Forty-seven patients with temporomandibular joint dysfunction were studied. A total of 100 subjective symptoms localized in the ear were encountered in thirty-nine patients. The treatment of dysfunction eradicated or reduced 56% of these symptoms. A hearing defect was established audiometrically in eight cases and the probable cause was outside the masticatory apparatus in seven cases. There was conceviably a causal relationship in one case between the patient's cochlear hearing defect and temporomandibular joint dysfunction. The neuro-otological finding was pathological in nine cases, in three of which the causative agent was independent of the masticatory apparatus. The vestibular disturbance diagnosed in six cases may have originated from temporomandibular joint dysfunction, but this could not be confirmed.
28 children, treated with gentamicin during the newborn period, were examined at the age of 2–3¾ years for the possible impairment of vestibular, cochlear or renal function. Five of the children showed lesions of the hearing and/or vestibular function, and one, possibly, had slight renal tubular insufficiency. In this case, and in 3 of the otologic cases, there were other, clearly more probable causes of the lesions than gentamicin, and we feel justified in excluding gentamicin as an etiological factor in these cases. In the 2 remaining cases, however, no definite conclusion can be drawn as to the possible role of gentamicin in the pathogenesis of the lesions. One of these cases is a boy who had been slightly asphyctic after birth, suffered a virogenic meningitis at the age of 2 weeks, and had a slight cerebral concussion at the age of 10 months. He had a slight vestibular dysfunction. The other case is a girl who was premature, had hypoglycaemia, and septicaemia. She had severe loss of hearing and possibly a slight vestibular dysfunction, but no other neurological signs. Neither of these 2 children have received other ototoxic antibiotics.
131 patients suffering from meningitis due to Haemophilus influenzae or parainfluenzae were re-examined after 1-15 years, using hospital records, questionnaires, and audiological examination, especially to compare chloramphenicol and ampicillin therapy. Mortality was 3.8%. Subdural effusions occurred in 14.5% of cases uni- or bilaterally. There was deafness in 2.3%, and moderate hearing loss in 8.4%. Convulsions appeared later in 6.9%. The final outcome was good in 60%. The most important factors in prognosis seemed to be the severity of the symptoms and the condition of the patient on admission to hospital. No clear difference was seen between the results of chloramphenicol and ampicillin therapy, but total loss of vestibular function was found in 3 cases in the ampicillin group, and in none in the chloramphenicol group. In mortality and deafness, the differences in outcome were similar, although not statistically significant. As these observations show, the therapy used in Haemophilus influenzae meningitis needs re-evaluation.
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