Sylvan E. Stool

Acute Otitis Media Toward a More Precise Definition

Eighty-five infants and children presenting with acute otitis media who had normal tympanic membrane landmarks and mobility within 1 month before entry into the study were studied. These criteria were used in order to avoid including children with prior otitis media with effusion (secretory otitis media). A diagnosis of suppurative otitis media was made in each case based on pneumo-otoscopic findings of diminished mobility, contour, and color of the tympanic membrane. The diagnosis was validated by myringotomy and posi tive culture of the middle ear fluid. A poorly mobile, bulging, yellow, opacified tympanic membrane was the most common type of tympanic membrane visu alized ; whereas a poorly mobile, bulging, red tympanic membrane was seen in only 19%. The color of the tympanic membrane did not correlate with a specific pathogen isolated from the middle ear exudate. Sixty-seven per cent of children had no fever; 28% had no pain or querulous behavior.

The syndrome of congenital deafness and otic meningitis: Diagnosis and management

Two children with congenital deafness with recurrent episodes of meningitis arediscussed. Enlargement of the vestibule indicating a congenital defect within the labyrinth was demonstrated on skull roentgenograms. The use of positive contrast basal cisternography demonstrated an abnormal communication between the subarachnoid space and the ear. On the basis of these findings, a direct transaural surgical approach was successfully performed.

The "Chubby Puffer" Syndrome Upper Airway Obstruction and Obesity, with Intermittent Somnolence and Cardiorespiratory Embarrassment

Upper airway obstruction and obesity can produce cardiopulmonary dis tress in susceptible children. Three such children with chronic airway ob struction due to hypertrophied tonsillar and adenoidal tissue developed pronounced obesity, which in turn helped to provoke sleep alternations, cardiac signs, and abnormal arterial blood gas values. After tonsillectomy and adenoidectomy the symptoms were relieved.

Congenital broncho-biliary fistula

Abstract A sixth case of congenital bronchobiliary fistula is reported in a 3-week-old infant. This is the fourth surgical success and the youngest patient reported.

Foreign bodies in pediatric otolaryngology. Some diagnostic and therapeutic pointers.

to foreign bodies. More children under five die in the home from accidental foreign body aspiration than from any other cause. A history of foreign body insertion is usually obscure or unobtainable. Nevertheless, the physician should keep this in mind when faced with a diagnostic enigma. The symptoms produced by a foreign body will vary with its size, composition, locatian, and length of time it has been pres-

Tracheal agenesis with broncho‐esophageal fistula

Intubation of the esophagus during efforts to resuscitate a newborn may result is disaster; (FN1) however, in one disease this may be the only method of providing an airway. This communication reports our experience with a newborn infant who had an unusual tracheal abnormality, and emphasizes the findings which aid in the diagnosis.

Electric Otoscopy—A Basic Pediatric Skill: Notes on the Essentials of Otoscopic Examination and on the Evaluation of Otoscopes

The typical head contains a 2x or 3 X magnifying lens, most helpful for appreciating subtle changes in the tympanic membrane, and also the bulb which is the light source. In recent years, bulbs have improved so that the previous objection of otologists that the electric illumination was not adequate no longer seems justified. Since the bulbs may become damaged and the filaments displaced, it is important to be sure that the filaments

Velopharyngeal Incompetence Pseudo Mental Retardation as a Consequence

Velopharyngeal incompetence (failure of the soft palate to affect closure of the nasopharynx) may result in hypernasal or unintelligible speech, chronic otitis media with secondary conductive hearing loss, or even pseudomental retardation. Such devastating consequences make early diagnosis mandatory. Here is an excellent ca se illustration, review of the literature, and a diagnostic checklist for office use.

Craniometaphyseal dysplasia: Report of a case

Craniometaphyseal dysplasia, often referred to as Pyles disease, is a hereditary disease involving the expansion of the metaphyses of the long bones, giving the appearance of an Erlenmeyer flask. There is diffuse hyperostosis of the entire cranial vault, along with absence or decreased development of the paranasal sinuses. In the case presented here the mouth demonstrated an abnormality wide maxilla with a slight palatal vault. Genetically, this appeared to be a dmoninant form of dysplasia.

Hearing Sensitivity and Physical Characteristics of the Eardrum Observed during Otoscopic Examination

This paper was presented at the second annual meeting of the Society for Ear, Nose and Throat Advances in Children in association with the annual meeting of the American Academy of Pediatrics, San Francisco, California. The research was supported by Public Health Service research Grant DE-02172-11 form the National Institute of Dental Research. From: H. K. Cooper Institute for Oral-Facial Anomalies and Communicative Disorders and the Lancaster Cleft Palate Clinic, Lancaster, Pennsylvania 17602. AN EARDRUM that appears abnormal N that