Seven cases of the carcinoma in the middle ear treated in our clinic for the last 10 years from 1947 to 1957 were reported. 1) All cases but one had the previous history of the chronic middle ear suppuration with continuous or intermitentdischarge. 2) The probe-biopsy of the tissue taken from the external auditory canal of the middle ear revealed the carcinoma in the vast majority of cases. However, in some cases, due to the marked inflammatory change of the tissue, the cautious observation was required for detection of carcinoma, which appeared only at the limitted area of the specimen. Of great importance is, therefore, the careful and through examination of the specimen for diagnosis of carcinoma in the middle ear. 3) Increase of the fetid discharge and persistent headache or earache are the signs of the malignant tumor in the middle ear. 4) According to the location and extension of the tumor in the temporal bone, carcinoma in the middleear is divided in to two types as follows. (a) External, or superficial type. (Tympanic cavity, mastoid antrum) (b) Internal, or profound type. (Tympanic cavity, pyramidal apex.) 5) The cases of superficial type revealed conductive deafness or combined deafness. While the cases of profound type showed total deafness with loss of vestibular function. 6) From the operation findings, the direction of extension of the carcinoma in the temporal bone was similar to that of the inflammation in the temporal bone. 7) In addition, the authors state as to the problems of treatment, especially theirradiation therapy.
Ingenral, it is presumed that changes in temperature and humidity during flying produce abnormal physical states in the mucous membrane of the upper respiratorytract and thus predispose individuals to inflamation of this region. It is therefore necessary to consider as physical causes of aero-otitis and aero-sinusitis, not only changes in barometric pressure, but also the entire atmospheric environment in the airplane. As humidification is the most important element in air-conditioning of the interior of the airplane, it is necessary to devise ways of providing optimum humidity.
According to the author's clinical experience, 8 of 12 cases of idiopathic peripheral facial palsy given antimony dervatives recovered within several weeks to several months.Almost all of the 11 cases of facial palsy occurring after ear operations also recovered following conservative treatment within several months to 1 or 2 years.Consequently a considerable number of cases of facial palsy can be cured with conservative treatment. However, recent publications on facial palsy suggest that decompression of the Fallopian canal, nerve grafting or suturing are more useful in gaining exact and rapid cure.Of course, these surgical methods require gentle and careful manipulations. When there is no improvement after performing these operations, plastic facial surgery seems to be more preferable than nerve anastomosis between facial and hypoglossal or accessory nerves.For facial plastic surgery to correct facial palsy the author recommends the following procedures: first, muscular neurotisation of the facial muscles employing a muscular stalk taken from the masseter muscle;and second, lefting of the mouth angle, using catgut under the skin fixed to the fascia of the temporal muscle.
The author reviews a few important points discussed, and misunderstood by Dr. T. Kamio in his article published in the first issue of O.R.L.Tokyo, and states that there has been no incidence of necrosis of the bone flap in his experience with this method in 300cases. According to the author, the criticism of Dr.T.Kamio commented too briefly and inadequately on the author's operative technic.At least, the management of the periosteum which is of vast importance in the author's technic should not have been omitted.
Plastic surgery employing resin was performed in two cases of long-standing traumatic saddle nose for which non-surgical correction had been considered infeasible. In the first case, an approach through a lobule incision was employed by this case resulted in failure.In the second case, the result was favourable with an incision in the eyebrow as the route of approach. In this presentation, the authors describe the clinical course in these two cases and state that the insertion of resin in such cases were adhesive changes are significantly present may be rather easily and exactly carried out by the facial route approach.
The thresholds of hearing in normal individuals were measured in microbars, and the following results were obtained. 1.The normal hearing threshold showed a variation of 10 to 20 db.in the individuals tested with lapse of time. 2.The types of variation in respect to time lapse were classified into the following 4 groups. a) Adaptative Variation Gradual lowering or threshold with lapse of time (20-60 minutes). b) Flat Variation Threshold subjected to changes within a range of 10 db. c) Sudden Variation Abrupt change in threshold of over 10 db.after a short time lapse (5 min.) d) Increasing Variation Elevation of threshold with lapse of time (5-60 minutes).
To learn whether or not specific histopathological changes occur in the faucial tonsils of old people and to reappraise the concept of excisional therapy in this age group, clinico-pathological studies were performed in 11 patients over 50 years of age. Seven cases in their forties and 80 cases under 30 years of age served as controls in this study. It was concluded from the results obtained in this study that the removal of diseased tonsils, as in young adults, is quite rational even in patients of advanced age. Careful evaluation of the patient's conditions and close observation for postoperative hemorrhage, however, are of paramount importance and complete removal of the tonsil tissue is required in this age group.
1. Three cases of paranasal sinus cyst managed intranasally and cured successfully are reported. 2. In cases, in which the cyst is monolocular and the dura mater or the orbital periosteum in directly exposed forming the wall of the cyst, and in cases, in which radical operation cannot be performed because of advanced age or weak constitution of patients, it is considered that by intranasal conservative management, especially the intranasal opening of the cyst without damaging the lining mucous membrane of the cyst, favourable results may be expected.