Three-dimensional analysis of 61 human endolymphatic ducts and sacs in ears with and without Menière's disease.

We used light microscopy and computerized graphic reconstruction techniques to examine the endolymphatic duct and sac in 20 pairs of bones from patients with Menière's disease and 21 bones from controls. The diameters of the endolymphatic duct and the proximal portion of the vestibular aqueduct were significantly smaller in Menière's disease ears than in controls. Graphic reconstructions showed the Menière's sacs to be smaller and to have fewer tubular epithelial structures in the intraosseous portion than in the control ears. The median volume of the sac in the Menière's disease side was substantially lower than in the contralateral ear. The width of the external aperture of the vestibular aqueduct was significantly smaller in Menière's disease ears than in controls. These findings indicate that the size not only of the vestibular aqueduct but also of the sac is reduced in Menière's disease. The results may suggest that the endolymphatic sac is pathologically changed in Menière's disease and that a reduced resorptive capacity of a small endolymphatic sac could result in endolymphatic hydrops.

Immunohistochemical localization of vimentin and S-100 antigen in small acoustic tumors and adjacent cochlear nerves.

To clarify the involvement of cochlear nerves in small acoustic tumors, we used immunoperoxidase techniques to determine the presence and distribution of vimentin and S-100 antigens in two acoustic tumor specimens and a transected vestibular nerve. Schwann cells and acoustic tumor cells failed to react positively with monoclonal antibody to vimentin. Reaction was observed in mesenchymal-appearing cells within both the normal nerve and the acoustic tumors, predominantly in association with blood vessels. Normal schwann cells and acoustic tumor cells reacted with polyclonal antibody to S-100 antigen with a similar, uniform distribution. Mesenchymal-appearing cells did not react with antibody to S-100. Immunostaining of a vestibular nerve from a Meniere's disease patient, used as a control, did not differ significantly from nerves adjacent to acoustic tumors. Because tumor cells and normal schwann cells stained similarly with antibody to S-100, it was not possible to establish with certainty if tumor cells invaded adjacent nerves.

Familial Treacher-Collins syndrome.

The major congenital malformations of the first and second branchial arch derivatives such as mandibulofacial dysostosis have a genetic basis. Treacher-Collins syndrome is transmitted as an autosomal dominant trait, although many cases occur as spontaneous mutations. The characteristics are hypoplasia of the malar, mandibular and maxillary bones, antimongoloid slanting of the palpebral fissures and a receding chin. The aural findings include malpositioning or maldevelopment of the pinna or external auditory meatus, an atretic bony plate instead of tympanic membrane, or ossicular malformations. Five members of a Hindu family affected by Treacher-Collins syndrome spanning three generations are examined in detail, with special reference to their hearing.

Absence of Dermatitis Among Rubber Plantation Workers.

None of the 40 rubber plantation workers exposed to latex for many years examined by us, had developed any significant dermatitis apart from thickening and lichenification of the dorsal aspect of right index finger and medial aspect of right thumb.