Acupuncture and phonostimulation in pollenosis and vasomotor rhinitis in the light of psychosomatic investigations.

Patients with vasomotor rhinitis (28) and pollenosis (23) were subjected to psychosomatic examination and treated either by acupuncture or phonostimulation exclusively. Acupuncture was performed after the classical method in 22 patients and phonostimulation in 29. Evaluation of the results was based on laryngological examinations and appraisals entered by the patients in special personal diaries. In pollenosis the condition was unchanged by the treatment. In vasomotor rhinitis, on the other hand, in which psychic factors were of importance, some of the patients usually improved temporarily at the beginning of treatment, whereas a few suffered exacerbation. These effects may be attributable to suggestion.

[Transtympanic neurectomy of the vestibular and cochlear nerves (author's transl)]. / Die transtympanale Neurektomie des Nervus Vestibulo-cochlearis

Tympanotomy and a transvestibular approach to the fundus of the internal auditory meatus is described. The surgical technique is modified from that proposed by Alvarez de Cozar and Antoli-Candela in 1970. The surgical anatomy of the operative sites is detailed. The surgical procedure is found indicated in patients in whom preservation of hearing is not considered and vestibular neurectomy required. The described technique provides a simple but efficient and safe alternative to the translabyrinthine approach to the internal auditory meatus for division of the vestibular and cochlear nerves.

Postauricular (12 msec latency) responses to acoustic stimuli in patients with peripheral, facial nerve palsy.

The postauricular (12 msec latency) response to a loud click stimulation was investigated in 23 patients with facial nerve palsy. Of these patients 21 had an intracranial cause for the facial palsy and 2 had an extracranial cause. Only in those with the extracranial facial nerve damage could the response be obtained from both sides. When the nerve was damaged intracranially there was no response on the paralysed side. This seems to indicate that the posterior auricular muscle is the effector of the presumed sonomotor reflex arc involving the cochlea, cochlear nerve and nuclei, undetermined brainstem pathway, facial motor nucleus, facial nerve and the muscles supplied by it.

An extended approach through the middle cranial fossa to the internal auditory meatus and the cerebello-pontine angle.

The submeningeal approach through the middle cranial fossa to the internal auditory meatus and cerebello-pontine angle after cutting the tentorium cerebelli is described. It is in some way similar to that used by Morrison & King. The approach is achieved by drilling the petrous bone to the level of the compact plate of the sigmoid sinus sulcus and to the lumen of the lateral semicircular canal. In this way it is possible to visualize safely the entire auditory-facial fasciculus, the region of the jugular foramen, the IX, X, XI, V, and VI nerves as well as the lateral surface of the brain stem. In our opinion this way should be and is preferable to the translabyrinthine approach through the mastoid process.