No exact count is available of the number of laryngectomee patients in Japan. In this study, 54 Laryngectomee Clubs were formed in Japan and total number of laryngectomee patients was 6, 799 in December, 1981. The percentage by sex were 86% for male and 14% for female.
The crude rate of laryngectomee per 100, 000 population was 5.8 and the laryngectomee index by prefecture was higher to the west of the Kinki area.
The average age of the laryngectomee was 67.2 years old (range 32-98 years old). The percentage of the laryngectomee over 65 years was higher (63.4%). Thus, it is stressed that these patients should undergo not only the management of chronic diseases, but also regular check-ups for early detection of a second primary cancer.
The average age in surgery was 60.1 years old (range 21-88 years old) and the average period after surgery was 6.5 years old.
The incidences of patients who use an artificial larynx and esophageal voice were 29% and 28%, respectively.

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Mass examination of laryngeal cancer has been attempted only in a few area in this country. From May to July in 1984, our mass examination for early detection of glottic cancer and other diseases of the vocal fold was performed in co-operation with eight health centers, twenty four E. N. T. clinics and a local press in Fukui prefecture.
Six hundred and eleven patients, who complained of hoarseness, underwent the examination. They consisted of 343 males and 268 females. Age distribution of the patients was 68 in thirties, 211 in fourties, 260 in fifties, 75 in sixties, 50 in seventies, 6 in eighties and 1 in nineties.
Seven males (1.2%) of the glottic cancer and eight males of precancer (seven hyperkeratosis and one leukoplakia) were found among the 611 patients. In these laryngeal cancers, six cases were T1a of early stage and one was T3 in the classification by Intenational Union Against Cancer (UICC).
Other 596 patients distributed to 296 chronic laryngitis, 60 acute laryngitis, 66 laryngeal polyp, 41 Rienke's edema, 55 laryngeal nodule and others.
We achieved our purpose by early detection of six glottic cancers in this mass examination, and look foward to the examination same as ours in other prefectures.

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The combined therapy of local intraarterial infusion (mainly the intraarterial injection) of 5-FU with simultaneously performed radiotherapy was tried on the patients with carcinoma of the larynx, the patients with hypopharyngoesophageal carcinoma and the patients with metastatic carcinoma of the cervical lymph node. All of 6 patients with carcinoma of the larynx, who had relapsed after the radiotherapy, were healed without relapse, and, in addition, the phonetic disorder did not persist. This therapeutic method is considered to be very promising not only for the therapy of the patients with hypopharyngeal carcinoma but also for the patients with metastatic carcinoma of cervical lymph node. The carcinoma in the area of intraarterial injection was healed very well in any of the patients. In general, the intraarterial injection has such various advantages as follows: (1) it is efficient and is capable of being performed as a reliable intraarterial infusion; (2) it is easy to perform; and (3) the sufficient objective of the therapy may be attained after three trials of the injection. But the drug is limited to 5-FU, and the simultaneous radiotherapy is indispensable. The result of this therapy is expected to be much better if the intraarterial injection could be performed at the sites closer to the heart.

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Paralysis of the recurrent nerve is one of the causes of upper airway obstruction and is an unrecognized cause of respiratory failure.
Therefore, in this study, we examined 20 patients with recurrent nerve paralysis and 20 healthy subjects using simple spirometry and usual flow-volume curve inorder to estimate the value of pulmonary funcion test and investigate the effects of upper airway obstrucion to respiratory system. For this purpose, pulmonary funcion tests were done during both expiration and inspiration.
The following results were obtained:
(1) The measurements of spirometry and flow-volume curve during forced inspiration were very useful to detect the abnormality of patients with upper airway obstruction due to recurrent nerve paralysis.
(2) Most of the patients showed “FEV_1.0%>FIV_1.0%” and “FEV_0.5%>FIV_0.5%”. “FEV_0.5%>FIV_0.5%” is very significant to detect the abnormality of the upper airway.
(3) The reduction of the MMIF/MMEF is a little diagnostic value of the upper airway obstruction.
(4) The flow-volume curve was markedly abnormal in most of the patients. The characteristic abnormalities were the reduction of peak expiratory flow and the markedly reduced, constant inspiratory flow.
(5) The values of respiratory resistance were high in all patients, but the absolute value of respiratory resistance was not useful to investigate the characteristics of the abnormality in lung-thorax system due to the upper airway obstruction. To analyze respiratory impairment due to upper airway obstruction, we would say that it is necessary to measure and analyze effective compliance on the forced oscillation method.

