

Rigid stapes fixation is not uncommonly found in chronic otitis media and can be caused by several conditions. Careful stapedectomy with some form of ossicular chain reconstruction is the treatment of choice, usually as a second stage procedure. Hearing results to date have been gratifying.     

Aural polyp in chronic inflammatory middle ear disease

240 patients with chronic otitis media (COM) were studied: 166 ears termed as non cholesteatomatous otitis media and 74 with cholesteatoma. In 38 ears an aural polyp was found with no evidence of cholesteatoma in 19 ears (11.4%) whereas a cholesteatoma was present in the remaining 19 ears. The histology of the polyp and the characteristics of the chronic process were matched: a) The aural polyp is an infrequent complication in COM. b) After histological analysis was found to present two different pictures: The inflammatory reaction polyp, present in non cholesteatomatous COM; and the polyp with granulation tissue and foreign body reaction (keratina) usually found in cholesteatomatous COM. c) The finding of granulation tissue reaction and keratina in an aural polyp is a good predictor for the presence of a cholesteatoma.