In this presentation the following interesting problems of sinobronchitis are discussed: the high incidence (30%) of bronchitis in younger children with sinusitis, co-incidence (60-75%) of the upper respiratory infection and small airway disease, relationship between sinusitis and bronchitis from the viewpoint of sero-immunological factors such as IgA, IgM, IgG and Alpha1-antitripsin, clinical difference between sinobronchitis and allergy of the airway. Finally, congenital diseases (Mounier-Kuhn Syndrome, Kartagener's Syndrome and cystic fibrosis of pancreas) which most frequently develop sinobronchitis were discussed.
Clinical observations of 62 patients with head and neck malignant lymphomas who were treated between 1966 and 1975 at the Otorhinolaryngological Clinic of Kanazawa University Hospital are reported. There were 49 cases (79%) with reticulum cell sarcoma, 8 cases (13%) of lymphosarcoma and 3 cases (4.8%) of Hodgkin's disease in the series of 62 patients. Malignant lymphomas were observed most frequently in the tonsil (33.8%), and then, in the nose and paranasal sinus (27.4%). Thirty-five of 62 malignant lymphoma cases were accompanied by regional lymphnode swelling at the first visit. The lymphnode swelling was more frequent in the tumor of the tonsil, while less in the tumor of the nose and paranasal sinus. Many cases with malignant lymphoma in the nose and paranasal sinus were of the type of progressive necrotic rhinitis. Staging classification of the cases of this series showed 27 cases (43.5%) as Stage I, 31 cases (50%) as Stage II, 4 cases (6.4%) as Stage III and none of Stage IV. The patients in the first half of this decade were treated chiefly with irradiation therapy, and those in the latter half were treated chiefly with Vincristine (VCR) together with irradiation therapy or with some other antitumor agents. Comparison of these two groups proved that the patients treated chiefly with VCR showed longer survival than those treated without VCR and with irradiation therapy chiefly. It was proposed that in the treatment of malignant lymphoma, chemotherapy (chiefly with VCR) should be applied even at the early stage of the disease, combined with irradiation therapy if necessary, for the malignant lymphoma would be scattered to various sites of the hosts in the very early stage of the disease.
The successful operation of thyroglossal fistula depends upon a total resection of the epithelial layer without leaving even a minimal residue of the tissue. A contrast X-ray study of the fistulous tract is of prime importance to attain the above objective. The authors used a plastic cannula for intravenous infusion to inject a contrast medium into the thyroglossal duct and found it very useful in a 19-year-old male with median cervical cyst. The method of this procedure and the surgical techniques are discussed.
Among various diseases and causes that might produce an unusual sensation or discomfort in the throat the authors report diverticula of the hypopharynx as a possible factor, as they have seen three such cases as follows: Case 1. A 41-year-old male who complained of discomfort in the throat was found to have a small diverticulum about 1.5 cm deep at the vallecula in a barium swallow test. Case 2. A 66-year-old female and Case 3, a 72-year-old female, both with functional diverticulum of the pharynx. Increased pressure in the pharynx on swallowing produced retraction of the pharyngeal wall between the middle and lower pharyngeal sphincter muscles. The related literature literature was reviewed and the clinical significance of the disease is discussed.
Percutaneous electrocoagulation of the trigeminal ganglion and rootlets in the surgical treatment of trigeminal neuralgia provides a safe method for achieving longstanding relief of pain without some of the objectionable side effects associated with other forms of surgical therapy. This procedure can be performed in any individual regardless of age or debilitated condition and be repeated without increased difficulty or hazard. Temperature control during radiofrequency lesioning enables selective destruction of pain fibers in the trigeminal ganglion and rootlets while preserving many fibers for touch and motor function in the face in the majority of patients and whenever necessary it can produce complete anesthesia of the whole trigeminal nerve like rhizotomy. The authors report their experience in four patients with trigeminal facial pain operated on by this procedure. In one of them with typical trigeminal neuralgia, pain was not relieved since the electrode tip could not be placed among the desired rootlets because of the narrow foramen ovale. The two patients with cancer pain have maintained complete trigeminal anesthesia andanalgesia, but one of them has complained of a sort of facial pain derived from another cranial and/or cervical nerves.