Fifty three patients were studied who showed bilateral caloric dysfunction. Eighteen had bilaterally “dead” labyrinths, 10 had hypofunction of one labyrinth and the other was “dead”, and 25 had bilateral hypofunction. These patients exhibited significant differences than a control group with normal carolic response in eye tracking, pendular rotation, visual suppression, and optokinetic nystagmus tests. Positional nystagmus and Mann's tests showed abnormal finding less often than the other tests. While 70% of the patients with bilateral hypofunction showed an average hearing loss of no more than 29 dB, only about 50% of the other two groups were within this level, and 10% of these two groups were totally deaf. Patients showing bilateral caloric dysfunction should have serologic tests for syphilis and CT scan of the head.

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In the present day, cholesteatoma in the middle ear is one of the most difficult diseases to treat because of intracranial complications. The conservative treatment of cholesteatoma is not adequate and operative measures are necessary. The etiology and mechanism of enlargement and expansion of cholesteatoma still remain unclear. Statistical observations were made in regard to: incidence, age distribution, region of cholesteatoma, size of excised cholesteatoma and degree of keratinization, bacteriological examination of otorrhea, the relationship between the radiological finding of bone defect and the degree of keratinization, and the appearance of cholesterol crystal. 1) There was a correlation between the size of the bone defect in radiological examinantion and the degree of keratinization. 2) The size of the excised cholesteatoma tissue was closely related to the degree of the keratinization. 3) The incidence of staphylococcus and proteus detection in otorrhea was 37 96 and 13 % respectively. 4) Epithelial cells involving keratin seems to play an important role in the enlargement and expansion of cholesteatoma.

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An artificial larynx, which is commonly used for voice rehabilitation after total laryn gectomy, was utilized in a unique way in two patients. A 16 year old male with a cervical spinal injury showed improvement of sleep-induced apnea and ICU syndrome utilizing this device. A 46 year old female with amyotrophic sclerosis and on a respirator was able to speak using an artificial larynx.

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A case of facial nerve neurinoma, originating from its vertical segment, is reported. The patient was 50 year-old woman complaining of left otalgia and left recurrent facial paralysis. The mechanism of recurrent facial paralysis was thought to be the result of spontaneous decompression, which was produced by the destruction of the bony facial canal by the growth of a tumor. We observed the tumor by transmission electron microscopy. Clumps of numerous interdigitating tumor cell processes which were surrounded by basement membrane were observed.

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Phonatory function after micro-laryngeal laser surgery for precancerous and cancerous lesions was assessed by the measurements of the following parameters; 1) stroboscopic mode of vibration of the vocal folds, 2) pitch perturbation and H/N ratio obtained by acoustic analyses of the voice, and 3) the mean air flow rate and AC/DC ratio during phonation. Comparing with the results after the radiation therapy, more apparent impairment in the function was detected after the laser surgery. Yet the voice was useful in daily life, and the laser laryngeal surgery was concluded to be advantageous in the selected patients.

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The morphological changes of nasal mucosa after nasal spray with drugs such as decongestants, anesthetics, lysozyme chloride, beclomethasone dipropionate and physiolosical saline solution were examined with scanning electron microscopy in human subjects and in guinea pigs. In a clinical study, 18 cases were investigated. The first group of cases composed of 11 with hypertrophic rhinitis and 5 with nasal allergy, were sprayed with a decongestant and anesthetic solution on one side of the nasal cavity for three to fourteen days before nasal operation undertaken. As a control, the other side was sprayed with only physiolosical saline solution. In two additional cases with nasal allergy, the nasal cavities were sprayed bilaterally with beclomethasone dipropionate for three days in one case and for over a month in the other. The specimens which were taken bilaterally by turbinectomies were observed by means of scanning electron microscopy. The characteristic changes of mucosal surface, such as squamous cell metaplasia, bulging of the, cell surface, swelling of microvilli, acceleration of secretion and cell destruction, were more marked in the drug-sprayed specimens compared with the control specimens. In an experimental study, 25 guinea pigs were divided into 5 groups and sprayed intranasally for fourteen days with decongestant, anesthetic, lysozyme chloride, beclomethasone dipropionate and physiological saline solution, respectively. The morphological characteristics of the nasal mucosa were indistinctness of the cell border, swelling of the cell surface and destruction of cell membrane with some ciliary damage. These morphological changes were most marked in the decongestant group followed by the anesthetic group. Little change was found in either the lysozyme group or the beclomethasone group. Topical treatments of the nose were evaluated and their clinical significance was discussed briefly.

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The present study was carried out to evaluate the clinical and bacteriological effectiveness of Bacampicillin (BAPC) in 20 cases of acute purulent otitis media in children under eight years of age. The clinical effectiveness rate was 90%. The bacterial strains most frequently isolated were S. pneumoniae and H. influenzae, which accouted for 80% of the total isolates. In 1 case, aβ-lactamase producing strain of H. influenzae was found with a minimum inhibitory concentration (MIC) of ampicillin of 25μg/ml. The MICs of ampicillin against S. pneumoniae and H. influenzae were remarkably lower than those of cephalexin (CEX) and bacampicillin showed rapid clinical efficay whereby clinical signs of infection disappeared 2-3 days after administration. Bacampicillin is considered to be an oral antibiotic of first choice for the treatment of acute purulent otitis media.

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