The results of tympanoplasty of 620 cases operated on from 1964 to 1974 (series K) and of 229 cases operated on from 1977 to 1980 (series M) were studied. The cases in which the postoperative air bone gap is smaller than 30 dB is judged to be successful.
In simple otitis media, the success rate for hearing and otorrhea was 91% in the series M and 75% in the series K. As the success rate in the series K had shown over 90% after 1970, it would seem reasonable to assume that the modern tympanopalsty had been consummated at that time.
One of the unsettled problems is the discouraging result for adhesive otitis media. The success rate in the series K was 41% and that in the series M was 44%. There could not be found any progress in the results of tympanoplasty for this disease during 1964 and 1980. The modern tympanoplasty seems to be unavailable for this condition.
The other problem is the poor results in type N tympanoplasty for all kinds of middle ear diseases. The success rate in both serieses are 27% and 24% respectively. To resolve this difficulty the use of TORP, PORP or homograft should be attempted.

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Inner ear pressure of the guinea pig was measured by use of semiconductor type mini-pressure transducer. It was found that the maintenance of normal inner ear pressure was mainly under the control of blood pressure. CSF pressure seemed to play an important role for transmission of the pressure from blood vessel to inner ear.
Inner ear pressure was strongly influenced by tympanic muscle contraction, anoxia, intense sound stimulation and the abdominal pressure change, but rupture of the round window membrane was not observed in any of these cases.

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In order to find the equilibrium function participated with the cerebrum in the man, the voluntary correction of the stepping deviation was studied in the 47 subjects with labyrinthine disturbance and the 13 subjects with equilibrium disorders of central nervous system origin.
For this purpose, the test was performed as follows.
The subjects, who had regular tendency of stepping deviation between the first and second stepping, were made to recongnize their own tendency of stepping deviation as to the direction of rotation and the magnitude of angle of rotation.
Then, they made to step trying to correct their stepping deviation in the third and the fourth stepping.
The results obtained were as follows.
1. Subjects with labyrinthine disturbance
13 of 47 subjects were able to correct the stepping deviation.
The subjects unable to correct the stepping deviation showed following tendency.
1) Dizziness continued.
2) Spontaneous nystagmus was present.
3) The magnitude of angle of rotation was large.
2. Subjects with equilibrium disturbance of central nervous system origin.
The voluntary correction of the stepping deviation was unsuccessful.

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Nine cases with psycogenic hearing loss were reported. The patients ranged in age from 11 to 57 years old, except two males aged 57, all of them were childlen and young females. Four cases had ‘saucer-audiogram’, and two had unilateral hearing loss.
Complication of our social circumstances should increase the incidence of psycogenic hearing loss. In diagnosis of hearing impairment it is important to keep the psycogenic factor of the patient in mind. To detect psycogenic hearing loss, objective audiometry-auditory brain stem response or stapedial reflex etc.-might be valuable.

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Tannic acid fixation method was used to evaluate the distribution of microtubules in the hair cells in the guinea pig. The microtubules were located both in the apical and bottom region of the cells. None of them was detectable in the middle region which occupies the greater part of the hair cell cytoplasm. The results indicate that in cochlear sensory cells microtubules are closely involved in the movement of ions and synaptic vesicles. The microtubules may be secondarily concerned in sensory transmission in the hair cells.

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50 patients (71 ears) with subjective tinnitus were treated by intravenous administration of xylocain once a week several times. Objective evaluation of the tinnitus revealed that their loudness diminished in 48.5 % of them. 48.9 % of the patients recognized that the loudness of their tinnitus became smaller subjectively. Repeated intravenous administration of xylocain can be one of the effective treatments for subjective tinnitus.

