Four cases of malignant tumor of the ear are reported: the first case is a case of squamous cell carcinoma of the auricle of a 78 year old female; the second case is an epidermoid carcinoma of the external auditory canal of a 14 year old male; the third case is squamous cell carcinoma of the middle ear of a 51 year old female; and the fourth case is a sarcoma of the temporal muscle of a 5 year old male. These cases are reported in details with a review of 187 cases of malignant tumor in this region appeared in Japanese literatature. Of 187 cases of malignant tumor 117 were cancer and 70 were sarcoma. Almost equal incidence of cancer and sarcoma was recorded in the temporal region. Those malignant tumors occurred more frequently in male than female by a ratio of 1.5: in cancer, and 2: 1 in sarcoma. It is of interest to learn in the literature that most of the middle ear cancer are presented by chronic otitis media, and sarcoma of the temporal area were seen in older people as much as in young age group.
Rhinogenic meningitis which developed in a 17 year old male due to injury of bony roof of the ethmoid sinus and the dura mater during radical sinusectomy had been treated by antibiotics for 7 weeks without alleviation of symptoms. A lateral rhinotomy was carried out in this case in order to perform appropriate procedures to the original focus. By this procedure intracranial complication was sucessfully treated.
Empynase has been used orally or topically in 20 patients with chronic sinusitis, and the results are summalized as follows: improvement in rhinoscopic and/or X-ray finding is obtained in higher freqdency in mild cases of chronic sinusitis among children. Generally, initial evidence of improvement is noted sometimes within 3 to 7 days after the administration. Decrease or disappearance of rhinorrhea are the first signs and then in 2 or 3 weeks swelling of nasal mucosa and other subjective symptoms show improvement. A clinical evaluation of this sevies rerealed 1) marked improvement in 6 cases, 2) improvement in 7 cases, 3) minimal improvement in 3 cases. This is interpreted as therapeutic effects obtained in 13 cases or 65%. No significant sideeffect is observed except for mild G-I disturbance in 2 cases.
Two cases of rhabdomyosarcoma of nasal origin are reported. Biopsy specimen of these cases are suspected of anaplastic carcinoma but at autopsy and histologically these cases were diagnosed as rhabdomyosarcoma. Case 1 is a 29 year old male, in whom a tumor developed in the nasal cavity, and then extend to the paranasal sinuses, submandibular region and to cervical muscles. Distant metastasis was also identified by X-ray examination. Histologic features were spindle cell type rhabdomyosarcoma. In case 2, a tumor developed in the maxillary sinus, and postoperatively distant metastasis was observed. Histologic examination of surgical specimen revealed a tumor of undifferentiated type featuring large round cell proliferation, which was less pleomorphic. Histological evidence of rhabdomyosarcoma was clearly diagnosed in a metastatic tumor.