The number of patients suffering from vertigo has greatly increased nowadays, so it is significant to evaluate the methods of examining the equilibrium of a body. The authors described the latest methods and discussed the effectiveness of them not only in view of the authors' studies but also in view of many criticisms on them of other researchers.
According to the remarkable progress of ENG, vertigo can easily be analyzed. But still the problems of artefact and inpracticability of recording rotational eye movement remain unsolved in this method. At this point high value is set on vector-electronystagmography which is able to record eye movement dualistically. And the practical use has been examined of DC amplifier instead of AC amplifier hitherto used.
Spontaneous and positional nystagmus play an important role in differential diagnosis whether it is central nervous disorder or peripheral one. Since Hallpike et al. introduced the conceptions of DP and CP, it has been able to estimate the vestibular response quantitatively and the examination of vestibular response has become more valuable. Some investigators said that caloric test can not have much diagnostic value compared with spontaneous and positional nystagmus. CP (canal paresis) is considered to show the difference between left and right vestibular functions, but there are many different opinions about DP (directional preponderance).
If the examination of optokinetic nystagmus was performed simultaneously with vestibular nystagmus, much diagnostic value would be gained. Ohm's rotating method with acceleration is convenient to see the patterns of nystagmus. Pathological signs in optokinetic nystagmus usually reveal the disorder of central nervous system.
The elect posture test, the Mann's test, the goniometer test, the past pointing and standing test can be easily applied for clinical purposes.
In addition to the examinations of vestibular function, a hearing test and neurological and internal examinations should be simultaneously performed.
The following are effective examinations arranged in order of value.
1) spontaneous and positional nystagmus
2) optokinetic nystagmus
3) CP in the vestibular nystagmus
4) DP in the vestibular nystagmus

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Recently, marked progress has been noticed in the field of hearing test for young children. The authors discussed it at three points.
1) Evoked response audiometry
The evoked responses of EEG to sound are often very small and buried in the much greater spontaneous electrical activity. The methods of superimposion of traces were devised by Dawson (1954), and then Asawa and others applied these methods to the clinical examination. The computer is the best equipment to extract the evoked responses. This extracting method is done by repeated sampling of the EEG output at fixed intervals following sound stimulation. The constant latency of the evoked responses makes the averaging possible for the computer. This method seems to be promising in the field of objective audiometry for young children.
The authors studied the V-potentials of EEG response to auditory stimuli in awake state and found that 1) the evoked potential consists of 3 or 4 phasic waves, 2) the largest responses are obtained at the vertex, 3) the responses' can be induced by any other type of stimulus and 5) the responses are recognized within 20 dB above the hearing threshold of adults, but need stronger stimulation in case of children. The authors also studied the audiometry in newborn babies, all sedated, with a computer, and found that a five-phasic wave was seen.
It was discovered that the evoked potential could be induces during sleep as well as in awake state. It follows that the audiometry in children w ill better be done while a sleep.
2) Hearing test for newborn infants
It has been said that newborn infants have various kinds of aural responses to tonal stimuli soon after birth. Many authors have previously reported on the auditory tests of newborn babies.
The authors made the auditory examination of newborn infants with pure tones and an artifical sounds of cow's mooing by means of the pneumogram and the macroscopically observed change. The responses were recognized in the inten sity level of stimulating tone from 40 to 90 dB, the average threshold value being 62.8 dB.
3) Response of fetus to and stimuli
Recently, much attention has been paid to the hearing test for fetus.
Peiper (1924) observed the signs of activity of a fetus responding (to tonal stimuli. Murphy and Smyth (1962) reported the change of heart-rate of the fetus due to sounds.
With further study, the reliability and validity of the audiometry for the fetus will increased.

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Dacryocystorhinostomy is usually performed easily when it is the first surgery for the patient. Difficulty, however, is found if the patient has received a preceding operation for the lacrimal sac.
For a 23-year-old male, who had received an incomplete dacryocystectomy two years before the admission, dacryocystorhinostomy was successfully performed with transplantation of the oral mucosal flap. The lower half of the lacrimal sac had been removed by the previous operation, so it was impossible to anastomose the remaining mucosa of the lacrimal sac with the nasal mucosa. Two pieces of free oral mucosal flap were transplanted on the lower portion of the lacrimal fossa, i. e. between the remaining lacrimal sac and the nasal cavity, so as to make a drainage way of tears to the nasal cavity.
Twenty-two months after the operation no obstruction was found in the new lacrimal duct and the patient was free from epiphorhea.

