The author made a clinical and histopathological study on 48 cases of recurrent frontal sinusitis developed from 10 days to 24 years after radical operation (Extransal procedure) of the frontal sinus. The materials used in the present study were 105 specimen including regenerated tissue and remained mucosa in the frontal sinus obtained at reoperation. The finding of the operation was also referred to note at the same time. The main cause of postoperative recurrence of frontal sinusitis is considered attributable to the mucosal epithelium remained in the sinus at the former operation; 36 of 48 cases were found to show the presence of remained mucosa, but other 12 cases exhibited non-existence of the mucosa. The frequency of the site of remained mucosa in the sinus is shown as follows; lateral fossa (Recessus lateralis)-14 cases, central part of the frontal sinus-9 cases, anterior ethmoid cells-6 cases, inner wall of the frontal sinus-4 cases, tegmen of the ethmoid cells, interosuperior wall and upper wall of the sinus-one case respectively. 8 cases were found to contain remained mucosa at more than two portions in the sinus. In cases following usual course of recovery, regenerated tissue appeared in the frontal sinus after the operation required 30 days in its completion. In these cases, the frontal sinuses were found to be filled entirely with healthy tissue. New formation of bony tissue in the sinus was observed in the specimen of the 15th day of operation. The process of ossification covered the entire stadiums of cases. In cases with remained mucosa, cellular infilturation was most markedly observed within the period of 6 months or a year. In other words, it is well understood that at this stage of the postoperative course of frontal surgery, the sinus shows itself to be most likely affected by infection from clinical standpoint, displaying high re.-activity. Regenerated tissue in co-existance with remained mucosa, becomes the most dense in texture during the period from 6 months to five years. 69% of cases with remained mucosa passed over the period of more than a year, showed abnormal thickening of basilar membrane of the mucosa. The most prominent changes observed in the remained mucosa were those of glandular tissue; flattening and cystic enlargement of glandular cells with occasionally observed remarkable hyperplasia or my omatous degeneration shown in the specimens. Regenerated mucosal epithelium was observed in 6 of 48 cases. As a conclusion, the only way to avoid previously development of recurrent frontal sinusitis is thought to consists in the total removal of mucosa of the sinus at the fist operation supplemented by ethmoid surgery which opens and cleans the cells radically.
In First Chapter: Thd Materials used for this study consisted of 71 cases, ranging between 14 daysbaby and 79 years of age. The cases in which the diseases of the salivary glands, mouth and pharynx were the direct cause of death were excluded. I studied these materials annualy and histologically, about glandular cells, intercalated duct, streated duct, excretory duct, interstitial connective tissue, fat cells and Iymph tissue. In Second Chapter: Clinically and Pathologically, I studied 14 extracted maxillary glands ofsaliolithiasis. The stastical observation of 98 saliolithiasis, which was reported in Japan from 1941 to 1957, was made. In Third Chapter: Based on these facts, I mentioned the cause and treatment of this disease.
The author had introduced the tests on the function of the auditory tube hitherto used and stated how the aviation aptitude tests should have been done. This time, direct and indirect tests of the auditory tube were done on the aviators of civilian airlines. As direct tests, the quantitative test by Valsalva's method was done on 132 cases and the functional test of the auditory tube by sound-wave following Perlman's method was done on 128 cases. As for indirect tests, the test of tendency of acute and chronic inflammation of the upper respiratory tract which might cause insufficiency of the auditory 'tube was done in parallel with oto-pharyngoscopic examination. Making 34 mrn.Hg in resistance to air douche and 2.0 (6db.) in opening rate of the auditory tube the limits, those who had less value in the former and more val in the latter were found to be not easily affected by aviation injuries of the Middle ear. However, it did not mean that the tendency of aviation injuries of the middle ear was seen more beyond these critical points. In other words, these results did not. bring much convenience to the physical examination for adoption of aviators, but. were helpful to know the etiology of the injuries. Such results seemed due to the fact that acute inflammation of the upper respiratory tract played the most important. part in the cause of aerotitis media. Therefore, it was quite significant to make efforts to find symptoms which showed the tendency of acute inflammation of the, upper respiratory tract.