It has long been known that emergency surgery is often necessary in cases of blowout fractures of the orbit. A fractured piece of bone often becomes a trapdoor, incarcerating and deviating the contents of the orbit. While imaging findings may reveal only slight deviation, the symptoms are often severe. Although very rare, this clinical condition is most often known to involve he inferior wall of the orbit in young people, in our patient reported herein, it involved the medial wall of the orbit.

　We diagnosed and treated 100 cases of blowout fractures of the orbit in our department between April 2000 and October 2016. The fracture involved the medial wall of the orbit in 17 cases, and in 2 of these, it was the linear type. Emergency surgery was performed in 1 of these 2 cases, and elective surgery in the other. The eye movements of the patients improved, and they don't recognize diplopia.

　In cases of fracture of the medial wall of the orbit, early recognition of the need for emergency surgery is of importance.

　Dizziness is a common complaint in patients visiting the emergency room. The differential diagnosis is broad and includes both benign and life-threatening disorders. We performed a retrospective analysis of all patients presenting to the emergency room with the chief complaint of dizziness in 2011. We compared the lifestyle characteristics and clinical symptoms between patients with and without cerebrovascular disease (CVD) and performed logistic regression analysis to identify predictors of CVD. A total of 364 patients visited the emergency room in 2011 with the chief complaint of dizziness and underwent computed tomography or magnetic resonance imaging of the head. Among these patients, 23 (6%) were found to have CVD, while the remaining 341 (94%) showed no evidence of CVD. The types of CVD in the 23 patients were cerebral infarction (7 patients, 30%), cerebellar infarction (6 patients, 24%), transient ischemic attack (3 patients, 13%), brainstem infarction (3 patients, 13%); brainstem and cerebellar infarction (2 patients, 8.6%); brainstem, cerebellar, and occipital lobe infarction (1 patient, 4.3%), and vertebrobasilar artery stenosis (1 patient, 4.3%). Our findings suggest that when patient complaining of dizziness are older and have the lifestyle of alcohol use and dyslipidemia, we should consider CVD. In patients with suspected neurological abnormality, magnetic resonance imaging should be performed.

　Langerhans' cell histiocytosis (LCH) is characterized by monoclonal proliferation and infiltration of Langerhans' cells, which are antigen-presenting cells originating from the bone marrow. The disease predominantly affects the bones, skin, lymph nodes and soft tissues. In particular, bone lesions are observed frequently, most commonly involving the temporal bone, femur and vertebral bones. Herein, we report the case of an 8-year-old boy who presented with exophthalmos caused by a posterior ethmoid mass with bone destruction. Endonasal biopsy was immediately performed and histopathology revealed the diagnosis of LCH. As imaging MRI evaluation revealed a distant lesion in the 11th vertebral bone, chemotherapeutic intervention according to the Japan LCH study group's protocol was undertaken. Until now, 10 years since treatment completion, there has been no evidence of disease recurrence. Otorhinolaryngologists should bear in mind the possibility of LCH developing in the paranasal sinuses.

　Lateral cervical ectopic thyroid tissue is uncommonly seen in clinical practice. We encountered a patient with papillary adenocarcinoma in the arising from lateral cervical ectopic thyroid tissue.

　A 40-year-old man presented to us with a left neck mass. After ultrasonography, MRI, and aspiration biopsy, we resected the cervical tumor. Histopathology revealed the diagnosis of papillary adenocarcinoma of the thyroid, including normal thyroid tissue. Therefore, the cervical tumor was diagnosed as papillary adenocarcinoma in the arising from lateral cervical ectopic thyroid tissue.

　Ectopic thyroid diseases should be borne in mind in the differential diagnosis of cervical tumors.