From the point of view of pathogenesis, 3 cases of sialodochitis fibrinosa were studied. The histopathological changes in the salivary glands examined were characterized by such findings as 1)mucous plug with a mixture of many eosinophils, a few neutrophils and desquamated epithelial cells in the ductal lumens, 2) marked thickings of the epithelial layers of the ductal walls, and 3)edema and hyalinization of the connective tissues, marked eosinophilia and a formation of lymph follicles in the periductal interstitial tissues. The smaller the ducts were, the slighter the above changes became.
From the above-mentioned observations, it was presumed that1) an involvement first occured in the main duct and then extended in the smaller ducts, 2)a stimulus extended from the surface of the ductal walls to the periductal interstitial tissues, and 3)this disease was presumably of allergic origin, although the evidence of allergy was obtained only from the microscopic examination of plug in the duct and sections of the salivary glands, but not from the examinations in history, blood and skin with test allergen extract in the present cases.
The plug which was specific in the duct of sialodochitis fibrinosa cases, was also observed in 3 cases of sialolithiasis suggesting a relation between these two diseases.

View full abstract

Six cases with highly resistant ulceration of the pharynx of unknown etiology were treated by irradiation. All of them had been already ineffectivelly treated with various kinds of therapeutic agents such as steroid hormone, anti-histamines, vitamines, antibiotics, anti-plasmines etc.
Eighty rads or 100 rads of irradiation were given once a week. Total amount was 1000 rads. Irradiation was remarkably effective on the pharyngeal ulcer in all cases ; however, two of them died of malignant lymphoma of the nose and of severe hepatitis a few months later. In another case the ulceration recurred at the same portion two months later, and re-irradiation of tumor dosis of ⁶⁰Co showed good result.
In view of the effective dosis of irradiation, the etiology of these ulcerations may be classified to the collagen disease such as autoimmune disease and the malignant lymphoma.

View full abstract

The results of 100 cases of reoperation among 600 tympanoplasties were analyzed and discussed. The primary operations were tympanoplasty, simple mastoidectomy and radical or modified radical mastoidectomy. The summary is as follows;
1. In the group of retympanoplasty, type III is the most frequent type and then type I, type IV and type II in decreasing order.
2. The better results were obtained in the cases of which primary surgery had been done in another clinic. This fact means that the primary operation had been done in poorer condition than in our clinic.
3. The results of the cases operated on other than tympanoplasty are satisfactory, especially the cases operated on primarily radical is the most convenient for the tympanoplasty.
4. Successful results were obtained in all cases with hearing loss of less than 30 dB and only 31 Z of the cases with hearing loss of more than 61 dB showed good results. 5. In the retympanoplasty, atticotomy is absolutely necessary to get a good result, even though it has been done in the primary operation.
6. The cases in which the reconstruction of posterior meatal wall or the mastoid obliteration combined with tympanoplasty have been achieved show good result of over 87%.
7. The result of ossicular reconstruction in type III is same to that of the original type E. In type IV, the reconstruction showed no success in all cases.

View full abstract

A case of stapes gusher with monopode stapes was reported. A 14-year-old boy with right progressive and left non-progressive deafness was admitted in our clinic on January-9, 1973. Audiometry of the patient revealed right pure conductive deafness and left combined deafness, but the threshold of left ear could not be decided because of right severe conductive deafness. The left ear was explored and the stapes was found to be monopode stapes. The footplate was small and fixed on the oval window. It had also a small fistula at the center of the footplate covered with normal mucous membrane. Immediately after manuplation, cerebrospinal fluid of in total 250m1 leaked out from the fistula. Stapedectomy was performed and the fluid leakage was controlled by packing the oval window with a teflon-piston wrapped with fascia.
Eight months after, the right ear was explored and fixed monopode stapes like the left was found. In order to avoid the labyrinthine damage, stapes mobilization was performed with good restoration of hearing. But the hearing loss relapsed again in 4 months. Finally stapedectomy with teflon-piston was performed without any complications such as stapes gusher. The hearing recovered to the normal range. Some clinical problems, especially on the stapes gusher, cerebrospinal fluid leakage and the indication of stapedectomy in congenital anomaly, were discussed.

View full abstract

Some of the patients who complain of vertigo and Itinnitus, do not recognize their actual recovery. Many of such patients gave us an impression of depression. So we prescribed them antidepressants and most patients recognized their vertigo and tinnitus almost disappear after the admistration.
24 patients who complained of vertigo or tinnitus and who gave us an impression of depression were given antidepressant. 12 cases of them admitted that their vertigo or tinnitus had disappeared. Other 9 cases of them recognized their symptoms improving. The only 3 cases of 24 did not recognized their vertigo and tinnitus improving. The effective rate of antidepressants for vertigo and tinnitus was 87%. As the antidepressants, amitriptyline and imipramine were used. Cornell medical index was useful for the judgment of the drug effect and the selection of the subjects for application of antidepressants.

View full abstract

7 cases of head and neck tumors, a case of laryngeal cancer, a case of buccal cancer, three cases of lingual cancer and two cases of epipharyngeal lymphepithelioma were treated by intra-arterial chemotherapy and radiotherapy, using superior thyroid artery, facial and buccal artery, lingual artery and ascending pharyngeal artery, respectively. 5 FU were used for the cases except of a case of lingual cancer treated by Bleomycin. Also ⁶⁰Co were used for the cases except of a case of buccal cancer treated by Lineac electron.
Several considerations were performed on the advantages and the disadvantages of intra-arterial chemotherapy.