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Thyroplasty type I (Isshiki) in 15 cases and arytenoid rotation operation (Isshiki) in 11 cases were performed among the cases with unilateral vocal cord paralysis. And the following results were obtained.
1. Postoperatively, the misdegultition disappeared in all 5 cases who suffered from the marked misdegutition within one month after the onset of paralysis.
2. A definite improvement in both hoarseness and maximum phonation time (MPT) was observed in all cases postoperatively. However, the improvement was generally transient, and the moderate degree of hoarseness recurred within one month after the surgery. The transient improvement was considered to be facilitated by local edema of the vocal cord, elicited by, operative manipulations.
3. A combination of voice training with silicone injection into the vocal cord was attempted for the management of postoperative recurrence of hoarseness. And good results were obtained.
4. It was concluded that a combined approach including laryngeal framework operation, silicone injection and voice training should be necessary for the treatment of hoarseness due to the unilateral vocal cord paralysis.

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During last 13 years from 1972 to 1984, 28 cases of foreign body in the tracheobronchial tree were treated in our clinic. The 28 foreign bodies were classified into two categories, i. e. radiolucent and radiopaque, and the ratio was 25:3 respectively.
In 16 of radiolucent 25 cases, by their histories, physical findings and chest X-rays tracheobronchial foreign bodies were suggested. In 4 of those 16 cases Holzknecht's signs were useful for the diagnosis. In other 9 cases with a negative findings in simple chest X-ray, foreign bodies were found by tomography for 2 cases, radionuclide lung scanning for 5 cases and CT scans for 2 cases.
We discussed the results from the viewpoint of the methods the detection of the radiolucent tracheobronchial foreign body in detail.

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A case of the neurofibroma was reported in this paper, which developed between the thyroid and trachea with interesting clinical findings.
This case was preoperatively diagnosed as the struma invading into the trachea. We tried to rebuild the defective tracheal wall, caused by the surgical removal of the tumor, by the use of collagen sheet and obtained good results. The following is the report of this case.

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A case of a 56-year-old man with tracheobronchopathia osteoplastica is reported. He had a history of dry cough for 5 months. Clinical examinations including bronchofiberscopy, CT scan were performed. Nodular lesions on tracheal wall except membranous portion and on the major bronchi were detected, but no co-existing disease was detected. Nodular formations with bony or hyaline degeneration were found by the histological study on the specimen. In addition, hyaline degeneration was observed in the surrounding connective tissue. It may suggest that these bony nodules were producted by the calcification of the hyaline degenerated deposits.
On the diagnosis for this disease, bronchofiberscopy have an important role, but now CT scan will play a great role of diagnostic examination.

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This paper presents an unusual case of a 63-year-old patient with an intrabronchial foreign body (a staple), that was impacted asymptomatically for at least four years. A chest X-ray showed the staple stayed in the right intermediate bronchus and the tip pointed centrally. Bronchoscopy revealed that the legs of the staple completely were covered by prominent granulation tissue. The foreign body was safely removed by transpleural bronchotomy. It was a U-shaped rusted iron staple to fasten an electric cord. The length of the legs was 2.0cm and its saddle 1.5cm.

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A case of drug-induced esophagitis is presented. A bacampicilin tablet was clinically thought to be the causal drug for this case. This patient is 28 years old female, and she swallowed the tablet without fluid just before lying in bed. Symptoms appeared 4 hours after taking the drug. The symptoms were odynophagia and retrosternal pain. Endoscopically, several stripes of whitish belag were attached on esophageal mucosa along almost all of its length, and erosive lesions were found at 25cm and 40cm from the incisors. We diagnosed this esophagitis of Bacampicilin-induced esophagitis because of the characteristic history and the relationship to the drug. The symptoms disappeared rapidly and no scar or constriction was left endoscopically. The pH, osmolarity, and electric conductivity of this drug were not significantly high for inducing esophageal lesions, and the pathogenesis of this drug was not identified.
But by fact that even the drug of such low pathogenesis could induce esophageal lesion depending on swallowing method, we would say that we should pay attention to the method of medication.

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