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Twenty-two guinea pigs were divided into four groups and administered 20, 40, 60, 80mg/kg of Nitromin intravenously. Then the changes of their hearing thresholds were monitored every thirty minutes using Preyer reflex recording. Endocochlear DC Potential was recorded twenty-four hours later. Ultrastructural changes of stria vascularis were also surveyed with electron microscopy.
The mean of the magnitude of EP in each groups were between +30 and +40 mV. The decrease of magnitude of EP wasn't proportinal to the increase of dose of Nitromin.
No remarkable histological changes in the stria vascularis was discovered even in the animals who was administered 80mg/kg of Nitromin.
The latent period in the appearance of the ototoxic effect of Nitromin was 90 minutes in the animals who was administered 40, 60, 80mg/kg of Nitromin.

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The glycerol test has been used as one of the methods for diagnosing MENIÈRE'S disease since 1966 (KLOCKHOFF 14 15).
This method is used as a preoperative test for the epidural shunt operation and subarachnoid shunt operation mainly from the aspect of auditory function.
However, the pharmacological effect of glycerol itself has not been elucidated yet.
The meaning and positioning of the glycerol test as the audiometrical examination and equilibium function test have not been established either.
With the cases of MENIÈRE'S disease as the subject, we performed the glycerol test and took a fine look at it from the aspect of the hearing and equilibrium function.
That is, we examined whether the positive rate of the glycerol test is affected by the degree and type of hearing loss, whether the positive rate is correlated with the period of time from the first attack or last attack, whether the presence or not of nystagmus leads to a difference in the positive rate, how the hearing (pure tone audiometry, recruitment phenomenon) and the equilibrium function (gaze nystagmus test, positional nystagmus test, past-pointing test, vertical writing test, stepping test, gait test, body sway test) change before and after administration of glycerol, what difference there occurs in the mode of response (to glycerol) between various audiometrical examinations and equilibrium function tests, and how subjective symptoms such as tinnitis or dizziness change before and after administration.
The following results were obtained:
1. Significant negative correlation of r=-0.908 was observed between hearing impairment (dB) and glycerol effect (%) before and after administration of glycerol.
2. There was no significant correlation between the period of time (days) from the first attack or last attack on the one hand and the glycerol effect (%) on the other.
3. As for two cases (13%) in which the recruitment phenomenon turned negative following administration of glycerol, they happened to fall on the period of attack, that is, within 10 days from the last attack and moreover showed the hearing impairment within 15 dB.
4. There was no equilibrium function test that showed a response significantly in correlation with the glycerol effect (%). However, the past-pointing test and stepping test in the group falling on the period of attack showed some response relatively sensitively.
5. Changes in positional nystagmus (increase, disappearance) did not necessarily reflect the glycerol effect.
6. The vertical writing test and past-pointing test were correlated significantly with administration of glycerol and showed similar mode of response.
7. As regards changes in symptoms, vertigo and dizziness were as important parameters for observations as tinnitus.

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The endocochlear dc potential (EP) decreased rapidly and developed a large negative potential (negative EP) of-40.7mV several minutes after anoxia in normal guinea pigs. The EP decreased slowly in kanamycin-deafened guinea pigs and did not develop a large negative potential. The K⁺ concentration in the endolymph also decreased more slowly in kanamycin-deafened guinea pigs than in normal guinea pigs. The rate of decrease of the K⁺ in the endolymph was about twice greater in normal guinea pigs than in kanamycin-deafened guinea pigs within 10 minutes after anoxia. The K⁺ conductance (Gk) to the cochlear partitions was calculated between 10 and 30 minutes after anoxia. The Gk calculated 30 minutes after anoxia was 22.1μM/min/mV in normal guinea pigs and 4.8μM/min/mV in kanamycin-deafened guinea pigs, when the EP was-29.5mV and 1.4mV respectively. These results suggest that a rapid increase in the permeability of K+ through the organ of Corti could produce a large negative K⁺ diffusion potential in early stage of anoxia. Such an increase in the K⁺ permeability may not occur in kanamycin-deafened guinea pigs because of the loss of the hair cells, which may result in the lack of the development of the negative EP.

