The brainstem auditory evoked responses (BAER) were utilized for the evaluation of central neural transmission in alloxan-induced diabetes in rats. The mean latencies of waves I, III, V and the interpeak latencies III-V and I-V were prolonged in diabetic rats as compared to the same rats before alloxan administration. The incidence of abnormal BAER was more frequent in the group of rats with severe diabetes (82 per cent) than in mildly diabetic animals (42 per cent). Our results may suggest the presence of a central neuropathy in experimental diabetes, which can be detected by the method of BAER.

In ears with minor conductive hearing loss of traumatic origin, it is sometimes possible to invert the deflection of the stapedial reflex by application of a small underpressure in the external auditory meatus of the injured ear (probe ear). This inversion can be explained by an ossicular discontinuity bridge by soft tissue.

Vitamin D (calciferol) dehciency has recently been claimed to cause cochlear hearing-loss (Brookes and Morrison, 1981; Brookes, 1983, 1984). In view of the therapeutic and pathophysiological implications of this finding, a confirmatory study was undertaken in the Department of Neuro-otology at The Royal National Throat, Nose and Ear Hospital.

Screening of 112 consecutive new referrals revealed 32 patients with biochemical abnormalities compatible with vitamin D deficiency. Of these, 26 agreed to serum vitamin D assay and normal values were obtained in all of these cases. This study does not support the claim that vitamin D deficiency is a cause of hearing-loss.

One hundred and six patients with nasal fractures, treated by reduction in 65 percent, were seen three months and three years after the trauma. The results were compared with a normal group.

Sixteen patients (15 per cent) had sustained recent nasal injuries, and another four patients had undergone correction of the nose during the follow-up period. These patients were left out of the statistical analysis, which thus comprises 88 patients.

Ninety per cent were satisfied with the result, and 84 per cent reported normal passage of air. Physical examination revealed a considerable number of deformities in all groups. including the normal group. Deviation of the external nose was significantly more common in the patients than in the normals. During the follow-up period, secondary deformity—saddling or hump—developed in some cases. Most deformities were slight and of little importane to the patient. Septal deformities were present in over 50 per cent of all groups, including the normal group. There was no aggravation of septal deformities or increasing nasal stenosis during the follow-up period. There patients were interested in secondary corrective treatment.

It is concluded that closed reduction of nasal fractures affords satisfactory long-term results. The study does not support the view that a large number of cases of nasal fracture should be treated by open reduction.

In order to assess the extent of the underlying pathology in Bell's palsy, the vestibular function of 24 patients was evaluated within the first week from the onset of facial paralysis. Seven patients had pathological findings by ENG and an additional three had subjective vestibular signs; four of these ten patients also showed abnormal auditory brain stem evoked potentials. There was no correlation between the severity of the paralysis or the prognosis for recovery and the presence of vestibular abnormalities.

Thirty-three of 58 patients with carcinoma of the external auditory meatus and middle ear were treated by radiotherapy. Nineteen patients suffered a recurrence. This proved to be unsuitable for petrosectomy in all patients with a tumour of the middle ear. A few patients with tumours of the external auditory meatus, usually of non-squamous variety, have survived for a reasonable period after ‘salvage’ petrosectomy.

Twelve normal adults were evaluated to determine their capacity to suppress caloric-induced nystagmus by visual fixation. Fixation suppression (FS) was assessed four times during the routine Fitzgerald-Hallpike caloric procedure. The results were characterized by large inter-subject as well as intra-subject variability. It is cautioned that diagnostic categories should not be inferred on the basis of absolute numeric values of FS.

The biocompatibility of the bioactive glass-ceramic Ceravital was investigated experimentally both in vivo and in vitro. In the former, ceramic discs were interposed in 30 rat middle ears for periods ranging from 6 weeks to 12 months. In the latter, Ceravital otological prosthesis were placed in human fibroblast culture.

Reactions to the biomaterial were assessed by means of scanning electron microscopy (SEM) with chemical analysis facilities (EDAX, WDAX) and light microscopy.

The interface reactions were similar in both in vivo and in vitro studies and confirmed the findings of other authors regarding the implants& biocompatibility and bioactivity. The technique of ion etching, however, enabled clear demonstration of this bioactivity on the implant surface, exposed merely to the middle-ear secretions, thus questioning the necessity of placing bone pate on the implant head at surgery, in order to encourage bioactive bonding with the overlying drum.

A clinical trial of Ceravital in 128 patients with an average follow-up period of 2 years is reported. Forty per cent of these patients underwent a type II tympanoplasty, 60 per cent a type III. Though relatively short-term, the results to date have been encouraging: 88 per cent of the implants have been well-tolerated; 70 per cent of the cases have yielded a satisfactory hearing result; and only 3 per cent of the implanted prostheses have been extruded.

Auditory Brainstem Evoked Potentials (ABEP) were recorded from 29 adults and children, accidentally exposed to lead through food until approximately a year prior to this study. ABEP were recorded in response to 75 dBHL click presented at rates of 10/sec. and 55/sec. Average values were calculated for peak latency and for interpeak latency differences. Average values of the effect of increasing stimulus rate were calculated as well. Similar values were calculated for normative child and adult control groups.

IPLD (I-III) showed the most significant and recurring results, with longer intervals in lead-exposed children compared with their control group. Increasing stimulus rate, on the other hand, affected the adult lead-exposed subjects more than the children. These results may imply an impairment of the auditory system with azonal and myelin involvement. ABEP is suggested as a sensitive detector of subclinical lead exposure effects on the nervous system.

This essay examines two possible mechanisms whereby a neuropathy affecting the efferent vestibular innervation may cause incoordination of vestibular afferent input to the Vestibular Integrating Centres: firstly, by loss of the normal fine control of afferent impulses; secondly, by a disruption of the sodium-potassium pump mechanism that maintains the ionic stability of the inner ear fluids.