Doctors' Discussion is a regular feature ofThe American Journal of Otologyand represents a summary of an actual Thursday evening discussion at The Otologic Medical Group (OMG) in Los Angeles. The following meeting was taped on January 22, 1981. Presiding was Dr. James L. Sheeny, and the following persons participated in the discussion: Doctors William F. House, Fred H. Linthicum, Derald E. Brackmann, Antonio de la Cruz, John W. House, Ralph A. Nelson, Jerald V. Robinson, and from the Audiological Staff, Dr. E. W. Johnson and Mr. Brian Forquer.On this evening, five cases were discussed. Case one concerned a three-year-old boy first treated at the OMG for serous otitis media in his left ear who was subsequently found to have a high frequency sensorineural hearing loss with a history of joint pain and seizures. At this time he was tested for autoimmune disease. A discussion followed regarding screening individuals with a rapidly progressing sensorineural hearing loss for autoimmune disease. Case two was that of a rheumatologist's wife in a similar situation. In the discussion that followed, several interesting thoughts were presented concerning the etiology of the autoimmune process. Case three concerns a 78-year-old man with a chief complaint of a clicking sound in his left ear that had been present for two years and was precipitated by high frequency sound. He was originally treated with Dilantin and ultimately taken to surgery where both the tensor tympani and stapedial tendons were cut. An interesting discussion followed on why the surgery was unsuccessful and whether this could have represented a palatal myoclonus. At this point in the discussion, one of the staff physicians reported on a meeting on tinnitus which he had recently attended in London. Case four involves a middle-aged female who developed a dead ear after undergoing reoperation on the ear in which she had had stapes surgery 20 years previously. In the discussion that followed the question of testing for ossilopsia was brought up. The last case involves a 5-year-old girl who has a 25 dB pure tone average in the left with a 35 dB in the right. The discussion concerns whether or not to put a hearing aid on this child.
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