The paranasal sinuses can be seen in animals higher than reptiles, and 13 different types of paranasal sinuses are known to exist in various animals. There is, however, no generally accepted concept regarding its entity and function. The author proposes the following view concerning the advent of the paranasal sinuses in animals and man. The maxillary sinus and the frontal sinus appear around the ethmoturbinate which is essentially an olfactory organ. In order to adapt to the erect position and to obtain a secure foundation for strong muscles of mastication, the facial bone has been gradually transformed, during which process secondary sinuses have come in to existence. The paranasal sinuses had been beneficial for lightening the weight of the head and for obtaining a buffer effect on impacts. Due to the advancements of visual organs in primates, the ethmoid bone had regressed to a smaller cavity. In man, further enlargement of the maxillary sinus occurred due to retraction of the facial cranium and enlargement of the molar teeth. In the process of hominization even further enlargement of the frontal and the sphenoid sinuses took place. The paranasal sinuses therefore seem to have developed during the process of advance of animals per se and particularly the advance of the olfactory organ, respiratory organ and the brain by means of both the allometry and the preadaptation phenomena.
Vestibular function tests were performed on 19 patients who had lost sight because of various diseases: 3 of pigmentary retinal degeneration, 3 of chorioretinal atrophy, 4 of diabetes mellitus, 4 of Bahcet's disease and one each of glaucoma and uveitis. Of the 19 patients three had subjective sense of disturbance in balance. The vestibular function test included Romberg's test, Mann's test, gait test and stepping test and writing test Results of Romberg's test and gait test were within normal limits in all the cases regardless of the presence or absence of a hearing defect or of subjective sense of disturbance. Results of Mann's test and stepping test were often abnormal in the patients with normal hearing. Interpretation of the results of writing test should be made in comparison with the findings of other tests for the upper extremities because these patients are lacking in the habit of writing. Mann's test and stepping test were found to be useful in testing the vestibular function in these patients, and at the same time, gait test was essential because the chief complaint of patients was frequently deviation in walking.
The subjects of the present study were 1393 patients with nasal allergy who had visited the allergy clinic at the above facility during the past 6 years. The patients with nasal allergy occupied 4% of all the patients visiting the hospital in 1982 compared with 1.8% 6 years ago. The most frequent single allergen was house dust, while the most frequent combined allergens were house dust and mites. The highest incidence of allergy occurred in March and August for house dust, March and April for cedar pollen and March and August for rag weeds. The result of observations at the allergy clinic indicated that hyposensitization should be continued at least one year in order to obtain significant results.
From 1970 through 1980, 228 airplane crew who failed to satisfy criteria for physical examination for airplane crew were studied. Of the 228 crew 65 were successfully followed up over 5 year periods as to the changes of hearing threshold. Their hearing threshold deteriorated about 10 dB at 2 kHz and 3 kHz in 10 years. The hearing loss in left ear was more frequently found than in the right. Because noise level (Leq) in cockpit was found to be about 90 dB, the noise did not seem to have caused the hearing loss. The authors presumed that hearing loss in cockpit crew might be either due to head phone sound from which the aircrew hear ATC (Air Traffic Control) from the control tower or to an individual hypersusceptibility.
Swollen cervical lymph nodes are of frequent encounter to otolaryngologists. They include maligant lymphoma, metastatic cancer, tuberculosis, infectious mononucleosis and reactive lymphadenitis. In most instances, the swollen lymph nodes are secondary manifestations of various other diseases. However, it seems to be a recent trend that clinical pathologists regard the diseases of the lymph nodes as an independent category. Necrotic lymphadenitis is one of a few diseases that considered to be an independent lesion of the lymph nodes. The authors report three such cases ; 2 cases was confirmed by histopatholgical studies and the other by evaluation of titer for EB virus.
A 32-year-old woman sought medical care after she had had tracheostomy because of difficulties in swallowing and breathing due to severe pharyngeal stenosis as a complication of Behcet's disease. A large U-shaped skin flap was prepared first in the anterior cervical area. After wide exposure of the pharynx by removal of the cicatrization the U-shaped skin flap was placed onto the radix of the tongue. The raw surface of the posterior wall of the pharynx was covered with a free skin graft. After one and a half months and irradiation of 2100 Rad, the wound was closed successfully obtaining an enough space for breathing and swallowing.