The ceruminous glands in the skin of the human external auditory canal are modified apocrine glands, which, together with sebaceous glands, produce the cerumen, the ear wax. Cerumen plays an important role in the protection of the ear canal against physical damage and microbial invasion. We studied the morphology of the glandular cells by light and electronmicroscopy. Antimicrobial and cytoskeletal components of the ceruminous glands were investigated by immunohistochemical methods. Numerous antimicrobial proteins and peptides are present in the ceruminous glandular cells: ␤-defensin-1, ␤-defensin-2, cathelicidin, lysozyme, lactoferrin, MUC1, secretory component of IgA. These data indicate a crucial role in the innate host defense against diverse pathogens. The apocrine secretion mechanism is a special mode of secretion by which the apical part of the cell cytoplasm surrounded by a membrane is pinched off. We could show that the presence of actin filaments, CK 19 and CK 7, seems to play a role in the pinching-off mechanism. Finally, we showed the secretion of lipid vesicles from the ceruminous gland. We could extend the number of detected antimicrobial peptides and proteins in human ceruminous glandular cells that protect the surface of the external auditory meatus. In addition, we detected proteins involved in the apocrine secretion mode of the ceruminous gland. Anat Rec Part A, 288A: 877-884, 2006.

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From our experience with computer-guided surgical procedures, we conclude that computer-guided navigational systems are so accurate that the risk of misleading the surgeon is minimal. In the future, their use in certain specialized procedures will be not only sensible but mandatory. We recommend their use not only in difficult surgical situations but also in routine procedures and for surgical training.

Extracorporeal shock wave lithotripsy is a rather new therapeutical method in the treatment of sialolithiasis. The objective was to evaluate retrospectively the results of the extracorporeal shock wave lithotripsy therapy performed with a Minilith SL 1 lithotripter on 167 out-patients with symptomatic stones (average size 5.94 mm) of the salivary glands over an observation period of seven years. A successful treatment with total stone disintegration was achieved in 51 (31 per cent) patients. In 92 (55 per cent) patients treatment was partially successful, with disappearance of the symptoms but a sonographically still identifiable stone. Treatment failure occurred in 24 (14 per cent) patients who then underwent surgery. The mean follow-up period was 35.6 months (minimum three, maximum 83), after which 83.2 per cent of the initially successfully treated patients were still free of symptoms.Therefore, extracorporeal shock wave lithotripsy, as a non-invasive treatment alternative with few side effects, is an efficient technique for the therapy of sialolithiasis in selected patients.

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