Cavernous sinus thrombosis (CST) is an intracranial complication of rhinosinusitis that has become quite rare due to improvements in with the introduction of effective antibiotics. If misdiagnosed and left improperly treated, CST can be fatal. We describe a patient with CST who was surgically treated without any deleterious after-effects. A 27-year-old woman without any significant past medical history presented at our hospital with the complaints of headache and right exophthalmos. She was admitted to our hospital, where imaging assessment indicated a diagnosis of CST. After emergency endoscopic sinus surgery to remove the inflamed portions of the sinus, she was administered steroid and anticoagulant therapy. There were no complications and the patient was discharged on postoperative day 17. Cavernous sinus thrombosis must be diagnosed early and treated promptly to prevent it from becoming fatal.

　Renal cell carcinoma is well known to be commonly associated with metachronous multiple metastases. Metastasis to the head and neck region from renal cell carcinoma is, however, rare. We encountered a patient with cervical metastasis from a renal cell carcinoma developing about 25 years after nephrectomy for the primary tumor. A 70-year-old man presented to us with a right neck mass. Needle biopsy of the mass showed metastatic of renal cell carcinoma. At the same time, an abdominal CT revealed sigmoid colon cancer. He first underwent operation for the colonic cancer at the department of surgery because of stenosis of the colon and hemorrhagic nature of the tumor. After the operation, we considered total thyroidectomy, right radical neck dissection and total laryngopharyngectomy, but the patient rejected the operation. Therefore, we started him on treatment with sunitinib at the department of urology. After about 17 months of intake of sunitinib, the cervical tumor reduced markedly in size, and we performed total thyroidectomy and right D2b neck dissection. The intraoperative blood loss was about 500 cc, and no postoperative complications were encountered. No recurrence of the neck tumor has been noted since the completion of this treatment.

　Orbital infection is an uncommonly encountered severe infectious disease, and usually arises as a complication of paranasal sinus infection. We report the case of a patient who developed an intraorbital abscess secondary to acute exacerbation of chronic sinusitis. The patient was a 33-year-old man who presented with swelling of the eyelid on the right side. The patient was referred to our hospital for further examination. Ophthalmologic examination showed ocular motility disorder, visual disturbance and intraocular pressure elevation on the affected side. CT revealed a low-density area in the right orbit and opacification of all the paranasal sinuses. We admitted the patient and performed emergency endoscopic sinus surgery (ESS) under general anesthesia. Discharge of pus from the right periorbital region definitively confirmed the diagnosis intraorbital abscess. After the surgery, the patient received intravenous antibiotic treatment. The patient recovered without any complications, and was discharged from the hospital 12 days after admission. While chronic sinusitis is a commonly encountered condition in clinical practice, it is necessary to be careful to avoid its complications, including orbital infection. Without prompt and appropriate treatment, orbital infection can lead to visual loss, intracranial complications, or even death. Prompt treatment is important to avoid serious complications.

　Polypoid vocal cord is characterized by diffusely edematous change of the membranous portion of the glottis, in particular, the superficial layer of the lamina propria. In general, it most commonly affects smokers in the 4th decade of life or later, and the main manifestations are hoarseness and deepening of the voice. This lesion usually shows chronic progression, patients occasionally develop dyspnea. Herein, we report 2 cases of polypoid vocal cords categorized as type III according to Yonekawa's classification. The body weight and body-mass index of the first patient were 142.5 kg and 49.6, respectively and those of the second patient were 98.5 kg and 43.0, respectively. Due to the severe obesity, we discussed about maintenance of the airway during the operation with the anesthesiologist prior to the surgery. In fact, conventional orotracheal intubation was successfully performed in the first case, and awake nasotracheal intubation was performed to secure the respiratory tract in the second case. Complete surgical resection of the vocal cord lesions was then carried out using the micro-debrider. The postoperative appearance of the glottis was satisfactory, with no evidence of recurrence of the disease.