The otolithic functional tests have not completely been established yet, because disturbance is hardly ever confirmed to the otolithic organ. Moreover it is difficult to observe locality of lesion and grade of damage objectively by the functional tests. At present the following tests are used in otolithic functional testing-linear acceleration, parallel swing, centrifugal force and tilt stimulation. Tracks and rockets are too huge to be widely applicable at present. The parallel swing test is useful for those cases in which standing or walking cannot be tested, but unilateral otolithic function may not be tested by this method. Centrifugation is a test designed to stimulate the otolithic organ, but cannot be completely rule out to stimulate the canal organs. Since 1975 we observed ocular reflexes caused by tilting stimulations having a subject in an orthocephalic sitting posture on a chair apparatus tilting continuously. We used tilt chair apparatus, which can be tilted at 1 degree repeating reciprocal motions of the frontal plane right and left up to 25 degrees. The eye movement was observed using the nystagmograph and an infra-red TV camera in front of the eyes. The test is performed with the eyes open in a dark room. Having ocular deviation and weak nystagmoid eye movement as indexes, it was confirmed that in healthy persons an oculogyration accompanied by ocular counter rolling is observed at around 10 and 20 degrees. Even in healthy persons nystagmoid eye movement (weak nystagmus) is observed in 3 out of 19 persons, showed nystagmus in a minor amplitude and small beat number.

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The combined therapy of Bleomycin-iontophoresis, laser surgery, and radiation were applied to seven cases of oral carcinoma composed of five buccal lesions and two lesions of the floor of the mouth. In six cases, improvement was evident in both clinical and pathological findings. Large amounts of Bleomycin infiltrate easily into tissue by iontophoresis, so it may be remarkably effective to the localized lesion without causing side effects such as lung fibrosis, etc. The CO₂ laser is useful for surgical management of oral malignancy, because there is little bleeding and manipulation is easy. It seems that Bleomycin-Iontophoresis combined with laser surgery is effective for reduction of the infiltrated tumor. As this treatment produces only minor pain, bleeding, scaring or defect of the tissue, the oral function and architecture can be preserved. For older patients this procedure can be performed successfully as well as safely because side effects are minor and localized.

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There are cases in which Ménière's disease-like attack occurs in repeated episodes after a latent period following head injury, chronic otitis media, viral otitis interna, sudden deafness, etc. Schuknecht named such a pathologic condition of the inner ear “delayed hydrops syndrome”, but this term, in our opinion, cannot be considered as fully explanatory of the condition in question. The present author proposes to describe it as “diminished capacity of preserving inner ear function”. More particularly, taking head injury as an example, he surmises that when the trauma has caused commotio labyrinthi with a resultant impairment of hearing and vestibular function, the third function of the inner ear, i. e. capacity of preserving its internal environment, might have also been diminished. If generalized autonomic imbalance occurs from overstrain and/or want of sleep after subsidence of the commotio labyrinthi, then the inner ear whose capacity to preserve its function has been impaired would be the first of all organs to suffer dysfunction and attacks of Ménière's disease would thus ensue. Organs have a disease or diseases which they are specifically affected with when they are involved in autonomic imbalance, for example, angina pectoris for the heart, asthma for the bronchus, ulcer for the stomach, neurogenic diarrhea for the intestine and Ménière's disease for the inner ear. A disease that is most likely to first occur from overstrain and/or want of sleep in a given individual is defining for that individual. This is because each individual has a predetermined ranking of organs according to their predisposition to involvement in autonomic imbalance. When the inner ear becomes diseased and its capacity of preserving its function becomes impaired, the situation changes and, in fact, there is even a possibility that the inner ear becomes the first to be affected with disease. As a consequence there may be instances in which the patient who has never experienced vertigo before develops attacks of Ménière's disease precipitated by overstrain and/or want of sleep before he is attacked by angina pectoris or gastric ulcer. The introduction of this concept of the ranking of organs concerning their liability to be involved in autonomic imbalance makes it more understandable that although Ménière's disease is unilateral in most instances, bilateral involvement does indeed occur. Based on the above concept, the unilateral occurrence of the disease may be explained as follows: the inner ear on the affected side ranks first in terms of predisposition to disease, some other organ comes next, while the inner ear on the opposite side holds the third or lower place. Under such circumstances, if stress is so powerful that organs affected by it might not be limited to the inner ear (Ménière's disease), a disease of other organs, e. g. bronchial asthma and gastric ulcer, will therefore ensue. In bilateral Ménière's disease as opposed to a unilateral one, the inner ear on one side ranks first in the order of predisposition to disease and the organ on the opposite side stands second. In such an instance a severe stress would therefore give rise to dysfunction of both inner ears, hence resultant Ménière's disease takes its bilateral form.

