We studied 188 patients complaining of abnormal sensations in the throat.
These patients were treated conservatively with anti-inflammatory drugs, Chinese medicines and minor tranquilizers. When these drugs were separately administered, their effectiveness was about 50%. Combinate therapies with these drugs were more efficacious.
No malignant cases were detected by hypopharyngo-esophagography among these patients.
The adequate guidance would be important for outpatients with this complaint.

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Five patients with supraglottic laryngeal cancer were operated on using Biller's technique of subtotal laryngectomy. Phonatory functions following the operations were inferior to those following vertical partial laryngectomy. Recovery of deglutition was satisfactory, although the duration of nasogastoric intubation was longer than that following the usual supraglottic laryngectomy. Supraglottic cancer with a possibility of downward invasion was believed to be safely treated with Biller's subtotal laryngectomy.

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For voice restoration after total laryngectomy, a new surgical procedure of a tracheopharyngeal shunt using an inverted epiglottic mucosa was reported. The epiglottis is conserved with a pedicle at the tongue base. Next, the epiglottic cartilage is extracted submucously, and the mucosal tube is inverted. The posterior margin is sutured with the upper end of the hypopharyngeal mucosa, making the new esophagus. The suture is covered by the sternohyoid and thyreohyoid muscles kept at the hyoid bone, making the new arytenoid. The inverted epiglottic mucosal tube is then anastomosed with the tracheal stump, making the shunt. With this technique, voice can be restored soon after surgery without aspiration. Fluoroscopic studies have revealed that the shunt was located at the tongue base and was covered closely during swallowing.

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Chondrosarcoma of the larynx is an uncommon cartilagenous tumor. In particular, instances in the cricoid cartilage are very rare. Since these are usually of low-grade malignancy, some laryngeal chondrosarcomas can be managed successfully by conservative laryngeal surgery through laryngofissure and partial laryngectomy. However, some authors have reported the cases of recurrent tumors or death, so it can be considered that in some cases total laryngectomy would be the first choice of treatment.
In this paper, we report on a 67-year-old woman with chondrosarcoma in the cricoid cartilage which required a total laryngectomy. We review 45 cases of chondrosarcoma in the cricoid and discuss the indications for total laryngectomy in accordance with the invasive limits of the tumor.

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Laryngomalacia is one of the most common causes of congenital laryngeal stenosis in neonates or infants. Main symptoms are stridor and dyspnea during inspiration. In most cases, these symptoms disappear spontaneously before the age of two years. Thus, prognosis is generally favorable and surgical treatment is not adopted. In this paper, a five-month-old boy suffering from laryngomalacia with cat-cry syndrome was reported. Inward collapse of the arytenoids and aryepiglottic folds was seen. Although we expected a normal recovery, 14 months after the first consultation we determined that he had made insufficient improvement. Therefore, the redundant mucosa over the arytenoids was resected with a carbondioxide laser. Stridor disappeared postoperatively, and the recovery course has been excellent for one year after the operation. The surgical indication for the laryngomalacia was the severe dyspnea requiring long-term intubation or tracheostomy. In addition, we suggest that surgical treatment is also indicated in patients who fail to thrive due to feeding difficulties.

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A 51-year-old female suffered a laryngeal injury in a traffic accident 2 months before visiting our clinic. The chief complaint was dyspnea, which had become worse one month after the injury. The larynx was small in anteroposterior length, and the anterior part of the thyroid cartilage was defective in CT images. These findings led us to suspect a delayed laryngeal stenosis due to the injury. However, surgical expansion following laryngofissure failed because the cartilages of larynx and trachea were flaccid. Since a deformity of the auricle appeared, we examined an anti-cartilage antibody and finally diagnosed this case as relapsing polychondritis. This case suggests that a flaccid larynx should be considered a symptom of relapsing polychondritis when it appears after laryngeal injury.

