The authors report a case characterized by a marked swelling of the maxillary bone and nasal obstruction. The specimen obtained during the exploration of the affected bone showed pathological characteristics similar to fibrous dysplasia of the maxillary bone. The patient however developed swellings of the knee joints after the operation and was found to have hemophilia. A careful study of the maxillary bone specimen and the clinical course implied that the changes seen in the maxillary bone were reactive osteogenic process to the pathology caused by hemophilia.
Choanal atresia is a rare disease usually of congenital origin. The authors encountered a case with bilateral choanal atresia of acquired origin and report on surgery by transpalatal approach and also on postoperative local treatment with injection of steroid. Local injection with Rinderon produced a favorable result in suppression of granulation tissue which developed 30 days postoperatively, but failed to control cicatrization of tissues after operation. The complete nasal obstruction, anosmia and persistent mouth breathing which were suddenly relieved after operation, as observed in this patient, presented evidence on which basis an interesting discussion could be made on the physiology of olfactory sense. The authors discussed the relation between hematogenous olfaction and accessory olfactory system and suggested that disuse atrophy of the olfactory cells seldomly occurs at least within 6 months.
A case of a giant cell tumor of the condyloid process of the mandible in a young woman of 24 years is reported. Conservative parotidectomy preserving facial nerve function was applied for removing the tumor. This approach is well applicable for surgical removal of mandibular tumors as well as parotid tumors and enables us to preserve the function of the facial nerve. Differential diagnosis of the tumors in the parotid region is also discussed.
Two cases with laryngeal hemangioma are reported. Case 1 is a housewife of 63 years who had been complaining of hoarseness for five months. Hoarseness, which was at first intermittent and then became continuous, gradually worsened and was associated with slight dyspnea. An index finger-tip sized red tumor was noted on the anterior aspect of the left vocal cord. This tumor was removed with laryngofissure after Co60 therapy (6000 rad). The section showed cavernous hemangioma. Case 2 is a female of 9 years who had complained of aphonia with a slight degree of dyspnea for one month. The pedunculated tumor, ulcerated partially, was located between the anterior and middle thirds of the vocal cord. The tumor was removed with laryngomicrosurgery. The section showed hemangioma simplex. A review of literature in Japan revealed 32 cases with hemangioma of the larynx. Hemangioma of the larynx may be classified clinically into two groups: adult type and infact type. The incidence of the adult type hemangioma is greater than that to the infant type. There is no difference in frequency between male and female. Main subjective symptoms are hoarseness and dyspnea. The 24 hemangiomas with detailed pathological descriptions were subclassified as follows: hemangioma simplex (12 cases), cavernous hemangioma (9 cases), hypertrophic (2 cases) and hemangioblastoma (1 case).
The Foley balloon catheter is used for continuous evacuation of urine, yet this catheter has been found useful in various procedures in otolaryngology. The authors described the following 3 different uses of the catheter; 1. For postnasal packing to control nasal bleeding: The catheter is introduced through the nasal passage, on the side where bleeding occurs, then the balloon is inflated when the end reaches the nasopharynx. Nasal bleeding can be controlled by packing against the inflated balloon without causing much discomfort to patients. 2. To control postoperative bleeding from the maxillary sinus: The catheter is introduced into the maxillary sinus through the nasoantral window, then the balloon is inflated to compress the bleeding points within the sinus. 3. For fixation, from underneath, of fractured maxilla or orbit: After reduction of the fractured maxilla or orbit, the catheter is introduced through the constructed nasoantral window and the balloon is inflated by injecting urographin and methylene blue to sustain and immobilized the repositioned farctured segments of the bones.