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Marrow-mesenchyme connections in the newborn
P126
Otolaryngology Head and Neck Surgery August 1995
ScientificSessions-- Tuesday
A novel and clinically practical method of delivering surfactant to the eustachian tube was studied in a gerbil model of OME. OME was induced in 20 gerbils via transtympanic inoculation of heat-killed Streptococcuspneumonia. Twentyfour of forty ears (60%) were successfully inoculated. Inhaled, nebulized surfactant was used to treat the animals with microscopically confirmed OME over a period of 5 days. Eustachian tube opening studies were performed on both affected and nonaffected animals. Successful eustachian tube opening pressures were obtained in 30 of 40 ears (75%). Mean opening pressure for animals without effusion (healthy) was 42.5 mm Hg. Mean opening pressure for animals with effusion treated with nebulized surfactant was 39.4 mm Hg. This pilot study in animals suggests that inhaled, nebulized surfactant may be efficacious in establishing normal eustachian tube function within the clinical picture of OME.
11:45 A.M, Marrow-Mesenchyme Connections in the Newborn FREDH. LINTHICUM,JR, MD (presenter), QING TIAN, MD, and WILLIAM SLATTERY,MD, Los Angeles, Calif. Examination of 10 fetal and seven infant temporal bones prepared for microscopic evaluation revealed direct connections between the hematopoetic bone marrow and the unresolved mesenchyme in the middle ear of the human newborn infant. The connections first appear 20 weeks before birth and become bridged by fibrous tissue that ossifies between 10 and 12 months. The areas in which the connections are most numerous are the anterior epitympanum, the facial recess medial to the stapedius muscle, and transitory bone that occupies the area that will become the additus of the antrum. In temporal bones with otitis media, dense collections of polymorphononuclear cells are present in the mesenchyme at the middle ear end of the marrow spaces. Immunohistochemical staining is the same for the cells in the mesenchyme as for those in the marrow.
POSTERS ( S E S S I O N C ) A u t h o r s will b e p r e s e n t a t t h e i r p o s t e r s T u e s d a y , Sept. 19, 9:15 t o 10:00 A.M,
Poster 1 Pliability of Canine Vocal Fold Mucosa in Relation to its Vibration YOSHIMIKADOTA,MD (presenter), and EIJIYUMOTO,MD, Ehime, Japan As we previously reported, a small mucosal eminence, called mucosal upheaval (MU), occurs during phonation on the lower surface of the canine vocal fold. The mucosal traveling wave, essential in vocal fold vibration, starts from the MU and propagates upward. Thus the MU plays an important role in vocal fold vibration in the canine larynx. We also reported that an increase in vocal fold tension caused
an upward shift of the MU toward the oral side and that contraction of the thyroarytenoid muscle caused a downward shift of the MU toward the tracheal side. The purpose of this study was to examine pliability of the canine vocal fold mucosa, one of the key physical properties of the vocal fold, in relation to the occurrence of the MU. Nineteen excised canine larynges were used in the study. Mucosal pliability was measured at several points along the mid portion of the membranous vocal fold until 6 mm below the free edge. The free edge showed a maximum pliability, which gradually diminished toward the tracheal side and reached a minimum 3 mm below the free edge. An increase in vocal fold tension resulted in smaller mucosal pliability at all measured points, and the point of minimal pliability shifted upward toward the oral side. The point of minimal pliability moved downward toward the tracheal side in association with direct electric stimulation of the thyroarytenoid muscle. These shifts of the point of minimal pliability corresponded to the shifts of the MU in response to an increase in vocal fold tension or direct electric stimulation of the thyroarytenoid muscle. These results suggested that the MU occurred at the portion where the vocal fold mucosa showed minimal pliability.
Poster 2 Vocal Fold Vibration Viewed From the Tracheal Side in Living Humans EIJIYUMOTO,MD (presenter), YOSHIMIKADOTA,MD, and TOSHIHIROMORI, MD, Ehime, Japan A small mucosal eminence occurs during phonation on the lower surface of the canine vocal fold. This eminence, called mucosal upheaval (MU), is important as a starting line of the mucosal traveling wave. An increase in vocal fold tension caused an upward shift of the MU toward the oral side. Contraction of the thyroarytenoid muscle caused a downward shift of the MU toward the tracheal side and, thus, a more dynamic mucosal wave appeared in the vertical direction. We observed in vivo human vocal fold vibration from below. Subjects were 14 men and six women. They had undergone tracheostomy for a temporary airway care because of various head and neck diseases. A rigid oblique-view endoscope was inserted into the tracheal lumen. The gap between the endoscope and the stoma was filled with cotton gauze so that air did not escape through this gap during phonation. Subjects were asked to phonate a sustained vowel /a/, first at the most comfortable pitch and then at a higher pitch. We asked subjects to perform these tasks when we endoscopically examined whether liquid drainage into the trachea occurred. The vocal fold was illuminated by continuous or stroboscopic light and its vibration was recorded on a videotape. These recorded vibrations were played repeatedly to qualitatively analyze the MU. The first task was possible in 19 of 20 subjects, and 10 of these 19 could phonate at a higher pitch. The MU appeared on the lower surface of the vocal fold during phonation in 19 subjects. The mu-
Otolaryngology Head and Neck Surgery August 1995
ScientificSessions-- Tuesday
A novel and clinically practical method of delivering surfactant to the eustachian tube was studied in a gerbil model of OME. OME was induced in 20 gerbils via transtympanic inoculation of heat-killed Streptococcuspneumonia. Twentyfour of forty ears (60%) were successfully inoculated. Inhaled, nebulized surfactant was used to treat the animals with microscopically confirmed OME over a period of 5 days. Eustachian tube opening studies were performed on both affected and nonaffected animals. Successful eustachian tube opening pressures were obtained in 30 of 40 ears (75%). Mean opening pressure for animals without effusion (healthy) was 42.5 mm Hg. Mean opening pressure for animals with effusion treated with nebulized surfactant was 39.4 mm Hg. This pilot study in animals suggests that inhaled, nebulized surfactant may be efficacious in establishing normal eustachian tube function within the clinical picture of OME.
