We report two cases of peripheral facial palsy following tooth extraction. The first case developed a palsy immediately after the extraction, while the second case developed it one day after the extraction. They were cured with conservative medical treatment. These unusual cases suggest the need for dentists and otolaryngologists to be aware of the occurrence of peripheral facial palsy due to a dental procedure.

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Sixty-nine patients with squamous cell carcinoma of the hypopharynx treated at the department of Otorhinolaryngology, University of Ryukyu Faculty of Medicine from 1977 to 1987 were reviewed. The following results were obtained.
1. Of the 69 patients, 66 were male and 3 were female. The primary lesion was located in the pyriform sinus in 55 patients, on the posterior wall in 11 patients, and on the postcricoid in 3 patients.
2. Thirty-one patients were treated with a combination of radiation and chemotherapy. Of 18 patients who were operated, 8 were given radiation, 2 were given chemotherapy, 2 were given radiation and chemotherapy, and 6 underwent surgery only. Eighteen cases were treated with radiation alone, and 2 cases were treated with chemotherapy alone.
3. Metastasis was observed in 11 of those 69 patients (lung 6, bone 2, skin 1, others 2).
4. Other primary carcinoma had occurred in 7 cases (esophagus 4, stomach 2, lung 1).
5. The five-year survival rate according to TNM classification (UICC 1978) was 44% in srages I+II (N=16), 25% in stage III(N=17) and 16% in stage IV (N=31).

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A case of a tooth erupting into the maxillary sinus is reported. A 14-year-old girl complained of right nasal obstruction and purulent discharge. X-ray examination revealed a tooth-like structure in the right maxillary sinus. The Caldwell-Luc operation was done and the tooth was removed. The tooth was situated in the superior wall of the maxillary sinus. No cyst formation was observed. Because of the increased danger in younger persons of orbital penetration, an erupted tooth situated in the superior wall of the maxillary sinus should be removed surgically whether or not there is infection in the maxillary sinus.

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Over a period of 15 years, the authors treated 10 cases of pyogenic granuloma occurring on the head and neck. The following results were obtained.
(1) The patients, predominantly female, ranged in age from 10 to 81 years.
(2) Such granulomas occurred most frequently on the center line of the oral cavity, followed by a high incidence on the anterior parts of the nasal cavity, and occurring least commonly on the oropharynx and larynx.
(3) Patients complained most frequently of bleeding or tumor. Because all patients were concerned about possible malignancy, it was important to distinguish between benign granulomatous tumors and malignanicies.
(4) Patients reported trauma, pregnancy, or surgical operation preceding the appearance of such granulomas.
(5) Such granulomas are extirpated most successfully by the employment of slide-swing plasty, dermoplasty or laser surgery.

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We treated 5 cases of abnormal dental erution in the nasal cavity. Two cases involved patients aged 56 and 28 years and the other 3 cases, including a rare case of bilateral eruption, involved children up to 10 years of age. One case involved a normal tooth; the others involved abnormal eruptions of supernumerary teeth. Although simple X-ray, panoral roentgenography or CT scan are all used for diagnosis, panoral roentgenography is most useful to distinguish the relationship of the surrounding normal teeth. All such abnomally placed teeth were extracted from the nostrils under local or general anesthesia.

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In this study we observed the differentiation processes of mucosal epithelia of the larynx and the trachea in guinea pigs at fetal, newborn, and matured stages. The following results were obtained. In the epithelia of the vocal cord and the supraglottic region, ciliated cells are grown densely and evenly at the fetal stage. In newborn guinea pigs, such ciliated cells appeared in decreased numbers and in mature animals they disappeared entirely. It appears that such cells, at the newborn stage, are in the process of receding, since they are characterized bey irregular arrangements and short lengths. At the fetal and newborn stages, ciliated cells were distributed evenly at the epithelia just below the vocal cord and extending to the trachea. In mature guinea pigs, such cells grew densely. When compared with the differentiation processes of mucosal epithelia of the larynx and the trachea in humans, differentiation of the squamous epithelia of the vocal cord and the supraglottic region, and the goblet cells of the subglottic region and trachea were found to be more retarded in guinea pigs than in humans.

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Although tonsillar concretions may be frequently seen in clinical practice, the presence of clinically significant tonsilloliths is relatively unusual. Two cases of tonsilloliths complaining of fullness in the throat are reported. Case 1: A 63-year-old female patient underwent local excision of the tonsillolith alone under general anesthesia. The weight of the stone was 3.1g. chemical analysis of the stone using the infrared ray absorbance spectrum method yielded a composition of 83% calcium phosphate, 6% calcium carbonate, 9% protein and trace amounts of magnesium carbonate. Case 2: A 28-year-old female patient had a history of recurrent tonsillitis, but after expressing the concretion, experienced no further episodes of tonsillitis. The etiology of tonsillolith is discussed, and a brief review of the literature is presented.

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A case of an abnormally large air cell in concha nasalis is reported. This rare case was characterized by the expansion of the left air cell in concha nasalis, which was found to contain air only. In a 47-year-old woman with intermittent left nasal obstruction and pain in the left root of the nose caused by focal expansion of the left air cell in concha nasalis, pneumocele was suspected. The clinical findings and the possible etiologies of this condition are discussed, distinguishing the principal differences between pneumocele and pneumosinus dilatans.

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Laboratory and clinical studies were carried out to evaluate the effectiveness and safety of panipenem/ betamipron (PAPM/BP) in the treatment of infections in otorhinolaryngology. The following results were obtained:
1. MIC₈₀, values of PAPM against isolates from patients with infection in otorhinolaryngology were found to be 50.025mcg/ml against S. aureus, S. pyogenes, S. pneumoniae and B. catarrhalis, 0.39mcg/ml against CNS and H. influenzae and 6.25mcg/ml against P. aeruginosa.
2. Penetration of PAPM into various tissues after the intravenous drip infusion of PAPM/BP at doses of 500mg/500mg, was detected on average by 0.93mcg/g in the mucosae of middle ears of 4 patients at 60 minutes after onset of treatment, by 4.23mcg/g in the mucosae of maxillary sinuses of 9 patients at 48-95 minutes after onset of treatment, and by 2.02mcg/g in the tonsillar tissues of 8 patients at 35-94 minutes after onset of treatment.
3. Clinical efficacy rates evaluated by physicians in charge were 76.9% for otitis media, 75.0% for sinusitis, 98.6% for tonsillitis, 100% for peritonsillitis and 94.1% for peritonsillar abscess, showing an overall efficacy rate of 89.7%. The results of the unified evaluation were comparable, disclosing and overall efficacy rate of 84.1%.
4. Bacteriological efficacy evaluations demonstrated eradication rates of 95.2% for monobacterial infection with Gram-positive organisms, 81.6% for monobacterial infection with Gram-negative organisms and 86.1% for polybacterial infection, showing an overall eradication rate as high as 91.5%.
5. Side effects occurred in 6 of 243 patients (2.5%), including 3 cases of diarrhea, 1 case of vomiting, 1 case of back pain and 1 case of diarrhea and rash. Abnormal laboratory findings including impaired liver and renal function were observed in 23 of 165 patients (13.9%) eligible for the evaluation. From these results, PAPM/BP was shown to be highly useful for the treatment of various infections in otorhinolaryngology, such as otitis media, sinusitis and tonsillitis (including peritonsillitis and peritonsillar abscess).

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