The patency of the hiatus semilunaris is essential for a cure of sinusitis in children. To open the closed hiatus, irrigation therapy is one of the best conservative measures. The present study was undertaken to determine the effect of a mixture of antibiotics and steroid in irrigation therapy for chronicsinusitis. Forty nine children with chronic sinusitis were divided into two groups, accrding to the kind of the drug administered, that is, the patients of one group were administerd with the mixture of antibiotics and steroid after each irrigation, the patients of the other group were treated with simple irrigation only. After the treatments, the condition of the hiatus, the cure rate and the period required for cure were compared. Furthermore, the resistance during the antral irrigation was used as an index determining the degree of opening of the hiatus. The results obtained from this study were as follows: 1) The average cure rate in the irrigation therapy was 35%. 2) The difference was not significant between the two groups in the rate of improved resistance and the cure of sinusitis. 3) The resistance at the last irrigation was minimal in all the cured cases. 4) The maximum and average frequency of irrigation were 15 and 5.2 times respectively, and in 90% of the cured cases the number of the irrigation therapy was less than 10. From the above results, it was suggested that the topical administration of the mixture once a week could not improve the disease considerably. In addition, the standard number of irrigation seemed to be 10 times in order to determine the usefulness of the irrigation therapy.
Fibrin sealant (Tisseel Kit) was used in 21 surgical cases in otolaryngology ; seven cases of middle ear surgery, one plastic surgery of the external auditory canal, six salivary gland tumors, three tonsillectomies and four maxillary sinusectomies. In three cases of tympanoplasty, Plasti-Pore TORP was fixed to the footplate of the stapes with the fibrin sealant. The fibrin sealant was also used to seal the fistula of the semi-circular canal in four cases. In surgery of the salivary gland the fibrin sealant was used to seal the leakage of saliva. In tonsillectomy it was effective in hemostasis. The agent has been found to be quite useful in fixation, suture reinforcement, filling, hemostasis and wound coating.
Transtympanic injections of Decadron (2 mg) were performed in 166 patients with tinnitus in the E.N.T. clinic at the Kobe University Hospital and Kobe Central Municipal Hospital. A variety of tinnitus patients without case selection were included in this study. Most of these patients had been previously treated in other clinics. The results obtained were as follows: (1) In 11 patients, tinnitus disappeared completely and in 56 patients, improved considerably. (2) This treatment was not effective for tinnitus due to CNS disorders. (3) The effectiveness of the treatment was not relevant to the duration, nature or the affected side of the tinnitus and also to whether the tinnitus was consistent or interrupted. (4) No permanent side effects were found.
A case of parotid mucoepidermoid tumor manifesting various cranial nerve symptoms, and pronounced cervical metastases without any physical findings such as abnormal X-rays, is reported. This case presented difficulty in diagnosis. From the finings during the operation and autopsy, it seemed that various cranial nerve symptoms had been caused by tumor invasions to the skull base and subdural area by direct infiltration of the tumor along the facial canal or through the juglar foramen. We have come to recognize that the facial nerve running in the temporal bone played an important role as a pathway for the spread of the tumor, and that the case like this presents difficulty in both diagnosis and treatment.
Apatite ceramic implant was used as a substitute after stapedectomy. This prosthesis (0.6 and 0.8 mm in diameter) has no wire loop to be fixed to the incus. For this reason, there were no complications such as prosthetic slippage or incudal necrosis. Instead, the fenestra was covered with perichondrium. In this report, we present results obtained in patients given the total stapedectomy using a 0.8 mm apatite ceramic implant. In 93% of such cases, a reduction was observed in the air-bone gap to less than 10 dB at conversational frequencies.