Radical resection for maxillary cancer has been performed as early as one and a half centuries ago. Since then much progress has been made in the treatment of maxillary cancer. The most effective way seems to be a radical maxillectomy in combination with radiation treatment. However, the clinical results are yet in general far from satisfactory.
Most of the operative procedures hitherto proposed to require facial incision. In 1947, the author developed a transoral maxillectomy technique which is unique in not involving facial incision. This technique has been used successfully in the Otorhinolaryngological Clinic of the Kyushu University in 120 cases thereafter to 1961. During nearly same period, 120 cases were operated with the usual external maxillectomy technique with facial incision and Denker's method was used in 10 other cases. As the most common initial symptom, nasal obstruction in 31.2 per cent, nasal hemorrhage in 14.0 per cent, toothache in 12.8 per cent and swelling of the cheek in 11.6 per cent have been found among these 250 cases. Cervical lymphnodes were palpated during the first examinations in about 28.4 per cent of the cases. However, the cases, in which metastases were actually confirmed by histological examination after the removal by radical neck dissection, amount to only 11.5 per cent.
Recently, we have analyzed the microvibration curves obtained from the patients with maxillary cancer. Invisible microvibration from the body surface was led through the pick-up laid on the cheeks or on the supraorbital area of the patient and was subsequently recorded by MT analyzer. Findings of the recorded curves indicated that the microvibration coefficient (counts per square) in case of maxillary cancer is much larger than that in sinusitis patients as well as in normal cases-the last being the lowest.
Although the use of Ohngren's malignancy plane offers considerable advantages in assessing extention of nasal tumours and their classification, its bilateral division alone is not always quite adequate. In order to set an anatomically appropriate division, the author proposes the vertical plane through the margin of Apertura piriformis and Lamina lateralis processus pterygoidei. The use of the combination of these two gives a clearer picture of the extention of tumour i. e. the invasion area type. In total 250 cases were classified into the 10 combinations according to their extention. Prognosis and other problems could be judged more adequately using these planes.
Preoperative radiation treatment with 60Co was also used in combination with radical maxillectomy. The most effective dosis has been found to be over 3000 rad according to the results of histopathological examinations.
The operation was conducted under general anesthesia with nitrous oxide or Fluothane using nasotracheal intubation through contralateral nose. In the majority of the cases, radical neck dissection and a ligation of an external carotic artery were done right before radical maxillectomy.
The technique of radical maxillectomy will be described briefly. Palatal D-form incision is made followed by extensive dissection of anterior surface of maxilla. Using electric saw, zygomatic bone is separated and the frontal process of maxilla is also divided by the same technique. Palate is transected along its midline. After dividing the bony junction of maxilla, traction is applied laterally and downwards in order to loosen the maxilla from its surrounding structures which is subsequently removed en bloc. If necessary, orbital content can also be removed transorally. The space thus formed should be packed tightly with rubber bag containing alginate hydrocolloidal paste right after the operation, in order to avoid the occurrence of facial retraction, shrinkage of wound diameter and other deformities. Temporal palatal pelote is used until epithelialization of the wound is completed. Permanent prosthesis is used thereafter.

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7% solution of sodium bicarbonate injected intravenously, whose efficacy for labyrinthine dizziness has been well appreciated in this country, is also found to be effective for what is called “Angio-neurosis”, a kind of peripheral circulatory disoder.
In animal experiments with this solution, excellent results were obtained without any side effects whatever, and we started infusion of this solution (250 cc for one time) in 1957.
In a 3 year-period of 1959 to 1961, 110 patients were treated with this infusion in the Clinic of Otorhinolaryngology, Osaka University Hospital.
The treatment was effective in 74 cases (67%), noneffective in 15 cases, and in the other 21 cases the results were untraceable.
The cases thus treated were mainly those of Meniere's disease, deafness of neural type and of sudden onset.
Satisfactory therapeutic results were obtained for Meniere's disease, deafness of sudden onset, angioneurotic rhinitis in contrast to the comparatively poor results for deafness of neural type and tinnitus.
On an average, 12 times of infusion were enough for the improvement of the complaints, and several fimes, for angioneurotic disorders.
We have briefly commented on the indication of the infusion of the 7% solution of sodium bicarbonate and its ordinary amount needed.

