Four cases of aspergillosis of the paranasal sinuses seen recently at the North Carolina Baptist Hospital are reported. Paranasal sinus aspergillosis is prone to develop in patients living in the southeastern states because those states 1. have an agricultural economy and 2. have a hot, humid climate that causes a high incidence of nasal and sinus disorders. The increasing use of immunosuppressive and oncological drugs should further increase the incidence of aspergillosis. Diagnosis of aspergillosis of the paranasal sinuses requires a high index of suspicion which should be present particularly for a patient who has unilateral sinusitis that does not respond to routine therapy, or who has a localized sinus mass or bony erosion. Immunodiffusion tests are specific for aspergillosis. Treatment consists of surgical removal of the diseased mucosa and adequate aeration and drainage of the sinus. Culture of the specimen on Sabouraud's agar will confirm the diagnosis.

Penner9 and Jaffe10 have postulated that hypercoagulation, embolic, and thrombotic problems may precipitate sudden deafness by affecting the microcirculation of the inner ear. These syndromes have been found to occur in decompression sickness11 and deafness and vestibular attacks are known to occur with diving.4 In our laboratory, we were able to demonstrate severe cochlear potential losses in guinea pigs with the induction of decompression sickness. The problem was largely prevented by the prophylactic administration of heparin. Preliminary study of the temporal bones of a guinea pig with a severe post‐dive vestibular attack and loss of cochlear potential function showed the presence of hemorrhage in the perilymph of the auditory and vestibular system. The above results are interpreted as evidence that hypercoagulation, embolic and thrombotic problems may precipitate a loss of cochlear dysfunction — most likely in a diving situation and potentially in cases of sudden deafness not related to diving.

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