No abstract

This double-blind study compares the effectiveness of two local anaesthetics with vasoconstrictive activity (10% cocaine and 4% lignocaine with adrenaline 1:1000) used in the nose. Anterior rhinomanometry was used to assess changes in nasal mucosal blood volume from a reduction in congestion of the nasal mucosa with a resulting reduction in nasal resistance. Nasendoscopy was then performed and the degree of subjective discomfort evaluated. Twenty patients presenting with nasal obstruction but without evidence of structural disease and nine healthy volunteers were entered into the study. Each received 10% cocaine in one nostril, and 4% lignocaine with adrenaline (1:1000) in the other in a double-blind study. In all subjects, there was a significant reduction of nasal resistance after the administration of both drugs (P < 0.005). The anaesthetic effects of both agents were comparable with subjects reporting only a mild discomfort during nasendoscopy. We conclude from this study that 4% lignocaine with adrenaline (1:1000) solution is as effective as 10% cocaine.

The role of mesenchyme in the temporal bone is still poorly understood. A microscopic study of residual mesenchyme was undertaken in temporal bones of children from birth to 5 years of age. Residual mesenchyme was found to be located in the mastoid antrum and epitympanum more often than in the mesotympanum. The amount of mesenchymal tissue remaining in the temporal bones decreased with increasing age. Persistence of mesenchyme in the temporal bone was related to congenital morphologic ear anomalies and syndromes. There was also an association evident with pulmonary disease, but not with congenital heart defects. Persistent mesenchyme was also found to be significantly associated with chronic middle ear inflammation, and in cases of unilateral otitis media the ear with otitis media had more residual mesenchyme than the non-otitis media ear.

The clinical and bacteriological efficacy of topical ciprofloxacin in saline solution and a saline solution without antibiotics, for the treatment of otorrhoea, was assessed. Fifty affected ears which had an acute exacerbation of chronic otitis media with tympanic membrane perforation were included in this study. Only 35 ears completed the study. Both medications were randomly given to patients. Therapeutic efficacy was evaluated on the seventh day of treatment. A favourable clinical response was observed in 89.5% of the ciprofloxacin-treated group and in 43.8% of the saline-treated group, respectively (P < 0.005). Bacteriological eradication was also observed to be higher in the ciprofloxacin-treated group (P < 0.005). From these preliminary results, topical ciprofloxacin appears to be effective in curing the acute phase of chronic otitis media.