The commonest cause of common cold is infection by one of many rhinoviruses, but coronaviruses and a variety of other common respiratory syncytial, influenza and adenoviruses may cause clinically indistinguishable symptoms. Early studies showed that colds were likely to spread via infected droplets expelled from the respiratory tract, and more recently it has been shown that manual transmission is also possible. The comparative importance of the two routes of spread is not yet evaluated. Intranasal inoculation of chicks with a mesogenic strain of Newcastle disease virus produced a localized infection of the middle turbinate which was histologically demonstrable 18 hours after inoculation. There was destruction of mucous cells of individual acini in the under surface of the middle turbinate, and the infection rapidly spread to ciliated and goblet cells and to neighboring acini. Normal nasal mucosa was essentially restored in 2 weeks after inoculation. These results were supported by the mucociliary function study, viral recovery from throat swabs and serum antibody titer. The infection is sequentially comparable to common cold of man. Susceptibility and morbidity of upper respiratory tract to virus infections may be affected by the change of conditions of the host such as dehydration, protein deficient malnutrition or SO2 exposure rather than by the amount of inoculum.
Sinusitis was produced experimentally in rabbits by the injection of the endotoxin of Hemofilus influenzae, (H. influenzae) was introduced into the maxillary sinus following sensitzing with the intra-maxillary administration of egg-white albumin. The rabbits were later sacrificed after anesthetizing with Nembutal Sodium solution. A comparison of mucosal pathology of the sinus natural ostiums, between the normal subject and the cases with experimentally induced sinusitis, was performed by either Light Microscope (L. M.) or Scanning Electron Microscope (S. E. M.). Every specimen was stained with Hematoxylin-Eosin (H. E.), Periodic asid Siff (P. A. S.), and High iron diamin-Alcian blue (H. I. D.-A. B.) staining methods. We found histopathological differences between the cases sensitized with eggwhite and the cases received endotoxin following sensitizing by albumin. Also, we applied the injection replica method for observation of the blood vessel around the ostium portion. We recognized the dense plexus of blood vessels including the venous plexus and the capillary. On the basis of the results thus obtained, a relation of the mucosal pathology between the natural ostium and maxillary sinus is discussed.
This a review of emergency patients visiting the otolaryngology department of Hiroo Metropolitan Hospital. Total caces of 327 patients seen during a two year period since 1984 were reviewed. Inflammatory diseases accounted for a half of the total and acute otitis media rated the highest incidence of 31%. The peak hour for the visiting patients was at 8 p.m., the ccurve decreased thereafter. However, during the period from 10 p.m. to 6 a.m., a doctor examined one or more patients at the frequency of one for two times of duty. Even during the period from 0 a.m. to 4 a.m., a doctor saw emergency patients at the frequency of one for four times of duty. These results suggest that the working system should be improved to maintain the presernt emergency clinic, and that a community-oriented medical care system has to be established to meet patients' requirements.
The author reports a case whose cerebrospinal fluid leakage developed after a resection of acoustic neuroma through suboccipital approach was successfully corrected. The patient was a 51-year-old female who developed CSF leakage into the nasal cavity, which could not have been controlled by continuous lumber drainage. The repair was done through translabyrinthine approach and the patient has been free from symptoms over one year.
Clinical evaluation was carried out on 13 cerebellopontine angle tumors which consisted of ten acoustic neuromas, two meningiomas and one facial nerve neurinoma. The relationship among the neurootological findings and CT scaning findings and gross appearance of the tumors were summarized as follows: 1) Many acoustic neuromas had initial symptoms of hearing loss associated with equilibrium disturbance and or gait disturbance at the time of diagnosis of tumors. As further increase in tumor size occurs, the patients tended to complain of a great variety of neurologic symptoms and nystagmus. With further enlargement in tumor size, appearance rate of abnormality in OKP test and ETT tended to be higher. 2) The acoustic neuromas which consisted mostly of cystic mass tended to show less hearing loss and nystagmus than those which consisted mostly of solid mass. 3) Caloric response appeared abnormal in all cases of acoustic neuroma. 4) In all cases of acoustic neuroma, Stenvers view and frontal tomographic sections of petrous pyramids showed enlargement of the internal audiotory canal. Plain CT scanning of acoustic neuromas tended to reveal iso-density or low density area. Contrast enhanced CT scanning tended to reveal ring-like high density area. Acoustic neuroma with ring-like high density on the CT scanning consisted of not only cystic mass but also solid mass. 5) In cases of meningioma and facial nerve neuroma, neuro-otological findings were scanty. 6) In ABR, none of the patients showed response or the presense of wave I only or waves I and II or the abnormality of interaural latency di fferene.
The case is a 26-year-old female, who had a swelling in the left cheek late in March in 1985. On the first examination, a swelling was seen in the left cheek, but no abnormal findings in intranasal examination. Neither nasal obstruction nor rhihorrhea was seen. She had dull pain and ginvival swelling about the maxillary 5th tooth on the left. Sinus roentgenography revealed a difffuse shadow in the left maxillary sinus and the bone erosion in its lateral wall. Left maxillary sinusectomy was done under local anesthesia on May 23, 1985. Histopathologically, it was diagnosed a juvenile ossifying fibroma. She was discharged on June 1, and has been without recurrence.
Bursa pharyngea is an embryological structure in the nasopharynx and occasionally cause a condition named Tornwaldt's disease. The disease is due to the persistance of bursa pharyngea, which lies dormant in most instances until trauma such as adenoidectomy occurs and the orifice of it is occluded. The persistance of bursa pharyngea is reported to be observed over 40% of human embryo and under 4% of adults. But reports of Tornwaldt's disease are rare and there have been only 9 reports in Japan until today. The authors have experienced a case of a man, aged 44, who complained of hearing loss and stuffed feeling of his right ear. His audiogram showed about 40 db conductive hearing loss and tymoanogram was C type. A large cyst was seen in his nasopharynx and it was remored with remarkable improvement of the symptoms.