Antiseptics commonly used in the middle ear cavity for the purpose of sterilizing the operating field are potentially hazardous to hearing. Antiseptics should never be instilled in the middle ear cavity. Alcohol and surfactant themselves are not only ototoxic but also appears to have synergestic effect.

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Gentamicin is known as an ototoxic drug as well as Streptomycin and Kanamycin. But only several clinical reports were seen on this subject. And it was not described in detail the results of vestibular test in these reports. In this paper, one patient who suffered from Gentamicin ototoxic effect is reported with detailed vestibular test.
A 70-year-old female had suffered from chronic pyelitis repeatedly for past six years. Her illness took a bad turn, so she was admitted to our hospital. She was given Chloramphenicol and other antibiotic drugs for a month. But they were not effective on her pyelitis. Then she was given Gentamicin 400mg for seven days. After the Gentamicin therapy she showed an ataxic gait and the ataxia made progress until that she could not walk by herself.
Otologicaly she showed signs as follows;
1) Sensorineural deafness was seen in her both ears in the level of 30-40dB at every examined tone. The recruitment phenomenon was positive by most comfortable loudness test.
2) Spontaneous and positional nystgmus were not found.
3) Ataxia was so severe that she could not keep Mann's posture even with open eyes.
4) By caloric test her left ear showed no response with both stimulations of 30°C and 44°C. The right ear did response for 150 sec. by the stimulation of 44°C water. But it did not show a certain response by 30°C water.
As a treatment, intravenous injection of Théraptique and Xylocaine and internal medication of ATP and so on were performed. After the treatment for a month, she could walk herself even though unsteadily. The caloric response of left ear was recovered at the cald stimulation. Her deafness too became in normal level.

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A case of hemoangioma of the temporal region is reported. The tumor was noticed in 2 years of age in a boy. He was treated surgically twice several years ago. At the age of 13 years, the tumor became to grow up rapidly, and was completely extirpated.

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The radiation therapy of laryngeal cancer has changed in these ten years in our country. We have been observed 72 patients of laryngeal cancer, who admitted to our clinic, about the method of their therapy, dosage, function of speaking and the prognosis. Among the 72 patients, the observations were gained by 59 patients as follows;
1. The therapeutic method has changed from Ra therapy to Co 60 irradiation in these nine years. All the patients who admitted after 1970 were treated by Co 60 therapy.
2. In 59 patients, Ra therapy was applicated to 31 patients and 28 patients were treated by Co 60 therapy.
3. The average dosage of Ra therapy was 11,090 rads and that of Co 60 therapy was 6,950 rads.
4. The five year survival of Ra therapy was 95%, though the five year survival of Co 60 therapy was 56%.
5. The dosage of radition was not relative to the survival of the patients in our observance.
6. As to the 9 patients who died after discharge,. no relation was seen between their dosage and death rate, which may suspect the proper dosage on radiation therapy of laryngeal cancer. The proper dosage on our observation of Co 60 therapy was 6,000 rads.

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The relationship between characteristic preferences for alaryngeal speech of the laryngectomee and fluency of the esophageal speech were discussed. Same approach was done in the cases speaking with artificial larynx. Personalities of 21 esophageal speakers were examined and classified by the test of “Cornell Medical Index” and “Yatabe-Gilford Characteristic Test”, as well as their occupation and motoricity were referred. It was clarified as results that his personality had big influence to the fluency of the esophageal speech as well as method of operation and condition of recovery.
The results were as follows.
1.“Type C” and “type D” discussed in “Yatabe-Gilford Characteristic Test” were most desirable ones in getting esophageal speech.
2. Personality of good speaker was diagnosed to be “normal”, but the one of poor speaker was to be “neurotic” by the test of “Cornell Medical Index”.
3. Referring to his motoricity, most of the esophageal speakers had adequate physical strength and had previous history of enjoying sports.
4. Cases acquired fairly well esophageal speech returned to their social life.
An artificial larynx was greatly improved by TAPJA and examined by many investigators from different points of view. However, paucity of reports in relation between characteristic preferences for alaryngeal speech with artificial larynx and fluency of the speech with artificial larynx prompted us to investigateit.
The personalities of 64 subjects with artificial larynges were examined by the test of “Cornell Medical Index” and “Yatabe-Gilford Characteristic Test” as well as referring to their age distribution and post operative years.
The following results were gained.
1. Skillfulness of the speech with an artificial pneumatic larynx had no any relation to the post operative years.
2. The subjects spoken by artificial larynges were ranged from 40 to 81 years of age, but skillful speakers were limited from 40 to 60 years of age.
3. The cases with artificial pneumatic larynges were generally inclined to be “neurotic” by the test of “Cornell Medical Index”.
4. Proficient speakers with instruments were inclined to be “less neurotic”.
5. The subjects classified into “group E” and “group B” were less skillful than ones classified into “group D” by “Yatabe-Gilford Characteristic test”.

