The authos discussed various effects of hominization upon the structure of the ethmoid bone and ethmoid sinus. Among the effects are 1) degeneration of the ethmoid sinus as an olfactory organ, 2) degeneration of the ethmoid sinus due to autodomestication, 3) distortion of the ethmoid sinus due to sinus degeneration, 4) distortion of the sinus due to deflection of the nasal septum. Although the ethmoid cells are olfactory organs in mammals, in humans they have degenerated and regressed to the lateral wall of the nasal cavity. We named such changes “lateralization” of the ethmoid sinus and discussed the significance of this lateralization change in modern man.
The authors studied the mirror drawing test in patients with vertigo in addition to regular vestibular function tests, Yatabe-Guilford test and Cornell Medical Index(CMI). The mirror drawing test, a test to induce psychological stress, was used in an attempt to detect psychosomatic or neurotic tendency in patients with vertigo. Although the results of this study failed to reveal any significant difference from those of Yatabe-Guilford test, a comparison of the results of mirror drawing test with those of CMI indicated an interesting aspect in patients with autonomic nerve disturbances.
Thirteen cases of acoustic tumor manifesting sudden deafness(5 cases treated by the author and 8 cases reported in the literature) were investigated from the clinico-statistical standpoint. 1) 6.4% of patients with acoustic tumor manitested sudden deafness as the initial symptom. In 4 of the 13 patients the onset of acoustic tumor was preceded by symptomsof a common cold. In 6 of the 13 patients vertigo was present as a concomitant symptom. 2) Acoustic tumors manifesting sudden deafness often lacked charcteristic objective symptoms. The frequency of each symptom has been found to be comparable with the figures contained in the previous clinico-statistics on acoustic tumors. 3) Establishment of crucial diagnasis was delayed in most of these cases, the tumors, accordingly constituted brain tumors, 2 cm or greater in diameter, when the treatment started.
Twenty-three patients with continueous tinnitus were treated by masking noise. Masking noise is generated from the audiometer and the tinnitus masker is a modification of the hearing aid. In eighteen patients among 23, tinnitus was reduced or disappeared after receiving the masking noise treatment. The effect of masking was clearly better in the cases who received complete and long term masking. In five patients, however, tinnitus remained unchanged after the treatment. Most of these cases had severe hearing loss and their tinnitus could not be masked by masking noise from the tinnitus masker. The tinnitus masker which we used in this study generates a maxium of 70 dB white noise. From these results it can be concluded that the masking method is useful for the treatment of tinnitus. However, it is also true that this method should be improved to obtain better results.
A total of 131 cases of chronic sinusitis were treated surgically. In some cases intense postoperative reactive inflammation occurred, and in others scar formation was seen postoperatively. The opening of the maxillary sinus created by endonasal operation tended to be stricture dinthe presence of severe chronic maxillary sinusitis. In most cases, the maxillary sinus was cured with obliteration and reduction of the sinus cavity after Caldwell-Luc's operation. However, the most important thing is to correct ethmoid sinus. This is because the ethmoidal sinus is closely related with the drainage of the surrounding paransal sinuses. Therefore, it is necessary to treat postoperative lesions in the ethmoidal sinus: in other words, local and systemic drug therapy should be performed to control inflammations as early as possible and minor surgical correction should be performed to web formations, adhesions and granulation, Amongthe cases treated by exercising such cautions, control of inflammatory reactions in the early phase could be confirmed aftertreatment in 104 cases. In these cases, cure could be obtained with less scar formations. On the contrary, in 27 cases extensive scar formation was observed. However, it should be emphasized that even among 55 cases with severe scar formation, and granulation cure with open cavity could be obtained in 47 cases by performing minor corrective operations. We consider that corrective procedures should be performed not merely as extended procedures of postoperative curettage of granulation of scar but rather as reconstructive measures to promote functional recovery.
The authors report their experience in removal of a glass foreign in the esophagus. The patient was a 7-year-old girl who visited the hospital 3 weeks after she swallowed the foreign body. At the initial attempt to remove the foreign body under general anesthesia, the glass ball was lost out of sight. The surgeons presumed that the glass ball had fallen into the stomach. Roentgenograms taken on the following day, however, showed the glass ball still lodging in the same site. In the second trial the authors inserted a Foley's balloon catheter beyond the foreign body, then inflated it, preventing the foreign body from falling into the stomach. The foreign body was then pushed up with the balloon to the level of the second physiological constricture, where it was grasped under direct vision through a Takino's FOT to be removed successfully. The authors attributed the loss of the foreign body during the initial attempt to the following factors: 1) the surgeons had preconception that a round foreign body at the distal end of the esophagus tends to fall into the stomach, 2) the foreign body was covered with granulation tissue, 3) greater distensensibility of the mucosal walls at the ampulla phrenica and 4) the foreign body located on the right side of the esophagus, off the usual direction of the advancement of the esophagoscope.