Twenty-two patients (24 ears) with persistent tinnitus were treated by band noise masking. Masking noise was ranged from 250 Hz to 5,000 Hz divided into 18 sections. Verbal feedback from the patient were taken during a two hour test period. Of the 24 ears, 16 ears showed disappearance of tinnitus and 4 ears reduction of tinnitus after treatment. In four ears, however, tinnitus remained unchanged after the treatment. All patients were not conscious of tinnitus while using the masker, and many mentioned the sense of relief. From these results it can be coucluded that the band noise masker is useful for the treatment of tinnitus.

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Recently, radioisotope scans have been used widely in the detection of metastatic malignant lesions. However, the evaluation of routine radioisotope scans in the metastatic tumors of the head and neck is controversial. The purpose of this study is to compare the accuracy of lung, bone and liver scans versus conventional evaluation to identify distant metastases of the head and neck. From a review of the literature as well as our experience, we concluded that lung, bone and liver scans are not useful diagnostic techniques in head and neck tumors when clinical, roentgenological or biochemical evidence of distant metastases is not present.

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The objective of this investigation was to assess the relationship among the otolithic organs, i. e. utricles and saccules, and motion sickness. For this, I used a lateral tilting chair apparatus designed to provide a linear acceleration stimuli to the otolithic organs of humans. A question and answer survey was made with regard to motion sickness and vestibular disorders. Included were benign paroxysmal positional vertigo (BPPV)(33), sudden deafness (38) and Meniere's disease (29). For the controls, 130 healthy persons were studied. The extent of motion sickness in those with BPPV, those with other vestibular disorders and the healthy persons revealed definite differences. ENG recordings of horizontal nystagmoid eye movements induced by lateral tilting, were made in 130 healthy persons and in 90 or more subjects peripheral vestibular disorders. Four types of the eye movement patterns were identified. Type 1: Fixed direction type-Fixed directional nystagmoid eye movemetns were induced by tilting to either side. Type 2: Changed direction type-Rightward nystagmoid eye movements were induced by left lateral tilting and leftward movements by right lateral tilting. Type 3: Combination type-Nystagmoid eye movements were induced by lateral tilting but the direction was uncertain i. e. except for Types 1 and 2. Type 4: Nystagmoid eye movements were not apparent. In the healthy individuals, those who readily experienced had a changed direction type (Type 2). On the other hand, among the groups with peripheral vestibular disorders, 70% of BPPV patients showed a changed direction type (Type 2). This was rarely seen in the others. This study led to the conclusion that persons who readily experienced motion sickness had definite reactions to a BPPV, and that such depend on the susceptibility of the otolithic organs.

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This study has been carried out mainly for the purpose of clarifing phonatory mechanism in both easy and minimum intensity phonations. Phonatory examinations were applied in normal and pathological cases by use of phonolaryngography by which fundamental frequency, intensity and air flow rate during phonation are able to be simultaneously examined. In order to obtain three different coefficients of correlation, average flow rate vs fundamental frequency, intensity vs fundamental frequency and intensity vs average flow rate in easy and minimum phonations, further study has been statistically performed. The statistical study indicated the following results; 1) In normal cases, no dominant difference was obtained among each correlation coefficient between easy and minimum phonations. 2) In cases of insufficient glottal closure and small mass on the vocal folds, highly positive correlation coefficient was observed in average flow rate vs intensity and fundamental frequency vs intensity among both easy and minimum phonations while there was no significant difference between the both phonatory modes. 3) In cases of stiffened vocal folds and large amount of mass on the vocal fold, notable difference of the coefficient of correlation between the two types of phonation modes was obtained.

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The phonatory function following laser surgery for glottic Tia carcinoma was investigated with 17 subjects. It was compared with the function following radiotherapy. studied in 14 subjects. The phonatory function following laser surgery for glottic T1b carcinoma was investigated with 10 subjects. It was compared with the function following radiotherapy studied in 6 subjects. The phonatory function was evaluated by (1) measuring maximum phonation time, airflow rate, fundamental frequency range, intensity range and phonatory efficiency,(2) stroboscopic examination,(3) psychoacoustic evaluation and (4) sound spectrography. The results are summarized as follows: A glottic T1a 1) The intensity of phonation during airflow measurement was louder following radiotherapy than following laser surgery. 2) The phonatory efficiency(ε) following radiotherapy was more greater than that following laser surgery. 3) The relative level of higher harmonic components was smaller following radiotherapy than following laser surgery. 4) Following laser surgery, the amplitude of vocal fold vibration was small or zero and there was little mucosal wave during vibration. 5) An incomplete glottal closure during vibration was found more frequently after laser surgery than after radiotherapy. 6) There were no significant differences in maximum phonation time, mean airflow rate, fundamental frequency range of phonation and intensity range of phonation between laser surgery and radiotherapy. B glottic T1b There were no significant differences in any test values between laser surgery and radiotherapy.

