Problems of the communicatively disadvantaged. An overview.

The article traces the attitude of various cultures through the centuries toward the hearing and speech handicapped. It outlines the early efforts to develop rehabilitative techniques for such handicaps, and describes a number of the pioneers in the field of education for the "deaf and dumb." The emergence of the opposing philosophies for training the hearing handicapped, the oral school and the signing school, and the influence these two had on the development of education for the deaf is described. The part played by basic research and the development of new instrumentation during the past 50 years in the solution of many of the problems of disordered communication is reviewed. Finally, the philosophic aims are described that led to the establishment of the Boys Town Institute for communicatively handicapped children.

The American Rhinologic Society: its foundation and its future responsibilities. Address of the guest of honor.

This presentation includes a brief outline of the historical background of rhinology and a description of the founding of the American Rhinologic Society 25 years ago. It disscusses the original aims of the society and points out a number of responsibilities that it should accept for the future development of rhinology.

Louis H. Clerf lecture. Otorhinolaryngology: A progress report.

The present status of the expanding specialty of Otorhinolaryngology is discussed. Some of the intradisciplinary problems which are developing as a result of growth and expansion of the specialty are reviewed and some solutions are suggested.

Otolaryngology manpower revisited.

In the December issue of the Archives, Nickerson et al published an article on the manpower resources of otolaryngology based on a report released in 1975. The conclusion reached by Nickerson and co-workers was that otolaryngology had a manpower pool too big for present and near future needs. This article was followed by a press release by the American Medical Association that endorsed the statements of the Archives article and in which Nickerson et al were quoted that no more otolaryngologists were needed from the training programs for some years. These statements were in sharp disagreement with the findings of the manpower studies carried out by another group in 1973-1975. Because the two surveys employed different statistical approaches, this article has been written to present the methods employed and to discuss the merits of the conclusions reached in each.

Histopathologic changes in the temporal bone resulting from measles infection.

We report the pathologic changes in the temporal bones of four children who died of bronchoppenumonia secondary to acute measles infection. All suffered from severe necrotizing otitis media characterized by round cell infiltration. In one case, multilobulated giant cells (Warthin-Finkelday) were found in the middle ear. These cells appear to be similar to those found elsewhere within the body during acute measles infection. Inner ear changes were seen in two cases. Severe loss of nerve fibers and ganglion cells with atrophy of the striae vascularis was present in one case. Adhesions were seen between the Reissner membrane and the tectorial membrane in one case and the Reissner membrane and the inner spiral limbus in a second case. Such findings are characteristic of those seen in the cochlear duct of persons suffering from prenatal rubella.

Manpower and the future role of otolaryngology.

Much discussion has taken place in the past three years in the media and in Congress concerning the delivery of health care in the United States. Our concern is to supply manpower to deliver adequate health care, to train enough new specialists, and to encourage needed research. There is presently a debate among otolaryngologists as to the scope of their specialty. Some believe that family practitioners should receive some training in this specialty, be certified by our Board, and act as the primary otolaryngologists. The need for fully trained otolaryngologists would then be reduced radically. Otolaryngologists could be concentrated in the medical centers, where they would act as tertiary physicians. Others believe that better quality care would be delivered by fully trained otolaryngologists, and that many otolaryngologists prefer to be primary and secondary physicians. This debate must be settled quickly in order to plan our manpower pool for the future. Decisions involving future manpower needs in our specialty must be made by the otolaryngologists.