Autologous fascia has recently been clinically used for vocal fold augmentaion, however, a fundamental evaluation of this method has not yet been sufficiently performed. Therefore, a histological, immunohistochemical and electron microscopic examination of autologous fascia injected into the canine vocal fold was thus performed in this study. Ten adult dogs were used for this study. Autologous fascia lata was minced and injected into each canine vocal fold. The follow -up ranged from 2 weeks to 6 months after the injections. The fascia was macroscopically found to remain in each vocal fold during the follow-up period. A histological study revealed a remarkable proliferation in the number of fibroblasts in the injected fascia block up until 1 month after the injection, however, the number of fibroblasts began to decrease from 3 months after the injection. In addition, few inflammatory reactions were observed and no capsulization of the fascia block was seen at any time. The fascia lata consists of mostly collagen type I tissue, however, some collagen type Ill tissue was also widely found in the fascia block after the injection. An electron microscopic study revealed that the nucleus of the fibroblast was in a euchromatin state which thus indicated the active synthesis of the protein at 1 month after the injection, while the fibroblast were in a heterochromatin state at 3 months after injection, which was the same state as before the injection. An immunohistochemical study revealed that TGF-β and b-FGF appeared in almost fibroblasts of fascia block 2 weeks after injection, while TGF-β and b-FGF appeared in only a few fibroblasts and endothelial cells of the fascia block 3 months after injection. The tissue reaction of injected autologous fascia is thus considered to almost completely disappear after the injection and the fascia remains in the vocal cord without having any substantial influence on the surrounding tissue thereafter. The findings suggest that the autologous fascia appears to be a suitable injectable material for vocal fold augmentation.

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The efficacy of a combination of shouseiryutou and eppikajyututou in the treatment of acute secretory otitis media in adults was assessed in a controlled, randomized trial of 46 ears of 34 patients. Shouseiryutou and eppikajyututou were prescribed for 28 ears of 20 patients (kampou group), s-carboxymethylcysteine and clarithromycin for 18 ears of 14 patients (control group). The tympanogram findings showed either an A type or improvement while the effusion in the tympanic cavities disappeared within 7 days in 21 of 28 ears (75.0%) in the kampou group and in 7 of 18 ears (38.9%) in the control group. The efficacy rate in the kampou group was significantly higher than that in the control group (p=0.02). The ear symptoms began to decrease significantly earlier in the kampou group than in the control group (p=0.005). These results indicated that the combination therapy of shouseiryutou and eppikajyututou quickly and effectively improved the symptoms of acute secretory otitis media in adults.

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Fas ligands were immunohistochemically observed in head and neck squamous cell carcinomas (27 cases). Eight of the 27 cases exhibited positive staining of Fas ligands in a part of the regional carcinomas. The expression of Fas ligands showed no relationship with either the postoperative TNM levels or the grade of histopathological differentiation.
In addition. no significant relationship was found between the expression of Fas ligands and the efficiency of radiotherapy on palatine tonsil carcinomas. In addition to the carcinoma regions, some cases also showed positive staining for Fas ligands in the surrounding stroma or normal epithelial cells. These results indicated that the apoptosis induced Fas ligands in cancer cells suppressed any cancerous development due to apoptosis. In contrast, both the invasion and metastasis of cancer were promoted by the apoptosis induced Fas ligands in the surrounding stroma and normal epithelial cells.

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A 63-year-old man with maxillary cancer which presented as a maxillary mucocele is herein reported. The CT and MRI findings showed a cystic lesion in the right maxillary sinus. Endoscopic sinus surgery was performed and a pathological evaluation revealed the existence of poorly differentiated squamous cell carcinoma in the right maxillary sinus. The literature related to cystic cancer in the paranasal sinuses was also briefly reviewed.

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Regarding dermatosis and chronic inflammation, the relationship between the tonsils and palmoplantar pustulosis is well known. We herein report the case of a radicular cyst in a 42-year-old male with skin lesions over his entire body. The chief complaints were hard palate swelling and general exanthema. The cyst was a lesion of hard palate which was shown to arise from the maxillary lateral incisor in the X-ray findings. The skin lesion disappeared within 6 months after the cyst was removed and the tooth was extracted. The cyst was diagnosed to be a dental radicular cyst based on a pathological inspection. Radicular cysts tend to arise in the maxillary lateral incisor division, which thus causes palate swelling. A skin lesion may occur due to an autoimmunity mechanism, if the antibody for the keratin of a the skin is produced in part of the chronic granulation tissue of the cyst wall. The possibility of dental focal infection should also be considered in such cases when a skin lesion of unknown origin is recoginized.

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Two cases of rare rhinoliths are reported. Case 1: A 54-year-old female presented with the chief complaint of a right nasal obstruction. Rhinoscopic examinations showed a dark-brown mass in her right nasal cavity. A biopsy was performed and the histopathological findings revealed actinomycosis. Her symptoms completely disappeared after the rhinoith was removed by means of intranasal procedure. Case 2: A 27-year-old female presented with a left nasal obstruction. Rhinoscopic examinations showed a white mass in her left nasal cavity. The mass was suspected to be a rhinolith, and was removed using intranasal procedures. The histopathological findings revealed that the mass contained both tooth and necrotic tissue with calcification. All symptoms quickly disappeared after the removal of the mass.

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A 52-year-old man with mycosis in the bilateral sinuses is herein reported. The patient presented with the chief complaint of bloody postnasal drip. The CT and MRI findings suggested the existence of a fungal infection in the bilateral maxillary sinus. Endoscopic sinus surgery was performed, and the caseous materials that were found during the operation were all successfully removed. The postoperative course was uneventful. The literature on paranasal sinus mycosis was also briefly reviewed.

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Due to the growing popularity of endoscopic operations, the opportunities for otolaryngologists to perform dacryorhinostomies are increasing. Both opthalmologists and otolaryngologists jointly performed a dacryorhinostomy for the treatment of a lacrimal passage obstruction in 7 cases on 8 sides. The operation used an endoscope and a light guide for the crystallite body operation. The results were good, although the operation had to be performed 3 times in 1 case on 1 side. Such endoscopic operations are now safe, effective and easy to perform. This surgical procedure is also especially useful for confirming the fenestration position using the light guide which can illuminate an area ranging from the lacrimal sac to the nasal cavity.

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