While chronic sinusitis is the most frequent cause of postnasal drip (PND), there are patients with clear PND who do not have sinusitis. Although several studies have reported the effectiveness of Shin'iseihaito for PND in patients with chronic sinusitis, no reports on clear PND have been published to date. This exploratory study investigated the effectiveness of Shin'iseihaito in the treatment of subjective symptoms in 63 patients with clear PND. Treatment resulted in marked improvement in 60% of patients, mild improvement in 13%, and no improvement in 27%. In comparisons between responders (patients with marked improvement) and non-responders (patients with mild or no improvement) revealed no significant differences in age, sex, or pre-treatment period of subjective symptoms. In contrast, a near-significant difference was observed in the oral medication period (7.2 versus 3.9 weeks, p=0.05). When scores of 2, 1, and 0 were given for marked improvement, mild improvement, and no improvement, respectively, patients who had been taking Shin'iseihaito for 6 weeks or longer showed better improvement of subjective symptoms than those who had been taking it for less than 6 weeks (p=0.03). Although this was an exploratory study, the results suggested the effectiveness of Shin'iseihaito in the treatment of clear PND in patients without sinusitis.

The swallowing function is greatly affected by the degree of progression and extent of resection of oral cancer, while dysphagia affects the quality of life of patients. Eighty-five patients who underwent surgery for oral cancer at the Department of Otorhinolaryngology, Fukuoka University Hospital from March 2017 to August 2022 were retrospectively reviewed and reported. The comparison of data obtained preoperatively and on postoperative day 30 revealed a significant increase in the number of patients with dysphagia, significantly prolonged LEDT, and significantly decreased laryngeal elevation distance. The stage was Stage IV, T classification was T3 or higher, and the dysphagia group was significantly higher in the floor of the oral cavity. The number of patients with dysphagia was significantly increased among patients who received mandibulectomy, and patients who underwent resection of more than half of the movable part of the tongue, tracheostomy, reconstructive surgery, or cervical dissection. The duration of tube feeding exceeded 120 days in 3 patients. All other patients completed tube feeding within 60 days. Early removal and replacement are important because the risk of aspiration increases as the duration of tube feeding increases, and gastrostomy should be considered early for patients who are expected to require tube feeding for a prolonged period.

Although there are many reports on the usefulness of intracordal trafermin injections, there are few reports on its safety. In particular, the long-term safety after injection is unknown; therefore, we conducted a retrospective study of our medical records. There were 45 cases (27 males and 18 females), ranging in age from 11 to 88 years old, with a mean age of 53.5 years old. The cases included 21 cases of vocal fold paralysis, 16 cases of atrophy, 5 cases of sulcus, 2 cases of scar, and 1 case of hypoplasia. The average follow-up period and standard deviation of follow-up was 279.1 ± 205.3 (range: 0-693) days, and the average number and standard deviation of vocal fold examinations from post-injection to May 31, 2024, was 8.0 ± 5.1 (range: 0-20). Except for 2 patients who did not have any outpatient visits after the injection, 43 patients had no complications in the vocal folds during the follow-up period. The safety of this simple and highly effective intracordal trafermin injection may lead to future regulatory approval.

This retrospective study included 182 patients who underwent surgery for thyroid disease between September 2016 and March 2022 at our hospital. The age, sex, histology (benign disease, malignant tumor, Basedow's disease), surgical procedure (hemithyroidectomy, total thyroidectomy, neck dissection), and postoperative complications (postoperative bleeding, hypoparathyroidism, vocal cord paralysis, lymphorrhea) were evaluated. Among the 182 patients, the incidence of postoperative complications was 3.3% for postoperative bleeding, 19.8% for hypoparathyroidism (including transient), 8.2% for vocal cord paralysis, and 1.6% for lymphorrhea. In particular, postoperative bleeding was observed in malignant tumors and Basedow's disease and was more frequent in total thyroidectomy cases than benign disease. Hypoparathyroidism was more frequent in patients with Basedow's disease than benign disease and malignant tumors, and it was also more frequent in patients who underwent total thyroidectomy than in those who underwent hemithyroidectomy and neck dissection . This is considered to be the result of total thyroidectomy in all cases of Basedow's disease. In addition, although the risk of vocal cord paralysis is high in malignant tumors and Basedow's disease, all cases of benign disease improve within 6 months, and 70% of malignant tumors improved within 1 year. Cases of lymphatic dissection near the thoracic duct are considered to be at a high risk of lymphorrhea. A sufficient preoperative explanation and careful surgical procedures are required, especially in cases in which preoperative malignancy is suspected.

