Ix the treatment by irradiation of malignant tumours in certain areas of the head and neck, the whole auditory apparatus lies within the radiation fields (Figs, i and 2) and may therefore be subject to its full effects. Probably because these effects are not very noticeable, and because no significant damage was observed in the past despite widespread use of irradiation for several other disorders of the ear, little attention has been paid to this subject both by radiologists and otolaryngologists. The literature, in consequence, is very scanty considering the huge amount that has been written about ionization effects in other areas of the body.Desjardins (1931) reviewing thoroughly the earlier animal experiments (Ewald, 1905;Marx, 1909; Chilow, 1927; Thielemann, 1928) which are chiefly related to the ionization effects in the labyrinth, considered the work of those authors inconclusive. He attributed the changes observed in the inner ear to surgical trauma during implantation of capsules containing the radioactive substances and to other mechanical effects of such intervention. Cullen and Girder (1933) were the first to investigate the effects of irradiation on hearing. The dogs they submitted to small doses of X-rays showed an increase in hearing of about 5-5 decibels. This increase would appear after a latent period of about 11 days and last between 2 to 5 weeks after which time hearing would return to initial levels. One animal exposed to a cumulative dose up to IT,100 r. showed no impaired hearing during or after the experiment.Novotny (1951) studying the ionization effects in guinea-pigs found a decrease in the hearing of about 8-4 db. at a frequency of 4,000 c.p.s. There were no changes in the histology of the inner ear and no alteration in the intralabyrinthine pressure.Kozlov (1958) also found a decrease in the hearing of guinea-pigs exposed to irradiation. This impairment was in the range of 3 • 9 to 9 • 1 db., and involved all frequencies between 500 and 8,000 c.p.s.
Meningiomas are benign tumours common in the central nervous system. Primary extracranial meningiomas in the jaws are extremely rare. We performed a systematic review of all the primary extracranial meningioma arising in the jawbones reported in the English-language literature including indexed and non-indexed journals and we report a unique case in our hospital of a man with two primary extracranial meningiomas, the first frontal intradiploic and 16 years later, a second located in the mandible. We found 14 cases with primary jaws meningioma and we report another one. A mandibular predominance was observed with only four cases in the maxilla. Most of them occurred in women, with a mean age of 35.9 years. It is the first published case of a patient with two primary extracranial meningiomas one of them in the mandible, which the gender, age and laterality of the lesion are less frequent.
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