Advances in automatic continuous positive airway pressure (auto CPAP) technology have made it possible to introduce CPAP in outpatient otolaryngology clinics. We examined the main clinical factors affecting the continuation of auto CPAP among 518 patients introduced to CPAP in our clinic. At 1 year post-initiation, 83.7% continued to use auto CPAP, and 60.0% continued to use it 10 years post-initiation. There were 137 cases of auto CPAP discontinuation, of which 81 cases (59.1%) were caused by CPAP mask-related complications. The most commonly reported complication (in 19 cases) was nasal congestion. Patients with severe nasal symptoms and swelling of inferior turbinates were offered nasal obstruction surgery. We compared rates of continued CPAP use between the 47 patients who underwent this procedure (Group B) and the 29 who did not and found that the patients who underwent nasal obstruction surgery (Group C) were significantly more likely to continue to use CPAP at 8 years post-initiation than those who did not. Strategies to manage nasal congestion, including nasal obstruction surgery, are critical for increasing and maintaining high rates of CPAP use over time.

We reviewed 38 cases of recurrent or metastatic squamous-cell carcinoma of the head and neck treated with Nivolumab in our hospital and reported the cases that developed adverse events associated with Nivolumab monotherapy. The clinical responses to Nivolumab were partial response in 9 cases, stable disease in 10 cases, and progressive disease in 12 cases. The response rate and clinical benefit were 27.3% and 57.6%. The 1-year overall survival rate and 1-year progression-free survival rate were 32.3% and 18.2%, respectively. The most common immune-related adverse events (irAEs) were liver dysfunction (n=2) and thyroid dysfunction (n=2). Other irAEs included hyperthyroidism, arthritis, and interstitial pneumonia (n=1, each). Careful follow-up is recommended in patients treated with Nivolumab monotherapy.

Nasal septal abscesses have been rare since the development of antibiotics. However, a delay in the diagnosis and treatment, such as with surgical drainage, may cause saddle nose deformity and intracranial complications. We herein report a case of nasal pain and obstruction with severe headache in a 49-year-old woman referred to our hospital due to trauma to the nose. A rhinoscopic examination revealed significant bilateral bulging of the nasal septum. We considered her severe headache to be an intracranial complication due to acute cellulitis of the nasal septum. However, a cerebrospinal fluid examination was negative for meningitis. Based on plain computed tomography findings, we suspected nasal septal abscess. Prompt drainage was necessary, but it was delayed to the day after the admission due to the patient's need to rest following the cerebrospinal fluid examination. She recovered gradually with antibiotic therapy and was discharged 17 days after the admission.

Alveolar soft part sarcoma is considered an extremely rare disease and its tissue origin remains unclear. We report a case of alveolar soft part sarcoma that developed in the nasal cavity. The patient was a 41-year-old man who initially presented to our hospital with right nasal bleeding. A tumor had arisen in the right nasal cavity. Tumor excision was performed under local anesthesia. The histopathological diagnosis was alveolar soft part sarcoma, due to the presence of alveolar structures composed of polygonal cells and PAS-positive diastase-resistant crystals. Additional excision of the surrounding tissues was performed under general anesthesia. There has been no evidence of local recurrence or distant metastasis in the 5 years since the operation.

In recent years, extremely high levels of PM2.5 dust and yellow sand have been observed during high-pollen-count seasons in northern Kyushu. Previous reports have noted that airway allergy symptoms can be exacerbated due to PM2.5 dust and yellow sand. For example, high levels of yellow sand increase the risk of hospitalization for asthma, and increased PM2.5 dust levels were shown to exacerbate symptoms of asthma, allergic rhinitis, and atopic dermatitis. How can we then survive this trifecta of cedar and cypress pollen, PM2.5 dust and yellow sand? First, avoiding exposure to pollen, PM2.5 dust and yellow sand absolutely reduces allergic symptoms. Therefore, it is important for patients to seek out information on PM2.5 dust and yellow sand levels themselves and avoid exposure to these agents. Furthermore, seeking proper medical treatment after taking preventive measures is crucial for combatting this trifecta. We herein report approaches to treating pollinosis with a focus on pharmacotherapy during seasons of high levels of PM2.5 dust and yellow sand.