The purpose of this study is to clarify the clinico-anatomical relation of the nasal septum to the lateral nasal wall. The anatomical preparations used in this study were nasal blocks procured from 69 autopsy materials which were found to be free from diseases of the mouth, pharynx, larynx, nose and accessory sinuses. In preparing nasal blocks, much care was taken not to spoil the natural view of these anatomical structures. Frontal sections of these blocks were made after imbedding in celloidin to facilitate observation on the topographical corelation of the nasal septum to the lateral nasal wall. As the result of thses observations, the compensatory hypertrophy of the middle turbinate was revealed to be closely related to the shape of the nasal cavity, particularly that of the nasal septum. Furthermore, the deformity of the nasal septum, attributable to the anatomical change of the lateral nasal wall, was also observed; i.e. tubinatory deviation of the septum. The anatomical change of the lateral wall was ascertained to be the protrusion of posterior portion of the nasal cavity, namely that of the posterior ethmoid cells direced toward the septal side. In this connection, state of rima olfactoria was examined also to reveal some cases with abnormal form to exist, which had not been hitherto observed. The abnormality of rima olfactoria in shape was also found to be closely related to pathological changes of the accessory sinuses. The author arrived at a conclusion that emphasis should be laid on the necessity to draw attention on the above mentioned pathological forms of the anatomical features when one preforms a reconstructive operation of the nasal cavity.
This study was undertaken in an attempt to investigate influence of proteindeficient condition on healing of operative wound of the frontal sinus from the histopathological standpoint. The materials used in the present study were 16 dogs, which were divided into two groups according to the manner of diet. Half of them were fed with standard diet and the other half with protein-deficient diet. The operation of the frontal sinus to remove the mucous membrane within was performed in each one of these animals and the feeding had been continued in the same way until they were put in decapitation for fixation at a certain time different in each case during the period from 10 days to 6 months after the operation. From histopathological observations on the specimens obtained from these materials, it was revealed that granulation tissue appeared in the operated area turned to be cicatrized in 6 months in the formerrgroup, however, edema and cell infiltration were still observed to remain at the same stage in the latter. As to the regeneration of epithelium, the appearance of newly formed epithelium with squamous or cuboid form took place in 30 days, that of columner epithelium in 4 months and that of pseudostratified columner epithelium in 6 months in the former group. On the contrary, regenerated epithelium with squamous or cuboid form appeared in 6 months in the latter group. In healing process of bony tissue, there were two types observed during this period, in the former group. That is to say ; the one showed an osseous impaction of the cavity in 3 months and the other exhibited cavity formation with involution of primitive medullary cavity and newly formed trabeculae. On the other hand, primitive medullary cavity and newly formed trabeculae of the bone were still observed at this stage of 6 months in the latter group. The bony window (aperture) at the tegman was found to be closed in 30 days after the operation in the former group, however, it was kept opened even after 6 months in the latter group. The mucous membrane remained in the sinus displayed, in both groups, cell infiltration and edema in submucosal tissue and it appeared to impair development of granulation tissue. Marked lose of weight in the protein-deficient group was observed only in cases subjected to long standing experiment. From these results, the author gathered that protein-deficient condition was considered as a deterrent factor of healing mechanism of operative wound.
The author made investigations on 40 cases of total extirpation of laryngeal carcinoma consisting of 19 cases operated at Department of Otorhiro-laryngology, Nihon Medical College and 21 cases of Massachusetts Eye & Ear Infirmary where he had studied. The studies were done on types of the carcinoma which had influence on postoparative prognosis, invasive range of the carcinoma, histological malignancy, whole histological construction and metastasis to the lymph nodes. 1. As for the relation between invasive range and postoperative recidivation, recurrence was increasingly frequent as the stage of the disease went on. The data obtained were as follows: Stage I -16.6%, Stage II -33.3%, Stage III-41.7%, Stage IV-60.0%. 2. The results of studies on relation between types of the carcinoma and postoperative recidivation revealed that rate of recurrence was 21.6% in glottic type, 41.7% in subglottic type and 55.5% in supraglottic type, showing low frequency in glottic type and high frequency in subglottic and supraglottic types in comparison with glottic type. No definite difference between rate of recurrence in subglottic type and that in supraglottic type was seen. 3. The author confirmed on total sections of laryngeal cardinoma that keratinization, presence of intercellular bridge, number of pictures of karyokinesis, and polymorphism of cells and nuclei were closely connected with postoperative recidivation, and thus established the standards in judgement of malignancy to presume prognosis histologically. This method seemed to be more complete than Broders'. 4. Results of examination on total sections showed that the histological pictures were rich in regional variety. Therefore, such pieces of tissue as obtained by biopsy were to small to understand the whole histological manifestations. 5. For this reason, carcinoma alveoli were classified according to types of carcinomatous development. Postoperative recidivation was more frequent in mushrooming type than in extending type or hypertrophic type. Type of intravascular development was seen in 5 cases complicating mushrooming type and all of them died of postoperative recidivation showing high rate of recurrence. 6. The whole histological constructions of the carcinoma including developing types and size of carcinoma alveoli, and inflammatory cell infiltration were classified in 3 types. The rate of recurrence was high in mushrooming type of small carcinoma alveoli. 7. Postoperative prognosis of laryngeal carcinoma from the histological viewpoint should be judged not only from the promary focus, but also from the metastatic foci. The regional lymph nodes began to prepare themselves to metastasis when inflammatory change of carcinomatous foci came to involve them.