11:45 A.M, Marrow-Mesenchyme Connections in the Newborn FREDH. LINTHICUM,JR, MD (presenter), QING TIAN, MD, and WILLIAM SLATTERY,MD, Los Angeles, Calif. Examination of 10 fetal and seven infant temporal bones prepared for microscopic evaluation revealed direct connections between the hematopoetic bone marrow and the unresolved mesenchyme in the middle ear of the human newborn infant. The connections first appear 20 weeks before birth and become bridged by fibrous tissue that ossifies between 10 and 12 months. The areas in which the connections are most numerous are the anterior epitympanum, the facial recess medial to the stapedius muscle, and transitory bone that occupies the area that will become the additus of the antrum. In temporal bones with otitis media, dense collections of polymorphononuclear cells are present in the mesenchyme at the middle ear end of the marrow spaces. Immunohistochemical staining is the same for the cells in the mesenchyme as for those in the marrow.
POSTERS ( S E S S I O N C ) A u t h o r s will b e p r e s e n t a t t h e i r p o s t e r s T u e s d a y , Sept. 19, 9:15 t o 10:00 A.M,
Poster 1 Pliability of Canine Vocal Fold Mucosa in Relation to its Vibration YOSHIMIKADOTA,MD (presenter), and EIJIYUMOTO,MD, Ehime, Japan As we previously reported, a small mucosal eminence, called mucosal upheaval (MU), occurs during phonation on the lower surface of the canine vocal fold. The mucosal traveling wave, essential in vocal fold vibration, starts from the MU and propagates upward. Thus the MU plays an important role in vocal fold vibration in the canine larynx. We also reported that an increase in vocal fold tension caused
an upward shift of the MU toward the oral side and that contraction of the thyroarytenoid muscle caused a downward shift of the MU toward the tracheal side. The purpose of this study was to examine pliability of the canine vocal fold mucosa, one of the key physical properties of the vocal fold, in relation to the occurrence of the MU. Nineteen excised canine larynges were used in the study. Mucosal pliability was measured at several points along the mid portion of the membranous vocal fold until 6 mm below the free edge. The free edge showed a maximum pliability, which gradually diminished toward the tracheal side and reached a minimum 3 mm below the free edge. An increase in vocal fold tension resulted in smaller mucosal pliability at all measured points, and the point of minimal pliability shifted upward toward the oral side. The point of minimal pliability moved downward toward the tracheal side in association with direct electric stimulation of the thyroarytenoid muscle. These shifts of the point of minimal pliability corresponded to the shifts of the MU in response to an increase in vocal fold tension or direct electric stimulation of the thyroarytenoid muscle. These results suggested that the MU occurred at the portion where the vocal fold mucosa showed minimal pliability.
Poster 2 Vocal Fold Vibration Viewed From the Tracheal Side in Living Humans EIJIYUMOTO,MD (presenter), YOSHIMIKADOTA,MD, and TOSHIHIROMORI, MD, Ehime, Japan A small mucosal eminence occurs during phonation on the lower surface of the canine vocal fold. This eminence, called mucosal upheaval (MU), is important as a starting line of the mucosal traveling wave. An increase in vocal fold tension caused an upward shift of the MU toward the oral side. Contraction of the thyroarytenoid muscle caused a downward shift of the MU toward the tracheal side and, thus, a more dynamic mucosal wave appeared in the vertical direction. We observed in vivo human vocal fold vibration from below. Subjects were 14 men and six women. They had undergone tracheostomy for a temporary airway care because of various head and neck diseases. A rigid oblique-view endoscope was inserted into the tracheal lumen. The gap between the endoscope and the stoma was filled with cotton gauze so that air did not escape through this gap during phonation. Subjects were asked to phonate a sustained vowel /a/, first at the most comfortable pitch and then at a higher pitch. We asked subjects to perform these tasks when we endoscopically examined whether liquid drainage into the trachea occurred. The vocal fold was illuminated by continuous or stroboscopic light and its vibration was recorded on a videotape. These recorded vibrations were played repeatedly to qualitatively analyze the MU. The first task was possible in 19 of 20 subjects, and 10 of these 19 could phonate at a higher pitch. The MU appeared on the lower surface of the vocal fold during phonation in 19 subjects. The mu-