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Cervical periesophageal abscess is one of the complications of foreign bodies in the cervical esophagus. A case of dysphagia due to traumatic cervical periesophageal abscess is reported. The patient was a 58-year-old female who had complained of dysphagia and a foreign body sensation in the larynx for approximately 2 days after a piece of large fish bone was ingested inadvertently. Roentogenological examination revealed a marked thickening of the periesophageal region caused by submucosal emphysema and abscess. Clinical symptoms and roentogenological reviews confirmed the diagnosis. Therefore, the abscess was widely opened by the lateral cervical incision, but no foreign body was found. The submucosal emphysema was supposedly caused by active mobility of the foreign body and the abscess occurred by secondary infection. The main cause of dysphagia was the mechanical obstruction by emphysema and abscess, disturbing the passage of bolus and the elevation of the larynx.

Cryosurgery is gaining more and more importance as a therapeutic modality within the field of head and neck surgery.Cryosurgery was performed in two patients with hemangioma arising from the entrance of the esophagus.Case 1: A 41-year-old woman was referred for the diagnosis of hemangioma in the entrance of the esophagus which had been present for approximately five years. The patient felt slight pain on deglutition and sometimes noticed hemoptysis. The lesion was treated with cryoapplication of -60°C on its surface through the direct laryngoscope under general anesthesia. Cryoapplications were repeated by overlapping frozen areas during treatment. The duration of the individual freezing cycles ranged from one and half to three minutes. Over a period of 3 weeks the patient received 2 cryosurgical treatments. Postoperative healing was uneventful. After 3 weeks following 2nd cryosurgery the lesion disappeared without leaving a remarkable scar. No recurrence was noted after one-year follow-up.Case 2: A 54-year-old man was admitted to the hospital with a history of foreign body sensation in the throat. Endoscopic examination revealed a dark, blue swelling in the entrance of the esophagus, suggesting a hemangioma. The lesion was frozen in three applications of -60°C each time. The frozen region was overlapped to compass the entire tumor. After thawing the frozen areas began to swell. In 24 hours it was almost twice of its original size. Then the necrotic tissue was well demarcated from vital tissue and on the seventh postoperative day the brownish lump exfoliated and showed a persistent smaller tumor. Total regression of the hemangioma and overgrowth of normal mucosa followed with a satisfactory functional result. No further growth was observed after six-month follow-up.The general treatment of the hemangioma in the larynx, hypopharynx and esophagus was briefly discussed.

A case of dysphagia due to traumatic cervical emphysema is reported. The patient was a 51-year-old female who had complained of a foreign body sensation in the throat. She thought that she might have pharyngeal cancer. She occasionally found a firm mass in the lateral region of the pharynx (this was actually a lateral pharyngeal band). She tried to remove it by an iron needle stick. The patient noticed cervical swelling after repeated swallowing action.Roentgenographic examination revealed a marked thickness of the posterior wall of the hypopharynx due to submucosal emphysema. Submucosal emphysema disturbed mechanically the elevation of the larynx and the movement of the epiglottis. Thus, the bolus of food was easily aspirated into the tracheal lumen.Cervical emphysema disappeared in approximately 2 weeks after the injury of the pharynx without any intensive antibiotic therapy.

Cerebrospinal fluid was examined in 20 patients experiencing sudden deafness. Pressure, protein, glucose and cell counts were measured, virus culture was done, and IgG, IgA, IgM in concentrated cerebrospinal fluid were measured by means of the single radial immunodiffusion method and IgE also by means of the radio-immunosorbent test. Pressures ranged from 110 mm H2O to 330 mm H2O and the mean being 178 mm H2O. Protein and glucose were almost normal, IgG and IgE were normal. In five cases, IgM were demonstrated. IgA ranged from 0.08 mg/dl to 1.7 mg/dl. In two cases, the viruses were cultured and were determined to be Herpes according to morphological features. In the group showing complete recovery and/or improvement, the initial pressure and glucose value were rather low; in the group showing no change, the value of IgA was low. In the two cases where virus was isolated, there was no alteration of pure tone audiometry nor was there any improvement of hearing acuity. The virus isolated from the two cases presented was of low virulence since the number of cells in the CSF was small and the virus grew poorly even after serial cultivation. Accordingly, virus such as these may act one of the causative agents in sudden deafness.

Five males and nine females aged 14 to 58 years were treated for hemangioma of the nasal cavity and paranasal sinuses from 1979 through 1984. There were eight cases of capillary, four of cavernous and two of non-specific hemangioma. The most frequent symptoms were nasal bleeding, noted in 11 patients (78%), and nasal obstruction, in five cases (36%). The lesions originated most often in the nasal septum, then the inferior turbinates. Eight patients were treated by local excision, three by cryosurgical procedures, two by cryosurgery plus excision and one with cryosurgery followed by an Nd-YAG-LASER procedure. The histological classification of these lesions and the clinical features are discussed.

A case of dysphagia with acute onset due to polyneuritis cranialis is reported.The patient was a 29-year-old female who had complained of dysphagia and hoarseness for approximately two weeks following common cold.Clinical symptoms of dysphagia, right soft palate paralysis, right vocal cord paralysis and right accessorius cranial nerve paralysis commenced in two weeks after upper respiratory infection possibly by virus. Clinical diagnosis was made of dysphagia with sudden onset due to polyneuritis cranialis on the basis of the following findings:1) The onset of symptoms (C2-3) was rather abrupt following upper respiratory infection.2) The paralysis of right IX N. glossopharyngeus, X N. vagus and XI N. accessorius was present.3) Initial clinical symptoms disappeared in 40 days under therapeutic regimen of Vitamin B1, B12, corticosteroid and antibiotic administration.4) The paralysis of right VII N. facialis and XII N. hypoglossus occurred in 4 months after disappearance of initial symptoms.5) The paralysis of VII N. facialis disappeared in 2 months under the same therapeutic regimen as applied for initial clinical symptoms. However, XII N. hypoglossus remains paralyzed.

The efferent nervous system of the guinea pig inner ear is histochemically investigated. Remarkable activity of alkaline phosphatase and acetylcholinesterase is demonstrated by Burstone's (1958) azo dye method and Koelle's (1949) method as modified by Gomori (1952) respectively. The distribution pattern of both enzymes in the efferent nervous system is entirely similar. The intraganglionic spiral bundles, fascicles of the osseous spiral lamina and efferent plexus of the organ of Corti reacted intensely for both enzymes. Afferent nerve fibers give no histochemical reaction for both alkaline phosphatase and acetylcholinesterase. However, spiral and vestibular ganglion cells are rich in both enzymes, though they belong to the afferent nervous system. The significance of both enzymes in the nervous system of the guinea pig inner ear is briefly discussed.