Cysts developing in the posterior paranasal sinuses viz. the posterior ethmoidal sinus or sphenoid sinus manifest more often symptoms relevant to the eye or the brain than the ones to the paranasal sinuses. The authors report 3 such cases and reviewed 90 other cases so far reported in the literature as to the incidence, age and sex distribution, specialities to which the patient sought medical aid first, duration of the disease, roentgenologic findings, treatments, pathology and bacteriology. It was found that the prognosis of the visual disturbance depended mainly on the time lapse between the onset of symptoms and operation. It seems important to perform an operation within two weeks of the appearance of the visual disturbance or one month at the latest. The importance of the use of fiberoptic telescope in operations for a detailed observation of Incal natholoav and meticulous surgery at the critical region is stressed.
Since the initial report by Albinus in 1754, there are many reports on so-called reversed (displaced) teeth which grow in abnormal positions due to misdirection of teeth eruption. The authors experienced 6 cases of displaced teeth, 2 in the maxillary sinus, 2 in the nasal cavity and the 2 others in the frontal process of the maxilla. Most cases of displaced teeth in the nasal cavity seem to be found during infancy with various symptoms such as nasal obstruction, rhinorrhea and nasal bleeding. But the teeth displaced in the maxillary sinus or frontal process of the maxilla are mostly asymptomatic, accordingly, the displaced teeth are found very late incidentally by X-ray examination when the patient visits the hospital with nasal symptoms.
The first case is a 57-year-old female who has been diabetic for 8 years and whose hearing of the right ear was 61.25 dB with a gradually sloping typed hearing loss. This case was not cured. The second case is a 46-year-old female who has been diabetic for 2 years, and whose hearing of the right ear was 71.25 dB, with a flat typed hearing loss. The hearing loss recovered in the low frequency range. Sudden deafness in diabetics is uncommon but tends to be a bilateral and gradually sloping type. It is suggested that the patients with diabetes may require periodical hearing tests.
The author studied the results of 1949 tympanometries in 981 patients with middle ear infections and summarized the results as follows: 1) Many cases of acute otitis media in children showed type B tympanograms during convalescence from infections. The frequency of type A increased in elder children. Only a few cases showed type C in adult patients. 2) Regular monthly follow-up of patients with acute otitis media showed a tendency for tympanograms to return more rapidly to normal in older children than in younger children. 3) The paracentized ears required longer periods before their tympanograms returned to normal than did the non-paracentized ears.
A case of primary malignant fibrous histiocytoma of the maxillary sinus occurring in a 41-year-old woman is described. This neoplasm spread rapidly and the patient died 17 months after surgery. At autopsy, widespread metastases involving the lung, thorax, kidney, vertebrae and brain were found. Malignant fibrous histiocytoma frequently occurs in the extremity, trunk and retroperitoneum. It rarely occurs in the paranasal sinus. It's histological origin remains controversial.
The authors introduced a simple method of esophagoscopy by utilizing a fiberoptic laryngoscope or bronchoscope, which can be done in the out-patient clinic. In this procedure, a fine Nelaton catheter is attached with adhesive tapes to the laryngoscope, through which suction or insufflation is feasible during the examination. The patient is placed in a sitting position in an examination chair. Foregin bodies and tumors in the esophagus are readily found with this method without causing undue discomfort to the patients. The procedure is easy to perform and it takes very little time.