Concerning the maxillary, ethmoidal, and frontal sinuses from 0 to 20 years of age, we studied roentgenologically about their developments and undertook general observations about them. In this experiment, we established a unit length for measurementfor the purpose of eliminating roentgenographical errors and measuring the true development, and classified them morphologically. In consequence the characteristicsof the development of the paranasal sinuses and the correlation in development betweenthe paranasal sinuses have made clear. Furthermore some amendment is applicable to the old standard of the development in age of the paranasal sinuses. We believe this clinically a concrete guide to the treatment and an important knowledge.
The clinical significance of hypertrophy of the tubercle of the nasal septum was reviewed on the basis of data obtained from the following materials: 1) Statistical observations made on 5, 395 cases who received the mass physical examination, and on 2, 286 cases who visited our clinic as patients. 2) Histopathological observations made 134 specimens of clinical materials. 3) Histopathological observations made on 63 specimens of cadaveric materials. From the observations mentioned above, hypertrophy of the tubercle of the septum was found to be commonly encountered in daily clinic with the close relationship between its occurence and sinusitis. It also gives rise to various clinical troubles due to anatomical feature of its location. In treatment of chronic sinusitis, therefore, the significance of the hypertrophy of the tubercle septi should be realized to be taken into consideration. As a conclusion, the present author is positively of the opinion that one should call full attention to the presence of the tubercle septi at the time of examination of nasal disorders in daily clinic.
Object of study: As a fundamental problem of bone pathology of sinusitis, histological and clinical-anatomical studies of the respective bones constructing the paranasal sinus were carried out. Method: Materials for observation were obtained from cases autopsied. Using the method based on Luc-Caldwell's operation combined with method in which one enters directly the ethmoidal sinus through the route of the canopy of the ethmoid, 76 specimens from respective areas of bone wall of the paranasal sinus were taken for study furthermore, 30 secimens of the nasal septum including surrounding middle meatus of nose, lomina orbitalis and ethmoidal canopy as a whole entity were taken out preserving the specific anatomical and structural relation of each respective bone. Dividing the materials into the group with gross pathological findings and that of normal, the histological findings of the two were discussed together with the observation of bone wall of the operated cases of sinusitis in which lesions are of slight grade, as a control for comparison. Conclusions: Even of both the maxillary sinus and ethmoid which were macroscopically considered as normal, some changes of bone in its reconstruction mechanism were recognized, though admissable as of physical range;and also local differences according to specific portion of the wall of the sinuses and those according to age were confirmed. In general, the ethmoidal sinus proved to possess higher activity in reconstruction mechanism with active tendency of absorption, compared with the mexillary sinus;and in the latter compact character of the change was intensified.Among the age group under 30 years old, reconstruction mechanism with active proliferative character was manifested with conpact change, whereas among the group over 50 years old changes with a tendency of absorption increasingly took place. Of the canopy of the ethmoid the reconstruction mechanism was markedly mani fested in the inner wall of the Haversian canals and mostly the findings were of compact change. Those with inflammatory lesions of gross findings in the sinus and its mucous membrane manifested stronger affect of bone especially of absorptive character in comparisone to the normal specimens.The findings belonging to the category of osteitis or osteomyelitis, however, were very seldom encountered, and the observed cnanges were to be regarded as those due to the accelerated reconstruction mechanism evoked by the repeated and prolonged inflammatory affect of the mucous membrane of sinuses. Serial section of bone wall of the ethmoidal sinus prepared with emphasis to maintain solid structure enabled us to follow up both the findings of mucons membrane and bone wall in their associating relation and the systemic observation which might be impossible to be obtained from those specimens prepared from tiny pieces of the respective bone.