View full abstract

A 58-year-old man had complained of symptoms of the nasopharyngeal tumor con-secutively for the past 7 years. The patient showed superior vena cava syndrome. The metastatic tumor of the liver and the stomach was discovered.
The histological finding was a malignant thymoma. Malignant thymoma that metastasized into the epipharynx is very rare occurrence.

View full abstract

A case of cervical neurinoma in a 26-year-old man was reported. Operation revealed the growth to be situation in deep lying area of the left neck between the internal and external carotid artery. The tumor measured 4×6×6 cm in dimensions, and histopathological examination revealed neurinoma. Postoperative course was unevevtfull but the patient developed Horner's syndrome. The authors made some comments on neurinoma with reference to previous literatures.

View full abstract

A 45-year-old housewife had a history of left otitis media. Examination of the left ear revealed an attic perforation with an opaque pars tensa. There was a 20 dB air-bone gap. X-rays showed an under-developed mastoid, diffusely sclerotic, with clouding throughout.
A left radical mastoidectomy was performed. A monolocular cholesteatoma with fistula in the ampulla of the lateral semicircular canal was found in the epitympanum, accompanied by a diffuse granulomatous mastoiditis and osteitis throughout the rest of the mastoid process. There were no ossicles. However, neomembrane was attached spontaneously to the fossa ovalis, forming a well-functioning natural type IV tympanoplasty. Removal of all diseased tissue and a wide exposure of the attic and aditus were carried out. Fascia tissue was used to close the labyrinthine fistula. No attempt was made to remove the neomembrane completely covering the middle ear. Postoperatively, audiological examination revealed a complete closure of air-bone gap.
The authors emphasized the usefulness of the sound conducting system which is shaped and preserved by Nature.

View full abstract

A case of mycotic infection of the left sphenoid sinus is described.
A woman aged 65 with a history of corticosteroid therapy for about 3 years for rheumatoid arthritis complained pain in the medial part of the left deep orbit. Although chronic sphenoiditis was suspected by the scopic and radiological findings, irrigation of the sinus yielded the fungus mass in the irrigated material. An excellent result was obtained by repeated irrigation of the left sphenoid sinus. Although the genus of the fungus remained undetermined, aspergillotic saprophytic infection was highly suspected.
A review of 5 cases in the literature was presented.

View full abstract

A 61-year-old woman was found to be affected with a pyocele of the frontal sinus that caused an amaurosis. After having had fever, orbital pain, and large swelling just above the right eye persisting several days, the patient lost her sight. It was diagnosed that the loss of sight was caused by orbital cellulitis complicated with the pyocele of the frontal sinus. The patient was finally treated surgically by complete frontal sinusectomy, but her vision was not recovered.
From the present case and the past literature the conclusions can be drawn as follows: 1) There may, if rarely nowadays, happen a case that a pyocele of the frontal sinus induces the visual impairment.
2) Such a case may be caused by orbital cellulitis or collateral inflammatory edema coming from subperiostal abscess formation in orbita, each of which is complicated with a pyocele of the frontal sinus.

View full abstract

A 52 year-old female presented bilateral hearing impairment with a sharply downsliding audiographic tracing from the 25-35 dB at 2000 Hz to 80 dB at 8000 Hz. She has a 13-year history of chronic fatigue, swelling of hands, legs and face, coarse skin, cardiac angina and sensory distubance. The patient's whole physical appearance was that of well established myxedema. The vestibular function was normal. She was treated with thyroid siccatum and got well with normal hearing with in 6 months.

View full abstract

The authors have found that the nasal discharge of the patient with chronic inflammation of the maxillar sinus decreased after contrast radiography with Moljodol, a contrast medium, was performed. Several patients were treated daily by antral irrigation with Moljodol. The nasal symptome was greatly improved after the treatment, The nasal discharge was decreased and it was also found that the thickness of antral mucous membrane was decreased after the treatment. Sterilizing effect of iodine in Moljodol and excitation of kinocilia of mucous membrane by Moljodol may operate on healing of sinuitis.

View full abstract

The 167 patients with laryngeal polyps (90 males and 77 females) were investigated clinically and histopathologically to elucidate its pathology and developmental process. They were classified into three groups: 125 cases with the vocal polyps, 29 cases with the vocal nodules, and 13 cases with the polypoid degeneration of the vocal cords. In this disease, male subjects were more frequent than those of females and most frequent ages were ranged from 30 to 40 years old. The vocal polyp was frequently observed of the anterior one-third portion of the membranous vocal cord. Main pathologic findings of the vocal polyps were observed the fibrous, edematous, and hemorrhagic changes. Through the all tissues, the most noticeable findings were the vasucular changes such as small vascular dilution, hemorrhage, edema, and thrombus which may suggest of degenerative changes of the menbranous vocal cords.
From this study, etiology of the laryngeal polyps may be mainly considered the vascular changes due to less blood supply in the vocal cords caused by the inf lammation but also by the vocal vibrations of excessive use of voices

View full abstract