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Two cases of tracheobronchopathia osteochondroplastica (TOP) are reported. The first case, a 72-year-old male, had complained of no airway symptoms; the second was a 60-year-old female who had suffered from an abnormal sensation in the throat for two months. Both cases were diagnosed initially by otolaryngologic examination on their first visit to our out-patient clinic. However, an initial finding of TOP determined by indirect laryngoscopy is extremely rare in the Japanese literature, although the cranial part of the trachea involved in this disease is often reported. Indirect laryngoscopy in routine otolaryngologic examinations can play an important role in diagnosing patients with TOP, including asymptomatic cases. There have been many claims regarding the etiology of TOP, although it remains unknown. It is interesting that the RA test was positive in 6 of the 11 patients reported in the Japanese literature, including our cases, although there have been no reports concerning the relation of TOP to the RA test. More study is needed regarding the RA test's clinicopathological significance for TOP.

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Three cases of dental prostheses in the bronchus were reported.
Case 1: A 40-year-old male who himself was a dentist, aspirated his resin dental cap during his dental practice. At that time, he had a cough and slight dyspnea. He consulted our clinic because he thought he might have bronchial foreign body. A chest X-ray film didn't reveal it. However, 99m-Tc scintigraphy revealed decreased pulmonary blood flow in the left lower field. This foreign body was removed with the aid of a ventilation bronchoscope.
Case 2: A 88-year-old male aspirated a silver dental cap during dental treatment. A chest X-ray film revealed a right bronchial foreign body. This foreign body was removed through a rigid bronchoscope under local anesthesia.
Case 3: A 43-year-old male aspirated a metal dental cap during dental treatment. At that time he had no cough or dyspnea at all. One month later, a chent X-ray taken at a regular medical check-up unexpectedly revealed a right bronchial foreign body. Infectious granulation with purulent secretion was found around the long-standing bronchial foreign body, which was removed with difficulty through a ventilation bronchoscope.
The authors emphasized that dentists should recognize the possible dangers of dental prostheses as foreign bodies in the airway and should pay more attention to avoid accidents involving prostheses.

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A case of the removal of an esophageal foreign body (dental prosthesis) by thoracotomy was reported. The patient was a 63-year-old male who had complained of odynophagia after swallowing a dental prosthesis by mistake. Chest X-ray examination showed a foreign body having four sharp clasps. Emergency direct esophagoscopy was carried out, but the foreign body could not be removed due to the probable depression of the clasps in the esophageal membrane. Therefore, thoracotomy was performed under general anesthesia. Opening the mediastinum, there was a bloody serous exudate. The esophageal wall was continuously incised, and a part of the dental prosthesis was cut off with a pair of pliers. The remainder of the foreign body was easily removed by esophagoscopy. Thoracic drainage and chemotherapy were continued, and esophagography was carried out two weeks after the operation. The patient was discharged without complications.

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Benign esophageal tumor is less frequent than carcinoma. We present a case of a pedunculated esophageal cyst found in a 70-year-old man. Endoscopic examination revealed a pedunculated polyp about 3cm long and 2cm in diameter covered by normal esophageal mucosa at 2cm from the esophageal introitus. The preoperative diagnosis was a fibrovascular polyp or a true pedunculated neoplasma. The polyp was surgically excised by cervical esophagotomy and diagnosed as a retention cyst of the esophageal gland. Among the benign tumor of the esophagus, leiomyoma is the most frequent, followed by polyp, cyst, fibroma, hemangioma etc. “Polyp” is originally not a histological, but a morphological term. In this regard, there has been great confusion in the histopathological classification of benign esophageal tumors. When tumors do not show real neoplastic character, we propose to call these tumors polyps, using an adjective to further specific type, for example, fibrolipomatous polyp. Esophageal cyst is rare, and its incidence is approximately 5% of all esophageal tumors. As endoscopic techniques develop, we have more chance to find small tumors. Cysts originate from the lower esophagus and do not increase more than 2cm in diameter generally. Endoscopic excision is recommended when their size is small, and esophagotomy is selected when their diameter is greater than 4cm.

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