It is known that middle ear mucosa has a characteristic with secretory function as a respiratory epithelium, and secretory cell also exists very slightly in the normal middle ear mucosa. In recent years, it is reported that increasing tendency of it has been noted, and by its pathohistological finding of the otitis media with effusion being studied about its etiology and morphology, goblet cell increases to 20-100 times compared with that of normal con dition. In this study, conditions of the goblet cell in the middle ear mucosa added various procedures for rabbits were observed, and its increasing factor was discussed and reported as follows. With regard to the experimental method, rabbits were bred proceduring close of tympanic orifice of the eustachian tube, close of pharyngeal orifice of the eustachian tube, stenosis of tympanic isthmus and stimulation of external auditory meatus, and subsequently they were sacrificed. A mass of osteoblast of middle ear and external meatus was extirpated, and increasing degree of the goblet cell in its middle ear mucosa, edema, condition of inflammatory cell infiltration, and presence or absence of tympanic perforation were observed. From the result, the increase of goblet cell was noted in 36.7%, 18.3%, 16.3%, 33.9%, and 25.8% of cases with close of tympanic orifice of the eustachian tube, close of pharyngeal orifice of the eustachian tube, stenosis of tympanic isthmus, opening of the external auditory meatus stimulated the external auditory meatus, and close of the external auditory meatus stimulated the external auditory meatus, respectively. The frequency of the tympanic perforation in the increaing case of goblet cell was noted in 68.2%, 54.5%, 42.9%, 100% and 93.4% of cases with close of tympanic orifice of the eustachian tube, close of pharyngeal orifice of the eustachian tube, stenosis of tympanic isthmus, opening of the external auditory meatus stimulated external auditory meatus, and close of external auditory meatus stimulated external auditory meatus, respectively, and goblet cell increased in infectious cases associated with ympanic perforation. Moreover, in the increasing cases of goblet cell, inflammatory cell infiltration on the subepithelium was noted in all cases, and the higher its degree is, the higher the decreasing degree of goblet cell became. The increase of goblet cell was remarkably noted in marked cases of the inflammatory cell infiltration in mainly lymphocyte, and somewhat relationship between change of the epithelium and condition of the subepithelium was estimated. It has been reported so far that the infection is considerably concerned for the increase of secretory cell, and from this experimental result, it is presumed that the infection concerned for the increase of goblet cell in the middle ear mucosa.
The patient was a 42-year-old female whose chief complaints were headache and unilateral hyposmia for 2 months. There was no unusual finding in her nasal cavities. Roentogenography of the olfactory clefts and paranasal sinuses revealed no abnormality. Standard olfaction test using T & T olfactometer revealed right side severe hyposmia. Olfactory discrimination test carried out at the right nasal cavity showed hyposmia due to intracranial disorders. Intravenous olfaction test (Alinamin 10 mg) with bilateral nasal cavities indicated normal duration time, but the same test with right nasal cavity indicated redution of the duration time due to intracranial disorders. As we could set the electrode and the odorous stimulation while observing the olfactory portion with Olympus selfoscope SES 1711D, we recorded the typical slow negative potential similar to those in normal olfaction cases. RI angiography, computed tomography and right carotid angiography done at neurosurgery were useful in this case and showed a typical frontal fossa tumor. Total removal of tumor was performed by neurosurgeons under general anesthesia. Histological examination revealed a typical meningioma with psammoma body and micronecrosis. Unilateral olfactory disorder is one of the important symptoms not only in nasal and paranasal sinuses diseases but also in intracranial diseases however unilateral olfaction test is not yet a routine test even for ear-nose-throat specialists at present.
In order to evaluate the influence of tympanoplasty upon tinnitus, the pre-and postoperative incidence of tinnitus who underwent tympanoplasty in our clinic was investigated. Before the operation. 30% of all the patients had clinical symptom of tinnitus, and among those patients the ones with chronic otitis media had the highest incidence (35%). The preoperative tinnitus disappeared after tympanoplasty in 45% of the patients. On the other hand, there was another type of tinnitus that appeared after tympanoplasty at an incidence of 12% and the frequency was highest (19%) in patients with cholesteatoma. Most of that type of tinnitus disappeared spontaneously a few days after the operation. Patients with tympanoplasty type III and IV had a higher frequency of tinnitus than those with tympanoplasty type I and myringoplasty. Manipulation of the stapes and its surroundings seemed to cause the tinnitus relatively often.
Calcifying epitheliomas are mainly found in young people, affecting the face, neck and arm regions. Four cases of calcifying epithelioma (age: from 7 months to 23 years old, clinical course: from 3 weeks to 5 years) are reported. Clinical and histopathological features were reviewed. We have confirmed that inflammatory changes (foreign body giant cell reaction) were prominent in the short term cases, and calcification was marked in the long term cases. Calcification was found by soft x-ray even in the shortest term case (3 weeks). Soft x-ray technique was useful for the preoperative diagnosis of calcifying epithelioma.
Two cases of intraparotid facial nerve schwannoma are reported. Case 1 was a 39-year-old male and case 2 was a 47-year-old female. Each patient complained of slow growing mass in the right parotid region. Case 1 was diagnosed at surgical operation by frozen section. As the facial nerve could not preserved, nerve grafting was performed. Case 2 was diagnosed after the operation. Schwannoma, as a rule, is solitary, slow growing and symptomless. Many cases of intratenporal facial nerve schwannoma have been reported so far, but only 53 cases of intraparotid schwannoma have been reported until now in Western countries and 14 cases in Japan. Intratemporal cases usually exhibit hearing loss, otalgia and facial palsy. But intraparotid cases are symptomless except a mass in the parotid region. Therefore preoperative diagnosis is often difficult in intraparotid cases.