A 84 year old man with a glass foreign body which was blocking his ear canal was reported. The patient had a history of hospitalization for laceration of the pinna by stumble down accident but no foreign bodies were noted in the external auditory canal at that time. The patient subsequently suffered from exhibited left otorrhea over four months and on medical examination, a glass foreign body was observed blocking the ear canal. There were no abnormal findings in X-ray examination, but by CT the foreign body was confirmed to be in the external ear canal. The foreign body was removed by post auricular incision under local anesthesia. The foreign body was the glass piece which was 12×24×3 mm. An experimental study was performed using a dummy head, and it was confirmed that the glass piece was able to detect only on thin bony part around pinna, but it was unable to detect on hard bony part as mastoid part. It was not sufficient to image the glass object in the mastoid part of the ear only X ray film and we stressed that CT was useful to confirm the location of the foreign body such as glass piece.

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Carotid body tumor is a rare disease but there are some reports about familial onset of this tumor. We experienced the cases of a father and his daughter who had a carotid body tumor. The father also had a parapharyngeal tumor that was revealed to be a paraganglioma by histopathological examination, suggesting that he had two paragangliomas at the same time, i.e., carotid body tumor plus vagal paraganglioma. The tumor of the daughter was diagnosed malignant because it was associated with lymph node metastases. Carotid arteriography demonstrated highly vascular lesion indicating that these tumors were rich in blood supply with tremendous vessels surrounding them. Surgical removal was done. Postoperatively the father had paralysis of cranial nerves IX, X, and XII, while the daughter had paralysis of the vocal cord.

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Our treatment of carcinoma of the oropharynx has basically been chemoradiotherapy or preoperative radiation therapy. Selective continuous intra-arterial chemotherapy with concurrent radiotherapy has been performed with the aim of organ preservation and improved local control, especially for lateral or superior wall type lesions, and lesions of other subsites (anterior or posterior wall type) have been treated with preoperative radiation therapy with or without chemotherapy. The focus of the present study was to determine whether use of this intraarterial chemotherapy approach improves the outcome of oropharyngeal cancer . A total of 47 patients with squamous cell carcinoma of the oropharynx were treated at Mie University between 1985 and 1998, and all of them have been followed-up for at least 2 years . Thirty-seven of the 47 patients had lateral or superior wall type lesions, and they were divided into two groups for evaluation in this study. The 19 patients in the intra-arterial group were treated by intra-arterial chemotherapy with concurrent radiotherapy, and they were compared with the other 18 patients, who received another form of treatment (control group). In the control group, eight patients were treated by radiation therapy alone and 10 patients were treated by surgery. A complete response rate of 68% was achieved at the primary site in the intra-arterial group. The local control rate was 15/19 (79%) in the intra-arterial therapy group and 9/18(50%) in the control group. The 5-year disease-free survival rates have been 54% and 53%, respectively. The regional control rates have been similar in both groups, but there have been six deaths from distant metastasis in the intra-arterial therapy group and one in the control group. These results indicate that intra-arterial therapy requires further investigation.

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A case of carotid body tumor was reported . The patient was a 69-year-old male, who complained of a swelling in the left upper neck . Enhanced CT and carotid angiography revealed a hypervascular tumor at the bifurcation.Matas test and SPELT (single photon emmision CT) were usef ull for preoperative evaluation of intracranial hemodynamics. The tumor was resected together with the bifurcation and carotid artery was sutured with internal carotid artery.The patient had no complication after operation . On histopathological study, the tumor was diagnosed as paraganglioma.

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Since 1990, twenty-three cases with papilloma in the nose and paranasal sinuses have been surgically treated at Kobe University Hospital. Five of them had received prior surgery. The tumors arose from the lateral nasal wall in 22 cases, and from the nasal septum in one. Tumor extension involved the maxillary sinuses in 13 cases and the ethmoid sinuses in 12. The tumors were resected en bloc in all cases. Eleven patients whose ethmoid sinuses were involved were treated with external resection through lateral rhinotomy approach, while tumors infiltrating the maxillary sinuses were resected through sublabial approach in nine cases. Endonasal resection was performed in three cases of which tumors were localized in the nasal cavity. There have been no recurrences. The overall incidence of carcinoma in our series was 17.4%, with synchronous lesions present in three patients, and one patient later developed a recurrent inverted papilloma associated with a carcinoma. Our experience shows that it is important to select the appropriate surgical approach with which the tumor can be resected en bloc.

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Twenty patients of chronic thyroiditis without neoplasm were operated in our department from September 1986 to August 2000. Of these patients, 15 were suspected the involvement of malignant tumors preoperatively, and 6 were observed class IlI by fine needle aspiration cytology (FNA). Hemithyroidectomy and partial resection were conducted in 17 patients, and subtotal and/or total thyroidectomy were conducted in 3 patients. Two patients underwent total thyroidectomy had dyspnea or swallowing disorder. Class i by FNA is sometimes observed in the patients with chronic thyroiditis, then the carefull interpretation for class III is proposed. Thyroid associated autoimmune antibodies (at least anti thyrogurobulin antibody) is necessary for the diagnosis of chronic thyroiditis. The operation for the chronic thyroiditis without malignancy is proposed to avoid by the accurate diagnosis of chronic thyroiditis.

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