1,438 cases of head and neck tumors were seen in our clinic since during the period from 1965-1978. Under our multidisciplinary treatment, average dosage of radiation for nasal-paranasal tumors was 200 rad, for oral-mesopharyngeal tumors 1800 rad, for nasopharyngeal tumors 2400 rad and for laryngeal tumors 3400 rad.
After reduction of tumors mass removal and topical cleaning procedure, 1) a dosage or radiation-number of patients curve shifted to lower left, 2) repeated surgeries for recurrence became less frequent, 3) extended surgeries were unnecssary and 4) social rehabilitation of patients was obtain much easier even in aged. Principles of our treatment were simple: short hospitalization and careful long term follow-up. Treatment plan should be decided according to clinical finding and course of illness in each cases.

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A new test of the EUSTACHIAN tube function with otoadmittance meter was report- ed. The apparatus used was Garson-Stadler Otoadmittance meter Model 1720 Band set for the aural reflex test. The test procedure comprised deep breath, Valsalva maneuver, normal breath and swallow in succession. The graphs obtained in normal 40 ears of 20 cases were devided into three types. Type A was seen in 32 ears and was a typical normal pattern. Type B was seen in 5 ears and indicated a little patent tube even in normal range. Type C was seen in 3 ears of 2 cases and thought to be a failure in Valsalva maneuver.
Furthermore the graphs obtained in patients of patent eustachian tube and stenotic tube were demonstrated. From the results obtained, we concluded that the new test reported here coincide quite well with the theoretical condition of the tube even if the function was normal or abnormal, and it was very useful because of its reliability.

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Cryosurgical treatment of the pharyngeal cavernous hemangioma proved to be functionally and cosmetically successful. A 37 year old man who had complaints of abnormal pharyngeal feeling and slight swallowing disturbance is reported. He was treated cryosurgically using Linde CE-2B type unit under local anesthesia. During and after the surgery there was no trouble except for some edema in the pharyngeal region. After about 3 weeks the tumor was completely necrotized and fallen off without any complication.

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Five cases of traumatic atresia of external ear canal were presented. In two cases of atresia at the bony ear canal which originated from temporal bone fracture the bony fragment and the scar were resected and the canal was enlarged. But no skin plantation was carried out. The rough surface was covered by epithelization from the surrounding skin of the canal. In a case of cartilaginous ear canal stenosis, the scar in the canal was resected and free skin plantation was carried out.
In the two cases of atresia at the introitus of the canal, the scar tissue was re- sected and the introitus was covered with a pedicle skin flap made Z-plasty technique.
To repair the traumatic stenosis, the surgical procedure should be selected according to the location of the stenosis.

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Effect on Eustachian tube function of fracture of the pterygoid hamulus or transection of the tensor veli palatini muscle, which was often used in cleft palate surgery, was evaluated by experimental and clinical methods. The results indicated that the fracture of the hamulus produced little tubal obstruction, but transection of the tensor muscle caused severe tubal obstruction of long duration.

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The process of wound healing was compared between laser vaporization and cold knife surgery on the vocal fold. Thirty-six adult dogs served as the subject. Surgical removal of the vocal fold tissue was done with laser on one side and with a cold knife on the other. The vocal folds were investigated under an operation microscope and also histologically at preplanned intervals after the surgery. The results are summarized as follows:
I. Observation under an operation microscope
(1) Edematous swelling lasted for one week after both surgergical procedures. It was more marked for cold knife than for laser.
(2) Development of whitish coating on the wound was more marked for cold knife than for laser. It lastes for one week after cold knife surgery and three days after laser vaporization.
(3) The edge of the vocal fold became linear one week after laser, whereas it took two weeks for the edge to become linear after cold knife surgery.
II. Histological investigation
(1) Inflammation was more marked and lasted longer after cold knife surgery than after laser vaporization.
(2) After laser irradiation, a layer of coagulation necrosis was developed on the wound.
(3) Excessive granulation and extensive fibrosis occasionally occurred after cold knife surgery. They were not observed in any vocal fold operated with laser.
(4) Epithelization on the wound took place earlier after cold knife surgery than after laser surgery.
The results described above suggest that laser is more favorable to postoperative phonatory function than traditional cold knife.

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Dynamics of swallowing was investigated in five subjects of amyotrophic lateral sclerosis (ALS). The data were obtained from simultaneous recordings for four-chan-nel electromyography and fluoroscopic X-ray video-recording. The muscles investiga- ted were the genioglossus geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeal and cricopharyngeal muscles.
Movements of the food channel, including elevation of the larynx, supraglottal clsure, and opening and closing of the hypopharynx were graphically shown as a function of time. Movements of the tip and the end of bolus were also investigated. All these movements were related to the muscular activity. The results were compared with those from normal subjects which had been reported.
The results are summarized as follows:
1. Among the muscles investigated, the genioglossus and geniohyoid muscles show abnormal activation during the oral stage of swallowing. Once the pharyngeal stage of swallowing starts, all the muscles investigated present a normal kinesiological pattern, although their contraction seems to be weaker than in normal. This indicates that the reflex mechanism for the pharyngeal stage of deglutition is hardly affected by the pathology of ALS.
2. The transport of the bolus from the oral cavity into the pharynx is markedly disturbed. This can be attributed chiefly to the paresis and atrophy of the tongue muscles. The passage of the bolus within the pharynx is also significantly delayed, and a part of the bolus stays in the vallecula and the hypopharynx even of ter the end of the muscular exertion of the pharyngeal stage. It enters into the larynx when the larynx stops closing, resulting in aspiration. The stagnation of the bolus in the pharynx is caused mainly by the weakness of the muscles related.
3. In ALS, difficulty in swallowing is primarily caused by weakness and abnormal kinesiology of the muscles related to the oral stage and weaknes of the muscles participating in the pharyngeal stage. Incoordination of the passage of the bolus and the muscular kinesiology in the pharyngeal stage accelerates the problems.

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