(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Children's Library | Biodiversity Heritage Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "Diseases Of The Nose Throat And Ear"

390

THE EAR

of new connective tissue and bone in the hollow spaces of the labyrinth.
The resulting deafness is complete and permanent in the ear (or ears)
affected.

After recovery the vestibular symptoms pass off rapidly in adults, but in
young children they may last as long as 1 year. In cases of sudden nerve
deafness, with or without vestibular symptoms, lumbar puncture should
be performed and the cerebrospinal fluid examined chemically and micro-
scopically. Serological tests for syphilis should be carried out. Repeated
lumbar punctures are of use in treatment, especially in cases of deafness
due to hydrocephalus.

HERPES ZOSTER OTICUS

Herpes zoster affecting the ear, or Ramsay Hunfs syndrome, is a rare disease
which is due to inflammation of the geniculate ganglion of the facial nerve,
the causative agent of which is probably a filterable virus. Hunt's concept
of the geniculate ganglion as the site of inflammation has, however, been
challenged. The facial nerve is a mixed nerve, having a sensory root (pars
intermedia) and ganglion (geniculate) similar to the sensory ganglion of the

MOTOR   NUCLEUS
INT AUDIT. MEATUS

GENICULATE GANGL.
GREATER  SUP  PETROS. NERVE

STAPEDIAL  NERVE
CHORDA TYMPANI

STYLOMASTOID FORAMEN


	REGIONAL DIAGNOSIS
	TASTE
	LACRIMATION
	STAPEDIUS REFLEX


	NUCLEAR
	+
	-f
	

ft
	SUPRAGENICULATE
	
	
	

r
	TRANSGENICULATE
	
	
	


	SUPRASTAPEDIAL
	
	+
	


	INFRASTAPEDIAL
	
	+
	+


	INFRACHORDAL
	+
	+
	+

Fig. 207. Classification of peripheral facial nerve lesions based on the anatomy and functions of the
facial nerve. (After Jepsen.")

spinal nerves. Fibres of general sensation emerge at the stylomastoid foramen
and are distributed to a portion of the auricle, external auditory meatus and
tympanic membrane.

The peripheral course of the facial nerve can usefully be divided into four
parts (Fig. 207): (1) Suprageniculate, where lesions will be associated with
absence or diminution of tears due to involvement of the secretory fibres
of the greater superficial petrosal nerve, but no loss of taste; (2) Transgenic-
ulate, where lesions will result in loss of taste of the anterior two-thirds of
the tongue and absence of tears; (3) Between the geniculate ganglion and
the point of exit of the chorda tympani nerve, where a lesion will result in
loss of taste, but tears will be present; (4) Below the exit of the chorda
tympani nerve, where lesions will not involve taste fibres, but associated
paralysis and normal tear secretion may result in epiphora. The recent