Hisaki Saito

Chronic sinusitis and woodworking as risk factors for cancer of the maxillary sinus in Northeast Japan

In the period 1983 to 1985, 66 patients presented to six Japanese university hospitals with squamous cell carcinoma of the maxillary sinus. Using self‐administered questionnaires, a case‐control study was conducted to examine history of nasal diseases, occupational exposures, and other possible risk factors for this disease. For each patient, two controls were selected from the general population, matched to the patient by sex, age (± 5 years), and district of residence. A history of chronic sinusitis was associated with a 2.3‐fold increase in risk (p = 0.05). A high relative risk was also observed in males with an occupational history of woodworking or joinery, particularly when these jobs involved sanding or lathing practices (RR = 7.5, p = 0.02). No association between cigarette smoking and maxillary sinus cancer was observed in this study and no evidence was found that indoor air pollution in the home is involved in cancer development.

Malignant fibrous histiocytoma of nose and paranasal sinus; A report of two cases.

Two cases of malignant fibrous histiocytoma (MFH) are reported. One in the nasal cavity of a 37-year-old, and in the maxillary sinus of a 36-year-old female. They were treated with vindesine, cyclophosphamide, and 6MP. The first patient is free of tumor, 2.6 years after surgery. The second died of endocranial invasion by a recurrent tumor 1.3 years after the histological diagnosis.

Effect of plasmapheresis on advanced malignant tumor of the head and neck.

The effect of the plasmapheresis using an IBM blood cell separator was evaluated in 5 patients. Three patients with malignant tumor of head and neck were histologically diagnosed as having squamous cell carcinoma, adenoid cystic carcinoma and malignant melanoma, the remaining 2 patients had Wegeners granulomatosis.After plasmapheresis, the improvement of performance status was observed in 4 patients, and all patients showed a remarkable reduction of serous immunosuppressive factors. However, these effects were transient and diminished soon after the treatment.To maintain the condition improved by the plasmapheresis, other immunochemotherapies should also be given.

Evaluation of laryngeal function after reconstruction following laryngeal injury.

Laryngeal function was evaluated in six patients after treatment of laryngeal trauma. The patients were all male, aged 18 to 61 years (average age 41.0 years). The injury in three patients was caused by automobile accidents, in two patients by industrial accidents, and in one patient by contusion due to being kicked in the neck. Treatment included tracheostomy, repositioning of fragments, grafting, arytenoidectomy, trough method, cricopharyngeal myotomy, upward fixation of the hyoid bone and thyroid cartilage, and introduction of silicon rubber T-tubes.The six patients answered questionnaires concerning their laryngeal symptoms: hoarseness, dyspnea, and dysphagia. Five patients were examined by phonation analyzer (PS-77, Nagashima Co.) and automatic analyzable system for pulmonary function (autospiror HI-498, Chest Co.)Two patients still complained of severe hoarseness, and four of moderate or slight hoarseness. Two patients still complained of slight dyspnea and four of slight dysphagia.The curve of the phonation analyzer in all patients demonstrated by fundamental frequency and intensity a disappearance of normal vocal cord vibration.The flow-volume curve of the autospiror showed decreased peak expiratory flow plateau formation in three patients.All patients except one with a gait disturbance, returned to work with only slight laryngeal symptoms.In the follow-up of laryngeal function in patients with laryngeal injury and in advising them about rehabilitation, the newly developed phonation analyzer and respirometer are very useful.