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How high endolymphatic DC potentials exist from the basal turn to the apex? This seems to be a clue to clarify the auditory mechanism of, and the impediment to the inner ear.
Method: The recording electrode consisted of a glass micropipette of 5-10 ti diameter, at the tip filled with 3 mol KCI solution in which a silver chloride wire was immersed. This wire was connected with a high input impedance amplifier. The potential difference between the recording micropipette electrode and the indifferent electrode was recorded with a pen writing oscillograph.
The cochlea of anesthetized guinea pigs was exposed through the auditory bulla. A small hole was made in the bony wall of the scala media of each turn except the apex. After compensation of the junction potential the electrode was slowly inserted into the scala media. At the apical turn, however, the hole was made in the scala vestibuli and the electrode was ivserted into the scala media through the Reissner's membrane.
Results: Measurements of the endolymphatic DC potentials were tried in thirty-three cases at the basal turn, in one at the second turn, in two at the third turn and in twelve at the apical turn.
The maxima potentials, we found, were 92 mV at the basal turn, 62 mV at the second turn, 81 mV at the third turn and 83 mV at the apical turn. The modes of the potentials were 70-90 mV at the first turn and 60-70 mV at the apical turn.
Discussion: Misrahy and others found as high as 110-120 mV endolymphatic DC potential in the scala media at the basal turn, but none at the apical turn. On the other hand, Gisselsson reported that the DC potential at the apical turn was as high as at the basal turn.
Our results reveal the existence of nearly the same positive DC potentials inside the scala media of each turn.

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In a thirty-four year old woman with the chief complaint of vertigo and disequilibrium, the author found spontaneous vertical nystagmus in the course of the disease.
From the results of the examinations the author considered this to be caused by the obliteration of A. cerebelli superior

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The patient, a coal miner of 54 years old, who had complained of headache, diplopia, and exophthalmus and blindness of the left eye for four years was in May 1961 admitted to the Ophthalmological Clinic, Yamaguchi University and had an operation under the diagnosis of left orbital tumor.
He was transferred to the Otorhinolaryngological Clinic thereafter and an extranasal operation of the frontal, ethmoidal and sphenoidal sinuses was performed. The operation disclosed mucocele of the sphenoidal sinus and pyocele of the ethmoidal sinus.

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Ein 2 jahriger Knabe wurde von einem Chirurgen wegen Atemnot tracheotomiert, die durch Verbruhung des Rachens und des Kehlkopfes verursacht war. Wegen der ungeschickten Operation konnte das Kind trotz Ausheilung der Grundkrankheit nicht durch die naturlichen Luftwege atmen.
Als Ursache der Atemnot des Kindes konnten wir die Anschwellung der Schleimhaut des Kehlkopfes, des subglottischen Raumes und eine Granulationswucherung urn die tracheotomierte Wunde, die an der Gegend des Ringknorpels vorhanden war, feststellen.
Nachdem wir Verfasser das Kind in die Universitatsklinik aufgenommen hatten, machten wir die zweite Tracheotomie am richtigen Halsteil. Das durch die erste unzugangliche Tracheotomie verursachte Granulationsgewebe konnten wir durch Verabreichung von Corticosteroid verschwinden lassen. Eine teilweise Anschwellung der subglottischen Schleimhaut blieb bis zu allerletzt zuruck und störte das Dekanulement. Die vollkommene Abschwellung erfolgte erst, nachdem das Kind aus der Klinik entlassen und zu Hause angenehm leben konnte, denn das Körpergewicht des Kindes nahm während seines Krankenhausaufenthaltes nur wenig zu. Nach vollkommener Ausheilung konnten wir die Trachealkantile leicht entfernen, da es dem Kind wegen der vollkommenen Abschwellung der subglottischen Schleimhaut möglich war, durch die naturlichen Luftwege zu atmen.

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The authors reported here 5 cases, which they recently experienced, of foreign bodies (hooked artificial dentures) in the first stricture of the esophagus, in which they succeeded in removing them by external incision after the failure of endoscopic removal. From these experiences they recommended safe removal by external incision in cases of esophageal foreign bodies difficult of endoscopic removal, especially with danger of associated lesion.

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The patient was a male miner, 64, suffering from mild hypertension and arteriosclerosis.
This operation was performed to remove a metastatic tumor in the left upper neck region which had developed about nine months after the primary operation of lingual cancer: partial resection of the tongue and radical dissection of the left neck.
In order to avoid severe results from the rupture of the carotid during or after the operation, the left common carotid was first ligated and then the metastatic tumor was resected.
Although it is not certain which of the following prophylactic measures was specially effective, no complication developed from the ligature of the common carotid: heavy irradiation, negative matas' test, repeated compression of the left common carotid before the operation, step by step ligation with the catgut, sufficient blood transfusion during the operation, atropinization, absolute rest of long period after the operation.

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The authors have studied the prosthetic treatment of cases of speech disorder caused by the operation of maxillary cancer.
33 cases, applied gauze pack or prosthesis to the resected maxilla, were estimated the grade of speech disorders with pronunciation test. They also were examined the decrease ratio of vital capacity and the relationship between the soft palate on the operated side and the degree of speech accuracy.
The prosthesis was most effective to cure a patient of speech disorder, although some nasalization still remained. The obturator of prosthesis occupying the resected maxilla exerted a delicate influence upon pronunciation. When it occupied about 70% of the defect, pronunciation was best. But the prosthesis has to be improved in its form, hardness and elsewhere.
The wider the remaining area adjacent to the choanae of the soft palate on the operated side, the better was pronunciation. But its width on the buccal side seemed to have little to do with pronunciation.

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