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A case of adenocarcinoma of the nasal septum is reported. The patient was a seventy-one year old female who had developed a nasal obstruction with swelling around nasal radix. Physical examination reveated that the bilateral nasal septum was enlarged with a tumor mass. She was treated surgically by an external nasal approach under general anesthesia. Pathological findings showed adenocarcinoma originating from the nasal septum. Carcinoma of the nasal septum is very rare. In Japan, only fifty eight cases have been reported to date. Including this case, only six cases of adenocarcinoma have been reported. Clinical features and treatment are briefly reviewed.

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The effect of specific immunotherapy was evaluated in 244 patients with nasal allergy whose treatment commenced more than 3 years ago. A course of therapy consisted of a large initial dose with maintenance dose injections for 3-6 months. 1. The success rate was 67.5% in the patients who completed one or more courses of treatment. If those who were recieving the maintenance dose were included, the success rate was 70.6%. 2. Among patients who discontinued treatment, those who were treated less than two years tended to have a recurrence of symptoms. 3. The cases suffering from nasal obstruction showed ineffective results. 4. Between pre-and post-immunotherapy, there was no significant difference in the examination results i. e. direct intradermal reaction, intranasal provocation test, eosinophile leucocyte count test of nasal smear and serum specific lgE antibody level.

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A case of a 14-year-old boy who is complaining of recurrent episodes of drainage in posterior crease of his right pinna with a congenital atresia of the external auditory canal and a slight grade of microtia, is presented. At surgery, the draining fistula is found to be almost parallel to the presumable auditidory canal and to end in a blind over a plate of bony atresia cavity, in which filled with cholesteatoma. Microscopic examination of the fistula shows squamous epithelium and skin adnexa, thus this lesion is diagnosed to be first branchial cleft anomaly with a primary cholesteatoma. Developmental anomaly around the first branchial cleft is also discussed.

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12 cases of malignant tumor and 2 cases of acute inflammation in our ENT clinic were administered with GM for the purpose of treatment of pseudomonas infection. In these cases, the concentration of GM in serum was measured by the fluorescent spectrophotometer. The mean concentration of GM, on 0.5 hour after the primary intramuscular injection of 60mg was 3.98μg/ml and on 3 hour after, was 1.59μg/ml. In two cases, which were received GM 60mg by intravenous drip infusion, the mean concentration of GM was 0.33μg/ml on 3 hour, 0.48μg/ml on 24 hour and 1.05μg/ml on 48 hour after injection. These concentration was enough for treatment of pseudomonas infection. The fluorescent spetrophotometer was useful for monitorring of concentration of GM in serum.

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Ultrastructure and permeability to macromolecules of the epithelial lining of the nasal respiratory mucosa of the guinea pig were examined by electron microscopy. 1) The epithelium of the nasal respiratory mucosa consisted of ciliated cells, non-ciliated cells, and basal cells. The cell type, here referred to as the non-ciliated cell, was not a specific cell group, but included various cell types such as secretory cells in the different stages of secretion, immature ciliated cells, or immature secretory cells. 2) In the control experiment, 30 minutes after intranasal injection of physiological saline, endogenous peroxidase activity was localized in the cisternae of the smooth endoplamic reticulum of ciliated cells. By contrast, reaction product was absent from non-ciliated cells and basal cells. 3) Thirty minutes after the intranasal injection of horseradish peroxidase (HRP), it was taken up by endocytosis into the non-ciliated cells with a few or no secretory granules, but not into the ciliated cells at all. Reaction product was seen in the surface pits, small vesicles, large vacuoles, tubular structures, multivesicular bodies, and lysosomes, and it was assumed that most of the tracer would be digested in lysosmes. However, at 45 or 60 minutes after administration of HRP, reaction product was seen both in the intercellular and subepithelial spaces. In all cases examined, tight junctions remained closed and no reaction product was seen in these areas. 4) This study suggests that macromolecules such as HRP can be transported across the nasal respiratory epithelinm not through the intercellular junctions but by combination of endocytosis and exocytosts through the cytoplasm of non-ciliated cells.

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Long acting amoxicillin granules (L-AMPC) is a preparation pharmaceutically designed to prolong the effective serum concentration of amoxicillin. When we administered L-AMPC to 19 patients with lacunar tonsillitis and 1 patient with acute suppurative otitis media at a daily dose of 1g (b. i. d.), the effect was found to be excellent in 17 cases, good in 1 case and fair in 2 cases (efficacy rate: 90%). Except for the occurrence of an eruption observed in 1 case, there were no noticeable adverse effects. In most patients with leucocytosis, a marked reduction in white blood cells count was noted after treatment. In 2 patients with increased S-GOT, the levels were normalized after treatment.

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