This is a report on a 54-year-old male who noticed a swelling in the right side of the neck one months prior to admission. Palpation of the tumor readily caused coughing spells. Surgical procedure to the tumor revealed a band arising at the center of the tumor extended into the intrathoracic cavity. The size of the removed tumor was measured 8×5×3cm. Pathological examination showed neurilemmoma, a combination of histological features of Antoni A and B types. The patient developed paralysis of the right vocal cord postoperatively but otherwise patient developed paralysis of the right vocal cord postoperatively but otherwise uneventful.
Five cases of chronic otitis externa which had been misdiagnosed as chronic otitis media because of redness of the tympanic membrane and creamy pus in the external auditory meatus were reported. The differential diagnosis from chronic otitis media was possible as a meticulous cleansing of the meatus revealed the aural discharge was not the product of the middle ear. Another problem was how to control this type of otitis externa. Two cases of them could be treated successfully by thorough daily cleansing of the meatus. However, the remaining three cases with fungus infection required hyposensitization therapy with fungus extract, which was very effective in the treatment of eczematoid dermatitis of the ear canal.
In order to clarify transition of the clinical picture of chronic sinusitis intranasal findings at the first consultation were recorded periodically at Nagoya City University Hospital from 1959 to 1972 and the following results were obtained. 1. The percentage of cases with chronic paranasal sinusitis among all the outpatients decreased slightly since 1968. But no change was observed in the absolute number of such patients. 2. Clinical findings and X-ray examinations showed the disease become somewhat milder in nature since 1966. 3. It appeares that the incidence of purulent type of this disease decreased since 1962 as seen from the fact that the frequency of purulent discharge showed an evident decline among these patients. 4. The incidence of polyp formation in the middle nasal meatus tended to decrease slightly since 1962 but it still is found in about 20% of the patients.
A case of sphenoid sinus mucocele developed in a 34-year-old male is reported. The initial symptoms of the patient included visual disturbance of the left eye and headache that started about four months prior to admission. The final diagnosis of the mucocele was confirmed by laminagraphy of the sphenoid bone and a puncture of the sinus. The patient was operated on through the transnasal approach and the left vision imporved from 20 cm. finger counting to 1.2 (1.2x + 0.25) postoperatively. A search of pertinent literature revealed 20 cases of sphenoid mucocele so far reported in Japanese literature and these cases are discussed in reference with 63 other cases reported by Nugent.
The authors report the findings of scanning and transmission electron microscopic observations of the nasal mucous membrane in five cases with chronic sinusitis and a case with allergic rhinitis. In severe cases with chronic sinusitis it appeared that the ciliary movement was considerably restricted due to attachments of thick mucus droplets. Infection of the mucous membrane appeared to have caused erosion and destruction of the epithelium. These changes seemed to induce elongation of the peripheral sheath, which in turn facilitate adhesions between the cilia. In even severe cases, basal membrane was exposed. In allergic rhinitis, the number of goblet cells was seen to have increased as compared with the cases of chronic sinusitis. The authors found no evidence as to the origin of the goblet cells or whether they come from ciliary cells or not.