Through intensive study of the morphology of the humsn nose as well as that of various animals, the author confirmed the presence of two cartilagenous processes in the human nasal septum. They are the processus sphenoidalis and the processus vomeris. The latter is found exclusievely in the human nasal septum and has a positive relation with nasal septal deviation, height of the nose and angle of the cranial basis or angle of sella turaca. In subjects with short processus vomeris the sella turcica in also small and often associated with severe septal deviation and rather high external nose. The author concluded that the septal deviation which can be recognized by intranasal examination is the deviation within the cartilage and is produced by the active growth of the nasal septum, while the septal deviation within the perpendicular plate of the ethmoid is created passively due to development of the ethmoid cells on both sides. The active deviation of the nasal septum is also related with metaplastic ossification and this gives a basis for the preservation of the external shape of the nose without being affected by senile atrophy. Archaeological study has suggested that the processus vomeris first appeared in Homoneanderthal Man.
The distribution pattern of adrenergic nerve fibers in the nasal and sinusal mucosa of dogs was investigated by the use of the fluorescence microscopic method of Hillarp and Falk. In the proper layer of the nasal mucosa, sympathetic nerve fibers were found distributed mainly to blood vessels; thus, spindle shaped areas of brillant fluorescence were noted in the outer portion of the media of arteries; The fluorescence was also observed relatively abundant around the adventitia. The specific fluorescence of high brilliancy was seen at around and in arterial and venous walls also in arterial and venous plexuses. These findings indicate that sympathetic nerve fibers are distributed in the nasal mucosa in such a pattern as to permit to serve the purpose of regulating blood flow through this structure.
Greenfield and Sulder described vidan neuralgia for the first time in 1910. Harris C. Vail in 1929 reported that vidian neuralgia was often associated with inflammatory lesions in the posterior ethmoid and sphenoid sinus regions. The neuralgic pain is often felt in the nose, eyes, ears, head, neck and shoulders, and can not be relieved by local injection of anesthetic agents. The authors describe 2 cases of vidian neuralgia. The first case is a 28-year-old male who complained of neuralgic pain in the radix of nose, nasal dorsum, right orbit and temple. The repetitive pains had been very severe and could not be relieved by various analgesics. The patient kept holding an ice bag against his cheek and stated that he had thought of commiting suicide when the pain was extremely severe. The second case is a 22-year-old female who complained of repetitive severe pains in the right eye and cheek which kept him from working. Vidian neurectomy was performed for the above two cases and produced good postoperative results. The authors discuss the two cases and describe differential diagnosis between vidian neuralgia and primary atypical facial neuralgia or trigeminal neuralgia.
Styptic effect of Transamin has been studied in Caldwel-Luc's operation. The total amount of blood loss and average blood loss in one minute during Caldwel-Luc'soperations have been studied in 21 patients who had about the same degree of pathology in the right and left maxillary sinuses. Caldwel-Luc's operation was performed on both sides at a different date, one side before and the other after administration of Transamin. The average blood loss in the group receiving Transamin after opeation (control) was 213 gr., while that of premedicated group was 153 gr. The average blood loss per minute was 6.6 gr. and 5.1gr. for control and premedicated groups respectively. The blood loss in the premedicated group was 66.7% of the control group for both total and one minute blood losses. No side effect due to the medication was observed.
A mixed tumor originating in the palate is rather rare, however, it has been understood that the tumor has a considerable tendency to malignant alteration. Any surgical intervention to the tumor such as puncture, incision or biopsy could act as a trigger for malignant changes. Pathologically the malignancy is either adenocarcinoma. squamous cell carcinoma or basal cell carcinoma. As the mixed tumors are frequently resistive to irradiation the primary treatment should consists of complete surgical removal of the tumor. The authors described a case in which a surgically removed mixed tumor originating in the soft palate of a 68-year-old male recurred 4 years later. The recurrence which occurred in the floor of the nasal cavity has been successfully removed by a partial resection of the maxillary bone. The authors discuss the case and have reviewed the related literature.
Pressure equalization within the tympanum for a sufficient length of time can be produced by making burn perforations in the tympanic membrane. Small multiple perforations placed close to each other or a large perforation of about one eighth of the quadrant of the tympanic membrane will equalize the pressure for more than three months. The procedure in described in detail. It is a minor procedure comparable to a myringotomy or removing plugged debris from ventilation tubes.