In past 13 years 134 cases of cancer of maxillary sinus were treated and in this paper we studied their long-term results retrospectively based on the clinical classifications. Two cases were classified to T₁, 36 to T₂, 74 to T₃ and 22 to T₄. Forty-one cases were treated by surgery alone and 93 by the combined methods of surgery, radiation and chemotherapy.
Their long-term results were investigated retrospectively and TNM classification indicated the clinical prognosis satisfactorily. The 5-year-survival rates were 50% in T₁and T₂, 33.7% in T₃ and 9 % in T₄V. Among 74 cases of T₃, 29 cases which invaded anteriorly showed 52.5% of the 5-year-survival rates and 21.7% in 45 cases which invaded posteriorly.
The results of the present study were as follows:
1) TNM classification corresponded well to the clinical prognosis of each case of cancer of maxillary cancer.
2) Among 74 cases which were classified as T₃, 29 cases which invaded anteriorly showed remarkably better prognosis than 45 cases which invaded posteriorly.
From the above mentioned results, we would propose the following new classification in which TNM classification should include the direction of tumor invasion, anteriorly or posteriorly.

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One hundred and eight ears with cholesteatoma were studied from clinical and Impedance audiometric viewpoints.
Those ears showed relatively large air-bone gaps on the pure-tone audiogram (mean 43.1 dB). Impedance audiometric data were available on 41 ears with attic perforation and without perforation of eardrum. Tympanograms in this group were typically type B (71%). Type C were observed in 19% and type A in 10%. The median static compliance was 0.15 cc, with the 10th and 90th percentiles at 0.03cc and 0.52cc, respectively. The stapedial reflex could not be elicited 84% of the time.
Here we typically observed the impedance pattern associated with a substantial increase in the mass of the vibratory system-a type B tympanogram and a very low static compliance.
Air-bone gap is small in the cases with type A tympanogram and normal static compliance, and in those cases, cholesteatoma were liable to be restricted in attic. With the exception of the instance cited above, the impedance audiometry did not always lead to correct assessment of ossicular lesion or expansion of cholesteatoma.

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The esophageal voice can be scarcely uttered after laryngopharyngoesophagectomy, because the reconstructed dermal pharyngoesophagus is usually wide opened without any constriction as the pseudoglottis. It has been a general concept. Unexpectedly, one male patient got the esophageal speech 2 months after the surgery. His esophagus was reconstructed with D-P flap. After clinical examinations of this case, the following requirements were found to be able to speak after laryngopharyngoesophagectomy.
1) A dermal tube should not be cicatricial, not adhesive and easily movable to the surrounding tissue. Therefore, the pharyngoeophagus is preferably reconstructed on one stage with D-P flap attaching excessive subcutaneous fat tissue, and the infection should be prevented as much as possible.
2) The pharyngoesophagus should be reconstructed flat in its middle portion so that the anterior and the posterior walls are attached together. This portion plays a role of the pseudoglottis. For this reason, the dermal tube is created rather longer than the size enough to substitute the excised pharyngoesophagus.
3) In training of the esophageal speech, the patient may slightly press the middle portion of the new pharyngoesophagus with his finger during phonation.

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The prognosis of facial palsy complicated with herpes zoster oticus is not so good as that of Bell's palsy. Decompression surgery for this disease is not always effective. Although corticosteroid has usually been used together with stellate block, the use of corticosteroid for viral infections has lately begun to be controversial. The recent trend is that corticosteroid therapy should be contraindicated in herpes zoster. The authors had two adult male patients with disseminated herpes zoster oticus. In both cases no relationships were recognized between the occurrence and the corticosteroid administration. In the literature the authors do not discover any descriptions of the dissemination of localized herpes zoster oticus under corticosteroid administration. There were rather many opinions which encouraged the high doses of corticosteroid for facial palsy complicated with herpes zoster oticus. In the treatment of herpes zoster oticus except associated with other factors leading to immuno-suppression, the authors would like to propose that because of the coinplication of facial palsy corticosteroid should be used simultaneously with the administration of gammagloblin.

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Rubella is an acute viral infectious disease characterized by a skin rash and generalized lymph node swelling, particularly of the postauricular, suboccipital, and cervical lymph nodes. Rubella is considered a mild and common disease in children and young adults. Complications caused by rubella such as arthritis, encephalitis and thrombocytopenic purpura have been reported since the 1920s. The most important otolaryngological complication is thrombocytopenic purpura that develops severe epistaxis. Thromobocytopenic purpura following rubella was first described in 1929 by Pitten.
A 17-year-old boy was admitted to our hospital, who suffered from thrombocytopenic purpura following rubella with severe epistaxis and petechial bleeding. The peripheral platelet count was only 4000/cmm. Bone marrow examination showed that megakaryocyte had vacuoles in cytoplasm but its platelet formation was normal. Bleeding time was uncountable but coagulation time was within normal range. Rubella antibody titer in his serum was high. Platelet function was normal. Hemorrhagic diathesis was recovered with corticosteroid therapy and platelet transfusion.
Severe epistaxis ceased in a few days and, at the same time, the peripheral platelet count rapidly increased. After 22 days, it was recovered within normal range. The serious thrombocytopenia in this patient was regarded to be caused by rubella.

