Serum squamous cell carcinoma (SCC) antigen is reportedly a diagnostic marker of sinonasal inverted papilloma (IP). We investigated 18 cases of IP and clarified the relationship between serum SCC antigen levels and sinonasal IP. The subjects were 18 patients with IP diagnosed by surgery at our hospital between January 2017 and September 2021. The serum SCC antigen level was measured in all subjects preoperatively and was also measured postoperatively in 13 subjects. At baseline, 13 patients were male, and 5 were female, and their ages ranged from 27 to 87 years old, with a mean of 60.2 years old. According to Krouse staging, 4 cases were T1, 4 cases were T2, 10 cases were T3, and 0 cases were T4. Preoperative serum SCC antigen levels were above the reference value in 14 cases. There was a positive correlation between the maximum tumor diameter and the serum SCC antigen level. There was no significant correlation between Krouse staging and the serum SCC antigen level. The serum SCC antigen level was significantly decreased after surgery. Given these findings, the serum SCC antigen level seems useful as a diagnostic marker of sinonasal IP.

We investigated the survival rate and prognostic factors associated with the condition three months after percutaneous endoscopic gastrostomy (PEG). The subjects were 123 patients who had undergone PEG between January 2015 and December 2020. The survival rate was 85% at 3 months after PEG. Poor prognostic factors included a high C-reactive protein (CRP), a low serum albumin level, and a low controlling nutritional status (CONUT) score. The incidence of oral intake of deglutition food at least once a day was 9% at 3 months after PEG. The Hyodo score was significantly lower in the patients who could tolerate deglutition food. The swallowing function as evaluated using the Hyodo score during PEG predicted the possibility of an oral intake of deglutition food at three months after PEG.

Of the 338 patients who visited our department due to a suspected foreign body, a foreign body was actually identified in 201 cases (59.4%). Foreign bodies commonly occur in children and the elderly. The proportion of foreign body parts and types was closely similar to those observed at other facilities. It is necessary to inform patients about foreign objects that are prone to inducing complications, such as partial dentures. To minimize the secondary damage caused by removing foreign bodies, it is best to refer such patients to a general hospital, where imaging tests and hospitalization are possible if it proves difficult to observe the entire foreign body at the initial visit.

Mycoplasma infections can present with a wide variety of systemic symptoms that may be accompanied by preceding symptoms, such as a fever. We herein report a case of bilateral mixed hearing loss and bilateral facial paralysis secondary to mycoplasma pharyngitis and otitis media. A 14-year-old girl visited our department (day 1) with a chief complaint of a fever and bilateral earache for the past several days. Bilateral otitis externa, bilateral otitis media, and nasopharyngitis were observed. The patient was started on CTRX on the same day, and prednisolone was tapered due to the appearance of left facial nerve palsy on day 2. Pure-tone audiometry showed moderate bilateral mixed hearing loss. On day 6, the patient was found to be positive for mycoplasma complement binding reaction and was switched to AZM. On day 16, right facial nerve palsy was observed, and steroid treatment was given again. The bilateral osteogenesis thresholds and right facial nerve palsy improved, but left facial nerve palsy showed no improvement, so left facial nerve decompression was performed on day 65. In cases of facial nerve palsy with preceding symptoms and acute sensorineural hearing loss, mycoplasma infection should be considered as a differential diagnosis.

Skull base osteomyelitis (SBO) with cranial nerve paralyses can be a fatal disease and is seen most commonly in elderly diabetic patients. Typical SBO results from malignant external otitis. Atypical SBO results from otitis media or sinusitis. We herein report a case of SBO with multiple cranial nerve paralyses that developed after acute otitis media. A 68-year-old man with diabetes mellitus presented with hoarseness, dysphagia and severe headache showing poor lifting of the right soft palate, right laryngeal paralysis and right abducens nerve paralysis. A nasopharyngeal tumor or SBO was suspected based on computed tomography and magnetic resonance imaging findings. He underwent a biopsy from the clivus bone via transnasal endoscopic surgery using a navigation system and was diagnosed with SBO. He was treated with antibiotics for six months and antifungals for one year. The soft palate paralysis and abducens nerve paralysis improved, and although laryngeal paralysis remained, his swallowing function improved. The SBO in this patient was suggested to have developed from latent mastoiditis after treatment for acute otitis media. An early diagnosis and long antibiotic therapy are deemed necessary to improve the outcome of SBO.

