Tracheal tumors are rather rare in the field of otolaryngology. Our patient was a 55-year-old man who complained of bloody sputum and dyspnea after exercises. Fiberoptic bronchoscopy revealed a tumor of the trachea originated from the right wall slightly cranial to the carina. Biopsy revealed that the tumor was a cylindroma. The tumor was removed with partial resection of the trachea under thorachotomy. The postoperative course was uneventful and there were no evidences of recurrence 6 months after surgery.
So called bronchial adenoma is generally thought to get malignance. Therefore, it is necessary to diagnose and treat as early as possible.
Thirty two cases of cylindroma of the trachea which have been reported in Japan were reviewed literally.

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Eine Kasuistische Mitteilung über das sehr seltene Vorkommen des Riesenzellen-tumors des Kehlkopfes. Der Patient ist ein 40-jähriger Büroangestellter, der über Heiserkeit und Atemnot geklagt hat. Der Tumor befand sich hauptsächlich an der unteren Fläche des gelähmten rechten Stimmbandes und erstreckte sich nach unten etwa 1.7cm an die Luftröhrenwand entlang.
Die Exstirpation des Tumors wurde unter der Laryngofissur vorgenommen. Da das Tumorgewebe histologisch Atypismus 2. Grades nach Jaffe zeigte, bestrahlten die Verfasser von außen den Bereich des Tumors (7692 rads) nach der Operation und gaben ihm 5 FU (4750mg). Glatte Genesung.
Soweit wir Verfasser die Literatur durchsahen, ist dies der 3. Fall, der als Riesenzellentumor des Kehlkopfes in Japan mitgetielt ist.

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Nineteen cases of granuloma of the larynx caused by intratracheal intubation were clinically investigated. Fifteen cases of them were female and most cases were of the ages from 20 to 50. The granuloma was located at the vocal process of the arytenoid cartilage in the majority of the cases. The most frequent surgery was heart operation. As a treatment of granuloma, endoscopic microsurgery of the larynx appears appropriate.

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Surgical results of 70 cases of tympanoplasty in attic cholesteatoma were analyzed and the propriety of this operation for cholesteatoma was discussed. The cases were devided into the primary operated group and the secondary operated group.
To get a sufficient results for the restoration or preservation of hearing the following conditions were convenient.
1. The preoperative hearing loss is under 45dB.
2. The perforation of ear drum is attic type or marginal type, not central type.
3. The extirpation of cholesteatoma matrix membrane is possible preserving the meso and hypotympanal mucous membrane.
4. The secondary operated cases with good regeneration of mucous membrane in hypo and mesotympanum.

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The authors statistically studied 2656 cases who had consulted Visual and Auditory Research Institute of Fukuoka Medical Association from 1970 to 1976. The results were as follows.
1) 2515 of 2656 cases (94.7%) were children under 15 years of age and 141 cases were adults over 16 years of age. In 2515 cases, 1497 cases had hearing impairment and 826 cases had speech disorder without hearing impairment. In 141 adult cases, 140 cases were hearing impaired and one case was speech disordered.
2) In 1497 hearing impaired children, 1135 cases ha d perceptive deafness and showed a highest percentage. There were 241 cases with acquired conductive deafness, 33 cases with conginital conductive deafness and 51 cases with mixed deafness.
A age constitution of perceptively deafened children had a peak in 2 years of age, and children with acquired conductive deafness showed higher frequencies from 3 to 5 years of age. Speech disordered children without hearing impairment were most frequent from 2 to 3 years of age. The male-female ratio was 3 to 1.
3) In perceptively deafened cases, a large number of them had severe hearing loss and the cases over 70% had hearing loss over 60dB. In acquired conductive deafness, a great number of cases showed slight loss under 30dB, and only 11 ears had hearing loss over 45dB. The children with congenital conductive deafness had more severe hearing loss than the acquired and there were several cases with hearing loss over 60dB.
4) In respect to types of audiogram, sloping type commanded a greatest number of the perceptively deafened. Secondarily horizontal type and thirdly high-cut type were frequently observed. In acquired conductive deafness, horizontal type showed a highest frequency, secondarily low-tone-loss type and thirdly mountain type. In congenital conductive deafness, low-tone-loss type showed a highest frequency and secondarily horizontal type.
5) Causes of deafness of 1186 cases with perceptive deafness (involved mixed deafness) under 15 years of age were studied. The frequency of hereditary deafness was 18.4%, prenatal deafness 7.7%, paranatal deafness 26.9%, prenatal and paranatal deafness 3.4%, postnatal deafness 6.1% and unknown causes was 37.5%.

