The human sinuses have developed in accordance with the development of man from Ramapithecus through ape man, early man old man and to modern man. During the developmntal process the morphology of the nasal cavity and paranasal sinuses has changed toward greater sinus cavities, lateralization of ethmoid sinuses and deflection of the septal cartilage. Although resistance of man against infections has been modified in various ways during the developmental process, modern man has become more susceptible to allergic reactions. The author describes his concept on the effect of human culture upon morphological changes, infections and inflammations in man during the process of human development, namely, hominization.
Based on many previous works concerning radiological diagnosis of chronic sinusitis the author reevaluated the significance of radiological examination in diagnosis of chronic sinusitis in children. The study indicated that a reliable diagnosis can be attained through informative radiograms by adjusting meticulously the position and condition of exposure in each individual. The pathologies of the ethmoid sinus are well shown in posterior-anterior views, of the maxillary sinus by Waters view and of the sphenoid sinus, posterior ethmoid sinus and nasopharynx by lateral views. It is also indicated that contrast studies in children have the same diagnostic significance as those in adults.
The incidence of candidiasis of the paranasal sinuses seems increasing in recent years due to spreading use of antibiotics. The authors report 3 cases of such candidiasis occurring in a 51-year-old and a 53-year-old female and a 56-year-old male, all in the maxillary sinus. Aspergillosis has been confirmed by pathological examination in all the cases. In one of the cases Caldwell-Luc's operation was performed followed by antral irrigations. The other two cases were treated only with antral irrigations.
The inferior turbinar bone has a rough and irregular indented surface; therefore, the mucoperiosteum cannot be separated with a blunt elevator, as in septal surgery. The author devised a new elevator used for submucous resection of the inferior turbinal bone. With this curette elevator the surgeon has a complete separation of the mucoperiosteum by sharp dissection from the lateral and medial surfaces of the inferior turbinal bone, if there is a tendency for the bone to cling to the mucoperiosteum. Tearing of the covering mucosa is thereby avoided. The instrument is made by Nagashima Medical Instruments Co., Ltd.