So-called abnormal sensation of the throat is a symptom complex of the pharynx, larynx and esophagus. Such patients complain of feeling of a ball, a bar or other material stuck in their throats. The symptoms are often aggravated by swalloing and disappear on concentration, deglutition or speaking. The patient often worries about if he might have a cancer or some other serious disease (carcinophobia). These symptoms entirely depend upon the afferent action of sensory fibers of the glossopharyngeal nerve, vagus nerve or trigeminal nerve. Polysynaptic action of afferent fibers have a great role in the sensation of the throat. The distribution and action of allied nerves are also discussed. Certain laboratory tests are necessary to rule out organic pathology, such as carcinoma, inflammatory changes, benign neoplasms and others. X-ray fluoroscopy is the best examination to make adequate differential diagnosis in the pharynx, hypopharynx and esophagus. The followings are to be carefully observed during fluoroscopy, 1. interrupted or not of peristalsis of esophageal walls, 2. irregularity or smoothness of the contour of esophagaleal walls, 3. contraction and relaxation of action of cardia, 4. periesophageal compresseion, Endoscopic examination is another important procedure to be performed to rule out organic diseases.
Congenital bilateral choanal atresia is rarely encountered by otolaryngologists mainly because many such cases die soon after delivery due to obstruction of the nasal passage which is the only respiratory passage in new-born infants. Many such deaths may be reported as still-birth, therefore the actual rate of incidence of the anomaly remains obscure. Several hundred cases of choanal atresia have been reported so far in Europe or USA, while only about 40 cases have appeared in Japanese literature. The authors report a case of bilateral choanal atresia in a 6-day-old infant, who died in about a week after operation because of postoperative penumonia. The authors also report the difficulties during the postoperative period and discuss recent trends and procedures in dealing with this rare anomaly.
The authors report three cases of lingual cysts located at the radix of the tongue in infants. The cysts in the three cases were removed successfully without causing any functional disturbance. Although the incidence of the cyst had been regarded as quite rare, our experience and a review of recent literature seem to indicate that it is not as rare as had been previously considered. The recent advances in pediatric otolaryngology together with the development in anesthesiology and optical instruments helped facilitate the surgical treatment of such diseases in small infants. The attendance and cooperation of a pediatrician is essential for the adequate postoperative care for such patients.
We have conducted a viro-serological study on patients with Ramsay-Hunt's syndrome, Bell's palsy and sudden deafness during the past 3 years. Antibody titers to eight viruses ; influenza A and B virus, mumps virus, adenovirus, herpes simplex virus and varicella-zoster virus were determined by complement fixation test and hemagglutination inhibition test. All cases in the Ramsay-Hunt's syndrome group (7 cases) except one exhibited significant increase in the antibody titer to varicella-zoster virus. This result was similar to other reports in which varicellazoster virus has been considered as an etiological virus for the Ramsay-Hunt's syndrome. Out of the 11 cases of Bell's palsy, 3 cases (27.3%) showed significant increase in the titer to varicella-zoster virus. Some of other patients showed high antibody titers to influenza A and B, and rubella virus. No significant rise in virus antibody titer was seen in sudden deafness except one case. A four fold increase of mumps virus antibody titer was seen between the acute and convalescent phase of the disease. It seemed that mumps might be one of the etiologic factors for sudden deafness.
When a cuffed tube is used for tracheal cannulation, tracheal stenosis often occurs at the region corresponding to the cuff which may cause detubation difficulty. Such cases are reported in many papers but these troubles seem to show no decrease in frequency, and there has been no recommendable treatment for these patients. Surgical treatment has both merits and demerits. Recently, we succeeded in conservative treatment of these cases after 1 to 1.5 years. The results obtained are presented here. The authors report the conservative treatment in detail.
The author reports his experience with the use of an ultrasonic nebulizer apparatus produeced by Carl Heyer GmbH Bad Ems in Germany. Transition of aerosol of 20% glucose into the maxillary sinus was found to be much greater with this apparatus than with the conventional nebulization method provided that the natural ostium of the maxillary sinus is greater than 1 mm in diameter. The new apparatus will be found quite efficient in aerosol treatment in the field of otolaryngology.