Various methods of rhinomanometry applied currently in Japan were introduced and explained. Expression of the nasal patency also was discussed.
The methods are classified into three large categories.
1. Pressure and flow velocity measurements under quiet nasal breathing; The methods in this category represent the most natural aerodynamic conditions in the nose. They are classified further as follows.
a) So-called standard method: Simultaneous measurements of flow velocity through the nose and pressure difference between the nostril and the epipharynx. The two parameters are lead to a cathod-ray oscilloscope or a X-Y recorder for visualization and recording of a pressure-flow curve (a rhinorheogram). This method gives both a total or binasal rhinorheogram and heminasal rhinorheograms of each side. When peroral conduction of pressure change in the pharynx is impossible, the pressure is recorded through a nostril, while the flow through another nose is measured. For simultaneous, bilateral heminasal rhinorheogram recordings two sets of the amplifying and recording system are needed, besides a special face mask with a median septum and two openings connected with pneumotachographs.
b) So-called an effective cross-sectional area measurement: A tube with a hole at free end is used, the cross-section of which is variable. When, by changing the cross-sectional area, the value of resistance created in the tube matches to that in the nose, the patency of the nose is expressed with the value of cross-sectional area of the tube at that moment.
2. Pressure and flow velocity measurements under oral breathing or breath-holding with the mouth kept open.
The methods in this category are performed by driving mechanically controled air in and out of the nose.
a) Oscillation method: Oscillating air flow passes through into and out of the nose while a patient holds his breath with the mouth open. The pressure-flow curve is shown on an oscilloscope. From the slope of curve the value of resistance is read directly.
b) Continuous flow method: While a patient keeps his mouth open, controlled air is sent into the nose. The pressure at the nostril also is measured. From the two values resistance is calculated.
3. So-called subtraction method.
The methods in this category are originally used for pulmonary function tests.
a) Total respiratory resistance measured with oscillation method
b) Airway resistance measured with a body plethysmograph.
c) Pulmonary resistance measured with a esophageal balloon method.
The difference between the values obtained during nasal and oral breathings is the component created in the nose.
Expression of the nasal patency has been proposed as follows. A pressure-flow curve (rhinorheogram) recorded on an X-Y recording sheet itself shows the best data of aerodynamics.
For practical convenience such numerical expressions as follows are used.
a) k₁ and k₂ in Rohrer's equation, P=k₁V+k₂V².
b) Resistance, R=P/V, at the points of 0.25, 0.5 l/sec or peak flow.
c) Conductance, G=V/P, at the point of 1.0 cmH₂O or maximum.
d) Effective cross-sectional area (cm²).
Upon comparative observation the authors recognized, as the expression of nasal patency, conductance or effective cross-sectional area is preferable to resistance.
The problems remained to be solved are standardization of the data expression and nomenclatures in rhinomanometry and improvement of the instrument to be more handy and simple as fit to daily clinical use.

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By the author's tapping test for the orientation of cerebral dominance, following results were obtained.
When complex sounds consisting of more than tow combination of narrow band noises with a 2% band width are used, the results are classified by frequency ratios into two groups. Normal Japanese subjects showed that harmonic complex sounds such as (1+2 KHz) displayed nonverbal hemisphere dominance (LEA), whereas inharmonic sounds displayed the verbal hemisphere dominance (REA).(Tsunoda, 1970). Since the frequency ratios of F1, F2 and F3 in steady-state vowels are usually in inharmonic relation, we can easily conclude that it is the reason for the characteristic cerebral dominance for vowels. The author found the fact that the ear advantage for vowels and CV syllables could be consistently reversed from the Right EA to the Left EA under the condition of extreme harmonic distortion.
The phenomenon was easily explained by the author's hypothesis on functional difference in auditory systems, i. e. the right ear for inharmonics and the left ear for harmonics.
The possibility of the existence of automatic switch mechanism in the brain stem was proposed which selects harmonic or inharmonic nature in complex sounds.

