Two cases of epidermoid cysts arising in the parotid region are roported. Case 1 was a 58 year-old male who had the episodes of recurrent parotid swelling and subsequent incisional drainage for 40 years. The surgical removal of the cyst was difficult since the cyst extended into the deep lobe and was firmly attached to the trunk of the facial nerve. Case 2 was a 36 year-old male who had gradual swelling of the left parotid region for 13 years. At surgery, the cyst was found in the extraparotid region. Dermoid or epidermoid cysts are usually located in the extraparotid region. Intraparotid occurrence is extremely rare, and diagnosis from other cystic lesions may be difficult. The treatment of choice should be parotidectomy with identification and preservation of the facial nerve.

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Two cases of carotid body tumor are reported. The first case was a 52-year-old female, who complained of abnormal sensation in the pharynx and swelling in the left side of the pharynx. The tumor was surgically removed. The second case was a 23-year-old female, who had swelling in the left side of the neck. The tumor was resected, but was found to have invaded the internal jugular vein. Radiotherapy was performed following surgery. The carotid angiography clearly supports our choice of therapy.

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Approximately 1400 high school students were surveyed to determine their loud music listening habits. The following group was selected for hearing acuity testing at 30 dB 500 Hz, 1 KHz, 2 KHz and 4 KHz: 33 students who listened to music with headphones for more than 5 hours a week at level at which they could not hear any other sound, 13 students who went to rock concerts more than 10 times a year, and 17 students who went to discos more than 10 times a year. Results revealed no hearing loss in any of the subjects. However, most of those who listened to loud music complained of temporary cochlear symptoms in our questionnaire. A follow-up study to determine the nature and extent of the suspected auditory damage should be carried out.

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From the results of promontory testing (PT) and electrocochleographi (ECochG), it is possible to differentiate between 4 types of deafness: 1) neural, 2) sensorineural, 3) sensory and 4) multilocated. Only sensory deafness is an indication for a cochlear implant operation. We have tested about 200 patients for cochlear implant (C. I.). About 90% had sensory deafness and were candidates for a cochlear implant. Further X-ray study of the temporal bone was done using an intracochlear device (Clark/Nucleus), to exclude patients with malformation and fractures of the cochlea. The PT and ECochG used together provide valuable information used in finding patients suitable for a C. I.

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In this study we reported a contradiction of the criteria of the prognosis of sudden deafness proposed by the Investigation and Research Group of the Ministry of Welfare, Japan 1975. This contradiction is presumed to be caused because the criteria consisted of judgement methods based on each aspect were discussed. In patients whose hearing level was 70 dB at the first examination both judgements agreed with each other and no contradiction was seen. New criteria for each judgement aspect were proposed.

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Twenty one patients 7 men and 14 women, 10 to 51 years old, with nasal allergy to house dust were subjects of this study. Each had at least a two year history of nasal symptoms related to house dust. Six patients had severe symptoms, 9 had moderate symptoms and 6 had slight symptoms. All patients selected had a 3+ or more intradermal skin test reaction to crude house dust extract. None of the patients had nasal polyps. A high-efficiency air cleaner (Green Safety Co. Ltd.) consists of the prefilter, the ionizer and a special filter. It has an electrified collector with a high voltage supply to conductive separators and a precharger for particle charging. The air flow is 1.2m³/min at the low setting and 3.6m³/min at the high setting. The noise level in 31dB in low and 37dB in high. Efficacy of the air cleaner for house dust nasal allergy was evaluated in 21 patients. In general, the effects on nasal symptoms were observed in 67% and 43% showed excellent results. The air cleaner is a useful therapy for house dust nasal allergy.

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We reviewed the records of 56 patients with head and neck carcinoma initially treated at our clinic from April 1984 to June 1986. The study focused on the time between initial symptoms and initial examination in hospital and correlated this time period with the stage of the disease. There were 44 males and 12 females, most age 50 to 70 years old. Many of the patients were in advaced-stage carcinoma, although they visited us within 3 months after the appearance of subjective-symptoms. The tendency to seek treatment at a more advanced stage of the disease was marked in patients over 70 years old.
It was suggested that more active steps be taken for early discovery and treatment of head and neck carcinoma.

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After previous studies on the fluctuation of ionization on proteins and phospholipids of hair cell membranes of the inner ear, we concluded a possible relationship between ion (atoms) disorders and tinnitus. Rare earth magnets were used with satisfactory results to the ion disorder and to treat tinnitus. A circular magnet (1,800 gauss) 4mm in diameter 2mm thick was sandwiched between two thin pieces of cotton and placed against the tympanic membrane in front of the cathode continuously for approximately one week.
Effective results were seen in 66% of the fifty-six subject tinnitus ears (50 cases). These patients had not shown satisfactory results with cell adtivators of various compound vitamins. There were absolutely no side effects. The longest period of continuous use was 104 days.
In many cases, tinnitus was noticeably diminished after three to four days of application of the magnet. The effectiveness of this treatment lasted after removal of the magnets. However, the improvement of hearing loss was not as good as had been expected. We also saw a relationship between the audiogram and the timbre of tinnitus.

