Hazardous party trick (infolding of the pinna).

Two cases of habitual pinna folding are reported. One case was complicated by the development of bilateral haematoma auris as a direct result of the trauma caused by the folding.

Pathology and pathogenesis of tympanic membrane retraction.

Temporal bones without evidence of otitis media, as well as temporal bones with various types of otitis media, were examined for the presence of retractions of the tympanic membrane and their related histopathologic progression to the formation of cholesteatoma. Retractions were not present in non-otitis media, purulent, or mucoid otitis media. Retractions were observed in 2.1% of temporal bones with serous otitis media and 19.5% of temporal bones with chronic otitis media. All temporal bones with retractions demonstrated evidence of current or previous otitis media. Histopathologic changes of the middle ear cleft were associated with the type and degree of retraction. This study supports the continuum theory according to which otitis media with effusion eventually leads to a variety of sequelae and/or to chronic otitis media. The tympanic membrane appears to follow progressive changes, from simple retraction to retraction pockets and finally to cholesteatoma.

[Treatment of acquired stenosis of the external auditory canal]. / Traitement des sténoses acquises du conduit auditif externe.

Often difficult surgical problems are encountered during treatment of acquired stenosis of external auditory canal. Theses stenoses can be of tumoral, inflammatory or traumatic origin and are the cause of infectious complications related to epidermal retention. Even with the assistance of modern imaging procedures, preoperative investigation is not simple, precise details of lesions being obtained in greater detail during surgical exploration. Four stages are involved in surgical treatment: excision of lesion, reaming of bony canal and enlargement of auditory meatus, providing cover and maintaining graft in place. The CO2 laser can be useful for excision of lesion or possible postoperative recurrence, and adjacent pedicle flaps are best for covering site. Postoperative inflammatory episodes can be treated by infiltration of local corticoids. Whatever the result of these different techniques, long-term surveillance of these patients is essential.

Hydrogen sulfide and the probabilities of 'inhalation' through a tympanic membrane defect.

We conclude that workers with tympanic membrane defects (perforated eardrums) should not be excluded from working in atmospheres containing concentrations of hydrogen sulfide (H2S). Several existing requirements and recommendations exclude workers with perforated eardrums from working in or around H2S. Such protective measures stem from the belief that H2S can enter the body through the perforation in sufficient measure to compromise the wearer's respiratory protection. However, based on calculations of anticipated leakage of H2S for a variety of eustachian tube conditions and in the absence of either medical literature or personal reports documenting H2S poisoning due to eardrum perforation, the recommendation for excluding workers with such a condition from working in or around H2S is not supported. The anatomy, physiology, and pathology of the eustachian tube are discussed, including the effects such devices as tympanomaxillary shunts might have on contaminant leakage. The National Institute for Occupational Safety and Health (NIOSH) criteria for respirator tests and sources of respirator leakage are examined and NIOSH recommendations for respiratory protection against H2S are outlined.

A slowly progressive degenerative condition characterized by mental deficiency, wasting of limb musculature and bone abnormalities, including ossification of the pinnae.

A condition is described in a 33-year-old Caucasian male in which there is severe mental deficiency present from an early age. There is non-progressive hydrocephaly and the eye findings include posterior polar cataracts. There is slowly progressive muscle wasting of the limbs along with degenerative bone changes. Ossification has occurred in the pinnae. Secondary sexual characteristics are underdeveloped and there is a low normal serum testosterone. The parents are not related and there is no similar occurrence in the family. Biochemical investigations do not show any abnormality, and the chromosome picture is that of a normal male karyotype. The case appears to be unique.