A thirteen-year period observation of the intranasal findings has been performed in two schools in different environment in an attempt to study the natural changes of the intranasal morphology or spontaneous changes of the intranasal pathology during the normal physical growth. In comparison between two different schools, one is in urban area and the other is in rural area. A definitely greater incidence of chronic sinusitis has been demonstrated among the pupils in rural school as had been expected. A comprehensive study has been done as to a variety of possible factors which might have created the high incidence of chronic sinusitis in the rual area, there found a strong evidence to support nutrition is one of the most important factors among other factors studied. During the survey authors recognized a particular period when there was an abrupt decrease in the incidence of the disease in rural children, and this period noticed to have coincided with the time when the Government started to supply high caloric diets to all pupils all over Japan as one of the health promoting programs. Further study revealed that there exists repeated remission and exacerbation in the pathology of the nasal and paranasal sinuses in the untouched course. And these changes are often affected by other pathological conditions of nose and nasopharynx for instance deviated septum or adenoid vegetation. Examination of the ear, pharynx, external nose, subjective symptoms, physical growth, school records and IQ have also been performed simultaneously.
Authors described a case of long-standing idiopathic epidural hematoma which caused erosion of inner plate of the skull and successfully operated by the hands of otolaryngologists. It was suggested that an intracranial hematoma located close by the paranasal sinuses could be operated with much benefit by the hands of otolaryngologists.
One of the nasal decongestant “Towk” has been given to ten patients whose chief complaints were nasal obstruction, thus the therapeutic effect of this drug has been evaluated by means of subjective and objective findings and utilizing intranasal pictures, recordings of breathing noise due to nasal strictures and nasospirometer. It has been revealed from above that Towk is a competent nasal decongestant of which effect of nebulization last as long as eight hours.
A total of 31 cases including 18 cases chronic paranasal sinusitis, 2 cases atrophic rhinitis, 10 cases chronic paranasal sinusitis operated, and one case allergic rhinitis operated, were treated orally with Empynase or Empynase plus antibiotics. The result was as follows: 1) 15 cases showed marked improvement, 8 cases improvement, 6 cases slight and 2 cases no effect. 2) In general, the effect was obtained within 5 days of administration. 3) It was found that the operated cases took a shorter treatment period. 4) No definite side effect was noted during the administration of this drug.
A good number of literature is available concerning therapeutic effect of proteolytic enzymes, which were reported to yield favorable results such as liquidation of the pus in the antrum, anti-inflammatory effect and anti-edematous effect in the treatment of chronic sinusitis. As administered to the patients with bilateral chronic sinusitis of mild to moderate severity in combination with antibiotics, this drug showed satisfactory results in qualitative and quantitativeimprovement of the discharge. Histopathological examination has been performed as to the difference between right andleft antral mucosa of one patient with bilateral chronic sinusitis of presumably identical severity, the mucosa was taken from one antrum before the medication and from the other after the medication. The mucosa taken after the medication showed positive evidence of improvement such as decrease in round-cell infiltation, edema and fibrin accumulation. There encountered no significant side-effect attributable to this drug.
Difficulty is often experienced in differential diagnosis of the tumor in the neck, and only histopathological examination may lead us to a correct diagnosis. Authors have reported three cases of hygroma which were originated from bursa of the hyoid bone, the tumors were taken for as of branchial origin before surgery. Comments were made on etiology, differential diagnosis and treatment of hygroma.