Sixty-two patients with Japanese ceder pollinosis were examined regarding subjective and objective sympotoms following treatment. Immunotherapy was a fundamental therapy, but it takes a long time and the effect was imperfact. Prophylactic treatment with an anti-allergic agent and CO2 laser surgery were effective for the relie of subjective symptoms. CO2 laser surgery was effective particularly for nasal obstruction.

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In order to facilitate restoration of the bone structure during plastic surgery, we developed a fiber-type hydroxyapatite (HA). Material specifications are included. An histological study was performed to decide the viability of the application of HA-fibers as an implant. HA-fiber implants in the tibia of adult cats, ranging in duration from one week to twelve weeks, were carried out. In all cases there were no foreign body reactions nor inflammatory cell infiltrations after implantation of HA-fibers. Following the first week of implantation, fibroblasts increased and coexisted with osteoblasts in the bone marrow. Two weeks after implantation, the osteogeneus area was enlarged in both the cortex and marrow, The periosteum covered the surface of HA-fibers completely. HA-fibers were compacted by surrounding tissues. Four weeks after implantation, osteogenesis increased. Connection between HA-fibers and bone tissue were bound tightly by collagen fibers. Eight weeks following implantation, pathological findings were almost identical to those of four weeks. Twelve weeks after implantation, the presence of osteoblasts decreased throughout. In the marrow, normal bone tissues were observed. We conclude from our investigation that HA-fibers have an advantage in tissue tolerance and in osteogenic activity.

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Four cases of chronic severe sensorineural hearing loss of unknown etiology, which showed significant improvements of hearing after steroid therapy, were reported. Some cases of chronic sensorineural hearing loss of unknown etiology seem to be improved by steroid use. It is impossible to predict the effect of steroids on the hearing of each patient with chronic sensorineural hearing loss. Steroid therapy should be tried once in all patients with sensorineural hearing loss of unknown etiology.

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We treated a 47-year-old man with initial symptoms of swelling and dermal induration of the left lateral neck. 67Ga scintigram revealed a high uptake into the neck lesion, and malignant lymphoma was highly suspected. At biopsy, however, atypical lymphoid cells indicating malignant lymphoma were not found but infiltration of eosinophiles was evident. A hard, fibrotic mass including the sternocleidmastoid muscle was removed and histological examination revealed eosinophilic fasciitis. To our knowledge, eosinophilic fasciitis of the neck has not been reported. Previous literature on this disease was reviewed.

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Two hundred and twenty-four patients with previously untreated squamous cell carcinoma of the maxillary sinus were treated during the period from 1962 through 1980 in the National Cancer Center Hospital. Five-year absolute survival rates of the patients treated with radiation and surgery only (RS group) and with radiation, surgery, and arterial chemotherapy (RSA group) were 44% and 43%, respectively. No difference was found between these two patient groups concerning survival rate. With the introduction of arterial chemotherapy, the end result was not improved. However, arterial chemotherapy did contribute to a better quality of life following treatment. Among 49 RSA group patients who survived 5 years or more, 35 (74%) did not require total maxillectomy. On the contrary, only 26 (52%) out of 50 RS group patients did not require total maxillectomy. In 72 (57%) out of 127 patients who were deadwithin 5 years after the initial treatment. residual or recurrent carcinoma was recognized at the primary site at the time of death.

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We reported a case of a 69-year-old male with Stevens-Johnson Syndrome result from an anticancer drug administered as a treatment for lingual cancer. He was given chemotherapy with Tegaful. From the 4th day following chemotherapy, he complained of general malaise and fever accompanied by eczema, and erosion and ulcer formation in muco-cutancous regions, especially of the face, oral cavity and genitalia. These symptoms led to a diagnosis of Stevens-Johnson syndrome. Despite the severeside effects of the drug, the tongue cancer responded extremely well to it, showing a marked decreasein volume (93%). The patient was discharged after having a combined therapy of radiation and LASER hyperthermia.

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Olfactory mucosa in two patients with olfactory disturbances following head trauma were examined by immunohistochemistry. In two cases, neuron-specific enolase (NSE) immunoreactivity was not found in the olfactory epithelium. Glia-specific S-100 protein(S-100) reactivity was seen in asmall number of disorganized Bowman's glands and nerve bundles in the lamina propria. Cytokeratin (CK) immunoreactivity was found in the basal cells which occupied the lower half of the epithelium. In these cases, functional olfactory receptor cells disappeared and epithelium degenerated. These results indicate that the prognosis of post-traumatic anosmia is poor and that regeneration of receptor cells does not occur in humans. Olfactory mucosal biopsy and its immunohistochemical examination are useful to detect the olfactory function objectively and to justify the prognosis.

