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Following the recommendations of the United States National Institutes of Health Consensus Conference in 1993, otoacoustic emissions (OAE) are now used internationally for hearing screening. The use of recording systems as well as the interpretation of results requires specially trained personnel although measurements are easier to perform than other recording methods available. To date, no objective method for general hearing screening, has been introduced in Germany, for neonates or children at risk, even though it would be desirable to detect and rehabilitate children with congenital hearing loss as early as possible (incidence, 1-6 per 1000). The Echosensor provides the means for carrying out OAE recordings within a short period of time and includes an automatic evaluation of results. Recordings can also be made by trained personnel. As a comparison test, audiologically trained staff recorded otoacoustic emissions in 111 new-born children in order to compare the results of the Echosensor with the results of a conventional OAE measurements device (the ILO88). The aim of this pilot study was to determine the reliability and validity of the recordings in comparison with available standards in brainstem audiometry. Our study showed that the results of the Echosensor corresponded well with the ILO88 results. Consequently, an OAE measuring method is now available is also provides high sensitivity and specificity and is easy to use. Our findings show that the Echosensor can meet the demands of systematic hearing screening in Germany.

Due to the uncommon biological behaviour with a slow growth on the one hand side and an aggressive local invasion on the other hand side the ACC can be regarded as a challenging malignant disease for the clinician whose adequate therapy does not allow any standardized regime. The tendency for recurrence even after a period clinically free of symptoms makes a life long follow-up mandatory.

The spontaneous malignant transformation of a juvenile papilloma in a squamous cell carcinoma is extremely rare. The surgical intervention as well the radiotherapy and chemotherapy using interferon was unsuccessful due to the high grade of malignancy. In view of the very short time interval between first diagnosis of juvenile papilloma and the subsequent malignant transformation, one must consider either the potential presence of a very aggressive form of papilloma or alternative two coincident independent diseases.

Eine 5ljahrige Patientin steilt sich mit seit einem Monat bestehenderi Doppelbildern vor allem beim Buck nach rechts vor. Eine Visusminderung sowie Kopfschmerzen werden von der Patientin verneint. Desweiteren lagen kein lnfekt, kein Schleimausflug aus der Nase oder eine Allergie vor. An nennenswerten Erkrankungen in der Vorgeschichte wird em zwei Jahre zuvor diagnostiziertes und in sano operiertes Mammakarzinom berichtet.

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