Nose and paranasal sinus operations require various specific surgical instruments as they deal with relatively narrow, complicated and deep operative fields. These instruments should meet the specific uses in such operative fields, accordingly, they need to be thin, easy to handle, sturdy and sure to bite small tissues in the sinuses. We now use the instruments which were devised many years ago by Hajek, Killian, Frankel and others. Although conceding that many of them are still useful today the author devised 18 new instruments for a more easier operation in the narrow field. The new instruments which were found to be particularly useful are chisels for use in antral opening, Rongeur, operative nasal speculum and revised Grunwald nasal forceps for use in children.
Many commercial aircrafts now in service are jet planes of large capacities. If any of the crew who operates such large planes has disorders of the vestibular system, it would present serious risk to the large number of passengers traveling together. It has been known that less experienced pilots or pilots in training occasionally manifest air sickness in flight or unsteadiness after landing. In order to survey the nature and frequency of disturbance in the sense of equilibrium among the commercial pilots, questionnaires were sent to a total of 1000 pilots, copilots, flight engineers and navigators, and 39.2% were recovered. The results showed that 73% of the crew experienced disorder of the sense of equilibrium in flight, 39.2%(140) had episodes of air rickness, while unsteadiness occurred in 26.5%(105). Temporary spatial disorientation during flight occurred in 16.0%(29). The author attributed the low incidence of disturbance in the sense of equilibrium shown in this study to the fact that the subjects of this study were limited to crews of commercial aircrafts.
Reported here are the results of our study on septal deviation, sella turcica angle and shape of skull in 35 artificially deformed skulls of old Maya people. It has been known that gradual enlargement of the skull vault due to development of the brain during human evolution has caused deviation of the nasal septum in man. The authors studied the artificially deformed skulls and concluded that artificial deformation of the skull also influenced the shape of the nasal septum in various ways.
Impedance audiometry and otoadmittance meter are used more often recently f or evaluation of the ossicular chain, patency of the eustachian tube and middle ear pathology. They are called either tympanometry or impedancemetry. Reported here are the results of studies on normal and diseased ears done at Toho Medical School with the use of Type 1720 otoadmittance meter made by Grason-Stadler. A total of 102 ears, consisting of 64 normal and 38 hard of hearing ears, ranging 7 to 18 years in age, were tested. Tympanograms obtained can be divided into 6 types. Most of the 64 normal ears belonged to Type I, while most of the 12 ears with conductive loss to type 2 and most of the 26 ears with sensorineural loss to type 4. The results of our test reconfirmed the data reported previously on the hard of hearing ears. However, they showed several interesting findings in normal ears, which will be discussed in the paper.
Paspat contains autolytic products of streptococci, staphylococci, pneumococci, tuberculin and methylephedrine. 56.3% of 295 patients with nasal allergy showed positive skin reaction to Paspat. 60% of 129 patients who had responded positively to Paspat skin test showed positive reaction to nasal provocative testing with 10% Paspat. Thirty six patients who had responded positively to Paspat in both skin and nasal provocative tests were treated with Paspat hyposensitization. 0.2 ml of Paspat was administered intradermally once a week. Twenty-three patients were treated with Paspat plus house dust. The patients in the latter group had responded only to both Paspat and house dust in skin and nasal tests. Paspat was administered in the same manner and house dust was given with the regular hyposensitizing program. Thirty-one patients who had showed positive reaction only to house dust in both tests were treated with house dust hyposensitization and served as control. The efficacy of the treatment was evaluated by the change of symptoms. Percentages of successful hyposensitization in the 3 groups were 64.4%, 69.6% and 74.2%, respectively. The difference was not statistically significant. The results indicate that Paspat is a specific antigen leading to hyposensitization in patients who are sensitive to Paspat. The size of skin reaction to Paspat and house dust was measured during the course of hyposensitization in the 3 groups. The changes in size of skin reaction was not statistically significant between the 3 groups. The change in the number of eosinophils in nasal secretion was not statistically significant during the course of hyposensitization in the 3 groups. These facts suggest that Paspat did not faciliate formation of blocking antibody against house dust.
The diseases of the middle ear are known to cause paralysis of various cranial nerves, among which the facial nerve is most frequently involved. Report of paralysis of the abducens is rare after the advent of various antimicrobial agents. The authors report a 20-year-old male who manifested paralysis of the abducens as well as of the facial nerve due to chronic otitis media with cholesteatoma. The cause of the abducens involvement appeared to be an extradural abscess and/or inflammation of the petrous apex. The two nerves resumed functions after surgical treatment of the cholesteatoma.