Septoplasty for nasal septal deviation provides relief from nasal obstruction, and this surgical procedure is usually performed only in the affected part of the septum so that the external configuration of the patient's nose can be preserved. In the case of caudal septal deviation, however, an innovative surgical technique is required, because it is essential to preserve the caudal part of the septum. Recently, we performed septoplasty using septal batten grafts, with exposure of the caudal end of the septum by the hemitransfixion approach in patients with marked caudal septal deviation. Twelve patients who underwent the aforementioned surgery were enrolled as the subjects of this retrospective study. Postoperative computed tomography revealed significant improvement of the cross-section of the right and left anterior nasal cavities. Marked amelioration of both the clinical symptom scores and the sleep quality index was observed after the surgery. We concluded that the hemitransfixion approach is beneficial for caudal septal deviation that cannot be adequately treated by conventional septoplasty.

　Acute calcific tendinitis of the longus colli most often manifests as acute neck pain, sore throat, and limited range of motion of the neck, and is caused by inflammation triggered by the deposition of hydroxyapatite crystals in the cervical muscles. The symptoms respond to treatment with anti-inflammatory drugs, such as NSAIDs, usually in about 1 to 2 weeks. Contrast-enhanced CT usually shows a low-absorption area in the posterior wall of the pharynx, therefore, the condition needs to be carefully differentiated from a retropharyngeal abscess.

　We encountered three cases of acute calcific longus colli tendonitis. One of the three patients was diagnosed as having retropharyngeal abscess. We retrospectively reviewed the medical records and imaging findings, and made the diagnosis of acute calcific tendinitis of the longus colli. The second patient was suspected as a case of acute longus colli calcific tendinitis, but a retropharyngeal abscess could not be ruled out. He was hospitalized after puncture of the posterior wall of the pharynx and treated with antibiotics. The third patient was diagnosed as a case of acute longus colli calcific tendinitis at the first consultation, and improved with NSAID treatment alone administered on an outpatient basis. In patients in whom this disease is suspected, a precise diagnosis made at the first consultation would allow unnecessary treatment and medication to be avoided.

　Laryngeal chondrosarcoma is a very rare disease, reported to account for about 1% of all laryngeal tumors. Herein, we report a case of laryngeal chondrosarcoma.

　The patient was a 74-year-old man, who visited a local otorhinolaryngologist with the chief complaint of dysphagia. No apparent tumorous lesion was found in the larynx at the first visit. Seven months after the first visit, however, a prominent lesion was found in the left piriform recess and he was referred to our hospital. Fiberoptic laryngoscopy revealed a submucosal, hard, tumorous lesion, however, it was difficult to collect a sufficient amount of tissue with the forceps. While the tissue biopsy findings led to the suspicion of chondroma or chondrosarcoma, it was necessary to explore the entire lesion for confirmation. The tumor grade should be determined based on the most dysplastic part of the tumor. When attempting a diagnosis, findings of biopsy obtained from only a portion of the tumor should be interpreted with caution. In general, treatment of laryngeal chondrosarcoma is surgery, and the benefits of chemotherapy and/or radiation treatment have not been established. Because the patient himself was desirous of highly curative treatment, we decided to perform total laryngectomy.

　It is difficult to diagnose chondrosarcoma, especially to differentiate it from chondroma, which is a benign tumor. We report a case of laryngeal chondrosarcoma that was difficult to diagnose and for which it was difficult to arrive at a treatment decision, with a review of the literature.

　We report a case of papillary carcinoma in a multilocular thyroglossal duct cyst associated with papillary carcinoma in the right lobe of the thyroid. A 72-year-old woman presented to our otorhinolaryngology clinic with a 1-year history of swelling of the anterior neck. Physical examination showed an elastic-hard tumor measuring about 40 mm in size. Imaging examination revealed a multilocular thyroglossal duct cyst extending from the midline of the neck to the thyroid cartilage and a calcified mass in the right lobe of the thyroid. A solid lesion with calcification was also observed in the thyroglossal duct cyst. The findings of fine-needle aspiration biopsy of the thyroid lesion were categorized as class V and those of the lesion in the thyroglossal duct cyst as class I. Surgery was performed under general anesthesia for resection of the papillary thyroid carcinoma and of the thyroglossal duct cyst. Histopathological examination revealed that besides the papillary cancer in the right lobe of the thyroid, the lesion arising from the thyroglossal duct was also a papillary carcinoma. We made the diagnosis of papillary carcinoma in a multilocular thyroglossal duct cyst and papillary thyroid carcinoma of the right lobe of the thyroid. Postoperative examinations revealed no lymph node metastasis or distant metastasis. As the malignant lesion in the thyroglossal duct was limited to one of the cysts, we followed the patient up without any additional treatment. Until the last follow-up, 8 months after the surgery, she had shown no signs of recurrence. In this patient, papillary carcinoma was found in a solid lesion within a cyst of the thyroglossal duct. If we had diagnosed papillary carcinoma of the thyroid with thyroglossal duct carcinoma preoperatively, we may have chosen total thyroidectomy and radioiodine thyroid ablation as treatment. For preoperative diagnosis of thyroglossal duct carcinoma, it is important to reliably harvest tissue from a site of calcification or solid lesion in the thyroglossal duct cyst.

　Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a lymphoproliferative disorder that sometimes develops in patients receiving long-term treatment with MTX, a first-line treatment for rheumatoid arthritis (RA). The disease is reported to recur in 29% of cases and usually within two to three years. Herein, we report a case of MTX-LPD that relapsed five years after the first episode.

　A 54-year-old man was admitted our hospital with the chief complaint of headache and numbness of the upper left lip and left side of the face. CT revealed a left maxillary sinus opacity, and repeated cytologies revealed malignant features. We performed endoscopic sinus surgery for biopsy and treatment. On the first day after surgery, left submandibular lymphadenopathy appeared. Also, intraoperative biopsy revealed the diagnosis of diffuse large B-cell lymphoma (DLBCL). Additional blood tests and PET-CT were carried out, and we made the diagnosis of MTX-LPD and decided to discontinue MTX. About 1 month after the discontinuation of MTX, the left maxillary sinus opacity on CT was no longer seen, and the sIL2R antibody titer in the serum decreased. One year after surgery, the MTX was still suspended and no recurrence was observed. Therefore, we decided to withdraw MTX permanently and followed the patient up.

　However, after about 5 years, the serum sIL2R antibody titer was found to be elevated at another hospital. Therefore, we performed left lower turbinate biopsy and made the diagnosis of recurrence of MTX-LPD, based on the histopathological diagnosis of DLBCL. The patient was treated with 6 courses of R-CHOP therapy, and remission was confirmed by PET-CT. Since then, the patient has been under follow-up at our outpatient department, and at the last follow-up visit at one year after completion of treatment, there was no sign of recurrence.

　If a patient with a history of MTX use presents with localized lymphoproliferative disease, the possibility of MTX-LPD should be considered. After remission, the patient must be monitored for a sufficient period of time to detect relapse.