72 consecutive patients of laryngeal and tracheal stenosis caused by various traumas were treated. Among them, thirty cases were resulted after prolonged tracheal intubation.
Larynx with stenosis was anteriorly opened according to our standardized surgical method. Airway was reconstructed in the gutter-like form by using the core mold after removal of fibrous scar tissue and transplantation of pedicle skin flap. Anterior laryngeal opening was secondarily closed by the door flap enclosed with cartilage. A silicon tube core mold was inserted in order to make better laryngeal and tracheal framework.

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Computer tomography (CT) was used in 14 patients with a working diagnosis of posterior cranial fossa tumors. Twelve CT scans revealed tumors. The smallest tumor demonstrated extended 15 mm to the angle.
The data from CT was analyzed in combination with the findings from multiple radiographic techniques and from otoneurologic examinations to define the extent and nature of the tumors.
CT provided an accurate and helpful preoperative evaluation of the tumos. CT should be included in a battery testing of posterior cranial fossa pathology.

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Eight patients were treated at Miyazaki Prefectural Miyazaki Hospital with diagnosis of foreign bodies in air passage from August 1976 to May 1977. Study of the cases indicates as follows.
1) Recent resuscitative procedure has enabled them to recover the cardiac function from cardiac arrest of a few minutes duration.
2) Treatment of such severe cases of foreign bodies in air passage requires additional intensive care after removal of foreign bodies. So the patient should be treated in close cooperation with all interests involved, such as laryngologist, anesthesiologist, pediatrist and so on.
3) It should be noted whether there is exact case history of foreign bodies in air passage from child and old.
4) Careful auscultation by skillful pediatrist is the most important for the detection of foreign bodies in air passage.
5) Occasionally, removal of foreign bodies in air passage is performed more smooth in Trendelenburgs position.
6) Spontaneous expulsion of foreign bodies in air passage happens to occur after premedication.

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A 24-year old male developed progressive and gangrenous lesions in the nasal cavity and of the palate.
Repeated biopsy revealed chronic granulomatous inflamation. On the basis of clinical features, we determined the pathology as reticulum cell sarcoma and gave him radiation therapy. A marked improvement of the local lesions resulted. The patient, however, died of remittent fever and general malaice. Autopsy revealed that most organs of the entire body were affected by malignant reticulosis. A careful review of the present case led us to the following conclusions.
1. When one treat a patient with a clinical manifestation of “rhinopathia gangrenosa progressiva”, diagnosis of the underlying disease should depend more upon the clinical features than upon biopsy.
2. Malignant reticulosis may be detected by a careful examination of blood cells. Re-examination of the blood cells taken before death of the present case revealed reticulum cells in the blood.
3. If reticulum cell sarcoma is suspected in “rhinopathia gangrenosa progressiva”, chemotherapy should be combined to radiation therapy.

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Fifty cases of malignant neoplasm of the head and neck were treated with cryosurgery from Sept. 1974 to Sept. 1976 at Kurume University Hospital. In forty cases, 33 primary cases and 7 recurrent cases, cryosurgery was applied for the purpose of erradication of the pathology, whereas, in the other 10 cases, cryosurgery was performed for a palliative purpose. Thirty-eight of forty cases of the former group were followed up for one year or longer. Recurrence was found in tweleve cases. In the latter group, palliative cryosurgery was more or less effective.
In some cases of carcinoma of the maxillary sinus, cryosurgery caused trismus, necrosis of skin, and/or temporary paralysis of eye muscle (s). In the cases of the tongue, pain and/or bleeding was occasionally developed when necrotic tissue was falling off.

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A new surgical technique was deviced in order to prevent the stricture of the permanent tracheostoma. This procedure is composed of two principles ; that is, to avoid the damage of the cartilage at the entrance of the trachea and to cover the margin of the tracheal mucosa with the skin by the inverting suture with the round needle and the nylon thread.
The first stage: The perichondrium of the second tracheal cartilage is stripped and then the cartilage is removed. The trachea is horizontally divided just under the inferior margin of the first tracheal cartilage and the tube is inserted into the trachea for general anesthesia.
The second stage: After the total laryngectomy is performed, five inverting sutures are tied at the cartilaginous portion of the tracheal end and the margin of the skin covers the mucosal edge of the trachea. These sutures should be carefully carried out in the way which the needle must not pierce the third tracheal cartilage but only the mucosa. The interrupted suture is done at the membranedus portion of the trachea. Any cannula is not used after the surgery.

