Biomedical subjects
Publications and source records attributed to B H Colman.
Despite the extraordinary prevalence of upper respiratory allergy and infection in children nasal polyposis is an extremely rare condition. Seven cases of cystic fibrosis are presented in order to demonstrate the nasal aspects of the disease. All but one had nasal polyposis. The literature has been reviewed with particular reference to clinical, radiological and histo-pathological features. Conservative treatment is stressed.
Nine patients with massive acquired cholesteatoma of the temporal bone were treated by radical mastoidectomy, facial nerve decompression, and excision of the inner ear. The commonest presenting symptoms were otorrhea and deafness, but otalgia, vertigo, external swelling and facial nerve palsies were also seen. Polytomography was helpful in assessing the degree of bone erosion preoperatively. The large cavity present following cholesteatoma excision was partially obliterated by a superiorly based temporalis muscle pedicle which helped to seal the internal auditory meatus and prevented the development of a cerebral hernia. Those patients with preoperative facial nerve palsies showed evidence of nerve degeneration and had incomplete recovery at a one year follow-up.
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Material for electron microscopy study was obtained from a patient previously suffering from Meniere's disease and treated by ultrasound. It consisted of parts of the membranous labyrinth as well as the vestibular ganglion. The neuro-epithelium of the macula showed degenerative changes and there was marked vacuolation of the cytoplasm. The endothelial cells lining the semicircular canal showed gross vacuoles contained degenerating mitochondria and some debris which may reach the endolymph. The wall of the semi circular canal was oedematous and the basement membrane lifted off by oedematous fluid. There was obvious change in nerves and neurones. The nerves showed loosening of the myelin sheath and ballooning. The neurones contained lipoid inclusions and multicystic lysosomes. Similar inclusions were also noted in some myelinated nerves.
Alcohol is known to produce severe cochlear damage and it is possible that deafness as a complication of tympanoplasty can be caused by alcohol which remains in homograft materials after inadequate washing. An investigation was made in which the quantity of alcohol taken up by ossicles, cartilage, temporalis fascia, dura and ear-drum was estimated. The rate of release of alcohol from such materials into saline during washing was also measured. The amount absorbed was found to depend upon the nature of the material, its weight and its surface area. The rate of release of alcohol from these materials differed significantly for each material.