Spindle cell carcinoma (SPCC) is a variant of squamous cell carcinoma, a malignant tumor with a mixed squamous cell carcinoma component and a malignant spindle cell component. It is quite rare, accounting for 1%-3% of squamous cell carcinomas of the head and neck. In the head and neck region, SPCC is relatively common in the larynx and oral cavity, but since only squamous cell components can be seen on the surface, a biopsy is often not sufficient to make a definitive diagnosis. Surgery is the first choice of treatment, and the efficacy of chemotherapy and radiotherapy has not been confirmed. We herein report our experience with a case of hypopharyngeal SPCC that was not definitively diagnosed preoperatively but was confirmed by a pathological diagnosis after pharyngolaryngo-esophagectomy. We describe this case of hypopharyngeal SPCC and eight other cases of head and neck SPCC experienced in our department.

Subcutaneous emphysema and pneumomediastinitis are rarely reported as complications of tonsillectomy. A 43-year-old woman with a history of sterno-costo-clavicular hyperostosis and palmoplantar pustulosis underwent bi-lateral tonsillectomy. Subsequently, the patient blew her nose many times because of nasal discharge, and then complained of difficulty breathing. Computed tomography revealed subcutaneous emphysema and pneumomediastinitis. After we advised her to stop blowing her nose, the symptoms improved, so we suspect that it had indeed been caused by the nose-blowing.

We herein report a case of right vagus nerve palsy due to Ramsay Hunt syndrome with dysphagia. Pharyngeal residue and the Penetration-Aspiration scale score were compared before and after type I thyroplasty. We compared the pharyngeal residue among the normal, head-rotation, and “resting the chin in the hand” (RCH) positions after type I surgery and found that the RCH position was associated with the lowest amount of pharyngeal residue. In addition, there was no aspiration in the RCH position, and oral intake was achieved. The side of hypopharyngeal transit in the normal position changed from affected-side dominance to healthy-side dominance. In addition to vocal cord paralysis, right pharyngeal muscle palsy and right soft palate palsy were observed, which might have limited the effect of type I thyroplasty. If guiding a food mass to the healthy side seems difficult in the head-rotation position, the RCH position should be attempted. Furthermore, continued use of the RCH position may improve swallowing in the normal position.

We herein report a case of systemic amyloidosis with a sporadic mass lesion in the larynx. An 85-year-old man complained of dysphagia and discomfort in the larynx. He was hospitalized for an examination, and computed tomography revealed a laryngeal mass. He was transferred to our hospital, but we found only a lesion in the epiglottis. We biopsied the lesion under general anesthesia, and the pathological diagnosis was amyloidosis. Increases in plasma cell counts and abnormalities among the surface antigens of plasma cells were observed in the bone marrow, indicating systemic amyloidosis. Given these findings, he was diagnosed with systemic amyloidosis derived from plasma cell disease. Amyloid neuropathy or amyloid myopathy may cause dysphagia. Dental equipment and rehabilitation improved his swallowing function, and he regained his ability to eat.

A 16-year-old boy with a severe mental developmental disorder due to Allan-Herndon-Dudley syndrome (MCT8-specific thyroid hormone cell-membrane transporter deficiency) had undergone total laryngectomy for recurrent aspiration pneumonia at 10 years old. A cannula-free state was achieved after surgery, and the frequency of respiratory infections decreased significantly. However, the shape of the trachea gradually deformed as his scoliosis progressed, causing upper airway stenosis. Therefore, from 15 years old, a straight silicone cannula had been inserted into the trachea to prevent upper airway obstruction. At 16 years old, bleeding was noted from a permanent tracheostomy at home, resulting in a diagnosis of tracheo-innominate artery fistula. A temporary hemostatic effect was achieved by placing a stent graft in the innominate artery, but rebleeding was noted about a month later. Therefore, after achieving temporary hemostasis by repositioning the stent graft, innominate artery transection as a radical treatment was performed, with a good prognosis noted for one year and three months thus far, without recurrence. Tracheo-innominate artery fistula is a highly lethal disease, and at present, tracheo-innominate artery transection is the mainstream curative treatment. The long-term prognosis of endovascular treatment, such as stent graft placement as another treatment option, remains unclear, but it is expected to help improve the survival rate of tracheo-innominate artery fistula as an emergency hemostatic method until radical treatment is performed.