A ten-month-old boy, who had a tracheostomy at the age of two months because of dyspnea after long term tracheal intubation, was unable to close the tracheastoma after surgical treatment for a tracheal stenostic lesion. Endoscopic examination revealed no orgnaic stenosis in the larynx and trachea, but an absence of glottic abductor function during inspiration was noted. Diagnosed as having a condition of functional inability of decanulation, the patient was trained by insertion of a silicone T-tube with an extension tube whose length was gradually extended in order to increase the respiratory resistance. One month of training enabled the patient to respirate without the tracheostoma. During the training, the monitoring of the arterial oxygen saturation with pulsoxymeter was useful for determining the length of the extension tube and for evaluating the training effect.

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Two cases of laryngeal cyst in a 57-year-old male and a 30-yea-old female were reported. The cysts of both cases were submucosal tumors which seemed to have arisen from the saccules in the paraglottic space and to have extended to the vallecula, the false vocal cord, and the aryepiglottic fold. They were palpable through the thyrohyoid membrane from the neck, and were uneventfully resected using an external approach. One cyst was lined with simple cuboidal epithelium, and the other with stratified squamous epithilium. Both cysts were considered to be classified as lateral saccular cysts.

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A 53-year-old female visited our clinic complaining of post nasal drip. Isolated osteoma was found in her right maxillary sinus. The dimensions of the osteoma were 1.5×1×1cm. She had a past history of trauma to her right cheek 7 years before the operation. A study was done of the reported cases of this disease in Japan and a statistical analysis of characteristics was performed.

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Equilibrium functions of children were examined in about 357 primary school students in Yonago city. Several tests of equilibrium functions were adopted. These included standing on one foot in the airplane position with or without eyes closed, walking on a rail, writing with eyes closed, and anamnestic table. With the increase of grade level, the results of standing on one foot with eyes open and rail walking showed the development of equilibrium functions. Standard values for standing on one foot with eyes open were 10 seconds for middle grade students, and 20 seconds for high grade students. A significant correlation was observed between school records and standing on one foot, but there were only weak correlations among the results of the other tests. The anamnestic table of 40 items was simplified by selection of 20 items chosen by the statistical method of quantification of the third type. This simplified anamnestic table is thought to be very useful for screening investigations. These results will be very helpful for future investigations of equilibrium functions in children.

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Over the past 12 years, 24 cases of orbital blowout were studied. They could be classified into 3 types based upon the site of orbital wall fracture. Eleven cases (46%) involved isolated inferior wall fractures, 8 cases (33%) involved isolated medial wall fractures, and 5 cases (21%) involved inferior and medial wall fractures. The cases of isolated medial wall fracture were more frequent, which differs from previous reports. These fractures presented at a later stage than the other types of fractures. Seventeen cases were operated by the transmaxillary approach and 7 cases were treated conservatively because of the tendency of spontaneous recovery. CT-scan and tomographic studies were useful in the diagnosis of blowout fractures, and in particular the medial wall fractures. In this paper, an emphasis has been placed upon blowout fractures of isolated medial orbital wall.

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This is the case report of a 33-year-old female who presented with ear discharge and pain. A soft tumor was discovered in the right external auditory canal and a biopsy was performed. Histology showed it to be squamous cell carcinoma. CT and magnetic resonance imaging demonstrated the features of tumors and intracranial invasion. Digital subtraction angiography demonstrated the occlusion of the sigmoid sinus. Carotid angiography demonstrated stenosis of the internal carotid artery (ICA). Six weeks after preoper-ative irradiation (40 Gy), subtotal resection of the temporal bone was carried out with removal of a portion of the dura mater, ICA and sigmoid sinus because of the tumor invasion. The dura mater was repaired and the ICA and sigmoid sinus were reconstructed with free saphenous and external jugular vein grafts. Postoperative irradication (25 Gy) was carried out 2 months after operation.

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To evaluate the effect of antiallergic drugs on reactivity of the nasal mucosa to histamine, the amount of nasal secretion and the frequency of sneezing induced by topical application of histamine chloride (0.25%, 20ul) were measured before and after topical use of DSCG or Ketotifen for 4 weeks. Topical use of either DSCG (p<0.05) or Ketotifen (P<0.01) caused a significant decrease in the amount of nasal secretion induced by histamine. Topical use of Ketotifen showed a tendency to reduce the frequency of sneezing induced by histamine (p<0.10).

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The branches of the bull frog vestibular nerve were sectioned and its effect upon motor function was studied. Changes of the posture, head righting reflex, walking, jumping, and swimming were examined before and after surgery. When the unilateral vestibular nerve was cut, a marked deviation of the posture was observed. When the bilateral anterior semicircular canal nerve was sectioned, the posture and head reflex were not affected. However, when the frog jumped, it displayed vestibular symptoms upon landing. It appeared that the frog did not have control of its forelimbs. When the bilateral posterior semicircular canal nerve was cut, the frog failed to jump straight. Both anterior and posterior semicircular canal nerves are closely related to the muscles of the extremities.

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Six cases of first branchial cleft anomalies treated in Miyazaki Medical College Hospital from 1979 to 1989 are presented. Two cases of Type I anomaly are presented, which include a fistula with congenital external auditory canal stenosis, accesory ear and ossicular chain anomaly. Four cases of Type II anomaly are presented, which include a cyst within the parotid gland. The basis of these anomalies are embryologically explained. Knowledge of the characteristics and the variations of these anomalies is helpful for early diagnosis and adequate treatment.

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The Stickler syndrome is a autosomal dominant connective tissue dysplasia, associated with ocular, generalized skeletal and orofacial manifestation and hearing loss. A rare case of Stickler syndrome associated with hearing loss was observed. A 19-year-old famale visited our clinic with complaint of bilateral hearing loss. The case was diagnosed as bilateral middle grade sensorineural hearing loss. Short increment sensitivity index test, auditory brainstem response and electrocochleogram showed the inner ear deafness to be of the subtractive loss type. The hearing loss in Stickler syndrome which appeared in literature was discussed.

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Bestron was administered to pediatric patients with otitis media and its efficacy, safety and utility were evaluated. Results were as follows.(1) The improvement rate in 11 childrenwith infantile otitis media (9 cases of acute suppurative otitis media, 2 cases of chronic suppurative otitis media) was 90.9% (markedly improved in 4 cases, improved in 6 cases). The clinical response was excellent.(2) The improvement rate in 9 children with other types of otitis media (2 cases of exudative otitis media, 7 cases of postoperative relapse of chronic otitis media) was 88.9% (markedly improved in 4 cases, improved in 4 cases). Thus, the response was again excellent.(3) Audiometry in 9 children with infantile otitis media disclosed no drug-related abnormal changes.(4) No side effects were found. The above results indicate that Bestron for otic use in therapeutically very effective against infantile and other types of otitis media and has a high degree of safety, thus promising a high clinical utility.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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