In otorhinolaryngology, diseases related to allergy are not few. Yet this fact has of ten failed to be reminded in our day to day practice. A certain allergic element is responsible for tinnitus, hearing hardness, forlign feeling of the pharynx and throat, vertigo, headache (frontal headache, bilateral frontal headache, visual abnormality, nausea, vomitting and throbbing pain can be caused by allergy), or the allergy plays a part during the disease process. History taking is quite important. Detail quetioning not infrequently points the responsible allergen. Allergic reaction is a chain of events; first it starts with combination of the antigen to the antibody, a certain enzyme system is activated, cells are damaged, their impairment promotes liberation of the activated substances such as SAS-A from the mast cells. The antigen is single, but can be multiple at times. Desensitization requires a long period and is impossible occasionally. “Intensified Minophagen C” acts inhibitive on the antibody production, the antigenantibody reaction and tissue reactions. The intensified Minophagen C reportedly works on relatively wide portions of the allergic reaction. It effects on the reticuloendothelial function and appeared to influence on phagocytosis and the anti-allergic actions. Following two points should be reminded during an inspection for diagnosis; 1) capillary dilatation of the cheeks. 2) pale face and tender skin. The capillary dilatation (either congenital or aquired, the dilatation is considered to be related to abnormal functions of the autonomic nervous system and endocrine system) and its relation to the allergy are now under inves tigation.
Air-sickness is occasionally experienced by those who are not accustomed to flying in airplanes, but vertiginous attacks in experienced airplane personnel while flying has seldom been encountered. Five such cases that experienced dizziness during their flights are presented. All of these cases were members of airplane crews of commercial airlines. No conclusive evidence of the cause of such disturbances was revealed, but a few speculations on probable causes are made.
No decisively-effective medicine has been found for complaints manifested during the early phase of cold. The disirable medicine should relieve these complaints and restore normal functions of the organs. The medicine is also expected to take effect in relatively short time and to keep its efficacy for a certain period with few side action. Newly developed Contac 600 was tried for this purpose on 100 patients who visited our out patient clinic. All patients were seen within 24 hours following onset of the cold symptoms. Fifty six of them were followed and results were analized. In summary 83.9% of the patients revealed objective clinical improvement while 87.3% showed subjective benifits.
To evaluate the actions of Indacin against postoperative pain in tonsillectomy cases. hospitalized patients undergoing tonsillectomy were divided into two groups, group 1 receiving the drug for 1 week and group 2 for 2 days from the day before operation. The daily dose was 3 capsules, given in 3 divided doses. None of the patients in either group complained of spontaneous pain of the throat. Local edema was observed in 6.6% in group 1 and in 13.3% in group 2. The average time for disappearance of local redness was 1.4 days in group 1 and 1.7 days in group 2. S wallowing pain was relieved after 15.5 days and after 12.3 days on the average in groups 1 and 2 respectively. In comparison with the control group, the administration of this drug was effective in suppressing spontaneous pain and edema, in hastening the disappearance of redness, and i n relieving swallowing pain, but there was inhibition of granulation and tissue healing which resulted in a longer period for complete cure. It is therefore necessary to exercise care in the administratian of this drug in the postoperativeperiod.
Allergic rhinitis has been one of the major allergic diseases in Otorhinolaryngology. Currently basic therapeutic approaches to the allergic rhinitis are to avoid allergen, to control a responsible environment and desensitize patients if possible. Yet, these are not final solution to the allergic rhinitis. Anti-allergic agents have maintained their places for this reason, though effects are known to be quite transient. Incidal, anti-histamine agent, was tried for the allergy and results were presented. Incidal was administered to 43 patients suffering from the allergic rhinitis. Six tablets of Incidal a day were prescribed for 7 days and its effects was interpreted in a week following t h e last Incidal administration. By maxillary mucosal tests performed radiologically, 74.4% of the patients treated were positive for intradermal a allergic tests and 46.2% revealed pathologic lesions in the maxillary sinuses (rest of 53.8% were normal). The results demonstrated that Incidal was quite effective on 8 patients, effective on 2 3, a little effective on 9 and was not effective on 3. Therefore it implied percentage-wise that Incidal was found to be effective on 72%, a little effective on 20.9% and not effective on 7.0 % of the patients. As for objective findings of the nose, no patient showed marked improvement, while one revealed some improvement and 9 resulted in fair responses. Remaining 33 patients demonstrated no objective benifit what so ever. Neutophiles decreased in general during the treatments. Regarding side-actions, it showed no hypnotic effect but on one. Two patients complained GI tract disturbances. In general, Incidal brought satisfactory results.
Ibunac was administered to 63 patients with various diseases of the nose and throat. T h e most striking effects were observed in cases with acute inflammation of the larynx and pharynx. The therapeutic results in this group of patients were excellent in 17, good in 12 and fair in 1. The results in 16 cases of chronic inflammation of the larynx and pharynx were excellent in 5, good in 3, fair in 4 and indefinite in 1. Thus the results in this group were not as pronounced as those in the group with acute inflammation. In 13 cases paranasal sinusitis, the results were excellent in 1, good in 5, fair in 5 a n d indefinite in 2. In this group, also, the drug appeared to be more effective in acute cases of inflammation than in those with chronic conditions. The drug was also administered postoperatively to 13 cases of paranasal sinusectomies. Of the 18 sides operated upon in these patients, the results were excellent in 3, good in 8, fair in 4 and indefinite in 3 sides. Thus, 15 or 85% of the 18 sides were favorably affected in one way or another. The pyretolytic effect, in particular, was quite marked. As indicated by the above results, the use of this drug in the field of otorhinolaryngology arouses great interest, especially in view of its marked effects in acute inflammatory conditions, and it is deemed a worthy drug for clinical use.
Trilafon (perphenazine) was administered orally to 12 cases that complained of tinnitis associated with nerve deafness and/or dizziness. The cases consisted of 7 with Meniere's disease, 1 with atypical Meniere's disease, 2 with senile deafness, 1 with occupational senile deafness and 1 with mixed deafness who complained chiefly of tinnitus. Dizziness was present in 8 and tinnitus in 11 of the cases. Following treatment with Trilafon, dizziness disappeared in all 8 cases, tinnitus disappeared in 2 and was improved in 7. Although tinnitus did not completely disappear in the majority of the cases, they reported that ringing in their ears was decreased in intensity. The functional state of the autonomic nerves was studied in 7 of the 12 cases with the Imidalin in tracutaneous test and the results were compared with the therapeutic results with Trilafon. In each case blood pressure readings, total serum cholesterol determinations and anemia studies were carried out. In summary, it appeared that the action of the drug in relieving tinnitus was slightly inferior to that against dizziness.
Considerably favorable results were obtained with oral administration of Sulfamethopyrazine for the treatment of acute infections in the field of otorhinolaryngology. The drug was particularly effective against streptococcal infections. There were no discernible side effects. It is considered an effective bacteriostatic drug that can be readily used for the treatment of ambulatory patients.