The methods employed at present in the treatment of paralysis of the facial nerve and their results are discussed. Selection of the therapeutic method should be primarily based on the results of electrodiagnostic tests as it is necessary to determine accurately the grade and extent or progression of denervation present. Conservative methods of treatment and their effectiveness in idiopathic peripheral facial paralysis, traumatic and postoperative facial paralysis, and the facial palsy of Hunt's syndrome are reviewed. Factors determining the selection of the operative method are discussed and the various operative procedures are described together with the results of operative treatment in actual cases. Lastly, some of the problems that need to be clarified in the treatment of this disorder and the otorhinologist's position in respect to these problems are considered.
Patients complaining of dizziness or equilibrium disturbance after head injuries are on the increase. A neurotological evaluation of head injury sequelae which was present in 3 cases is attempted and the literature concerning brain-stem trauma is reviewed. In many cases that present neurotological symptoms attributable to damage of the brain-stem or cerebellum after head injuries, neurological findings are generally absent. Careful examination of the type of nystagmus presented by these cases together with the results of objective tests of dizziness or equilibrium disturbance are of significant value in, the diagnosis. In studying nystagmus methods that allow quantitative evaluation such as electronystagmography or the optokinetic pattern are especially useful and further improvement of these methods should aid in the clinical management of head injuries, particulary in diagnosing the site of the lesion.
1068 cases of tympanoplasty were carried out during the period between Jan. 1958 and Dec. 1967 at the Department of Otolaryngology, Okayama University Medical School. Among them the cases of so-called specific type tympanoplasty were 292 including 113 successful cases. In the case of specific type with mobile stapes or stapes footplate, ossicular remnants or auricular cartilage were generally utilized to reconstruct ossicular chain. In the cases with mobile stapes in which only incudostapedial joint was broken, polyethylene tube was used for this purpose.
Maxillary mucous membranes of normal rabbits and those with experimental sinusitis werestudied by vitamin B2-14C microautoradiography. It seemed obvious from this experiment that vitamin B2 was preferably rich in the pathologicalmucosa as compared with the normal subjects, and that vitamin B2 should be evaluated asone of the important factors in the causation of chronic sinusitis. This result also supports theview of our previously reported histochemical study.
For the past few years, the oral treatments of chronic sinusitis have been actively performed. Most of these oral drugs, however, are composed of proteolytic ferments, and so called “non-specific anti-inflammatory drugs ” have not been used yet on this disease. The author attempted, therefore, to use Indomethacin, a non-steroidal anti-inflammatory drug, for the treatment of 20 patients with chronic sinusitis. As the result, the author had an impression that Indomethacin seems to be somewhat inferior to proteolytic ferment-drugs, but Indomethacin was effective on chronic sinusitis subjectively and objectively. Thus, the study on this drug should be continued for further clarification on the actions of Indomethacin. Also, the author discussed the mechanism of action on the effect of Indomethacin from the Medical viewpoint on inflammation.
An autopsied case of lymphosarcomatosis is reported. This patient was a 51-year-old man who, fi rst presented the chief symptoms of respitory distress and bilateral swelling of the neck. The clinical picture and eventual course of the disease together with the pathological findings at autopsy are presented. A general discussion of lymphosarcomatosis and lymphosarcoma. follows together with a review of the literature concerning differentiation of this disease from lympatic leukemia and reticulum cell sarcoma.
Surgical restoration of the tympanic membrane with fascia, which was first performed quite a number of years ago, still presents the problem of slow restoration of hearing and delayed dry healing requiring a long period. To overcome these disadvantages with this method, which has. engaged the efforts of many investigators, the author has devised an instrument for curettage of the inner surface of the tympanic membrane. Trials with this instrument in a small number of cases have resulted in early restoration of hearing and rapid epithelization of the new tympanic membrane. The operative procedures with method are described and the principles on which thismethod is based are presented.