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In 1977, a 45-year-old male developed rotatory vertigo with tinnitus and hearing loss in his left ear. With these symptoms he consulted us at our hospital, where he was found to have nystagmus and body deviation of labyrinthine origin. Audiometric examination revealed a slight sensorineural hearing loss of peaked configuration in both ears, slightly more severe on the left. Under the tentative diagnosis of Meniere's disease, the patient was admitted to the hospital and received treatment of oral steroids and bedrest, with resolation of symptom. The caloric test revealed a left CP of 9%. X-ray revealed as unremarkable internal auditory meatus. There was no cranial nerve involvement other than the eighth cranial nerve and no noticeable cerebellar symptoms. The patient experienced a similar attack in 1979, which improved following hospitalization. However, audiometry showed an increase of hearing loss in the left ear (threshold value increased to 80 dB from 55 and 20 dB previously). A caloric test revealed a left CP of 27%. X-Ray examination revealed no abnormalities in the internal auditory meatus, nor did it yield any findings suggestive of central nervous system involvement. In 1987, the patient experienced a third attack. At that time, he suffered severe impairment of hearing in his left ear, with the residual hearing being preserved in the low frequency range. The caloric test demonstrated a left CP of 17% and left DP of 9%. On suspicion of an acoustic tumor, a brain CT was administered, which confirmed enlargement of the left internal auditory meatus. The patient was referred to the Department of Neurosurgery, where he was found to have a tumor of approximately 1.0 cm in diameter at the cerebellopontine angle on MRI. The tumor was removed by left retromastoideal suboccipatal craniectomy and identified histopathologically as neurilem- ma. He was able to return work. This case of acoustic tumor was considered to be of interest and worthy of particular mention because of its unusual clinical features. In this case, which demonstrated repeated episodes of Meniere-like manifestations, MRI permitted us to delineate the location and extent of a tumor which had attained a disproportionately small size (only 1.0 cm in diameter) in the 10 year interval since onset of symptoms.

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A case of metastatic hepatocellular carcinoma of the temporal bone presenting as sudden deafness is reported. The patient, a 57-year-oldm an was treated for suddend eafness in his neighboringh ospital. Approximatelyt wo days prior to his admission, h e noticedv ertigo and suddend eafnessa nd tinnitusi n his right ear. His impairedh earing did not recovera t all. Duringh is hospitalizationh, e also noticedh oarseness and slightd ysphagia. I ndirectl aryngoscopyre vealedr ecurrentn ervep aralysiso n the right side. Onem onth later, a tumorous mass was found in the bony portion of the right external auditory canal adjacent to the tympanic membrane. No widening of the internal auditory canal was observed by X-ray examination. However, CT and MRI revealed a large mass destroying the base and posterior surface of the right petrous bone. The patient has obtained relief by radiation to the metastatized tumor and systemic chemotherapy.

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The authors treated 10 patients with pigmented nevi in the external auditory canalover a 10 year period at the Department of Otolaryngology, Ebetsu Municipal General Hospital and at the Department of Otolaryngology, Sapporo Medical College. Pigmented nevus of all cases were removed through extensive surgery. Histological examination showed intradermal nevi in 7 cases and compound nevi in 3 cases. No patients experienced postoperative stenosis of the external auditory canal after surgery.

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Department of Otolaryngology, Sapporo Medical College, Sapporo 060, Japan Hemangiomas of the nasal bones are uncommon, relatively small, usually 20 mm or less, and demon- strate characteristic radiologic findings. The lateral view shows a “sunburst” or “soap bubble” appearance. A 44-year-old female noticed a painless mass on the right root of her nose before visiting our hospital. X -ray examination disclosed a “soap bubble” appearance on her nasal bone. Surgical excision and recon- struction with a bone graft was performed. Histopathological examination revealed a cavernous heman- gioma. At her 8-month postoperative evaluation, the patient was still asymptomatic.

