Previous studies have shown that viral upper respiratory tract (URT) infection predisposes to the development of bacterial otitis media (OM). The mechanisms underlying this phenomenon have been well defined for influenza A virus in the chinchilla model of experimental OM but have not been for adenovirus because of the heretofore lack of an appropriate model. In this study, chinchillas were inoculated intranasally or transbullarly with type 1 adenovirus to assess whether or not the chinchilla could serve as a suitable model for future investigation of adenovirus predisposition to bacterial OM. Data indicated that the chinchilla readily supported an active infection by and responded serologically to this agent and that route of inoculation markedly influenced otoscopic findings, elicitation of middle ear fluids, onset and location of histopathology, and progression of disease. The time course of disease onset and recovery and an assessment of the effect of this virus isolate on the mucosal epithelial integrity and on both the ciliary activity and transport function of the eustachian tube epithelium for both routes of inoculation are presented.

Abnormal middle ear findings during stapedectomy occur in a significant percentage of patients. Reasonable rates of success and overclosure can still be expected, but this is somewhat finding-specific. The predictive value of these findings, the associated rates of success with potential impact on surgical counseling, and planning for the "other ear" are discussed.

The incidence of pulmonary atelectasis following head and neck surgery is not well reported. This study retrospectively evaluated the incidence of pulmonary atelectasis in 161 head and neck cancer patients, with 152 being evaluable. There were 90 patients evaluated following pectoralis musculocutaneous flap reconstruction with their effective flap size and 71 nonflap patients as a control group. Clinical findings were correlated to radiographic scores. Of pectoralis musculocutaneous flap patients screened for preexisting pulmonary disease (PEPD), nine of 45 (20%) demonstrated pulmonary atelectasis in the first 24 hours compared with 10 of 39 or 25.6% nonflap controls. Major pulmonary atelectasis was not found in the pectoralis musculocutaneous flap patients by scoring criteria, and in only one of 39 (2.6%) nonflap patients. In flaps larger than 40 cm2, the incidence was eight of 37 (21.6%), with no major pulmonary atelectasis noted. Only one of nine (11.1%) patients with radiographic pulmonary atelectasis exhibited clinical symptoms (three of 10 or 30% control). In patients with PEPD and pectoralis musculocutaneous flaps, 22 of 45 (48.9%) had evidence of pulmonary atelectasis in contrast to 13 of 32 or 40.6% controls. There were two of 45 (4.4%) who had major pulmonary atelectasis with zero of 32 in the nonflap group. For flaps larger than 40 cm2, the incidence was 19 of 39 (48.7%) with two of 39 (5.1%) scored as major pulmonary atelectasis. The clinical correlation for this group and the major pulmonary atelectasis group was each approximately 50% compared to 15.4% for nonflap patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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