Effects of perineural application of glycerol on the facial nerve: an experimental study.

Current procedures for treating hemifacial spasm control its symptoms but the condition is often complicated by facial weakness. We undertook this study using a rat facial nerve model to determine whether peripheral glycerol injection could be recommended as a feasible and safe technique in the management of hemifacial spasm. The animals were given a perineural application of glycerol on the facial nerve and killed at 3 days or 2 or 4 weeks after operation. The facial nerves were then examined with light and electron microscopy. Our results show that myelin disintegration and axolysis occurred after glycerol application and both the myelinated and unmyelinated fibers were affected at random, although the most striking histological changes were seen in the myelinated fibers. No evidence of persistent facial weakness in the animals was associated with this method.

Diagnostic importance of the nucleolar organizer regions in Wegener's granulomatosis.

The number and distribution pattern of silver staining nucleolar organizer regions (AgNORs) were thought to reflect the cellular proliferative activity and the malignancy of tumours. Using a silver-staining method, the variations of AgNORs have been studied in patients with atypical inflammatory lesion (n = 5), malignant reticulosis (n = 5) and Wegener's granulomatosis (n = 6). Our results reveal that there was a statistically significant difference (p < 0.01), highly suggestive of a difference in AgNOR counts between the atypical inflammatory lesion and Wegener's granulomatosis, with the Wegener's granulomatosis specimens having the higher irregular AgNORs, but the difference between Wegener's granulomatosis and malignant reticulosis is probably not clinically important. It is concluded that AgNORs may be useful in differentiating Wegener's granulomatosis from an atypical inflammatory lesion, and the simplified counting technique is adequate for the purpose.

Anterior ethmoidal glycerol rhizotomy for vasomotor rhinitis.

The treatment of vasomotor rhinitis by anterior ethmoidal glycerol rhizotomy (AEGR) was assessed in 78 patients with a follow-up period ranging from 12 to 15 months. The reduction of nasal hypersecretion obtained with AEGR was maintained over six months. At the final assessment, sixty patients (76.9%) reported complete relief of symptoms and are taking no medications; seven (8.9%) were improved with minimal drug therapy required for symptom relief; and 11.9% had poor results with unsatisfactory control even with medication. Nineteen patients required a second treatment because of an initial suboptimal infection or recurrence. Apparently, this method offers those patients with vasomotor rhinitis a valid option for treatment of clinical symptoms, with the additional benefit of experiencing no serious complications when compared with vidian neurectomy.

Magnesium levels in middle ear fluids and sera in otitis media with effusion.

Middle ear fluids (MEE) and matched sera (S) were obtained from 50 patients with serous otitis media and magnesium levels were measured to determine if magnesium concentration was distinctly varied in otitis media with effusion (OME). The MEE/S ratio was considerably raised along with transient sensory hearing loss in chronic OME when compared with acute OME. The higher magnesium level found in the MEE implies that it is probably produced locally by the middle ear mucosa and may contribute to the hearing loss found. We also regard the MEE/S ratio as a prognostic factor in OME.

Nasal mucociliary clearance in patients with diabetes mellitus.

Fifty insulin-dependent diabetics and 50 non-diabetics without a history of nasal disease have been studied for nasal problems including mucociliary function complicated by diabetes mellitus. For the diabetics, the mean value of nasal mucociliary clearance was considerably decreased and this was more often associated with dry noses but increased pH-values, both of which were higher than those for non-diabetics (p less than 0.05). As suggested in earlier literature, more aggressive nasal moistening therapy must be recommended for those patients presenting with these conditions in the light of systemic diabetic abnormalities.

Clinical significance of atrial natriuretic peptide in different diseases of the nose.

Atrial natriuretic peptide (ANP) levels of nasal secretion and blood plasma were measured in 40 patients with chronic nasal conditions and 20 healthy subjects by a sensitive radioimmunoassay. In the healthy subjects, the mean blood ANP level was lower than, but not parallel with, the mean nasal ANP level (p less than 0.05). Among the patients, the blood ANP levels were higher in those with nasal polyposis, atrophic rhinitis and nasal allergy, while lower in simple rhinitis and recurrent epistaxis, than in the control group. Apart from nasal polyposis, all the patients were found to have a lower level of nasal ANP. The conclusion is that the nose may be capable of producing ANP independently from the plasma level. In patients with chronic nasal obstructive disease, the endocrine function of the heart is affected also. The relationship of the plasma and nasal ANP may help to explain some rhinological abnormalities.

Otolaryngological problems associated with thrombocytopenia purpura in children.

Otolaryngological manifestations of 90 patients (of which 50 were under 16 years) with immune thrombocytopenia purpura (I.T.P.) appearing at the Pingdingshan Hematological Institute over 10 years have been studied. Among the sick children, epistaxis was the most common complaint (of which 60% responded to nasal packing), followed by gum, buccal, conjunctive, tongue, lips, eyelids, facial and throat bleeding, in this order. Severity and recurrence were correlated with the sick children's condition: the presence or absence of local trauma and infection, blood platelet level and capillary fragility, especially in acute I.T.P. Some therapeutic principles for these associated abnormalities are recommended. Other conditions included: hearing loss, vertigo, or dizziness, tinnitus, facial paralysis and so on. Our conclusion is that the role of immune responses may be important in the etiopathogenesis of these non-hemorrhagic abnormalities, and should not be ignored in treating the problems as result of I.T.P. In this paper, these immunological and pathological mechanisms implicated in the two problems described above are also discussed.