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Since paranasal sinuses are anatomically adjacent to the orbit, various sinusal diseases are apt to cause ophthalmic symptoms. We treated three cases of orbital cellulitis with severe impairment of visual acuity due to pyocele of the frontal sinus. In these three cases, we obtained a diagnosis of orbital abscess and cellulitis on the basis of CT scanning and clinical findings, including orbital pain, proptosis, immobility of the eye, and chemosis. These CT-imagings were confirmed at surgery. After complete frontal sinusectomy, we gave the patients large-dose i. v. injections of broad spectrum antibiotics supplemented by corticoster- oids, vasodilators and Vitamins B6 and B12. As a result, in two cases, visual acuity improved after surgery from 0.03 to 0.5 and from 0.01 to 0.4, respectively. However, in the third case, which involved complete loss of visual acuity, no postoperative improvement was achieved.

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A case of squamous cell carcinoma of the nasal septum is reported. The patient, a sixty-seven-year-old male, presented with complaint of bloody nasal discharge. Physical examination revealed a perforation of the cartilaginous portion of the nasal septum. He was treated by tumor extirpation with lateral rhinotomy, pre-and postoperative irradiation, chemotherapy and immunotherapy. No recurrence nor distant metastasis were observed for three years after the operation. This case suggests that a patient with nasal septum carcinoma should be treated by en bloc operation with wide surgical excision and irradiation to the primary region.

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A clinical study was made using Cefteram pivoxil (CFTM-PI), a new oral cephem antibiotic, for acute lacunar tonsillitis. The results were: 1. Out of 49 cases of acute lacunar tonsillitis, clinical efficacy was rated as excellent in 9 cases, good in 38 cases, and fair in 2 cases. The efficacy rate was 95.9%. 2. All 40 strains of bacteria responded to antibiotic therapy, with an erradication rate of 100%. 3. The side effect of diarrhea was observed in one case. We conclude that CFTM-PI provides an excellent result for acute lacunar tonsillitis.

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This paper describes the results of 74 nasal allergy patients with nasal obstruction who were treated with Celtect. A high rate of improvement (84%) was observed during the final four weeks of administration. The rate of improvement of nasal obstruction was 84%. Severe cases showed progressive improvement. The rates of improvement of sneezing, nasal secretion, dysosmia, and disturbance of daily activities were 65%, 66%, 67%, and 70%, respectively. Adverse effects, mainly drowsiness, were observed in nine patients (9%). Drug administration was not discontinued for any patient.

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DKB was used in the treatment of 19 patients with paranasal sinusitis. Eight of these patients were diagnosed with acute sinusitis and 11 with chronic sinusitis. Results were: 1. An improvement of 57.9% as judged by doctors in charge. 2. An improvement of 73.7% by standardized criteria. 3. An improvement of 43.8% in X-ray findings. 4. An eradication of 78.6% including replacement of isolated organisms. 5. No side effects were observed. From the above results it is concluded that DKB is a highly effective antibiotic in the treatment of paranasal sinusitis.

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The efficacy, safety, and usefulness of Cefuzonam (CZON) was objectively evaluated as a treatment of suppurative otitis media (acute infections and acute exacerbation of chronic infections), using Cefotiam (CTM) as a comparison drug. The dosages used were 1g, IV, bid for 7 days, as a rule. Results were: 1. A clinical efficacy rate was 68.7% (68/99) for CZON and 62.4% (58/93) for CTM as judged by the physicians in charge. The rate was 66.7% (66/99) for CZON and 63.4% (59/93) for CTM when assessed by committee. Neither of these reflects a significant difference between the two groups. When assessed by disease type, the efficacy rate for the CTM group was higher in acute otitis media and that for the CZON group was higher in chronic otitis media, but there was no significant difference. 2. No significant difference in subjective and objective findings was observed on days 3 or 7.3. Bacteriological effect was not significantly different. In total cases, bacterial eradication (excluding bacterial replacement) was noted in 64.0% (55/86) of the CZON group and 58.8% (47/80) of the CTM group. CZON was noted to be significantly superior to CTM in the MIC against S. aureus and all strains isolated prior to drug administration. 4. There was nosignificant difference between the groups in overall safety. Side effects were noted in one patient from each group. Abnormal laboratory values were noted in 4 cases (6.2%) of the CZON group and 2 cases (3.6%) of the CTM group. The difference is not significant. 5. The rate of usefulness was 65.7% (65/99) for the CZON group and 64.5% (60/93) for the CTM group, with no significant difference between the groups. From these results, we conclude that CZON is highly useful for the treatment of suppurative otitis media.

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[in Japanese]

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