Twenty cases of labyrinthine fistulae have been reviewed. From 1979 to 1987, 234 patients with cholesteatomatous ears were operated on by one surgeon, 20 of these had a labyrinthine fistula (incidence 8.6 %). In 75 % only the lateral semicircular canal was involved and in 25 % the other semicircular canals and/or the cochlea were involved. The fistula test was positive in 50 % of the cases. The surgical technique used in all 20 cases was a one-stage closed tympanoplasty, i.e. removal of the cholesteatoma matrix, covering of the fistula with fascia and bone, obliteration of the cavity and reconstruction of the meatal wall. 76 % of the patients achieved a hearing improvement, while 1 patient had anacusis (5 %). The results indicate that it is possible in one stage to remove the cholesteatoma matrix from the fistula and still be able to restore useful hearing in the majority of the patients.

In conventional underlay tympanoplasty the graft is placed medial to the malleus handle. The present study evaluates the results of a modification of this technique, in which the graft is placed lateral to the malleus handle, which has been dissected from the drum remnants. 39 ears with predominantly large or anterior pars tensa perforations were operated upon in this manner. After a median observation time of 20 months one ear was found to have a small reperforation. All ears had normal tympanomeatal angles, but 12 ears showed a small degree of laterofixation of the graft from the malleus handle. Analysis of the hearing showed good hearing improvement and no adverse effects attributable to the dissection of the ossicular chain. It is concluded that the technique is a good alternative to conventional underlay myringoplasty in ears with perforations involving the area anterior to the malleus handle.

On 64 temporal bones from slightly abnormal and pathological prematures and newborn infants, children, and adults, 35,000-40,000 counts of goblet cells were done in different parts of the Eustachian tube and middle ear. The goblet cells were present in all Eustachian tubes and middle ear areas. In ears previously exposed to infection the density was slightly increased in the tubal orifice and in most parts of the middle ear. In subacute and acute pathological actions, especially tubal occlusion, and chronic diseases, such as active chronic otitis and in secretory otitis media, the goblet-cell density is appreciably increased.

The entire intra- and extralaryngeal mucosa from 10 adult persons having macroscopically normal larynges was examined by the whole-mount method and selective staining of the mucous elements by PAS-alcian blue in order to assess the number, distribution, and density of the subepithelial glands. After microdissection of the mucosa the glandular orifices were quantitated under the stereomicroscope. Glands were demonstrated in the various regions of all larynges. The total intralaryngeal number, when excluding the saccule, ranged between 603 and 1579 (median 890) glands. In 6 larynges, glands could be quantitated in the saccule, where their number ranged between 32 and 324 (median 89). In the extralaryngeal region the count for the total series ranged between 1 and 53 (median 9) glands. The median intralaryngeal density, excluding the saccule, was 0.27 gland/mm2, ranging between 0.23 and 0.47. The density was significantly greater in the glottic than in the sub- and supraglottic regions. The highest concentration of glands was observed in the saccule in which the median density was 0.82 gland/mm2. A correlation between gland density and age or sex was not demonstrable. On the basis of the results, the subepithelial glands must be considered a normal component of the mucociliary system in the laryngeal mucosa.

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