Malignant tumors of the mesopharynx are not common among malignant tumors of the head and neck region. The incidence at the National Cancer Center Hospital (NCCH) was 10.6% (209 out of 1966 patients). From 1962 through 1974, one hundred and five patients with malignant tumor of the lateral wall of the mesopharynx were treated at NCCH. 57 of them were squamous cell carcinoma and 48 were malignant lymphoma. The male to female ratio was 3.4:1 in the patients with sqamous cell carcinoma and the majority of the patients were between 50 and 79 years of age. There was no sex predominance in the patients with malignant lymphoma and they ranged equally from fourth to eighth decade. The most common symptom was sore throat in cases with squamous cell carcinoma and a mass in the neck in cases with malignant lymphoma. Radiation therapy was used as the initial treatment in 82% of the patients with squamous cell carcinoma and in 90% of the patients with malignant lymphoma. The five-year crude survival rates for the cases with squamous cell carcinoma and malignant lymphoma were 49% and 56%, respectively. Squamous cell carcinoma of palatine tonsil were predominantly poorly differenciated type and freaquantly developed cervical lymph nodes metastases. Control of clinically involved cervical lymph nodes is imperative. In the majority of the patients with squamous cell carcinoma from anterior pillar, radiation therapy was done and faild to control the primary site. Surgical treatment should, therefore, be considered.
Clinical study of 133 cases (140 sides) of the postoperative cyst of the maxillae was performed by the analysis of such clinical data as chief complaints, age at onset, years after the initial sinus surgeries and the affected sides. Radiographic evaluations as to the sites of the cysts were performed using polytomographies of both the frontal and lateral sections. By comparing the cysts with the occult (clinically silent cysts), it was suggested that the anlage of the cyst originates, with predilection, at the medial ventral aspect of the sinus and further development of the cyst follows with the elapse of time. The sites of the cysts and other clinical statistical data were compared. Compression at the medial orbital floor gives rise to epiphora and subsequent extensive compression of the orbital floor produces diplopia and exophthalmos. Limited compression at the lateral orbital floor is seen by polycystic cases and produces no orbital signs. Compression of the sinus floor was little related to the oral signs including toothache and gingival swelling. The extension of the cysts to the sinus floor was restricted when the initial sinus surgeries were performed before the age of 15.
Betamethasone (BM) solution (0.1%) was topically administered at 2:00p.m. to the ear of seventeen preoperative patients, and then the serum concentrations of both BM and hydrocortisone, product of the adrenal gland, were measured at 3:00p.m. and 4:00p.m. The tested ears showed various kinds of pathology, such as a large central perforation, attic perforation, eustachian tube malfunction. The of preoperative diagnoses were as follows: 2 otosclerosis, 1 sudden deafness, 1 traumatic dislocation of the ossicles, and 13 chronic otitis media. The purpose of this study was to ascertain whether or not the ear-drop steroid suppressed the adrenal function, and to speculate the total steroid dose that might be absorbed from the external canal skin, tympanic membrane, middle ear mucous membrane and tubal mecous membrane. The results were summarized as follows: 1) Three drops of 0.1% betamethasone to the ear may suppressed the adrenal function in patients with the perforated tympanic membrane. 2) The rate of absorption of ear-drop steroid was speculated. If the tympanic membrane was perforated and tubal function was good, the rate was calculated to be 100%, similar to that of oral administration, and if not, the rate might be less than 25%.