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Since 1971, an improved technique of glottic reconstruction following extended frontolateral partial laryngectomy has been used in our clinic; a bulge is constructed at the level of the vocal cord with a superiorly based sternohyoid muscle flap, which is covered by either a rotating hypopharyngeal mucosa or a free graft from the oral mucosa. Clinically, postoperative phonation has usually been satisfactory. The purpose of the present study was to investigate macroscopic and microscopic changes in the newly constructed bulge. The surgery was carried out on 30 mongrel dogs divided into three groups: (1) The nerve supplies appeared in the operative field were preserved and the muscle flap was covered with a rotating pharyngeal flap.(2) The nerve supplies were eliminated and the muscle flap was covered with a pharyngealflap, and (3) The nerve supplies were preserved and the muscle flap was covered with a free graft from the oral mucosa.
The results obtain ed are as follows:
I. Macroscopic findings.
1) The size of th e bulge did not depend on the groups as described above.
2) In most cases the top of the bulge was located at the same level as that of the unoperated vocal cord or slightly lower.
3) The medial edge of the bulge was more frequently uneven in the cases in which a rotating flap was used than in the cases in which a free graft was used.
4) There was no necrosis in the mucosa of the bulge or adhesion at the anterior commissure in any case.
II. Microscopic findings.
1) The epithelium of the mucosa of the bulge were thicker than that of the normal vocal cord in many cases regardless of its original places.
2) The epithelial retridge of normal oral and hypopharyngeal mucosa became flat after the surgery in almost all the cases.
3) The lamina propria of the mucosa of the bulge were thinner than that of the normal vocal cord, especially it was very thin in the cases of free graft.
4) The elastic fibers were seldom observed in the lamina propria of the mucosa of the bulge, whereas the collagenous fibers were found more densely than in the normal vocal cord. Especially, in the cases of free graft of the oral mucosa, the lamina propria was extremely thin.
5) Degeneration and atrophy were found more or less in the muscle flap in all the cases regardless of preservation of the nerve.

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One hundred and fourteen cases which presented a furrow on the vocal cord (s) were clinically investigated. In eighty-two of the entire cases the furrow was the only or the most dominant pathology whereas the other thirty-two cases presented some other dominant pathology, such as polyp, carcinoma, inflammation, paralysis, and so on. Among the former eighty-two cases, voice disorder was the chief complaint in seventy-five cases (sulcus vocalis). In addition to the clinical investigations, vocal cords of five autopsy cases and a laryngectomy case in which a clear furrow was found was histologically investigated. The results lead us to the following conclusions:
1) The onset of voice disorder, mostly hoarseness, is at very young ages, at the puberty or at advanced ages.
2) The typical findings of sulcus vocalis consist of existence of a furrow near the edge of the bilateral vocal cords extending from the vocal process to the anterior commissure, a concave edge of the vocal cords during respiration, incomplete glottic closure during phonation, and excessive adduction of the false cords during phonation.
3) The sulcus is located in the region covered with squamous epithelium and in the superficial layer of the lamina propria. The epithelium in the sulcus is occasionally thickened. Collagenous fibers are often increased and capillaries are poor underneath the sulcus.
4) Etiologic factors of sulcus vocalis do not seem singular. Congenital deformity, some factors related to puberty, residue of repeated inflammation, and senile changes are the possible causes of sulcus vocalis.
5) In about one third of the cases, excessive abuse of air is found during phonation.
6) Vibration is more or less disturbed at the sulcus during phonation. This results from an increase in stiffness of the tissue arround the sulcus.
7) Intracordal injection is effective for mild cases but not so effective for cases with a deep and wide furrow. Sulcusectomy may be effective to replace the stiffened tissue with more pliant tissue.

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Clinical usefulness of the rheoencephalography (REG) was proved in this paper.
The author comfirmed that suprascalp electrodes REG reflected intracranial hemodynamics, and compared the rheoencephalograms (REGs) of the various vertiginous patients to those of the normal controls.
The REGs were analyzed on the wave form, the amplitude (from the base line to the highest point of the REG wave; milliohms), the R-P time interval (from the R wave of ECG to the first peak of the REG wave; seconds) and the rise time (the time from the start point to the first peak of the REG wave÷one period of the REG wave×100; %).
The results were summarized as follows:
1. Every obstruction of common, internal and external carotid artery showed reduction of the amplitude, but being compared to the third, the second obstruction showed significant reduction. Then, the REGs more reflected intracranial hemodynamics than extracranial.
2. The normal controls had no right-left asymmetry of the REGs. There was no change on the REG wave in neck torsion and caloric test, but in posture change from supine to sitting position, the amplitude significantly reduced.
3. The REGs of the Ménière's disease and other peripheral vestibular disease were not different except the wave form between those of the normal controls.
4. The patients with the vertebro-basilar insufficiency showed reduction of the both sides amplitude and increase of the both sides rise time comparing to the normal controls. In those patients, right-left asymmetry of the amplitude and the R-P time interval were distinguished. In neck torsion to the injured side, the amplitude reduced on the ipsilateral side.
5. Half of the patients with the brain tumor showed right-left asymmetry of the amplitude.
6. The REGs of the patients with the post-traumatic vertigo were not different from those of the normal controls except the wave form. But, one of six showed right-left asymmetry of the amplitude, two of six also showed asymmetry of the R-P time interval and the rise time.
7. On the wave form, right-left difference was present with a high percentage in each vertiginous patient group.
8. The REG could easily and continuously record the intracranial hemodynamics and was very safe to patients.
9. From above, the usefullness of the REG to the vertiginous patients was comfirmed.

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