A nasal septal abscess is a rare disease that causes nonspecific symptoms, such as nasal obstruction and fever. A delayed diagnosis leads to serious complications, including external nose deformities, such as saddle nose, intracranial infection, and sepsis. Therefore, an early diagnosis and early initiation of treatment are important. We herein present two cases of nasal septal abscess. Abscess formation was observed in the anterior nasal septum in both cases. The symptoms improved after incision, drainage of the abscess, and the systemic administration of antibiotics. In case 2, recurrence of the abscess was observed, but it was cured by the readministration of antibiotics. The causative bacteria were not identified in either of the two cases. The coexistence of ulcerative colitis in both cases suggested the possibility that aseptic abscesses may occur as a complication of ulcerative colitis.

Organized hematoma is a general term for mass-forming lesions caused by hemorrhage and inflammation. Most organized hematomas occur in the maxillary sinus, whereas those in the sphenoid sinus are extremely rare. In this study, we report a case of organized hematoma in the sphenoid sinus that was successfully removed by endoscopic nasal surgery. The mass showed a slow increase in size, and bone destruction could be observed on imaging, which required differentiation from malignancy. Preoperative biopsy alone is often not sufficient to make a diagnosis, but the characteristic imaging findings, together with the clinical picture and biopsy results, allow for a preoperative diagnosis. An accurate preoperative diagnosis is important to avoid unnecessary extensive surgery. However, the sphenoid sinus is located in close proximity to important organs, such as the dura mater, making complete resection difficult in some cases. Preoperative angiographic evaluation of blood flow and adequate surgical planning are necessary for safe complete resection.

A 48-year-old male presented with swelling in the left parotid gland. Ultrasonography and contrast-enhanced CT revealed an approximately 4-cm mass in the left parotid gland with an indistinct border to the masseter muscle. The patient was referred to our hospital for further examination and treatment. Contrast-enhanced MRI revealed a lobulated mass with equal signal intensity to skeletal muscle on T1-weighted images and high signal intensity on T2-weighted images. A needle biopsy revealed no atypical cells. Partial excision of the left parotid gland, specifically the shallow lobe, was performed to differentiate between polymorphous adenoma and malignancy. The lesion was located in the shallow lobe of the parotid gland and was partially adherent to the masseter muscle at a deeper level, prompting partial excision of the masseter muscle. Fasciitis nodosa was diagnosed based on pathological findings, including immunostaining. Fasciitis nodosa is a benign disease that can be difficult to distinguish from malignancy because of its sudden enlargement and unclear boundaries with the surrounding tissues. Nodular fasciitis should be differentiated from nodular fasciitis in the presence of a parotid mass with indistinct borders to avoid complications from an enlarged resection.

We present a case of a voice disorder resulting from laryngeal injury following a dog bite. The patient, a man in his 30s, initially sought medical attention because of expiratory leakage from a wound sustained on the neck during a dog attack. After a tracheotomy was performed by his primary physician, who diagnosed the patient with subcutaneous and mediastinal emphysema resulting from laryngeal injury, he was referred to our hospital for further evaluation of his voice impairment. Although the patient did not experience hoarseness during regular speech, he experienced difficulties with high-pitched speech. Computed tomography (CT) revealed a fracture on the left side of the thyroid cartilage. Subsequently, open reduction and internal fixation were performed, followed by postoperative voice therapy. This case underscores the importance of assessing not only the patient's speaking ability, but also any deviations from their typical voice, including high-pitched speech, when determining the appropriate surgical intervention for laryngeal injuries. We advocate proactive measures such as open reduction and internal fixation combined with postoperative voice therapy in such cases.

Laryngeal mask airway (LMA) is a device used to secure the airway that was first reported by Brain in 1983. It is currently used clinically as an extremely useful device for securing the airway for difficult intubations and emergency resuscitation. We encountered a case of right arytenoid cartilage dislocation that occurred after the airway was secured using an LMA, which is said to cause less damage to the larynx. On the 25th postoperative day (post-injury), right arytenoid cartilage dislocation reduction surgery was performed under general anesthesia with good results. An early diagnosis and therapeutic intervention are important because many of the causes of arytenoid cartilage dislocation are iatrogenic (e.g., tracheal intubation), and because irreversible changes may occur over time.