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In unsere Klinik kam eine 52 jährige Patientin mit rechtsseitiger Mucocele der Stirnhöhle. Trotz hochgradiger Augenverschiebung liess sich die Patientin ungefähr 5 Jahre lang von keinem Arzt behandeln.
Die Patientin wurde durch Pansinektomie geheilt. Durch diesen operativen Eingriff machte der Verfasser eine grosse Gegenöffnung im mittleren Nasengang. Urn das Schliessen der Gegenöffnung zu verhindern führte der Verfasser einen Polyethylentubus ein und verabreichte gleichzeitig Steroidhormon. Den Augapfel brachte der Verfasser wieder in die normale Lage, indem er den durch die Mucocele nach unten gedrängten papierdiinnen Orbitaldach-Knochen entfernte.

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1) Two cases of sinusitis maxillaris neonatorum, 2 months old male and 15 days old female, were reported. In both cases, the radical operation of osteomyelitis and administration of antibiotics were performed, and results were successful.
2) Fifty cases of this disease, which were admitted in E. N. T. clinic of Kyushu University Hospital from 1907 to 1964, were statistically discussed with regard to sex, age, pathogenesis, route of infection, treatments.
3) The treatment of this disease has become easy by the application of antibiotics. But it should be noted that the tolerance of Staphylococcus aureus to antibiotics has been increased.
4) In this study, the mortality was only 2%. This result widely different from those of previous reports.
5) From this statistical observation, it was concluded that the radical operation must be actively performed as early as possible to get a short-term healing.

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The author reported here a very rare case of chondrosarcoma which occurred in the right maxillary sinus. The patient was a 53-year-old man and had been suffering from toothache for 1 year and the diffused swelling of the right cheek for 4 months. He was administrated the total maxillectomy under the diagnosis of maxillary cancer, but the post-operative histological examination revealed chondrosarcoma.
After the operation candidiasis was found on the maxillary wound.
The patient received post-operative irradiation and administration of antitumor agent, but died of the candidiasis on the maxillary wound without any recurrence of tumor about 5 months after the operation.

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Sometimes it is difficult to differentiate scar from perforation on eardrum. In such a case, the author blows a powder (Boric acid etc.) against the eardrum. If that is a scar, it will become opaque with the powder. So we can see the eardrum is nowhere opened. If that is a perforation, a crescent shadow where is no powder will be appear at the perforation edge. So the perforation becomes clear.
We have usually used the Siegle's method for such a differentiation. But this method needs a special instrument, Siegle's or Briining's ear-speculum. And by Siegle's method, we can not differentiate adhesive scar from perforation. The author's method does not need any special instrument but a insufflator for powder. This method is not, like Siegle's, for mobility of eardrum, so we can judge also a adhesive scar as a scar.

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Twenty-five cases of chronic sinusitis were treated with “Empynase”(Pronase-P), and therefore hyperrhinorrhoea, nasal obstruction and headache were cured to various degrees in 83.3% of the patients, and choanal discharge in 64.7% of them.
The decrease of swelling of the turbinate was observed in 36.8% of the patients, and the discharge from the Meatus nasi medius decreased in 73.6% of them, but the diminishing of nasal polyp and the decrease of swelling of the ethmoid bulla were not observed.
The findings of the nasal cavity were evaluated with figures, and 61.7% of the patients got good marks.
The pus in the maxillary sinus was observed decreasing in 44.3 % of the patients, and the decrease of swelling of the mucous membrane in the maxillary sinus was roentgenologically observed in 22.7% of them.
It must be noted that subjective complainments became fewer, but this is partly due to the psychologic effect upon the patients by the administration of the drug. From the objective standpoint, the findings of the nasal cavity were considerably cured by the administration of this drug, but the swelling of maxillary mucous membrane was not so easily removed.

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Recently, the cases of re-tympanoplasty are remarkably increased because of the absolute increase in the number of tympanoplasty.
The author discussed the problems in re-tympanoplasty from the many standpoints of view in 35 cases of reoperation which were performed in E. N. T. clinic of Kyushu University Hospital from Oct. 1964 to Sept. 1965.
The 35 cases were divided into two groups ; one was the continued group and the other re-admission group. The reasons of reoperation, the kind of graft for new ear drum at the first operation and the second operation, the types of operation performed, the changes in tympanic cavity were discussed.
In the continued group, re-tympanoplasty was intended within 35 days after the first operation on the average, because of re-perforation on the new ear drum which were most frequent in the cases operated using Thiersh's skingraft. As f indings in tympanic cavity at the time of reoperation were not so aggravated, the same type of operation was performed in most of cases. The hearing as the f irst one was improved in 55% above 30 dB.
In the re-admission group, the reoperations were intended within 3 years after the first operation on the average because the ear discharge and deafness continued for long time after the first one. The findings in tympanic cavity at the time of reperation were more severe than the continued group and the hearing improvement was successful in 46%.
In conclusion, reoperation is sometimes unavoidable in relatively indicated cases for tympanoplasty, and the necessity of reoperation, therefore, should be previously informed in such cases and should be performed as soon as possible when it is necessary. The results in cases which needed operations of three or four times were very pessimistic.

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