A histopathological study on the relationship of the palatine tonsils to the adajcent mucous glands in 44 cases is presented. Even in cases of non-pathological tonsils infiltration of small round cells, chiefly lymphocytes, is observed to a certain degree around the mucous glands adjacent to those tosils. This is considered, however, as a functional and reactive migration of cells. On the other hand, in cases of severely inflammed tonsils it is observed that pathological changes i.e., inflammation of the tonsils hardly invades the adjacent mucous glands except for those groups of mucous glands with ducts whose orifices are situated in the crypts where severe pathologic changes are present. In general, it is confirmed that the mucous glands are hardly influenced by inflammatory changes in the palatine tonsils.
More than 60% of the cases of bilateral chronic otitis media are found to suffer from chronic paranasal sinusitis. This rate is more than two times in the cases of unilateral otitis media. When the patient as suffered from sinusitis, perforation is often formed by Wullstein's II type and adhesion is frequently made up by Wullstein's III type ; therefore, otitis media chronica will probably relapse afterwards even if tympano-plasty may be successfully nerformed. Treatment for sinusitis before tympanoplasty must be attached great importance to and the condition of upper respiratory tracts, especially of paranasal sinuses are considered in order to determine the indication of this operation.
Squamous cell carcinoma of the paranasal sinuses is said to occur infrequently in the first two decades of life. Having encountered such a malignancy in the maxillary sinus of a youth of fifteenth years of age, we concidered it worth bringing to your attention. Our original presumtive opinion was that the patient was suffering from an acute supprative hyperplastic left maxillary and ethmoidal sinusitis, and a left orbital abscess and spontane gangren. This conclusion was arrived at because of the age of the patient and the rapidity of the oncet and development of her symptoms.
The authors present an unusual case of primary carcinoma of the nasal septum in a young man, 22 years 7 months old, who works in a factory painting electric cars. No relevant facts were disclosed in his past or family history. There was no history of carcinoma in his family. The subjective symptoms of nasal obstruction and tenderness on pressure in the nose root region had been present for about one year and a half before the patient first visited a doctor who diagnosed his disorder as chronic sinusitis and performed a sinus operation. Postoperatively, a swelling in the nose root region on the left side was observed. In addition, polypoid growth in the region of the tuberculum of the nasal septum appeared, from which repeated biopsies revealed a histological picture of squamous cell carcinoma. The patient was admitted to the Toho University Hospital and treated with irradiation, radon-seed implanation and intravenous injections of Sarkomycin. Sincetermination of treatments to the present time three years and six months have elapsed without any signs of recurrence of the tumor and apparent cure has been achieved. The incidence of primary carcinoma of the nasal septum is evidently very rareas only 22 cases have been reported in Japan, not including the one presented here. Of the 22 reported cases, only two occurred in young adults. The case reported here is younger than these two cases and, therefore, is the youngest to be reported in Japan. In view of the occupation of the patient, paints may be considered as an important factor in the cause of the parimary carcinoma of the nasal septum in this case. According to histopathological study of specimens taken from the nasal septum, especially serial sections of the mucous membrane, cartilage and bone in the mass, it was learned that irradiation therapy was extremely effective in the treatment of this carcinoma which was believed to have originated from the tuberculum of the nasal septum.