Endoscopic Modified Medial Maxillectomy for Resection of an Inverted Papilloma Originating from the Entire Circumference of the Maxillary Sinus.

For treatment of a sinonasal inverted papilloma (IP), it is essential to have a definite diagnosis, to identify its origin by computed tomography (CT) and magnetic resonance imaging (MRI), and to select the appropriate surgical approach based on the staging system proposed by Krouse. Recently, a new surgical approach named endoscopic modified medial maxillectomy (EMMM) was proposed. This approach can preserve the inferior turbinate and nasolacrimal duct.

IgG4-related disease in the sinonasal cavity accompanied by intranasal structure loss.

IgG4-related disease was recently proposed under the classification of systemic chronic inflammatory disease. In the field of otolaryngology, organ-specific diagnostic criteria have been established for the occurrence of this condition in the salivary glands, but not in the sinonasal cavity. Here we report a case involving a 70-year-old man with IgG4-related disease in the sinonasal cavity.

Identification of Onodi cell and new classification of sphenoid sinus for endoscopic sinus surgery.

Background: There is no effective classification method for the opening of the sphenoid sinus. The objective of this study was to examine the effectiveness of identification of the Onodi cell and classification of the sphenoid sinus using sagittal computed tomography (CT) for sphenoidotomy.

Methods: CT images of the sinuses of surgical patients (n = 261; 522 sides) were studied.

Primary adenoid cystic carcinoma of the nasolacrimal duct treated with proton beam therapy.

Primary malignant tumors of the lacrimal passage, particularly of the nasolacrimal duct, are rare. We describe a 72-year-old woman who presented with lacrimation 5 years previously. She had pain and bloody and purulent lacrimation, and a mass was identified in the inferior meatus.

Characteristics of eosinophils migrating around fungal hyphae in nasal discharge.

It is known that eosinophil granular proteins cause tissue damage. To explore how eosinophils degranulate, we studied the degranulation of eosinophils that had migrated around fungal hyphae. In electron microscopic observations of allergic mucin from patients with allergic fungal sinusitis, fungal hyphae were detected, surrounded by numerous eosinophils.

[Navigation-aided surgery for congenital cholesteatoma at the petrous apex].

Computer-aided navigation in otolaryngology has been used mainly for nasal operation and rarely for ear surgery. The reason for its limited use in ear surgery appears to be that microscopic observation may be sufficient in most cases of ear surgery. We report a case of congenital cholesteatoma at the petrous apex operated on using navigation.

Cytolysis of eosinophils in nasal secretions.

It is still unknown how eosinophils degranulate in nasal mucus. Currently, cytolysis is being reevaluated as the mode of degranulation of eosinophils in allergic nasal mucosa. To examine whether eosinophils migrating to the nasal mucus degranulate by cytolysis, we sampled nasal mucus from 9 patients with nasal allergy and observed it under electron and light microscopes.