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Behavior of EP modified by anoxia and injection of furosemide was compared on anesthetic and nonanesthetic guinea pigs. The results obtained on both group of guinea pigs were statistically analyzed and no significant differences were observed in all experimental conditions. So the effect of anesthesia on behavior of EP was denied.
The effect of autonomic drugs (adrenalin, noradrenalin. isoproterenol, phenoxy- benzamine, propranolol, acetylcholine, atropine) was observed. In all animals, output of EP decreased ca. 4 my after injection of adrenalin or noradrenalin, and these effets were prevented by preliminary injection of phenoxybenzamine (α-blocking agent) but these were not prevented by propranolol (β-blocking agent).
EP has been considered to be maintained by blood flow of stria vascularis which should be affected by autonomic nervous system. Out of the results obtained by our studies, a-receptor dominant innervation was seemed to exist in the inner ear.

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The purpose of this investigation was to propose an experimental basis on which technical developments in phonosurgery can be expected. Canine larynges were used for the experiment. Six surgical procedures were applied along the length of unilateral vocal fold.
(1) Removal of the superficial layer of the lamina propria.
(2) Following the procedure 1, the wound was covered with an advanced mucosal flap.
(3) Removal of the entire mucosa.
(4) Following the procedure 3, the wound was covered with an advanced mucosal flap.
(5) Removal of the entire vocal fold.
(6) Following the procedure 5, the wound was covered with an advanced mucosal flap.
Phonatory function was investigated at earliest three months after the surgery in each canine. The function tests included measurements of subglottal pressure and mean air flow rate, observation of vibration of the vocal fold, and psychoacoustic evaluation of voice under different glottal adjustments.
The results were summarized as follows:
1. The greater the extent of removal was, the worse the phonatory function was.
2. Mucosal flap lessened disturbance of phonatory function in each experimented condition.
3. When removal of the superficial layer of the lamina propria was followed by mucosal flap procedure, almost normal function was obtained.
4. When removal of the entire mucosa was followed by mucosal flap procedure, the disturbance of function was thought to be compensated for by glottal adjustments.
5. When the entire vocal fold was removed, the recovery of phonatory function was impossible even by mucosal flap procedure. A necessity of reconstruction of a bulge comparable to the vocal fold was suggested for this condition.

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Antibacterial activity, stability of solution and clinical effect of new antibiotic, PIPC were evaluated. The results obtained are as follows.
1) In vitro antibacterial activity: The minimal inhibitory concentration (MIC) of PIPC was measured by an agar plate dilution method using heart infusion agar. PIPC revealed an excellent, broad spectrum antibacterial activity against 13 standard strains of various bacteria. PIPC had same antibacterial spectrum like those of other penicillin antibiotics. The MIC of PIPC against 60 strains of Staphylococcus aureus isolated from otorrhea was distributed over range of 0.78 to 50 μg/ml, with a peak being observed particularly at 3.13μg/ml. The MIC of PIPC was 1.56 to≥100μg/ml against Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae. The MIC against 60 strains of Pseudomonas was 1.56 to ≥100μg/ml, showing its peak at 6.25μg/ml.
2) Stability of PIPC solution: As to the stability of 10 mg/ml of PIPC there was no change in its color, pH and antibacterial activity when the solution was kept at 5°C and 37°C for 12 days.
3) Results of clinical treatment: When administration of PIPC was applied locally in 32 cases of the acute or chronic purulent otitis media, it was good in 22 cases, fair in 2 cases and poor in 8 cases. When the cases in which it was good and fair were considered together, the rate of effectiveness was 75 percent. No side effect was observed when PIPC solution was locally used.

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