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The effect of xylocaine intravenous injection on the subjective tinnitus was evaluated subjectively by questioning and objectively by the pitch match and loudness balance methods.
Xylocaine intravenous injection significantly decreased the loudness of the tinnitus but less affected on its frequency.
Objective evaluation of the changes of tinnitus after xylocaine administration well coincide with its subjective evaluations.
Based on these results, we proposed that pitch match and loudness balance methods are reliable evaluation of the tinnitus.

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Guinea Pigs were administered 12.5mg cis-diamminedichloroplatinum (cisplatin) per kg of body weight intravenously and sacrificed at 1-7 days after the injection. Afterward, the ultrastructural changes of cochlear hair cells were studied. At one day after injection, endoplasmic reticulum and ribosom were increased in outer hair cells, but at 3 days after injection, on the contrary, compared with control those were decreased in its and these outer hair cells were began to collapse. Mitochondrias were almost normaly remained. At 6 days after injection, the endolymphatic space was began to collapse, and finally the Reissner's membrane closely touched to the Corti's organ and the stria vascularis. At this time, remarkable changes were observed in the stria vascularis. According to these findings, the endolymphatic collapse was seemed to be caused by changes of the stria vascularis.

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The results of auditory brain stem responses (ABR) in five patients with pontine lesion, four pontine tumors and one pontine hemorrhage, were reported.
The abnormal waveforms of ABR in the patients with pontine lesion were classified into 4 types,(1) wave I-III were normaly recorded, and wave V was prolonged in latency, deformed or vanished.(2) wave III was prolonged in latency.(3) Only wave I was clearly recorded.(4) no ABR responses.
More advanced abnormal patterns of ABR were observed on the affected side which was detected with other neurological examinations.

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Immunopathological study of human nasal mucosa (inferior turbinates and nasal polyps) with chronic inflammation was done by examining the distribution of several immunoglobulins and other factors using an immunofluorescent technique. Secretory activity of SIgA was also studied. Diffuse fluorescence for IgG and other immunoglobulins was observed, more or less, in every specimen. The most intense fluorescence was found throughout the connective tissue area in every nasal turbinate and nasal polyp when the specimens were stained with anti-IgA antisera. In mucosa with mild inflammatory changes, most IgA seemed to be produced locally by IgA producing plasma cells. On the contrary, in nasal mucosa with severe inflammation and in nasal polyps in which plasma cells were relatively few, the distribution of IgA generally corresponded to the pattern of fibrin deposition. Such findings suggest the transduction of plasma pool IgA in severe inflammatory changes. Secretory activity of SIgA was well retained in every glandular tissue of nasal turbinate. In contrast, most of the dilated glandular ductule of nasal polyps appeared to be lacking of SC synthetic activity and SIgA production seemed to be lost. In some nasal polyps, glands preserving SC synthetic activity were present. The active glands, however, contained SC unproducing glandular cells irregularly and such inactive cells increased in the consecutive sections followed by mucous flow stasis. The glands became dilative and were occupied with mucous materials.

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Two cases with severe arterial epistaxis were reported. The first case, a 56 year old female, had left sided epistaxis which came from sphenopalatine and anterior ethomoidal arteries. The ligation and clipping of these arteries were performed under local anesthesia. There was no further bleeding. The second case, a 38 year old male, had right sided epistaxis which came from sphenopalatine artery. Even after the ligation of it epistaxis still sometimes happened, however it became to be controlled by common nasal packing.

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A clinical study in 62 inpatients of epistaxis was reported. About 30 % of them were still bothered with occasional epistaxis even after being discharged. They had some systemic diseases such as hypertention, hepatic disease, etc., which may aggravate the epistaxis. Not only local treatement for epistaxis but also clinical survey for systemic diseases should be important.

