Rhinosinusitis (RS) is caused by genetic, anatomical, immunological, and metabolic factors in host and external exposure factors. RS causes unpleasant symptoms such as nasal drip, postnasal drip, nasal congestion, loss of smell and flavor, headache, facial pain and pressure, and consequently results in sleep disorders, decreased productivity, inhibition of social behavior, decreased quality of life, and economic burden. Therefore, it is necessary to accurately understand the pathogenesis of RS and provide appropriate treatment. Depending on the clinical course of RS, acute RS (ARS) is defined when cured within four weeks from onset, and chronic RS (CRS) is when persists for more than 12 weeks.
　Detailed interviews are useful for not only understanding the pathogenesis but also confirming patients' actual needs. Clinical diagnostic scoring systems are often used in medical treatment. However, some of the scoring systems that are widely used have many evaluating graded-scores and are not suitable for Japanese. Thus, we have proposed two questionnaire scoring systems for Japanese [nasal symptoms questionnaire (NSQ) and self-administered odor questionnaire (SAOQ)]. When diagnosing, we should be aware of odontogenic lesions in unilateral RS and related diseases with systemic type 2 inflammation, such as bronchial asthma and vasculitis in bilateral RS. Particularly, in CRS, it is critical for treatment to diagnose whether the patient fulfill the diagnostic criteria for ECRS that indicates a type 2 inflammation dominant.
　A goal of treatment for RS is to suppress acute inflammation by using antibiotics and aeration of the middle nasal meatus for ARS, and to stably improve the condition and prevent recurrence without using systemic steroids for CRS. Our therapeutic strategy for CRS with nasal polyps (CRSwNP) is to first perform ESS and to select steroids, followed by biological agents for postoperative recurrence. We aim to improve therapeutic outcomes by setting treatment goals and providing appropriate treatment interventions from an early stage.
　In this review, the pathogenesis, diagnosis, and treatment of RS and related diseases are mentioned and discussed from the otolaryngological perspective.

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　It is important for the treatment to diagnose whether it¹s inflammation, tumor or congenital anomaly in the maxillary sinus lesion. While the pathological specimens at hospitals of Tokyo Dental College in 2018 to 2023, we obtained 81 cases of several diseases from maxillary sinus. Twenty-one cases of chronic sinusitis, 17 cases of postoperative maxillary cyst, 2 cases of mucous cyst of maxillary sinus, 8 cases of odontogenic keratocyst, 5 cases of foreign body pigmentation, 3 cases of mycosis, and others were diagnosed for specimens from maxillary sinus. In addition, recently augmentation of maxillary sinus floor is operated for dental implant treatment, hence using bone prosthetic material is increase. So, we can often obtain the materials from maxillary sinus as foreign body pigmentation for pathological examination.

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　In many pediatric cases of oral self-mutilation, psychiatric disorders may be the main causative factor. Recently, the presence of sensory processing disorders as characteristics of autism spectrum disorder has attracted attention, and it has been added to the diagnostic criteria. We report a pediatric case of autism spectrum disorder diagnosed through tongue ulceration due to self-mutilation. The patient was a 7-year-old boy who visited our clinic with the chief complaint of intractable ulcer with itching on the tongue tip. We attempted to consult a pediatric psychiatrist based on a diagnosis of tongue ulceration resulting from self-mutilation due to sensory abnormalities. However, we encountered difficulties since the department of pediatric psychiatry refused his registration because he had no history of psychiatric consultation or referral by a dentist. Meanwhile, the tongue ulceration rapidly deteriorated and abnormal behavior with suicidal ideation became apparent. We desperately explained the urgency of the situation to a pediatric psychiatrist, and he was finally accepted by a specialized hospital for pediatric psychiatry. Consequently, he was definitively diagnosed as having pediatric autism spectrum disorder and received appropriate medication. As a result, the abnormal behavior and tongue ulceration disappeared. Since then, there has been no recurrence of symptoms for 3 years and 5 months.

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　Peripheral ameloblastic carcinoma is an extremely rare malignant odontogenic tumor arising outside the jawbone. We report a case of peripheral ameloblastic carcinoma in the maxilla. The patient was an 81-year-old woman. A neoplastic lesion on the left maxillary gingiva was noted by a local dentist and she was referred to the department of oral surgery of a hospital. A biopsy was performed, however it was difficult to determine whether it was benign or malignant, therefore the patient was referred to our hospital for further examination and treatment. A contrast-enhanced CT image of the maxillofacial region revealed only mild compressive bone resorption in the buccal cortical bone on the left side of the maxilla. Clinically, however, the surface of the tumor was rough and prone to bleeding. Cytopathology resulted in possible signs of malignancy. An excisional biopsy revealed a high degree of cellular atypia, and a preoperative diagnosis of ameloblastic carcinoma was made. A partial maxillectomy was performed under general anesthesia. Based on the histological findings of the resection specimen, a diagnosis of ameloblastic carcinoma was made. One year and ten months have passed since the surgery, and there has been no evidence of recurrence or metastasis.

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