Recent advances in immunology have opened a new approach to investigating the etiology and pathogenesis of aural cholesteatoma by the immunohistochemical technique. Immunohistochemical and submicroscopic analysis of human cholesteatoma matrices revealed the presence of Langerhans' cells. Several reports have suggested that Langerhans' cells in cholesteatoma are significant, and that the pathogenesis of this disease including bone resorption could be explained as a cell-mediated immune response, but this is still controversial. In this study, Langerhans' cells in cholesteatoma were quantitated and compared with those in postauricular skin and in skin of the open mastoidectomized cavity. The results did not support the hypothesis that Langerhans' cells have a primary role in the development of aural cholesteatoma.
Cholesteatoma, Middle Ear/*immunology/pathology ; Human ; Immunohistochemistry ; Langerhans Cells/pathology/*physiology ; Skin/immunology/pathology

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

Sudden deafness may be defined as a sensorineural hearing loss that develope over a period of hours or a few days. The severity of the hearing loss may vary from mild to total loss of perception of the most intense sound. The loss of hearing may be permanent, or the hearing may spontaneously return to normal or near normal. Proposed explanations for sudden idiopathic sensorineural loss revolve primarily around viral or vascular etiologies. In addition to noise-induced deafness, which can be divided into a slowly progressive deafness caused by prolonged intense noise exposure and acute acoustic trauma caused by a single exposure to very intense sound. 45- and 52-year-old healthy male smokers with no previous otologic history, noted the acute loss of hearing with tinnitus in his right ear during his unusual intense noise exposed activities. There were no other associated symptoms of dizziness or visual change. After several days without improvement, they presented to the department of otolaryngology. Physical examination, neurologic evaluation, and otorhinolaryngologic examination were essentially within normal limits except for the hearing loss on the right ear. An audiogram revealed a severe primarily sensorineural sensitivity loss on the right. Routine laboratory studies were within normal limits. Two patients denied previous barotrauma, atypical or unusual drug usage, and unusual physical exertion or strain. We observed evidence of cochlear abnormality. The presence of cochlear dysfunction is supported by acoustic reflex threshold and auditory brain-stem response. These findings strengthened the probability of an acoustic trauma origin for the sudden sensorineural hearing loss.
Barotrauma ; Deafness ; Dizziness ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Male ; Middle Aged ; Noise* ; Otolaryngology ; Physical Examination ; Physical Exertion ; Reflex, Acoustic ; Tinnitus

The purpose of this study was to describe the luminal development of the murine eustachian tube and middle ear. Thirty specimens, aging from gestational day 11 to postnatal day 21, were investigated through the light microscopic observations. The present study also used digitizer, computer, and serially sectioned temporal bone specimens for three-dimensional reconstruction to measure the volume of the eustachian tube and middle ear cavity at different gestational and postnatal ages. The first pharyngeal pouch elongated during gestational day 12 to form the tubotympanic recess. Between gestational day 13 and 14 this tubotympanic recess extended to the middle ear area. A rapid increment in the volume of the tubotympanic recess was noted between gestational day 15 and 16. At this age, a definite division of the tubotympanic recess into the eustachian tube and middle ear cavity was observed. During the postnatal period, the maximum change of the middle ear volume was noted on postnatal day 11 when the mesenchymal tissue in the middle ear cavity disappeared completely.
Animal ; Ear, Middle/anatomy & histology/*embryology/growth & development ; Eustachian Tube/anatomy & histology/*embryology/growth & development ; Female ; Male ; Mice ; Mice, Inbred BALB C ; Pregnancy

In order to reduce the test time in real ear hearing-aid fitting for children, the validity of applying the average real ear to coupler differences (RECDs) in prefitting procedure using a 2cc coupler measurement system was evaluated by checking whether the majority of people's RECDs might occur within 5 dB of the average RECDs (N = 116) in each test frequency and age group. The percentages of occurrence were around 90% in test subjects' RECDs in saturation sound pressure levels (SSPLs) and around 70% in gain in each important test frequency. Appropriate test frequencies in prefitting are 500, 1000, 1500 and 2000 Hz.
Adolescence ; Adult ; Aged ; Child ; Child, Preschool ; Ear ; Hearing Aids* ; Human ; Infant ; Middle Age ; Otolaryngology/methods* ; Otolaryngology/instrumentation* ; Prosthesis Fitting/methods* ; Time Factors

In order to describe the developmental anatomy of the murine eustachian tube and its related structures, seventy six mice of ages ranging from gestational day 11 to postnatal day 21 were investigated through the light and electron microscopic observations. Development of the ciliated cells was seen concurrently in both the eustachian tube and middle ear on the 16 th gestation day, one day earlier than the epithelial secretory cells appeared in both the eustachian tube and middle ear. The number of ciliated cells and secretory cells increased rapidly after birth. Tubal glands were well identified with evidence of secretory activity around the time of birth. Thus, the findings of this study indicate that the mucociliary defense system starts to develop during the fetal stage and is well established immediately after birth.
Animal ; Animals, Newborn ; Cilia/physiology/ultrastructure ; Epithelium/ultrastructure ; Eustachian Tube/*cytology/embryology/ultrastructure ; Female ; Male ; Mice ; Mice, Inbred BALB C ; Mucous Membrane/physiology/ultrastructure ; Pregnancy

No abstract available.

No abstract available.
Ear, Middle* ; Eustachian Tube*

No abstract available.
Cholesteatoma, Middle Ear* ; Ear, Middle*