Cancer of the oral cavity accounts for approximately 2-3% of all malignant tumors in the entire population of Japan. Squamous cell carcinomas are the most common malignant tumors of the oral cavity, representing a little over 90% of all oral malignancies. Poor oral hygiene and the habits of tobacco and alcohol and contraction of syphilis are all important underlying or predisposing factors. Metastases to the cervical lymph nodes certainly define a high risk category of patients and this has been well documented. Paradoxically, in spite of the fact that the mouth is readily accessible for inspection, biopsy, and radiotherapy the outstanding feature of these neoplasms is the poor prognosis of a type of cancer which presents exceptionally good opportunities for early treatment. The major implication is that diagnosis is usually late. Approximately 60% of oral carcinomas are well advanced at the time of their diagnoses.
The incus notch and the crista stapedis in auditory ossicles were investigated morphologically. Of 47 incudes the notch was present in 22 (47%). It was located in the inferior border of the short process of the incus, near the apex. Its depth and extent were variable. The medium degree of notch was most frequently found in the present series of ossicles (77%). Scanning electron microscopy revealed that a part of the posterior incudal ligament was anchored deeply into the notch of the incus. This suggests that the notch may possibly function to tighten the posterior incudal ligament to the incus. The crista stapedis was detectable in 9 of 32 stapeses (28%). It is an inconstant ridge passing between the crura on the tympanic surface of the stapedial base. Marked crest formation was extremely rare. In the mared degree of the notch, however, it was so large and high that the shape of the stapes resembed that of a fetus. This crest may be a remnant of a once-complete layer of the periosteal bone on the obturator surface of the base. Clinical and embryological significances of the incus notch and the crista stapedis are briefly discussed.
An otologic examiation of 582 school children, 1 st to 6 th graders, in the Tokyo area revealed that bilateral changes of the tympanic membrane such as redness or retraction had improved or disappeared as the children grew older. However, the unilateral changes, such as retraction localized to the posterior superior quadrant of the eardrum, persisted. The authors ascribed those unilateral changes to the inadequate development of the mastoid pneumatization due to inflammatory diseases.
Olfactory neuroblastoma is an uncommon tumor arising in the nasal cavity. Since the first description by Berger in 1924, about 200 cases of such tumors have been reported in foreign literature. In Japan 31 cases have been reported in the literature and in proceedings of various meetings. The authors report two cases of olfactory neuroblastoma. Case I. is a 67-year-old male, who complained of unilateral nasal obstruction and epistaxis. X-ray studies revealed an intracranial extension. Case 2 is a 69-year-old female who developed visual disturbance and complained of headaches. She was found to have an intracraniatl mass by computed tomography. Both patients died in spite of extensive therapy and the autopsy results are reported.
The authors report a case who placed an earphone in his right ear after drinking alcohol, turned up the volume to a high level to listen to channel 1 (NHK) on television and then fell asleep. After the completion of broadcasting late at night, he was exposed to the sound coming from the television continuously for about six hours, and developed a hearing defect. Fortunately, the hearing defect improved in about 10 days. This hearing disorder appeared to have occurred because the right ear was exposed continuously for about 6 hours to the interior sound of an FM detector circuit which exceeded 84.6 dB. Because the noise generated by an FM detector circuit after the completion of TV broadcasting has a higher sound level than that during broadcasting and also has more components in the middle register than normal environmental noise, the frequency characteristics are likely to cause hearing disor ders.
A case of thyroid cancer associated with marked eosinophilia in the peripheral blood is reported. The patient was a 65-year-old female, who suffered from a recurrence of thyroid cancer. She had hemithyroidectomy elsewhere about a half year prior. On admission, total thyroidectomy with total laryngectomy and neck dissection were performed because of tracheal invasion. Pathohistological findings showed mixed papillary and follicular adenocarcinoma. After further neck dissection, pulmonary metastasis developed. And leucocytosis and eosinophilia developed 5900 to 40800/mm3, 6.8 per cent to 39.5 per cent respectively, without apparent signs of infection. White blood cell count and eosinophil count were gradually elevated in parallel with the area of the metastatic lesions. Due to irradiation, eosinophilia partially decreased, but began to increase again. The results suggested that the tumor might produce some stimulating factors for eosinophil proliferation, although we could not detect the colony stimulating factor in that patient's urine, serum and tumor.
A 39-year-old man with Harada's disease had a sudden attack of vertigo with tinnitus and hearing loss of both ears. Repeated examinations of vestibular function and caloric tests indicated a canal paresis of the right vestibule. Pure tone audiometry, SISI and Beckesy audiometry showed the hearing loss to be of sensorineural nature. As was indicated by the results of electrocochleography, the hearing loss improved when the patient had remissive uveitis.
A case of blow-out fracture involving the medial wall of the orbit in a 40-year-old man is reported. The fractured bone fragments were repositioned and fixed in place both from the maxillary sinus and ethmoid sinus by using a 30 ml balloon in the maxillary sinus and a 5 ml balloon in the ethmoid sinus. CT images of the orbital contents revealed a thickening of the medial rectus muscle due to slackening of the muscle caused by retraction of the globe, which was presumed to be a sign of fracture of the medial wall of the orbit.