Expectorationof large, branching, bronchial casts, termed plastic bronchitis, is an uncommon condition in children. Asthma or allergy often is the cause of cast production, but in some instances no etiology is found. Five children produced large, obstructing bronchial casts that either were expectorated or were extracted at bronchoscopy. Four of the children had asthma or allergies and the fifth had congenital tricuspid atresia and chronic pericardial and pleural effusions.
The histopathology of the facial nerve 1 week after the onset of Bell's palsy is reported. The entire nerve was infiltrated by inflammatory cells. Myelin breakdown, axonal changes, and edema were present, suggesting viral neuritis. The role of decompression in this disease process is discussed.
The course of a fourth branchial fistula is reviewed. Although no complete fistula has yet been described, the anatomy of such a fistula can be determined from a knowledge of the embryologic development of the brachial region. The fistula must first ascend over the hypoglossal nerve before caudal to the fourth area arterial structures. This description is different from the one commonly recognized by otolaryngologists.
It has been postulated that otosclerosis may produce vertigo by several mechanisms. One mechanism is by causing endolymphatic hydrops. We present six temporal bones in which otosclerosis and endolymphatic hydrops coexist. We consider that there is a spectrumlike interrelationship between these two entities. At one end of the spectrum the relationship is coincidental, while at the other end of the spectrum we consider the massive amount of active otosclerosis to be a causative factor in the development of the endolymphatic hydrops.
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