Although there have been many reports on the toxicity of tobacco smoke, fewer studies have reported the relationship between the smoke and carcinogenesis of head-and-neck cancers. It is assumed that direct stimulations due to tobacco smoke, such as chemical and mechanical stimulations, strongly influence the epithelium of the nasal cavity, paranasal sinuses, pharynx, and larynx. We investigated the influence of active and passive cigarette smoking on head-and-neck cancers. The subjects were 283 head-and-neck cancer patients examined at the otolaryngology department of Showa University Northern Yokohama Hospital in a 9-year and 2-month period from April 2001 to June 2010, in whom the presence or absence of active and passive cigarette smoking could be confirmed in detail. The active and passive smoking rates and the Brinkman index were retrospectively investigated according to the primary cancer site, gender, and histopathological classification. The active and passive smoking rates were high (about 90%) in patients with hypopharyngeal, laryngeal, and cervical esophageal cancers, and the Brinkman index was high in all. Squamous cell carcinoma (SCC) patients accounted for a high ratio of the head-and-neck cancer patients, and the active and passive smoking rates were significantly higher in SCC than in non-squamous cell carcinoma (non-SCC) patients (p < 0.0003). The active and passive smoking rates and the Brinkman index were high in patients with head-and-neck cancers in regions receiving strong direct stimulation from tobacco smoke, and the Brinkman index was also high in these patients, suggesting that carcinogenesis of head-and-neck cancers is strongly influenced by direct tobacco smoke stimulation

Metastatic lung tumours rarely lead to development of pneumothorax, and no case of bilateral secondary pneumothorax due to lung metastases arising from tongue cancer has been reported. Here, we report a case of a patient with tongue cancer with lung metastases complicated by bilateral secondary pneumothorax soon after the completion of concurrent chemoradiotherapy. A 39-year-old man with cervical lymph node metastases originating from pT2N0M0 tongue cancer underwent neck dissection and postoperative concurrent chemoradiotherapy. Shortly after the completion of chemoradiotherapy, he developed bilateral secondary pneumothorax. Subsequently, he underwent partial lung resection for the pulmonary fistulae for diagnostic and therapeutic purposes; nodular lesions found in both the lungs. The diagnosis of secondary pneumothorax was based on histopathological findings. Although all pulmonary fistulae disappeared after partial lung resection, he died of the primary disease despite our best efforts to control the metastatic pulmonary lesions.

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Background: Cervical schwannoma is a relatively rare disease, and it is difficult to experience many surgical cases because it may be followed up without surgery. We examined 100 patients who underwent inter-capsular resection for cervical schwannomas at our center and classified the patients according to the nerve of origin. Methods: We retrospectively reviewed 100 patients who underwent inter-capsular resection for cervical schwannoma at our center from April 2005 to September 2019. We examined the patient's characteristics including age, sex, tumor size (maximum diameter), origin nerve, preoperative symptoms, and postoperative neurological deficits for all cases. We classified the cases according to the nerve of origin and the occurrence of postoperative neurological deficits. Results: The occurrence of postoperative neurological deficit for all cases was as follows: "none" was 73%, "temporary paralysis" was 21%, and "permanent paralysis" was 6%. In the case of vagus nerve: "none" was 65.4%, "temporary paralysis" was 23.1%, "permanent paralysis" was 11.5%. In the case of sympathetic nerve: "none" was 64.7%, "temporary paralysis" was 29.4%, "permanent paralysis" was 5.9%. In the case of brachial plexus: "none" was 87.0%, "temporary paralysis" was 13.0%, "permanent paralysis" was 0%. In the case of cervical and accessory nerves: "none" was 86.4%, "temporary paralysis" was 13.6%, "permanent paralysis" was 0%. In the case of facial nerve: "none" was 0%, "temporary paralysis" was 80.0%, "permanent paralysis" was 20%. In the case of lingual nerve: "none" was 80.0%, "temporary paralysis" was 20.0%, "permanent paralysis" was 0%. Conclusions: Inter-capsular resection is useful for the treatment of cervical schwannoma and a simple comparison is difficult, but probably with good