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Concentrations of cefsulodin in the mucous membrane of middle ear and otorrhea were studied. Sixteen patients who underwent tympanoplasty or radical mastoidectomy were intravenously injected with a 1g dosage of cefsulodin before the operation. Mean cefsulodin concentration in the mucous membrane were 29.0, 30.4 and 16.3 μg/g at 0.5, 1 and 2 hours after injection, respectively. Five patients with chronic suppurative otitis media were intravenously injected with a 1g dosage of cefsulodin. Otorrhea was collected using 6mm paper discs and cefsulodin concentrations in the samples were determined. Concentrations in otorrhea were 9.5 μg/g at 2 hours after injection. The tissue concentrations exceeded the antibacterial levels of cefsulodin against Pseudomonas aeruginosa.

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In order to evaluate the clinical efficacy and safety of DL-8280 on acute suppurative otitis media, acute exacerbation of chronic suppurative otitis media and chronic otitis media, a double-blind trial was carried out in comparison with pipemidic acid (PPA). Six hundred (600) mg of DL-8280 or 2000mg of PPA was administered daily for seven days and the following results were obtained. Clinical efficacy: 1) The clinical efficacy was able to be evaluated in 136 cases of DL-8280 group and 138 cases of PPA group. 2) When judged by the committee members, the overall efficacy rate (cases of excellent and good responses) was 57.3% in DL-8280 group and 49.3% in PPA group. A trend of higher efficacy rate was observed in DL-8280 group (P<0.10). The efficacy rate of DL-8280 group (80.5%) was superior to that of PPA group (60.7%) on the treatment of acute suppurative otitis media (P<0.05). 3) The clinical efficacy judged by the doctors in charge was similar to the evaluation by the committee members, however, no significant difference was observed between two groups. 4) Concerning the symptoms, the property of otorrhea was much improved by the treatment of DL-8280 (improvement rate 79.1%) than by the treatment with PPA (65.5%) on the last day of treatment (P<0.05). Bacteriological efficacy: The causative organisms isolated from the patients were eradicated in a higher rate in DL-8280 group (67.5%) than in PPA group (56.3%) in total patients (P<0.10). For the acute suppurative otitis media, the ratios of eradication were 87.5% and 64.3%, in DL-8280 group and PPA group, respectively (P<0.05). Of the strains isolated, S. aureus and P. aeruginosa were particularly well responded to DL-8280 treatment. Safety: Side effects were observed in 8 of 145 cases (5.5%) in DL-8280 group and in 8 of 146 cases (5.5%) in PPA group. No serious side effects were observed. From these results, it was concluded that DL-8280 is a safe and useful drug which is able to provide a higher clinical efficacy as PPA, at a dose level of only one-third of PPA.

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The clinical effects of Merislon (Betahistine dimethyl sulfonate) were studied on 23 patients with vertigo, principally Meniere's disease. Merislon was effective in about 90% of 23 cases. As to subjective symptoms, the frequency and intensity of vertigo were prominently improved, but no improvements of tinnitus and hearing impairment were observed. As for objective findings, curative effects on disappearance of abnormal nystagmus such as spontaneous nystagmus and improvement of the stepping test were observed. No obvious side effects were seen, even in the long term administration cases. Thus Merislon seemed to be effective for treatment of vertigo. principally peripheral vertigo.

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Our experience with the use of a new tissue adhesive (Tisseel®) in otolaryngology particularly in middle ear surgery is reported. A prosthesis in tympanoplasty was kept successfully in the proper position by placing the fibrin glues around the prosthesis and the ossicle to be united. No inflammatory reaction was observed in all cases with the noninfectious ear. Wound healing was significantly enhanced in one case, compared to the surgery previously performed. Considering from its excellent wound healing effect in addition to the bonding and hemostatic ones, Tisseel deserves further application into otolaryngology.

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The thyroplasty type I, described by ISSHIKI et al.(1975) and the arytenoid adduction technique, proposed by ISSHIKI et al.(1978) have been employed on patients with imperfect closure of the glottis due to unilateral vocal cord paralysis. The arytenoid adduction technique is specially indicated for a wide, glottal chink and when there is a difference in level of the two cords. Both techniques are rather simple and the improvement of voice is significant. The surgical procedures are described in detail.

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