It has been discussed that inflammatory conditions, mainly in the areas of the frontal, maxillary and sphenoid sinuses, are involved in the phenomenon of nasaoparanasal physallization. However, middle turbinate pneumatization, or physallization of the ethmoid sinus, has many unsolved clinical questions, including its causes.
On the other hand, the middle meatus, which has become the main area to be covered by sinus surgery following the development of conservative endoscopic sinus surgery, is the main route to the nasal sinus.
It seems very important, therefore, to acquire a full clinical understanding of middle turbinate pneumatization, which is closely related to the middle meatus.
The present survey has revealed the presence of middle turbinate pneumatization in 93 out of 500 cases selected at random. A large pneumatization, considered to be related to a morphological abnormality of the lateral wall of the paranasal sinus, was discovered in 33 cases (27.2%), and 12.3% of which showed a shadow in the pneumatization. These findings suggest the presence of infectious conditions, as well as morphological abnormalities in the paranasal sinus.
Consequently, in cases where abnormalities in the lateral wall of the nasal cavity are present, reconstruction of the latter comprising not only reconstruction of the septum, but also of middle turbinate pneumatization will play a very important role.
This paper reports the results of studies of the incidence, morphological classification and shadow of middle turbinate pneumatization, that is a morphological abnormality of the ethmoid turbinate, explains their clinical significance and describes methods of surgery.

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Seventy-two cases of vertigo were investigated on their difficulties in daily lives: whether they felt difficult and the causes of their difficulty on three items; going up and down staircase, reading newspapers or journals, and hanging up washings or take out or put on in higher places.
The causes of their difficulties were different from the actions; in the actions with movement they mainly came from imbalance and anxiety based on imbalance. On the contrary in the actions with seeing they mainly came from uncomfortable feeling in reading.
In conclusion, the difficulties of the patients with vertigo consisted with imbalance, anxiety, one of which was against vertigo and the other was based on the difficulties in action and autonervous symptoms. In the rehabilitation of vertigo the exercise treatment is not only required, but also the treatment for autonomic disorders and anxiety are required when necessary.

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Post-operative maxillary cyst has been reported by many investigators since it was first described in 1927 in Japan. Although various surgical techniques have been proposed to prevent the formation of cysts, this complication still occurs in a large number of patients.
Surgical treatment modalities of post-operative maxillary cysts include peroral method in which cysts are totally removed by making an incision from the gingiva and the endonasal method in which the cyst wall is opened to the nasal cavity. The latter has been used in patients with unilocular cysts located near the nasal cavity. In recent years, however, this method has been increasingly used, as accurate diagnosis and safe surgical procedures have become possible with the wide use of CT and endoscopy. In the present study, we statistically analyze data made available regarding postoperative maxillary cysts over the last five years in our department and review various issues related to surgical techniques and their indications.
Included in the present study were 83 patients, 62 males and 21 females, who were operated on for post-operative maxillary cysts in the Jikei Univ. Dept. of Otorhinolaryngology in the 5-year period between August 1987 and July 1992. The peroral and endonasal methods were used in 40 and 43 patients, respectively. In recent years, however, the latter has been used in an increasing number of patients. In fact, it was used in 17 of 22 patients (77%) in the last one-year period. Post-operative course is generally eventless after this method; fenestrated parts are kept open and patients complain of no symptom. Major advantages of the endonasal method include less surgical invasion and the fact that symptoms do not recur as long as fenestrated parts are kept open. However, the extranasal method is still needed for multilocular cysts or cysts located far from the nasal cavity.

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Since 1965, polypeptide derived from urine of allergic patients (MS-antigen, abbreviated as MS-A) has been used for the treatment of allergic diseases and excellent results have been obtained. We have experienced 9 cases (4 infants and 5 adults) that showed conversion of skin test results to negative after the treatment. We reported this finding in the 22nd General Meeting of Japanese Society of Allergology.
We have investigated the mechanism of these conversions of skin test results.
Since 1987, we have selected subjects randomly from patients with nasal allergy, especially Japanese cedar pollinosis treated with intramuscular injection of MS-A and compared the results of skin tests and specific IgE antibody titer (RAST) determined before the treatment with those obtained during the treatment.
When MS-A was intramuscularly injected twice a week at 40mg/time for 30-80 times, it was revealed that the thresholds in skin test with Japanese cedar pollen, orchard grass, house dust, etc. increased and there were even cases with conversion of skin test results to negative. Simultaneously, the value of the corresponding specific IgE antibody decreased gradually to become negative (down regulation of specific IgE antibody) and the RAST score became 1 or 0.
MS-A is considered to be a useful therapy for the radical cure of allergic diseases involving type I allergy reaction when it will be used for a relatively long time.

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In this study, 98 cases of sphenoid sinus cysts reported in the last 20 years were divided into primary cysts (40 cases) and postoperative cysts (58 cases) and their pathogenesis was investigated. The average age was slightly higher in the primary cases and the average period of the ailment was also longer for primary cases than for postoperative cases. Of all cysts, 80% were large to medium sized and 20% were small sized cysts. Of primary cysts, 50% were large and 30% were medium sized; of postoperative cysts, 40% were large and 40% were medium sized. The rate of postoperative improvement of vision was almost the same for primary cases and postoperative cases. 22.2% of the cases which lost eyesight were primary cysts and 71.4% were postoperative cysts, a significant difference.

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A case of Osler's Disease in a woman, aged 64 is reported. The patient complained of repeated epistaxis since she was 40 years old. The telangiectases was found in the lips, tongue, cheek, and nasal mucosa. Family history revealed the hereditary influence to be conclusive. We chose estrogen therapy, because the amount of nasal bleeding occurred from the depth of olfactory cleft. In this case, intranasal dermatoplasty, laser, and other therapies were thought to be unsuccessful. Administration of estriol 2mg daily was started. Estriol 1-2mg, continued almost one year. Severe side effect did not occure. Estrogen therapy appeared to be successful. Estrogen therapy appears to be useful for this case.

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Nasal polyps were obtained from an aspirinsensitive asthmatic patient.
On one side methylprednisolone has been systemically administered for three days before the operation, while the other side has been left untreated before surgery.
Histopathology showed an infiltration of eosinophils and degranulated mast cells in both nasal polyps as stained with toluidine blue.
Furthermore, by immunohistopathological examinations of histamine and IgE, the effect of methylprednisolone on mast cells in nasal polyps was evaluated in this patient.
The results were showed as follows:
1. Histamine release occurred prominently in both sides of nasal polyps.
2. More IgE positive mast cells were observed in methylprednisolone-untreated polyps.
These results suggest that methylprednisolone may inhibit the production of IgE antibody or block the combination of IgE antibody to FCreceptor, on the surface of the mast cells.

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Recently, endoscopic images are recorded as the video images instead of the bromide-silver photographs. The video images are convenient to file, but the medical video filing system was often constructed of the special set, therefore its cost is too expensive to use in a small hospital or a private clinic. We tried to use the personal computer with a video interface board for the endoscopic video image filing. The video signal was digitalised by the 6 bit A/D converter in every pikcell (RGB 200×250 dots) and recorded image was enough to diagnose. We report a possibility of the endoscopic image filing system constructed of a personal computer.

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