JIBI INKOKA TEMBO

Occupational rhinitis (OR) and occupational asthma (OA) are closely associated and share aetiological agents. Although the prevalence and determiants of OA have been widely studied, the epidemiology of OR has been investigated less, mainly because it is not considered such a serious disease. Additionally, there is no standardized approach to diagnosing OR. Several determinants of OR (such as incidence, pervalence, natural history and pathogenic mechanisms) are not well understood, and the morbidity burden of OR on workers remains unknown. However, several surveys of workforces exposed to sensitizing agents indicate that OR is two to four times more common than OA.
This review covers new developments on the diagnosis, monitoring, management, and socio-economic impact, preventive strategies and medicolegal issues. We most emphasize that OR will develop OA. It is a particularly important point as an accurate and early recognition of OR in surveillance programs is not only important per se, but also useful in the prevention and early diagnosis of OA.

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Vestibular evoked myogenic potentials (VEMP) are derived from the reflex arc of the saccule which extends over the vestibular nerves, vestibular nuclei and motor neurons, to the neck muscles. In this study, we examined the VEMP in cases with unilateral peripheral vestibular disease. We conducted the analysis in 62 patients with Meniere's disease, 33 with idiopathic sudden hearing loss (ISHL), and 39 with vestibular neuronal disorder (VND).
Abnormal VEMP were recorded in 19 patients with Meniere's disease, 9 with ISHL and 13 with VND. The average hearing levels in Meniere's disease and ISHL patients with impaired VEMP were worse than those in the patients with normal VEMP. The average hearing levels between patients with normal VEMP and those with abnormal VEMP among patients with Meniere's disease and ISHL was significant.
In VND patients, the lesions of the vestibular nerve were evaluated by the caloric test and VEMP recording. Of all the patients with VND, normal VEMP were recorded in 26 patients and abnormal VEMP in 13 patients, and canal paresis was found in 27 patients.
We classified the VND patients according to the results of the caloric test and VEMP. Among the 39 patients with VND, 20 had superior vestibular neuronitis (VN), 7 had superior and inferior VN, and 6 had inferior VN; the remaining 6 patients were labeled as undetermined. The percentage of patients with abnormal VEMP was higher among the VND patients without superior canal disorder than in those with the other types of VN .

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Four hundred forty-two patients with epistaxis who visited Niigata University of Medical Hospital during the previous three years were analyzed statistically. The patients comprised 242 males and 220 females. The average age was 58 years, and the number of patients between their 50's and 70's tended to be higher. Epistaxis occurred more frequently in March and December, but the number of admissions was significantly lower in the autumn season.
Of the total, 227 patients were treated by tamponade and 83 by electric and chemical coagulation. As for the general complications, hypertension was the most common. In regard to anticoagulant therapy, 69 patients were receiving anticoagulant therapy, with 51 receiving antiplatelet drugs, and 36 receiving anticoagulant drugs.
In all, 55 patients had rebleeding after the hematostatic therapy. Among these patients, more than half had complications or anticoagulant therapy and 28 required hospitalization. Proportion of them with all complication and anticoagulant therapy was more than that of rebleeding patients. The percentage of patients with complications or receiving anticoagulant therapy, in particular, the latter, was higher than that with rebleeding in the hospitalized patients.

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The characteristic clinical features of nasal septal abscess are nasal obstruction and rhinalgia. Although nasal septal abscess is an uncommon disease, early diagnosis followed by prompt, appropriate therapy is needed to prevent complications such as saddle nose, meningitis, sepsis and cavernous sinus thrombosis.
The reported case was a 56-year-old woman, with the chief complaints of nasal pain and bilateral nasal obstruction. The patient had undergone transnasal operation for a pituitary gland lesion 42 days before the diagnosis of nasal septal abscess. The nasal septum was markably swollen bilaterally, suggesting the presence of nasal septal abscess.
Immediate surgery was undertaken for drainage of the septal abscess. Although the patient improved gradually after the surgery, she developed saddle nose deformity as a complication of the nasal septal abscess.

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