Toshio Ogoshi

Allergic fungal sinusitis caused by Bipolaris spicifera and Schizophyllum commune

There have been very few reports in Japan of patients with allergic fungal sinusitis (AFS). We describe two cases caused by Bipolaris spicifera and Schizophyllum commune. The patients were a 70-year-old male (Case 1) and a 55-year-old female (Case 2). Both presented with nasal obstruction and purulent nasal discharge. CT scans revealed each to have a soft tissue mass extending from the ethmoid sinus to the sphenoid sinus. In addition, pathological studies on the contents of the paranasal sinuses of both patients revealed the presence of fungal elements in the allergic mucin. Microbiological studies resulted in the recovery of Bipolaris spicifera from Case 1 and Schizophyllum commune from Case 2. To date there have been no reports of AFS due to these two fungi in Japan. It is very important in the diagnosis of AFS to demonstrate the presence of fungal elements in the allergic mucin. Squash cytology of the paranasal sinus contents was especially useful for proving the presence of fungi.

P173: Observation of Nasal Cycle Using a Portable Rhinoflowmeter

oculomotor nerve palsy caused by paranasal-sinus desease. Clinical course and computed tomography (CT) image are documented, and pathogenesis relating to local anatomy is discussed. METHODS: Retrospective case report and review of pertinent literature. RESULTS: Report of three cases of isolated oculomotor nerve palsy caused by paranasal-sinus desease. All the patients complained of double vision and had unilateral disturbance of ocular movement and ptosis, but no visual impairment in opthalmologic examination. In two cases, CT demonstrated soft tissue density (STD) in the posterior ethmoid and the sphenoid sinuses and also inside the ipsilateral anterior clinoid precess (ACP) of sphenoid bone. In the remaining case, CT showed STD in the ethmoid sinus and pneumatization in the ACP. Endoscopic sphenoidectomy was performed on the former two cases, and the last case was treated conservatively with steroid and antibiotics. Their ocular movement returned to normal approximately one month later. In all the cases, CT demonstrated a bony defect at the inferior wall in ACP, which is adjacent to the superior orbital fissure. CONCLUSIONS: Since the oculomotor nerve runs just under the ACP, the authors speculate that compression and/or inflammation through the pneumatized ACP might easily cause isolated oculomotor nerve palsy as in the present cases.

Angiofibroma in the Nasal Cavity; A Case Report.

Angiofibroma in the nasal cavity is very rare.Our patient was a 28-year-old female with right nasal obstruction and tearing of the right eye. A nodular mass was seen ocupying the right inferior meatus. X-ray examination showed clear paranasal sinuses.Under general anesthesia, the tumor was removed with contact type Nd-YAG laser through a perimaxillary approach. The tumor, which originated from the posterior half of the right inferior nasal turbinate, measured 28 × 17× 7mm.The histopathological diagnosis was angiofibroma.The patient was followed for 28 months after the operation and showed no recurrence of the tumor.

201TlCl for Head and Neck Tumor Scanning

(1) 頭頸部悪性腫瘍11例中7例において201TlClスキャンニングで陽性を示した.(2) 扁平上皮癌, 乳頭腫に対して201TlClの集積をみたが肉腫においては陰性であった.(3) 舌癌 (7mm×4mm) の早期癌例においては陰性であった.(4) 201TlClの利点として(i) 骨に集積をみない.(ii) 静注後5分後よりスキャンニングが可能であり, 数十分後に判定できる.(5) 201TlClの欠点としては, 生理的集積部と重なり読影上支障となることがあった.以上より頭頸部領域でも使用できる核種と考える.