The pattern of auditory brain stem response (ABR) evoked by binaural stimulation was compared with that evoked by ipsilateral and contralateral monaural stimulation and the summation of the two. The effects of electrode locations and the direction of stimuli were also examined to observe the direction of vectors of each component potential and to study the possibility of the so-called binaural interaction. Further comparison was made between psychoacoustic effects of binaural hearing and the pattern of ABR with special regards to each wave component. The results were as follows. 1. Each component of ABR is basically a vector trending toward vertex, and the later components tend to incline upward. Thus the direction of the potentials appears to oincide with that of the central auditory pathway. It is assumed that Wave I is derived from the acoustic nerve, while the waves after Wave III are from the nuclei or nerves of the brain stem auditory pathway. 2. It is considered that binaural ABR is an algebraic sum of scaras of each vector evoked by simultaneous stimulation of both ears and coincides with the summed ABR of monaural stimulation. It is thus concluded that the presence of binaural interaction can not be substantiated. 3. It is concluded that psychoacoustic binaural summation is related to Wave JJJ, while Wave V is indispensable to sound lateralization or localization. 4. The result of the present study would suggest that those waves after Wave III are derived from nuclei or nerves in the brain stem innervated by bilateral neurons. More specifically, Wave III is derived from the superior olivery complex and Wave V is from the nuclei or nerves above the superior olivary complex, lateral leminiscus and inferior collinuli.
Forty-one cases of necrotizing sialometaplasia (NSM) have been reported in the world, but none in Japanese literature. A 37-year-old male visited our clinic with a complaint of sore throat. A deep ulcer was recognized at the left anterior pillar and symmetric shallow ulcers were on the bilateral softpalate. The deep ulcer extended to the tonsillar capsule. A biopsy specimen showed necrosis of acini and squamous metaplasia of acini and salivary ducts, being consistent with NSM. The lesions have been followed for about 7 months with no special treatment. Although no exacerbation has been noted, the deep ulcer is still present. It is most important not to confuse NSM with malignant tumors, such as squamous cell carcinoma and mucoepidermoid carcinoma.
We experienced twenty-one cases of blowout fracture in the period of twenty-nine months, from October 1979 to February 1982, in Osaka University Hospital. All the cases were male except one. All cases had diplopia and disturbance in eyeball movement. Radiologic examinations were made with such radiological projections as occipito-frontal view, Water's view, occipitofrontal polytomography and CT-scanning. We obtained much important signs of fractures by CT-scanning. We classified these fractures into two types, pure-impure type and punched-outdoor type. Surgeries were done for nineteen cases and postperative courses were different intwo types.
It was clarified that several positive DC steps recorded by inserting a microelectrode through the stria vascularis signify the intracellular potentials of the strial cells in the anxious previous study. This paper describes an attempt to ascertain the source producing the singular positivity of the intracellular potentials in the strial cells. The intracellular positive DC potentials of the strial cells as well as the EP was depressed markedly by anoxia or the intravenous injection of furosemide. However, it was observed that there was a remarkable difference in the changing pattern between the two potentials. Though the potentials recorded from the strial cells reached low levels, they always remained positive and never changed polarity, while the EP became negative by exhibiting polarity reversal. Assuming that the positive component of the EP originates from the activity of the electrogenic K-ion pump, this experimental result suggested that the major part of the positivity of the intracellular DC potential is also generated by the action of the K-ion pump which draws K-ion into the strial cells and that the other part of the positivity maintains for a long period of time is probably supported by something else besides the active ion transport. In other words, it seems to be reasonable to consider that the positive DC potential in the strial cells is composed not only of the positive electrogenic potential generated by the active transport of K-ions but also of another potential which causes a positive sign inside the strial cells even when the action of the K-ion pump has completely stopped. This experiment showed that the electrophoretic microinjection of Na-ions into strial cells, but not the injection of K-ions, decreased the magnitude of the positive intracellular DC potential in these cells. This data indicates that the strial cell membrane is much more permeable to Na-ion than to K-ion, whereas it is common knowledge that the cell membrane generally shows selective permeability to K-ion but not to Na-ion. Therefore, it can be concluded that the positive Na-ion diffusion potential originating from the Na-ion concentration gradient between the inside and the outside of the strial cell is directly related to the composition of the intracellular positive DC potential of the strial cells in addition to the positive electrogenic potential generated by the active transport of K-ions in the strial cell membrane.