Post-viral olfactory dysfunction (PVOD) is an olfactory disorder caused by upper respiratory tract infection, whose pathophysiology has not yet been clearly elucidated. In clinical practice, we often encounter differences in the results and degree of recovery depending on the odor during assessments made with a T&T olfactometer or Open Essence. Investigating the severity of the disorder and degree of recovery for different odors may contribute to elucidation of the pathophysiology of the disorder. However, the degree of olfactory impairment and effect of therapy are evaluated based on the average cognitive value for odors, and the results for each odor are not reflected. In this study, we investigated the changes in the results for each odor using both the tests and attempted to identify factors affecting the prognosis.

　The subjects were 109 patients visiting the Otorhinolaryngology outpatient clinic at the hospital of Tokyo Jikei Medical University from May 2009 to March 2015, who were diagnosed as having PVOD. The efficacy of therapy was evaluated at the first visit, at 3 months from the first visit, and at 9 months after the first visit. The improvement rate was 58.3%. Assessment with the T&T olfactometer revealed significant improvement in the results for all odors during the course of treatment. The factors affecting the prognosis were the disease duration and the detection threshold value for odor E at the first visit.

　The possibility has been suggested that degree of disability and recovery may differ depends on the odor. And we should pay attention to difference of odor in evaluation of disorder and treatment.

　Mucous membrane pemphigoid is an autoimmune bullous disease in which autoantibodies against epidermal basement membrane antigens cause subepidermal bullae and erosive lesions, predominantly in the mucous membranes. Erosive lesions occur mainly in the intraoral and ocular mucous membranes, often associated with mucous membrane involvement in the nasal cavity, larynx, esophagus, pudendum, etc. Herein, we report our experience of a case of mucous membrane pemphigoid with severe laryngeal stenosis that required tracheostomy. A 70-year-old woman presented to us with the chief complaints of hoarseness and dyspnea. Examination revealed laryngeal stenosis caused by a deformed epiglottis and adhesion of the false vocal cords, and emergency tracheotomy was performed. The patient was then admitted for airway management and detailed whole-body examination, which revealed, in addition to the laryngeal lesions, adhesion of the bulbar conjunctiva and erosion of the nasal and pudendal mucous membranes. Histopathological examination of biopsy specimens from the oral cavity led to the diagnosis of mucous membrane pemphigoid. Although three months have passed since the tracheotomy, there is no sign of relief of the laryngeal stenosis, and the patient remains tracheotomized for respiratory management.

　Laryngeal stenosis due to mucous membrane pemphigoid is often refractory, making closure of the tracheal stoma difficult.

　We report the case of a 37-year-old male patient with a schwannoma arising from the nasal and paranasal sinus. The patient presented with the complaint of right nasal obstruction. Fiberoptic nasopharyngolaryngoscopic examination showed a tumor located in the right nasal cavity. CT and MRI examinations showed an obstructive mass in the posterior part of the right nasal cavity. We suspected schwannoma from the biopsy findings. The tumor was removed completely by endoscopic sinus surgery. Based on the positive result of immunohistochemical testing for S-100 in the resected specimen, the tumor was diagnosed as an Antoni type A and B neurinoma. There was no evidence of malignancy. The patient has shown no evidence of tumor recurrence or neurological deficit after the operation.

　While most of Schwannomas occurring in the head and neck region are known to arise from the acoustic nerve, it is difficult to identify the nerve of origin of schwannomas arising from the nasal and paranasal sinuses. Patients usually show no recurrence or neurological deficit after complete resection of a schwannoma via the transnasal endoscopic approach. We select the best approach to resect neurinomas, so as to be able to remove schwannomas with the capsule under clear visualization. This could be the reason for the low rate of tumor recurrence at our institution.