The author discusses various useful aspects of laser surgery as a new armamentarium in otolaryngological practice and generalized that, 1. Laser surgery of tracheal stenosis under the bronchoscopic control is one of the most useful means in otolaryngological application which can not be substituted by any other alternatives. 2. Resection of tumors or other superficial diseases by laser, which causes little bleeding and less insult to the neighboring tissues can constitute relative indication of laser in otolaryngology. 3. In treatment of cancers laser can be used as the sole treatment for TIS, T1, γATi cases with good results. Bulky tumor masses can be debulked effectively by this method. 4. Nd-YAG laser has been confirmed to be particulary effective in surgery of hemangiomas and other readily bleeding tumors.
Human olfaction is known to have regressed and it is now far inferior to the that of other mammals. The author ascribed the regression to hominization and urbanization in the process of human development. It is speculated that the regression of olfaction began in the primate stage and acutely retrogressed during the urbanization of Homosapiens. Modern culture, abuse of olfaction or decadence of man might have contributed to the regression. The process of such regression in biological activity may evolve in the human sex in the future.
From the study of 7 cases of cholesteatoma of the external auditory meatus, the authors summarized the characteristics of the disease as follows: 1. Chronic granulation with inflammation was seen in all cases accompanied by enlargement of the bony canal wall. 2. Matrix of cholesteateatoma and debris were found in the proximal part of the canal. 3. Destruction of the annulus tympanicus and thinning, retraction or perforation of the tympanic membrane were seen in some cases. 4. Cholesteatoma of the external auditory meatus has the potential to pervade into the middle ear. The authors speculated its etiology as a disturbance of migration of the epithelial layer, which brings accumulation of exfoliated cells, secretions, debris where infections supervene to form cholesteatoma with erosions of the bony canal wall. Most of these cases can be controlled by coneservative measures, while surgical removal with a free skin graft may be necessary in a few cases.
Adriamycin is one of the chemotherapeutic agents for treatment of neoplastic diseases. However, the use of this agent is often hindered by its adverse side effects. Adriamycin ointment was first reported by Fukuda et al. in 1981, and their report described remarkable results when this ointment was used for treatment of local recurrence in breastcancers. Our newly developed adriamycin ointment was used on a patient with recurrent ethmoidal cancer appearing on the forehead. The patient showed a remarkable improvement with severe necrosis of the tumor when application of this ointment was combined with radiation therapy and hyperthermia. No severe adverse side effects were found except for a slight alopecia. We conclude that adriamycin ointment is useful as a local chemotherapeutic agent for head and neck cancer patients when used in combination with various other treatments.
Two cases of psychotic patients were studied, one with hypochondriasis and the other with cenesthopathy, both complaining of discomfort in the throat, . Many patients with hypochondriasis visit otolaryngological clinics with complaints of discomfort in the throat, which can be improved by careful treatments by the otolaryngologist. The cases of cenesthopathy however, must be treated by a psychiatrist even if the complaints are confined to the throat. The psychiatrist can benefit greatly by knowing the nature of exact pathology of the thorat in these patients.
The authors report four cases of cancer of the external auditory meatus. One of the cases involved the cartilaginous portion and the other three cases the bony portion in the external auditory meatus. Two cases had a history of radical mastoidectomy and one had a habit of ear scratching. In the three cases with cancer in the bony portion, chemotherapy by arterial infusion was performed prior to surgical treatment. In a case that showed some response to the chemotherapy by arterial infusion, although the area of dissection was reduced, a recurrence was observed. In the other cases where dissection was made en block inducing the cartilaginousand bony portions of the external auditory meatus and the middle ear, no recurrence was observed. The authors concluded that even in cases where preoperative radiation therapy and chemotherapy by arterial infusion were found to be effective, dissection should include a wider area in order to prevent recurrence.
The clinical course, histological findings, treatments, and other characteristics in 4 cases of his own and 429 others reported in the literature are reviewed. The authors summarized the characteristics of this disease as follows. 1. This is a chronic and benign disease found chiefly in young males. 2. The main signs are development of masses in the subcutaneous soft tissue suchas parotid, submandibular, or buccal region, and generalized enlargement of superficial lymph nodes independently or in combination. Furthermore, in some cases, there are complaints of pruitus and pigmentation at the site of swelling. 3. Histological picture of such masses or lymph nodes shows neoplastic or hyperplastic lymph follicular structure accompanied by large, well defined germinal centers, and at the same time marked infiltration of eosinophils can be seen in the interfollicular tissue. 4. Leukocytosis, eosinophilia, and an increase of serum IgE are found in the majority of the cases. 5. There are many reports which consider the disease an atopic allergy or a Type I allergic reaction whose allergen is Candida albicans. 6. The authors observed that the frequency of recurrence in the cases treated by surgery alone or by corticosteroids alone was high, and the response to Oxyphenbutazon and irradiation was good. It is concluded that this disease should be treated in combination with surgery, chemotherapy and irradiation rather than by a single modality of treatment alone.