Tympanic plethysmography is a simple non-invasive diagnostic technique which is used to differentiate between intra-temporal carotid aneurysms and glomus jugulare tumours and to predict the degree of extension of the tumour. It is performed by the indirect recording of volume pressure changes of pulsating tympanic masses using a pressure transducer. The volume pressure change of the pulsating mass is transmitted to the pressure transducer through a saline-filled system.

Medical technology has undergone considerable progress with the introduction of new techniques in medical diagnosis less harmful to the patient and with a reduced risk of complications. The collaboration of doctors, scientists and bioengineers has resulted in the evolution of such changes, thereby trying to replace the more aggressive or invasive diagnostic techniques. The ideal diagnostic technology is one without pain, harm or complications to the patient.

Medical diagnostic technology may be classified as invasive or noninvasive. Non-invasive diagnostic technology is either active, using an external source of energy such as ultrasound (ultrasonography) or a small dose of X-rays, as in computerized axial tomography; or passive, using the energy emitted by human structures, as in plethysmography.

Plethysmography is the recording of volume pressure changes. Oculoplethysmography is used to monitor extracranial occlusive carotid disease (Kartchner and McRae, 1973). The use of sound energy as an internal energy emitted by the human body has proved effective as a passive, non-invasive diagnostic technique (Tewfik, 1976, 1977).

Volume pressure changes of intra-temporal carotid aneurysms have been recorded, using a pressure transducer (Tewfik, 1974).

In this article the volume pressure changes of glomus jugulare tumours have been recorded and the findings compared with those obtained, and previously published, for intra-temporal carotid aneurysms. Volume pressure changes of pulsating tympanic masses may be called tympanic plethysmography. A trial of this simple non-invasive diagnostic technique for differentiating pulsating tympanic masses is here reported, together with an assessment of the technique in its ability to predict the degree of extension of glomus jugulare tumours.

Transcranial attenuation for bone conduction as a function of frequency (0.25 to 4 kHz.) was measured on a group of unilaterally deaf (n 15) and a group of normal (n = 35) ears. The results indicate a positive mean attenuation for all frequencies with a peak value of 13 db. for both groups at 2 kHz. Inter-subject variability was extremely large. This is considered to be a result of variability in skull bone thickness.

On the basis of clinical and histologic examination, history and epidemiologic survey of 591 patients with vocal cord polyps, the authors evaluate the morphology of the pathologic substrate, indicate possible pathogenesis and analyse the most frequent factors in the formation of polyps such as vocal abuse and unfavourable microclimate at work. Sex does not play any role in the incidence, and the histologic structure is not related to the time factor.

A 55-year-old man with symptoms of hearing loss, balance disturbance, and facial weakness was treated by translabyrinthine eighth cranial nerve trans-section. The patient also had a history and physical signs of chronic alcoholism and peripheral polyneuropathy. Results of laboratory tests revealed concomitant nutritional deficiency. Histopathological examination of the eighth nerve showed extensive degeneration of both myelinated and unmyelinated nerve fibers in both cochlear and vestibular divisions. Light and electron microscopic features of the degenerative process were compatible with previously described pathology of experimentally induced Wallerian-like degeneration. Alcoholic neuropathy as the cause of hearing loss and balance disturbance—and probably facial paresis—is suggested.

A case of progressive hemifacial atrophy (PHA) with extensive atrophy of the walls of the maxillary sinus is reported. Prolapse of subcutaneous tissue and orbital fat through the bony defect simulated the presence of a tumour and led to surgical exploration. Such a severe degree of bony involvement with relatively mild soft tissue atrophy is exceptional. Radiological evaluation by hypocycloidal tomography contributed greatly to the diagnosis in this case.

Unilateral progressive atrophy of the face was first described by Parry (1825) and by Romberg (1846). Eulenberg (1871) coined the name ‘progressive facial hemiatrophy’, but ‘progressive hemifacial atrophy’ (PHA) is a more appropriate term (Gorlin and Pindborg, 1964; Kabir and Halprin, 1964). The disease commences usually in the first or second decade of life, and is more common in females. Over several years there is a slowly progressive atrophy of the face on one side, with involvement of the skin and subcutaneous fat, and on rare occasions also of the muscles and bones (Gorlin and Pindborg, 1964; Finesilver and Rosow, 1938; Bramley and Forbes, 1960; Singh and Bajpai, 1969; Crikelair et al., 1962). The etiology of the disease is unknown.

We report an unusual case in which the hemifacial atrophy affected the bone much more than the soft tissues and which presented as a mass in the maxillary sinus.