The causes of MLF syndrome are generally considered to be vascular lesion, tumor, multiple sclerosis and head trauma. In clinical practice we often encounter such cases, where neurotological examination is important for the diagnosis of MLF syndrome. It is well known that MLF plays an important role in the system of vestibulo-ocular reflex. For instance, clear electrical potential can be obtained from MLF during the electrical stimulation of individual vestibular nerve branches. Such anatomical and physiological data are shown in this paper. On the other hand, when MLF is stimulated electrically in monkey at the level between trochlear and abducens nucleus, only the ipsilateral eye adducts. Furthermore, when electrical lesion is made in MLF, the ipsilateral eye cannot adduct. In clinical cases, MLF syndrome presents the following signs, as described by M. B. Bender.: 1) paralysis of ipsilateral ocular adduction. 2) nystagmus in the abducted eye during horizontal gaze. 3) preservation of convergence. In this paper, two clinical cases are presented, which showed typical MLF syndrome. The first case was suspectedly due to vascular lesion and the second case occurred after head trauma. For diagnosis of MLF syndrome, neuro-otological examination, especially the test of eye movement, is essential. So it is emphasized that the fundamental knowledge of MLF syndrome is important for otologists.
Both malignant and benign tumors can be seen in the nasal septum, but the incidence of either tumors is rather rare in Japan. The authors report a case of vascular leiomyoma (angiomyoma) of the nasal septum occurring in a 39-year-old male, and discuss the incidence, pathological features and surgical treatment of the tumor. Also described are the differential diagnosis of leiomyoma and vascular leiomyoma in relation to the location, incidence and pathological characteristics of the tumors.
The introduction of ventilation bronchoscopy has enabled the safer and more accurate removal ofbronchial foreign bodies among children and infants and at the same time, helped decrease the incidenceof complications such as pneumonia or bronchitis. From their experience in removal of tiny pieces of a peanut from the bronchi of an infant the authorsdiscuss the technique of foreign body removal and selective bronchial washing.
The authors report 20 cases (28 sides) of frontal sinus diseases, that had been treated with obliteration of the postoperative cavities with self-prepared heterogenous bones. The bones were prepared with 30% peroxydase solution, ether, ethylenediamine and ethylenediamine carbonate, the method reported from orthopedic department of Kobe University Medical School. Of the 20 cases, 18 cases or 25 sides showed uneventful course without complications. A case developed a postoperative fistula, which was successfully treated with simple curettage, the other case could not be followed. The authors proposed that self-prepared heterogenous bones can be an alternative to autogenous bone or deproteinized heterogenous bones available commercially.
The authors report a case of plexiform neurofibroma in a 16-year-old male. The tumor in the lateral neck deriving from a peripheral, nerve sheath was as large as a fist of man with dendrite extension into the surrounding tissue, which made complete removal difficult. The tumor did not accompany neurofibromat osis. Histopathological examination revealed neoplastic hyperplasia of the nerve fascicles associated with hyperplasia of the perineurium. Higher magnification showed hyperplasia of Schwann cells, fibroblasts and collagen fibers. This rare tumor is known for its high incidence of recurrence with proximal extension along the nerve, which occasionally cause compression of the spinal cord or central nervous system leading to grave consequences.
The author devised a new forceps incorporated fiberoptic telescope for easier removal of bronchial and esophageal foreign bodies, particularly in children and infants. With this instrument the surgeon has a clear view of the tip of Jackson's forceps together with a foreign body through the fiberoptic telescope. This very narrow instrument could be introduced through a 5mm ventilatory bronchoscope, and therefore, can be used even in infants The tip of the forceps is exchangeable making it possible to even obtain precise bronchial biopsy under direct vision. The versatility of this instrument also includes its use for laryngomicrosurgery, suction of secretion or specimen in the deep bronchial tree for cytological and/or bacteriological examinations, and selective bronchography.