The major climatic variations that have affected the summit slopes of the higher Apennine massifs in the last 6000 yr are shown in alternating layers of organic matter-rich soils and alluvial, glacial and periglacial sediments. The burial of the soils, triggered by environmental–climatic variations, took place in several phases. For the last 3000 yr chronological correlations can be drawn between phases of glacial advance, scree and alluvial sedimentation and development of periglacial features. During some periods, the slopes were covered by vegetation up to 2700 m and beyond, while in other phases the same slopes were subject to glacial advances and periglacial processes, and alluvial sediments were deposited on the high plateaus. Around 5740–5590, 1560–1370 and 1300–970 cal yr B.P., organic matter-rich soils formed on slopes currently subject to periglacial and glacial processes; the mean annual temperature must therefore have been higher than at present. Furthermore, on the basis of the variations in the elevation of the lower limit reached by gelifraction, it can be concluded that the oscillations in the minimum winter temperatures could have ranged between 3.0°C lower (ca. 790–150 cal yr B.P.) and 1.2°C higher (ca. 5740–5590 cal yr B.P.) than present minimum winter temperatures. During the last 3000 yr the cold phases recorded by the Calderone Glacier advance in the Apennines essentially match basically the phases of glacial advance in the Alps.

The insertion of a myringotomy tube is a common ENT procedure. Traditionally, this procedure is performed under otomicroscopic view. In this paper I describe a technique using rigid endoscopy with the Hopkins rod and a video monitor as a visual aid for the insertion of myringotomy tube in older children and adults. The technique is safe and effective; it allows demonstration of the entire tympanic membrane during surgery and also enables better teaching of the procedure than does the otomicroscope.

Narghile (water-pipe) smoking requires the generation of significant negative intrapharyngeal pressure, which may be transmitted to the middle ear through the Eustachian tube. A total of 80 ears from regular narghile smokers were examined otoscopically and by tympanometry. Seventy ears from heavy cigarette smokers were similarly examined and served as a control group. There was a highly significant increase in the prevalence of atticretractions (P < 0.01) in the narghile smokers. The tympanometric changes were not significantly different between the two groups (P > 0.05).

We report a case of mucoepidermoid carcinoma (MEC) originating from the eustachian tube and middle ear. A 31-year-old male who presented with otorrhoea and methicillin-resistant Staphylococcus aureus (MRSA) in the right ear was admitted to hospital due to cerebral infarction and deep vein thrombosis. After recovery, biopsies from a granulomatous mass found in the middle ear during operation for chro ic otitis media revealed intermediate-grade MEC and a nasopharyngeal mass identified after surgery also revealed the same result. He received combined radiation therapy and chemotherapy and no residual or recurrent tumour was detected after two years of follow-up.

The case of a five year old boy who presented with a lower motor neurone facial nerve palsy secondary to primary non-Hodgkin’s lymphoma (NHL) of the middle ear is discussed. Any child who presents with a facial nerve palsy and conductive hearing loss requires thorough evaluation to exclude the possibility of temporal bone malignancy.

Glomus tumours can present in several sites in the head and neck. A red mass in the middle ear, visible on otoscopy generally indicates a glomus tympanicum or glomus jugulare. We present photographic and radiologic evidence of such a lesion arising from the course of the intra-tympanic facial nerve, the Fallopian canal, and review the differential diagnoses.

We have developed a prototype middle-ear hearing implant which uses a multilayer piezoelectric actuator. In this series of experiments the actuator was attached to the medial wall of the attic so that it makes contact with the body of the incus. Initial in vitro evaluation has been carried out using a laser vibrometer (Polytec CLV) to measure stapes velocity. Stapes displacement is calculated by mathematical integration. The device used in this way is particularly effective at transmitting high frequency sound to the stapes. When switched off the actuator impairs the transmission of sound to the ossicular chain at low frequencies, but this effect is only 7 dB at most. The stapes displacements resulting from the action of the implant have a linear relationship with the voltages used to drive the system. The high capacitance of the present actuator means that its power requirements are higher than that of other comparable devices. An optimal method of coupling the device to the incus has yet to be identified.

Middle-ear adenoma has been reported only in small numbers by surgeons. The few large series reported have been presented by histopathologists. We add two cases of middle-ear adenoma to the published literature, together with pre-, per- and post-operative imaging of one case, as a demonstration of this rare clinical entity. We discuss the pathology of middle-ear adenoma, its diagnosis and treatment, and suggest ways of improving its management.

The effect on the taste pores of denervation of the chorda tympani nerve in the middle-ear cavity was studied comparing confocal laser microscopy with lingual nerve resection. Taste pore cells were stained for actin with rhodamine-phalloidin and positive fluorescence was observed as a ring shape at the transverse cross sections. Within three days after chorda tympani nerve resection the ring reaction disappeared, although the pore morphology remained intact as seen by scanning electron microscopy. On the other hand, lingual nerve resection did not induce such rapid disappearance of the ring reaction. These results suggest that the chorda tympani nerve plays a predominant role in the maintenance of actin filaments in taste pore cells.

The purpose of this study was to evaluate the long-term effect on middle ear and eustachian tube function following the packing of the middle-ear space to prevent cerebrospinal fluid rhinorrhoea at the termination of translabyrinthine vestibular schwannoma removal.

This was an observational study of a sample of 14 patients examined between two and five years postoperatively. Photo-otoscopy and tympanometry were performed bilaterally to evaluate appearance and function.

All operated middle ears were air-containing although eight out of 14 showed scarring as evidence of operative intervention. There were no drum retractions. Ten out of 14 middle-ear compliance peaks were lower in the operated ear with four flat traces. Two out of 14 were the same and two out of 14 showed high compliance. The middle-ear pressure was always within the normal range when determinable.

This technique appears to have no detrimental effects on the middle ear and does not permanently obliterate the eustachian tube. The reduced compliance in the majority of cases is probably a result of scarring and fibrosis. When drum hypermobility is seen this is accounted for by incus removal.

During the placement of a mould for a hearing-aid by a hearing-aid dispenser, moulding material entered the middle ear through pre-existent perforations in the tympanic membrane in both ears. Besides hearing loss, there were no other symptoms. Surgical removal of the moulding material by tympanotomy was necessary, and was complicated by encirclement of the ossicles by the material. All the material could be removed and the hearing was saved. Recommendations for an improved procedure of mould-making are made including more detailed information of the otoscopic findings at the prescriptions for hearing-aid moulds.