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20 operations (tooth extraction, sinectomy, deviatomy, tonsillectomy, etc.) upon the acupuncture anesthesia were performed. The needles and stimulators that were made in China were used, and these acupuncture were performed by Chinese method. In these cases, 12 cases were performed without local anesthesia, 6 cases were perfomed by using a small amount of local anesthetics, and 2 cases were not revealed on the effects of acupuncture.
On the blood pressure, pulse rate and respiratory rate, the remarkable changes were not revealed during acupuncture anesthesia. The premedications were not needed.

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Ion specific liquid ion-exchanger microelectrode has been successfully applied to the inner ear fluids. With this electrode, continuous and reliable measurement of the potassium ion concentration became possible.
Pathogenesis of the inner ear deafness such as Meniere's disease are thought due largely to imbalance of potassium and sodium ions in the inner ear fluids. This technique provides a useful tool for the better understanding of the inner ear pathology. Technical aspects of making electrodes and detailed technical advice in applying to the living animal have been presented.

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Pitressin is one of the hormons of the posterior pituitary. The authors reported that pitressin causes a depression of the cochlear microphonics. In this paper the effects of pitressin on CM modified by NaCl-crystals administered on the round window membrane were studied. The following results were obtained.
1. The placement of NaCl-crystals caused an overshoot of CM for 3 min. and 20 sec., a primary depression to 55.0% of the initial value within 15 min., a gradual recovery to 71.0% within 40 min. and then a gradual second depression.
2. The repeat placement of NaCl-crystals caused an overshoot of CM for 3 min. and 20 sec. and a gradual decrease to 140μV (46.7% of the initial value) within 20 min., to 80μV (26.7%of the initial value) within 50 min.
3. The NaCl-crystals were placed on the round window membrane 1 hour and 30 min. after injection of 0.4unit of pitressin. The placement of NaCl-crystals upon the round window membrane caused a gradual decrease of CM. The CM decreased to 226±33μV (75.3±11.0%) within 30 min., to 195±25μV (65.0±8.3%) within 1 hour and to 154±13μV (51.3±4.3%) within 2 hoursl As compared with the control, it is characteristic that the CM caused a gradual decrease without a recovery and the value of the CM at the 60th minute was less than the control.
4. The repeat NaCl-crystals were placed on the round window membrane 3 hours and 30 min. after injection of 0.4unit of pitressin. The placement of NaCl-crystals upon the round window membrane caused a mild depression of CM to 280μV within 10 min. and a rapid decrease to 220μV at the 55th min, to 190μV at the 60th min., and to 100μV at the 62th min. The CM decreased to 80μV within l hour and 30 min.
It was apparent that pitressin would cause an increase in the volume of the inner ear fluids, an increase of the hydrostatic pressure and the osmotic pressure and increase the impedance of the inner ear conductivity after the placement of NaClcrystals. Pitressin would also promote the reabsorption of sodium ion in the inner ear. According to these actions, the repeat placement of NaCl-crystals on the round window membrane with the premedication of 0.4unit of pitressin would prolong the rapid decrease of CM as compared with the control.