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We reported whether nasal provocation tests demonstrate the protective effect of antiallergic drugs. Beclomethasone dipropionate (Bdp) was used as a model in double-blind cross-over testing. Judging from the nasal provocation test, 14 of 17 cases showed greater protection with Bdp than with the non-active placebo, 2 cases showed greater protection with the placebo, and one case showed no difference. Thus, significant protection was seen with Bdp. It is concluded that nasal provocation test are useful in evaluating the efficacy of anti-allergic drugs like Bdp.

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Twenty-three patients with perennial allergic rhinitis were treated with AA-673 nasal drops. The results were as follows: 1) Final global improvement rating showed “moderate or better improvement” in 73.9% of patients, and “slight or better” in 97.5%. 2) Mild side effects were observed in three patients, but none of them were severe. 3) Global utility rating resulted in “fairly or better useful” in 69.6% of the patients, and “slight or better” in 91.3%. 4) Therapeutic effect of AA-673 appeared within 4 weeks after beginning the treatment. It is concluded that AA-673 nasal drops are useful in the treatment of allergic rhinitis.

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Cefuroxime axetil (CXM-AX) was evaluated objectively for its efficacy, safety and usefulness in suppurative otitis media (acute infections and acute exacerbation of chronic infections), in an intergroup double blind manner using Cefaclor (CCL) as the comparator. In both CXM-AX and CCL groups, the drug was orally administered (after meals) in the dose of 250mg t. i. d., for seven days in principle.
1. As to the clinical effectiveness in all the cases, the efficacy rates of CXM-AX and CCL were 70.3% (83/118) and 57.9% (70/121), respectively, in the assessment by the doctors in charge, and 61.9% (73/118) and 54.5% (66/121), respectively, in the assessment by the committee, with no statistically significant difference between the two treatment groups either in the doctor's or in the committee's assessment (either in χ²-test or in e-test). However, clinical effectiveness assessed by the committee in the cases of acute exacerbation of chronic suppurative otitis media was significantly better in CXM-AX group (U-test). Also clinical effectiveness in monomicrobial infections by Gram positive organisms was significantly better in CXM-AX group both in the doctor's and the committee's assessments (both in U-test and in χ²-test).
2. In the overall improvement rates assessed on the 3rd and the 7th day of dosing, no significant difference was observed between the two treatment groups. However, when the improvements in subjective symptoms and objective findings were evaluated on the 7th day, the improvements in feeling of ear obstruction and volume and properties of otorrhea were significantly better in CXM-AX group both in the total cases and in acute exacerbation cases of chronic suppurative otitis media.
3. The bacteriological response was significantly better in CXM-AX group both in all the cases and in the cases of acute exacerbation of chronic suppurative otitis media. The complete bacterial elimination rates (excluding ‘replacement’ of organism) in all the cases. were 70.2% (73/104) in CXM-AX group and 55.6% (60/108) in CCL group, being significantly higher in CXM-AX group. However, in the elimination rates (including ‘replacement’ of organism), there was no significant difference. The bacteriological response of CXM-AX was significantly better than that of CCL in monomicrobial infections by Gram positive organism when it was assessed by infection type, and against S. aureus when it was assessed for each species isolated.
4. With regard to overall safety, no significant difference was observed between the two groups. Adverse events, mainly gastrointestinal tract symptoms, were observed in 4 cases out of 127 (3.1%) in CXM-AX group, and in 7 cases out of 128 (5.5%) in CCL group, without statistically significant difference. Abnormal laboratory findings were noted only in 1 case in each of the treatment groups.
5. Clinical usefulness was significantly higher in CXM-AX group in all the cases and in the cases of acute exacerbation of chronic suppurative otitis media.
The above results suggest that CXM-AX is a highly useful drug for the treatment of suppurative otitis media.

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Thirty patients with abnormal sensation in the throat were given Tsumura Saiboku-to (TJ-No.96) and its clinical usefulness was evaluated. The drug was remarkably effective in 30.0% of the patients, effective in 23.3% and slightly effective in 23.3% of patients after 4 weeks. Efficacy was good females over 50 years with nervous, methodical or optimistic character and complaining of psychological symptoms.

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We have used Acyclovir in the treatment of five patients with Ramsay Hunt Syndrome. Four of five patients have made a complete recovery within two months. One patient had incomplete paralysis after 6 months. The recovery rate is the same as for Bell's palsy. The prognosis is good and is more expeditious than with steroid treatment of Ramsay Hunt Syndrome.

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