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Thyroid scanning with ²⁰¹Tl-chloride was performed on 32 cases of thyroid pathology, comparing with that with ^99mTc, 3 cases of follicular adenocarcinoma, 10 cases of papillary adenocarcinoma, 2 cases of mixed type of follicular and papillary adenocarcinoma, a case of poorly differentiated squamouse carcinoma, a case of Hiirthle cell carcinoma, 8 cases of follicular adenoma, 5 cases of chronic thyroiditis, a case of subacute thyroiditis and a case of Basedow's disease.
The most important evidence of thyroid scanning with ²⁰¹Tl-chloride is the hot nodule in primary malingnat tumor and also metastasis in the mediastinal area.

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Maxillar cancer was observed in a brother, in that family, stomach cancer had been occured two of ten in maternal family, one of six in paternal family. A patient 42 years old male complained nasal obstruction and epistaxis. Histopathological examination revealed an undifferentiated carcinoma of maxillar sinus. He was treated with radiation and pansinectomy, but he died when he was 48 years old due to meningitis. His older brother, 50 years old, complained nasal obstruction, epistaxis and swelling of right face, after two years onset of the disease in his young brother. He was treated with radiation and then resection of hard palate and face with eye was performed, but he died two years later.
Nasopharyngeal cancer were observed in a brother and sister. A female 39 years old, complained of epistaxis and slight fever. At first she was diagnosed otitis media, but three months later, she was diagnosed as an anaplastic epidermoid cancer in nasopharynx and treated with radiation but she got a Garcins syndrom, and she died three years later. Her elder brother got an abducens palsy, and nasopharyngeal cancer was found. He was treated with radiation and neck dissection was performed, but he died one year later.
These cases were so few, so it could not be assured that genetic factor or circumstance in childhood played a role on the cause of these diseases.

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The patient was a 27-year-old man. He first became aware of difficulty and awkwardness in moving his mouth on February 25, 1977 and on the following day he was seen by one of us, who diagnosed him as left-sided facial paralysis and treated him with prednisolone and other medication. When he visited us on referral at the Department of Otolaryngology of Hamanomachi Hospital on February 28, his face was found to be paralyzed on both sides. He was quite unaware of extension of the paralysis to the other side of his face.
At the onset of disease he was in a rather poor physical condition associated with fatigue, insufficiency of sleep and symptoms of common cold. About one month of hospital treatment mainly with orally administered adrenocortical hormones and stellate ganglion block brought about complete cure of the paralysis bilaterally. Recovery began earlier on the right side than on the left.
In view of a suspected abnormality of sugar metabolism glucose tolerance test was performed but yielded a negative result. None of clinical and laboratory tests done concurrently revealed any noticeable abnormalities.
By ruling out possibilities that have to be considered in differential diagnosis, a diagnosis of bilateral Bell's palsy was arrived at. There are two distinct types or varieties of bilateral Bell's palsy, simultaneous and non-simultaneous. A review of cases reported so far reveals that there are considerable differences between these two types in clinical features. Firstly, the simultaneous types, in the vast majority of cases thus far available, had a favorable prognosis whereas in most cases of the non-simultaneous type the paralysis was not cured. Secondly, whereas paralysis occurred in 2 or more repeated episodes in a good proportion of cases of the non-simultaneous type, even a single instance of such recurrence of paralysis was not reported with the simultaneous type. These facts suggest that there might exist a substantial difference between these two types of bilateral Bell's palsy in underlying pathology. It was felt more reasonable therefore to designate the simultaneous type as bilateral simultaneous Bell's palsy so that it might be sharply distinguished from its counterpart, and this designation was proposed. Also it seems appropriate to label those cases as “simultaneous” in which the time interval between the onset of paralysis on one side and that on the other side is less than 14 days.

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After subcutaneous injection of crystallized egg Albumin and Ampycillin Natrium emlsified with Freund's adjuvant several times, their solutions were injected through the tympanic membrane of Guinea Pigs. Consequently, marked allergic inflammation was histologically observed in the cochlea.
The results obtained were as follows.
1. Blood cells and nubeculas appeared in the endolymphatic and perilymphatic spaces.
2. Vascular dilatation of the stria vascularis was seen in the basal turn.
3. The particles of acting carbon were leaked in the scala vestibuli.
But organ of corti and vestibular organs showed no histological changes.

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This experiment was designed to evaluate the effect of intravenous injection of lidocaine on the nystagmus after labyrinthectomy in rabbits. The inhibitory effect on the nystagmus was evident after 1 min, and it continued as a rule for 2-10 min, depending on the dose. After the temporary reduction the nystagmus recovered again to the pre-injection value. This may result from the action of lidocaine on cortical and also subcortical regions.

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Fundamental and clinical studies on “Combipenix” were performed with the results of following conclusions.
1. Using SD strain rats, the basic preliminary experiments showed no change of antimicrobial activity of the drug either in muscle homoginate or in blood within 10 days at -20° in a deep freezer.
2. Blood levels of the drug in healthy adults who were given three capsules of “Combipenix” as a single oral administration reached at the peak level about two hours after the administration, then it began to decrease. In tissue levels, activity of the drug was demonstrated almost same concentrations in human nasal polyp and mucous membrane of maxillary antrum.
3. When “Combipenix” was orally administered, as a first choice, to 126 cases of representative infections in ENT field, the clinical effect was excellent or good in 83 cases, fair in 20 cases and ineffective was seen in 10 cases. That is a ratio of effectiveness of 92%.
4. Side effect was detected in 5 cases (4%), but oral administration of the drug was discontinued in only 1 case. In the case, eruption was appeared immediately after oral administration.
5. Thus “Combipenix” can be administered, as a first choice, with its excellent antimicrobial spectrum, even when a causative organism is unknown.

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