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Since March, 1978 a series of 20 patients with maxillary cancer were determined for the peripheral lymphocyte count, lymphocyte response to PHA and T-cell count serially prior to Denker's operation and 1 or 2 and 4 days, 1, 2, 3 and 4 weeks and 2 months after operation and at monthly intervals thereafter up to 6 months after operation in an attempt to evaluate cellular immunity in this malignancy.
A group of patients in whom complete regression of cancer was attained vith our multidisciplinary treatment had better results of the above-mentioned tests than those having a relapse or metastasis. Notably in respective of lymphocyte response to PHA the difference between the two groups was significant from 2 weeks after operation onwards.
The lymphocyte count and lymphocyte response to PHA are considered to be useful indices of the immunocompetence of patients with maxillary cancer.

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Three children with subglottic stenosis resulting from tracheal intubation were successfully treated by laryngotracheoplasty. In the first case, the dilation of the tracheal lumen with a silicone T-tube left in place through a tracheotomy orifice had failed. Two years later, the stenosis was repaired by inserting a T-tube through a vertical midline incision of the anterior laryngotracheal wall. In the other two cases, a T-tube was placed in the tracheal lumen dilated by making a step ladder incision on the anterior laryngotracheal wall. This type of incision has less possibility to induce deformity of the reconstructed airway than the midline incision and will be advantageous for the treatment of subglottic stenosis in infants and children.

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We treated two cases of intracranial complications caused by frontal sinus infection. Having lived in cities with ready access to medical care, these two young patients still suffered from such serious life-threatening complications. Study of these two cases indicates as follows.
1) Inspite of the wide use of an ever-increasing number of antibiotics, the intracranial complications caused by sinus infections continue to present.
2) Close cooperation with neurological parts is inevitably necessary to recognize and treat these intracranial complications.
3) Computed tomography is very effective to detect any persistent intracranial lesion.
4) Surgical drainage of the frontal sinus is most important procedure to treat these conditions.

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Inspection is the most valuable diagnostic technique in the otorhinolarygnology. However, it is sometimes difficult for student to examine the ear drum, the nasal cavity, the epipharynx and the larynx with a head mirror. This newly devised teaching scope is composed of a half mirror, an image guide of glass fiber and a light guide cable which are all set up on the head mirror. While the examiner observes the object through the half mirror, the student watches the same figure which is reflected on the half mirror, because this instrument has no parallax between the eyepiece for the examiner and that for the student. This teaching scope is also useful for surgery in the otorhinolaryngological field. The superviser can lead the surgeon by observing the same surgical field with the image guide. It is easily done by this teaching camera in order to show it simaltaneously to many students want.

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Studies of basophilic granular cells in the nasal secretions are limited although these cells are presumed to be important in nasal allergy. In order to elucidate the dynamics of these cells in nasal secretion and the role of the cells in nasal manifestation, it was studied in nasal allergy (1) what kind of methods should be choiced for the quantification of the basophilic cells in nasal secretion,(2) the relationship between the number of these cells and clinical symptoms, nasal provocation reactions and nasal eosinophilia,(3) the appearance time of these cells after nasal provocation,(4) the change of these cells' in numbers during hyposensitization,(5) the antigen induced histamine release from nasal lavage cells and blood leukocytes, and degranulation rate of nasal lavage cells by antigen and (6) daily changes of the basophilic granular cellsin nasal secretion and blood basophils.
The preferable method for quantification was that, after collection of the amount of nasal secretion as much as possible by noseblowing the total number of the cells in the thicking nasal smear on the slide glass were counted or graded by our criteria. The numbers of these cells were correlated in degree with nasal symptoms, nasal eosinophilia, and nasal provocation reaction. In season of Japanese ceder pollination, the numbers of these cells in nasal secretion increased markedly as early as 2 hours after nasal provocation, while in off-season 16 hours or more. In the patients with complete improvement by hyposensitization the basophilic cell disappeared, while unchanged or fluctuated up and down in the patients with unsatisfactory improvement. The amount of histamine released from lavage cells and blood leukocytes by contacting the specific antigen was higher than by the control, and degranulation rate of nasal lavage cells by antigen was higher than by the control. Circulating basophil counts were significantly increased at night but decreased in the morning and basophilic granular cell counts in nasal secretion of atopic subjects reversely decreased at night and increased in the morning, but in nonatopic subjects, the circulating basophil counts were not significantly changed throughout the day and these cells in nasal secretion were negative.
As a conclution, it should be emphasized that the blood basophils emigrate on the surface of the nasal mucosa and play an important role in nasal allergy

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