Aims: The recurrence rate of sinonasal inverted papilloma (SIP) still remains over 10%, even though the techniques and instrumentation adopted for surgical treatment have improved. Despite SIP being classified as a benign tumor, surgeons must consider the possibility of malignancy. The most suitable procedure for resection of SIP, namely, piecemeal resection or en-bloc resection, still remains controversial. The aims of this study were to present the results of SIP treatment and to investigate the effectiveness of endoscopic surgery for SIP resection.

　Methods: We enrolled 15 cases of SIP, classified as T3 according to Krouse's classification, and treated by surgical resection from January 2015 to March 2020. The 15 cases were divided into two groups according to the surgical procedure adopted: the piecemeal resection group and the en-bloc resection groups; the outcomes in the two groups were compared.

　Results: The endoscopic approach, without resorting to the external approach, was used for the tumor resection in all the 15 cases. There was no case of recurrence. Endoscopic modified medial maxillectomy was performed in all the cases of the piecemeal resection group. In addition to a direct approach to the anterior and lateral part of the maxillary sinus with an endoscope, transseptal access with crossing multiple incisions, Draf type 2a, Draf type 3, and endoscopic medial maxillectomy were performed in the cases of the en-bloc resection group, as needed. The operation time was statistically significantly shorter in the piecemeal resection group than in the en-bloc resection group.

　Conclusions: Endoscopic surgery with the adoption of newly described procedures is effective for even cases of T3 SIP, regardless of whether the resection is piecemeal resection or en-bloc resection.

　Fish bone foreign bodies are frequently encountered in daily clinical practice, and most are easily detected with the naked eye or by laryngoscopy. However, treatment becomes difficult if the foreign body becomes buried in the oral/pharyngeal mucosa. We encountered a case in which a fish bone had become buried in the muscle layer of the tongue. The patient was a 55-year-old man with a sea bream fish bone stuck in his tongue. He complained of pain in the tongue ever since he ate pasta with sea bream. He was referred our department, but we could not detect any fish bone in his oral cavity or pharynx. A CT examination revealed the fish bone in his tongue. We performed surgical exploration of the tongue to locate the lost fish bone. We detected the fish bone using the electronic CT image as reference. We report this rare case of a fish bone buried in the tongue, with a review of the few previously published reports.

　We report a case of focal myositis of the masseter muscle. A 68-year-old woman complaining of swelling of the left cheek and trismus was referred to our hospital. Based on existing reports, we initiated the patient on treatment with an oral steroid, which resulted in remission of the symptoms at 2.5 months after the start of the steroid therapy. Focal myositis is a very rare disease classified as an idiopathic inflammatory myopathy, and there are only two reported cases from around the world of focal myositis involving the masseter muscle, in particular. The possibility of focal myositis should be considered in patients presenting with cheek swelling and trismus. There are some reports to suggest that focal myositis can progress over time to polymyositis, so that patients with focal myositis should be carefully watched for the emergence of symptoms of polymyositis.

　Relapsing polychondritis is a relatively rare and unexplained disease characterized by damage to the cartilage tissue over the entire body and a variety of manifestations. Early diagnosis is often difficult, and it could take years from onset to diagnosis.

　In our case reported herein, we performed a biopsy immediately after the appearance of auricular chondritis, so that we could make a diagnosis within 1 month from the initial presentation (that is, within about 3 months from symptom onset) and initiate early treatment, and obtained a favorable clinical course. We report the case, with a review of the literature.

　In patients presenting with auricular chondritis, the possibility of relapsing polychondritis should be borne in mind, in addition to bacterial infection. If relapsing polychondritis is suspected based on the symptoms and clinical findings, prompt biopsy may enable early diagnosis and treatment.

　Although perforating neck injuries are rare, they can have fatal outcomes or cause complications due to damage to vital organs. In the present study, we report on a case of perforating neck trauma caused by a fall that we encountered.

　The patient, an 18-year-old male, was found with a log penetrating through his right neck and appearing in his mouth after he slipped and fell during forestry work. When the emergency team arrived, his level of consciousness was JCS-20, bleeding from the wound and right facial nerve palsy were observed, and he was intubated in the helicopter and transported to our emergency center.

　At the time of his arrival at our hospital, he had a lacerated wound extending from the right side of his head to the mandible, which was bleeding continuously. The log had already been removed at the scene of the accident, and after compression of the wound with bosmin gauze and contrast-enhanced CT, emergency surgery was performed to stop the bleeding. The buccal mucosa was sutured with absorbable sutures from the floor of the mouth. After the surgery, the patient was intubated and managed in the ICU. Tracheostomy was performed on the 9th day of hospitalization, and the multiple facial fractures were treated with hematopoietic restorative fixation. The patient was eventually able to resume oral intake, without any postoperative infection, and was discharged on the 33rd day of hospitalization.