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The clinical records of 112 consecutive patients undergoing laryngectomy at Kyushu University Hospital between 1970-1979 were reviewed. Eleven (9.7%) had stomal recurrences. Of the 112, 33 underwent emergency tracheostomy at 5-15 day intervals prior to the laryngectomy. In these 33, 26 had been given preoperative radiation of 3000 rads. In 2 (7.7 %) of these 26, there was a stomal recurrence. In the 7 not given radiation, 6 (85.7 %) had a stomal recurrence. From of the 11 (36 %) in whom there was a stomal recurrence had a supraglottic tumor and lesions involving the vocal cord, in addition to those of the supraglottic structures (range T₃-_T4). In the remaining 7, stomal recurrence was noted in 5 with a glottic tumor and 2 had a subglottic tumor.

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Electromyographical studies demonstrate that the intrinsic laryngeal muscles contract in different grade and different phase during respiration, phonation and deglutition. In this investigation, the author tried to elucidate the relationship between the structure and the function of the canine laryngeal muscles by histochemical techniques.
Thyroarytenoid, lateral cricoarytenoid, posterior cricoarytenoid, arytenoid and cricothyroid muscles were precisely removed and immediately frozen with aceton-dry ice solution. These muscles were sliced as the cross section of 8-10 micron thick in a cryostat (-20°C). Each serial section was stained with myofibrillar adenosine phosphatase, phosphorylase, reduced diphosphopyridine nucleotid dehydrogenase and succinic dehydrogenase respectively. Stained specimens were photographed in color and the distribution of various muscle fibers was histochemically observed.
Histochemical property of the canine laryngeal muscle fibers could be divided into two types. The type I of muscle fiber showed low activity with myofibrillar adenosine triphosphatase and phosphorylase and high activity with reduced diphosphopyridine nucleotid dehydrogenase and succinic dehydrogenase. On the contrary, the type II of muscle fiber showed high activity with adenosine triphosphatase and phosphorylase and low activity with reduced diphosphopyridine nucleotid dehydrogenase and succinic dehydrogenase.
The results of each muscle is as follows:
1) Thyroarytenoid muscle; This muscle is usually divided into two parts, i. e. external part (M. lateralis) and internal part (M. vocalis). The maldistribution of muscle fibers is markedly observed in this muscle. The type I fiber is mostly distributed in the inner part of the muscle and gradually decreased and not found in the external part.(type I fiber =12.8%±6.02 SD)
2) Lateral cricoarytenoid muscle; Both types of the muscle fibers are uniformly distributed at any part of the muscle, and amount of type II fiber is markedly dominant in general.(type I fiber =12.1%±5.26 SD)
3) Posterior cricoarytenoid muscle; In this muscle, the distribution of type II fiber is slightly dominant.(type I fiber=39.8%±4.45 SD)
4) Cricothyroid muscle; The distribution of both types of fibers of this muscle is resembled to that of the posterior cricoarytenoid muscle.(type I fiber =52.8%±13.75 SD)
5) Arytenoid muscle; This muscle has also two types of muscle fibers.(type I fiber=9.6%±3.47 SD)
On the physiological point of view, it is considered that the type I fiber is a slow twitch fiber and the type II fiber is a fast twitch fiber. Therefore, the mode or strength of the contraction of a whole muscle depends on the ratio of amount of these two types of muscle fibers. According to the physiological investigations, the contraction time of the intrinsic laryngeal muscle is longer in the thyroarytenoid, lateral cricoarytenoid, posterior thyroarytenoid and cricoarytenoid muscles in this order. This result corresponds to our histochemical observation on the distribution of type I fibers in a whole muscle.

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In electromyographic examination, an intensity-duration recording is one of the best means to detect the status of denervation. We are able to obtain valuable informations to evaluate the status of recurrent laryngeal nerve paralysis with I-D recording of internal laryngeal muscles. But we must solve a lot of problems in measuring I-D curve of internal laryngeal muscles. Here we present a new system that describe the I-D curve of internal laryngeal muscles within a short time and minutely with fiberscope and computer controlled electronic stimulator. It takes only a few minutes to get accurate results from 15 points of various durations. The reappearances of the results are excellent.

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The authors designed the phonometer which was able to demonstrate the relationship among pitch, intensity and flow rate in each dimentionally. The new phonometer seemed to be useful for clinical examination of the voice disorders.