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Furosemide and ethacrynic acid are diuretics which act to inhibit the Na-pump in the kidney tubule. It is known that both diuretics cause a sensory-neural deafness in the patients of renal failure. In this paper the effect of both diuretics upon the inner ear was studied by means of the evaluation of the amplitude of the cochlear microphonics (CM) which were recorded from the basal turn of the cochlea in guinea pigs with differential electrodes technique.
A) Effect of furosemide and ethacrynic acid upon the cochlear microphonics
1) The amplitude of CM after the intravenous injection of 2mg/kg of furosemide showed a slight increase and then a rapid decrease to 65.0±23.3% of the initial value within 40 minutes. Thereafter it maintained almost the same value for over 210 minutes.
2) The amplitude of CM after the intrayenous injection of 1mg/kg of ethacrynic acid showed a slight depression with a gradual recoyery within 50 minutes and then an overshoot which showed 116%of the initial value as the highest one and 103% at the 150th minute.
3) The amplitude of CM after the intrayenous injection of 10mg/kg of ethacrynic acid showed a rapid decrease to 51.7±9.3% within 60 minutes, to 47.0±7.6% within 120 minutes and then to 43.7±5.0% within 180 minutes. Furosemide and ethacrynic acid decreased the amplitude of CM for a long time without a recovery during the obseryation over 180 minutes. The changes in the ionic gradient of Na/K between the endolymph and perilymph caused by the inhibition of Na-pump in the inner ear should be presumed as the mechanism of their depressive effects.
B) Effect of furosemide and ethacrynic acid upon the changes of CM by the place. ment of NaCl crystals on the round window membrane
As the inhibition of Na-pump in the inner ear by the diuretics had been presumed the changes of CM by the placement of NaCl crystals on the round window membrane with the premedication of furosemide or ethacrynic acid were observed.
1) The placement of NaCl crystals on the round window membrane caused an overshoot at first for 3 minutes followed by a primary decrease to 55.0% of the initial yalue within 15 minutes, and then a recovery to 71.0% within 40 minutes followed by agradual secondary decrease.
2) The placement of the crystals 120 minutes after the injection of 2mg/kg of furosemide caused a longer overshoot and a slighter primary decrease to 78.8% of the initial yalue within 25 minutes. The recovery was also more gradual showing a level of 87.3% of the initial yalue within 55 minutes. The secondary decrease showed a level of 87.8% within 60 minutes and 68.7% within 120 minutes.
3) The crystals were placed 100 minutes after the injection of 1mg/kg of ethacrynic acid. The CM showed an overshoot for 31 minutes and then a rapid decrease to 54.0% of the initial value without any recovery.
4) The crystals were placed 90 minutes after the injection of 10mg/kg of ethacrynic acid. The CM showed an overshoot for 15 minutes and then a primary decrease to 72.3% within 60 minutes and to 66.3% within 90 minutes without any recovery.
With the premedication of furosemide the pattern of CM-modification were more prolonged and milder than that of the control. With the premedication of ethacrynic acid the CM showed the oyershoot for a longer period and then the greater primary decrease without a recovery. From the results obtained in the experiment B, it is apparent that ethacrynic acid would have some different actions in the inner ear as compared with that of furosemide although both diuretics cause a depression of CM.

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Fundmental and clinical evalution of new antibiotic, Coumermycin (CUM) were performed. The results obtaind are as follows:
1) In vitro antibacterial activity: Against 80 strains of coagulase positive staphylococci isolated from the otorrhoea of purulent otitis media, the MIC, measured by agar plate dilution method, distributed with two peaks, ≤0.19 (74%) and 3.13-50mcg/ml (26%). Further, the MIC of CUM was 1.56-50mcg/ml against Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, and 25-≥100mcg/ml against Pseudomonas aeruginosa. Some tendency toward Cross-resistance with CUM and NB was observed at medium concentrated of CUM.
2) Stability of Coumermycin solution: As to the stability of 10mg/ml solutions of CUM, there was no fluctuation in its color, pH and antibacterial activity within a 16-day period when the solutions were kept at 5°C and 37°C.
3) Results of clinical treatment: When CUM was administered applied locally in 35 cases of the acute or chronic purulent otitis media, it was good in 20 cases, fair in 8 cases, and poor in 6 cases. When the cases in which it was good and fair were considered together, good results were obtained in 30 cases, that is a ratio of effectiveness of 80 percent.
4) Side effect: no side effect was observed when CUM was locally used.

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