Letter: Endolymphatic hydrops and glaucoma production.
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Biomedical subjects
Publications and source records attributed to M H Stroud.
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In certain cerebellar lesions, optokinetic tracking is deficient, especially on tracking or following to the ipsilateral side. However, in many cases optokinetic nystagmus can occur, and apparently in better degree than would be expected from a study of pendulum tracking. This may be due to the patient leading into the stimulus and picking it up as soon as it is presented in far lateral gaze (in the direction of the fast component) and allowing the drift caused by the tone deficit to assist the tracking. An added vestibular tone can eliminate such a pseudo reflex. Induced vestibular nystagmus is enhanced and assumes a more dominant role so that optokinetic nystagmus is overcome, not only on gaze to the side of the tracking, but also on straight ahead gaze and even on some deviation of the eyes in the opposite direction.
Voluntary or passive head movements in normal and awake individuals with or without visual clues other than prior visual fixation, produce an occular movement in the same direction as the head movement rather than the expected counter gaze movement.
A series of 15 intramembranous (IMTC) and mesotympanic (MTC) cholesteatomas associated with intact tympanic membranes in children is presented. Clinical observations, audiometric and radiographic data, and surgical findings are correlated. A history of recurrent otitis media was obtained in 85% (13/15) of the cases, differentiating them from the usual congenital cholesteatomas. The possibility that many of these are indeed "acquired" lesions is emphasized. Hypothetical pathogenetic mechanisms are discussed. The basal cell papillary proliferation theory is considered the most attractive explanation of the development of both IMTCs and MTCs. The need for careful, prolonged, follow-up otoscopic examination of children with recurrent otitis media is stressed, if more of these lesions are to be recognized early.
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