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A Phonation Analyzer (type PA-500) is a useful rapparatus for the analysis of the pathological voice. It is clinically available for the flow rate, ratio of the vocal wave, intensity and pitch to be calculated by this apparatus.
The glottal efficiency was able to calculated from the DC and AC components of the flow rate. So, the glottal efficiencies by the Phonation Analyzer were objectively evaluated using normal 15 subjects and 107 voice disorders, whether the results were really significant for the glottal efficiency or not.
The results were as follows.
1) The efficiency in male was increased parallel to the increment of the intensity, and was decreased ranged from intensity of forte to fortissimo. The efficiency in female was proportionally increased according to the intensity.
2) The vocal efficiency of the male was inclined to be high compared with the female.
3) In pathological groups, our results showed the low value compared to the one of Isshiki. But the relationship between RBA classification of hoarseness and the efficiency was followed the data before mentioned by Isshiki in speech range.

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Of the tumor forming diseases noted in the submandibular space, the most common one is the inflammatory disease of the submandibular gland. Subsequently, there is neoplasm of this gland followed by inflammation and neoplasm of the neighboring tissues. If there are some inflammatory signs and symptoms in the submandibular lesions, it is not difficult to distinguish inflammatory one from others. It is, however, quite difficult to know the nature of the tumors in a few cases, if they do not present any sign of inflammation and so on.
Forty five patients with submandibular space tumor who were operated in our clinic in the last ten years were analysed clinically and were discussed further. The conclusions reached from these observations were as follows;
In the submandibular space tumors,
1.75 % of the tumors originated from the submandibular gland and 25 % from the neighboring tissues.
2.62% of the tumors were diagnosed as inflammatory disease and 33% as neoplasm.
3. In diagnosing tumors, the findings obtained from sialography were of rather limited use. Final preoperative diagnosis should be made by battery tests of sialography, ultrasonics, CT scanning, RI scintigraphy and so on.
4. Schwannoma and malignant lymphoma were not so rare diseases in the submandibular space.
5. The painless tumors in this space should be handled with caution as possible malignant tumors.

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74 cases of parotid tumors treated in the Department of Otolaryngology of Kyushu University Hospital during the past ten years were clinically investigated. They were composed of 55 cases of benign tumors and 19 cases of malignant tumors.
The diagnostic and therapeutic procedures were inquired and some clinically interesting cases were also presented.

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Immunocompetence of the patients with advanced head and neck malignancies was studied. As the parameters of the immune responses, skin sensitivity tests by PHA, PPD, Candida, and SK-SD, and also T and B cells counts were chosen.
Many of the fatal patients and of the patients with advanced t umors tended to show impaired skin sensitivity of PHA and Candida, and reduced T/B ratio.
Follow-up examination of the immunocompetence is recommended in the treatment of patients with head and neck malignancies.

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Seventy-two cases of carcinoma of the hypopharynx and/or cervical esophagus, treated f rom 1966 to 1980 at Kyushu University Hospital, were investigated retrospectively. In 1966-1972, all patients were treated with radical surgery included radical neck dissection. However, we applied the conbination FAR therapy to the patients of hypopharyngeal cancer in 1972-1980. So we compared the five-year survival rates of the different groups. The results were that one of the FAR therapy-group was 38 %, others of the non-FAR therapy-groups was 24 %. These differences were thought to be significant.

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We report here a useful method of immune elimination of nude mouse stromal cells for the cultivation of human tumors transplanted into nude mice. We used the rabbit antiserum immunized with spleen cells obtained from nude mice and a normal rabbit serum as the source of complement. Complement-dependent cytotoxicity was determined by direct cytotoxic test. The antiserum in the presence of complement specifically killed cultured cells derived from nude mice, but it was not cytotoxic to cultured cells drived from human. When cultures consisting of human cells and nude mouse cells were treated with the antiserum and complement, the nude mouse cells were selectively removed from the culture and this was determined by fluorescent antibody technique.

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