The background in the treatment of maxillary cancer in France may be traced back to 1827 when Gensoul in Lyon succeeded in total maxillectomy. Nelaton, Velpean, Pean also contributed in providing better incisions for the surgery. Moure and Sebileau, qn the other hand, proposed partial resection of the maxillary bone in a more conservative surgery. Regaud was the first who advocated a combined treatment by surgery and irradiation. Dargent, Baclesse Huet and Leroux-Robert, in recent years, described various new aspects in the treatmat of cancer of the maxilla. These works of French doctors do not seem to be familiar to Japanese doctors. The author who stayed at Lyon university for about a year in 1968-69 term described various aspects in diagnosis and the treatment of the cancer of the maxilla in France.
It is said in Japan that approximately half of the entire out-patients visiting to Oto-rhinolaryngology Clinics are suffering from chronic paranasal sinusitis. Therefore, it is not surprising that numerous and voluminous works have been made concerning its symptomatology, etiology and treatment. Yet types of the chronic paranasal sinusitis in Japan are denitely different from the types seen in Europe or in U. S., and so are treatments. Thus problems encountered in Japan should be solved by own Japanese ways. So far the final answer for these subjects have not been made. When school children are inflicted by the paranasal sinusitis it presents problems because it hinders learning and the satisfactory treatment has not been 'established. For the past ten and more years, the author directed his studies to the long term nasal on the school children, both living in the urbun and in the rural areas. Natural courses of the intranasal diseases were studied and followed. The nasal cativities were well examined and particular attentions were paid on, the middle nasal meatus and its adjacent area, since the local findings of these areas were thought to be closely related to pathology of the paranasal sinuses. Relationship between nasal discharge and the intranasal findings of the inferior turbinate was investigated. In general, pathology of the nasal mucous membrane was found more frequently in the elder children and found to be more extensive as the children grew older. Such propensity was more pronounced among the children living in the rural areas. Rhinorhea was a symptom observed in the younger age group and it was found less as they became older. The more children living in the urban areas had mucoid nasal discharge, while it was of purulent in nature among majority of the children in the rural areas. The inferior turbinate was more or less atrophic in the younger children and found to be thickened as they became older. But it was interest of note that some children in the rural areas showed continous atrophic change of the inferior turbinate was not always associated with diseased state, but the atrophic change was closely related to pathologic state. These findings, gross local findings of the mucous membrane, were found to subject to change in the younger school children. The pathology was easily reversible and could return to the normal. Preceeding to establishment of the chronic paranasal sinusitis, mucoid nasal discharge was usually seen. The discharge underwent changes, mucoid to purulent in nature, as the sinusitis progressed in severity. In another word, the rhinorrhea became more purulent as the chronic paranasal sinusitis was aggravated. Reverse was true with recovery. It appeared that the intranasal findings became worse more often when the children were in the early middle school days and in the middle of grammer school years. Lastly it was confirmed that the paranasal sinusitis in the young could be reversed and cured, even if it was severe. Early detection and early institution of the treatments are again principles of the treatment.
The authors reported on 10 cases of maxillary sinus cyst caused by radical sinusectomy (postoperative Wangenzyste: Kubo) encountered in 1961 and 34 other cases encountered during the two-year period of 1968 and 1969. The greatest interval between the time of surgery and that of development of symptoms was 50 years. The authors discussed and commented on grounds of the data upon problems in extranasal sinusectomy and reminded rhinologists of possible complications that might develop in a few decades after surgery.
Three cases of aerosinusitis, encountered recently in the department of Otorhinolaryngology at The Jikei University School of medicine were presented. From anatomical and physiological standpoint, reconstructions of the lateral nasal walls appeared to be the most adequate treatment, through which almost complete cure could be expected. The intranasal findings and the operative findings were not always in parallel. Etiology, common to the three cases, was considered to be pressure change on the mucous membrane adjacent to the natural orifices of the paranasal sinuses. The inti anasal findings were not always indicative of the disease. Yet, it was thought important that flight crew were to be examined and followed by subjecting them to regular physical examinations in a pressure-chamber. Changes elicited in the nasal cavities and the paranasal sinuses should be closely evaluated in the examination.
From the result of E. N. T. examinatian at the Ashiya-Seido primary school, it was known that there was no relation between E. N. T. diseases and I. Q. or merits of school. But most children with impaired hearing showed poor merits regardless to their I. Q., the author assumed that hearing is the important factor in primary school. It is possible that rhinitis accompanies inflammation of Tube auditiva and some hearingloss. The author comment on importance of phoniatrics training at universities.
The authors reported a case of lethal midline granuloma occurred in a 34-year-old male whose initial symptoms were nasal obstruction and fever. Treatment including steroid, irradiation and chemotherapy alleviated the symptoms but the patient died in four and a half years later. Discussion was made on the various modalities of treatments and also on the pathological findings in the case.
Cauterization of congenital aural fistula with silver nitrate cristals, that initiated by Dr. Higuchi, was performed on about 30 cases. The authors reported on the results and concluded that Higuchi's Method would be widely applied to various types of aural fistula even for suppurative type and with satisfactory results.