A 37 year old male whoh ad been complainingth at he had the sensationo f a lump in his throat for the past year was referred to our clinic by his practitioner. Many small red spots were present across the skin of his entire body. Laryngofiberscopiecx aminationr evealed a dark violet colored tumor the size of the small finger, in the piriform sinus, and attached to the right arytenoid. Tracheostomy was performed under general anesthesiaa, nd the tumor mass was removedb y a lateral pharyngotomy.T he tumor was approximately 2.0c m in diameter, a nd 3.0c m in length. The pathologicald iagnosisw as one of cavernoush emangioma.

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A one stager econstructioonf the hypopharynwxa sp erformedin a case of a localizedp iriforms inus cancer. Half the larynxa nd the preservehdy popharynwx asu sed. A myo-mucosfalal pw aso btainedby removingth et hyroidalc, ricoidala, r ytenoidaal, n de piliglottacl artilagef romt he preservelda rynx. A tube was reconstructewd ith this flapa nd the intacth ypopharyngemalu cousm embrane.T his techniqueh as somea dvantages: 1.O nes tager econstructio2n., Shortero perativeti me, 3.A smoothepr assagea ftert he operation4,. A bettere sophageavlo icct han witha cutaneoutsu be.

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We reporta case of Garcin'ss yndromew hichw asp ossiblyc ausedb y secretoryo titism edia. A 55 year-oldw omanw, hof irst noticedti nnitush, earingl oss, a nd pain in herl eft ear wasd iagnoseads having secretoryo titism edia 8 monthsp riort o admission Four months later, palsyo f the Vth and VIIthn erves begant o appear. The palsy extended to the other cranial nerves, and at thet ime of admission, the cranial nerves from III to X werec ompletel pyaralyzed CAT and MRI revealed fluid accumulatio in the air cells of the left temporal bone, mucosal thickening of the epipharynx, and hypertrophic dura mater at the base of the skulle xtending from the left cavernous sinus to the left jugular foramen. The histological diagnosis of the biopsie dura mater was one of cranial pachymeningitis.Treatments with antibiotics were effective. Paralyses of the cranial nerves, with the exception of the VIIIth, disappeared completely within 3 months. It is reasonable to assume that a mildly toxic bacterial infection in the middle ear had extended into the dura matert hrough the internal auditory canal, spread in the anteroposterior direction, and resulted in Garcin's syndrome.

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A 43 year old female complaining of a lump in the throat was discovered to have a large cystic tumor in the epiglottis, and right aryepiglottic fold. CAT and MRI revealed a dumbbel-shaped cystic tumor extending through the thyrohyoid membrane and projecting in the neck from the larynx. The cyst was histologically diagnosed to be a retention cyst. The large cyst was excised externally along with a portion of the hyoid bone.

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Harada's disease is regarded as an autoimmune disease of melanocytes, and it is well known that this disease causes inner ear dysfunctio in addition to uveitits, meningitis vitiligo alopecia etc. Otological and ophthalmological data for 63 ears of 34 patients thought to have had hearing impairment due to Harada's disease was analyzed. This data had been collected over the past 12 years. We compared the cases of Harada's disease with those due to sudden deafness which is also a sensorineural hearing disorder, especially in the aspects of treatment efficacy and prognosis. The following results were obtained: 1. Hearing impairment in Harada's disease is relatively mild, and tends to take the form of bilateral inner ear dysfunction.Even in cases of unnoticed hearing loss, considerable recovery of hearing can occur. 2. Recovery of hearing for Harada's disease is more gradual than that observed in sudden deafness. There is a good response with steroid treatment. 3. There is a clear mutual relationship between a prognosis of hearing impairment and visual impairment. 4. Otological examinations should always be performed, whether or not symptoms of hearing loss have been noticed. The results obtained through otological examinations will also aid in determining the appropriate opthalmological treatments.

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After noticing a clinical relationship between abnormal throat sensations and thyroid disorders, we studied patients with these sensations which occurred following thyroid operations. 67.5% of the patients who had had thyroidectomy also had abnormal throat sensations. Patients with malignant thyroid tumors, especially those patients who were anxious about their illness, had abnormal sensations more frequently than patients with benign thyroid diseases. The former group tended to have the sensations more severely just after the thyroid operation, with the discomfort decreasing over time. Abnormal sensations in the latter group, however, occurred only occasionally and had no specific association with the healing process following the operation. The quality of discomfort in the two groups was similar.

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MAST is a new system for detecting allergen-specific IgE antibodies. Multiple antigens can be examined simultaneously in a short period of time by this method. This method was evaluated using 101 serum samples from patients with nasal allergies.More than six allergen-specific IgE antibodies were simultaneously detected in 25% of the 101 serums amples. We compared MAST and RAST using six allergens: HD, D1, D2, Jpanese cedar, Timothy and Ragweed.Good correlation was observed in all six. Similarly, there was good correlation between MAST and skin testing with these allergens. From these results, it was concluded that the MAST system would be useful for detecting specific IgE antibodies.

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Injectable collagen has been used for vocal fold augmentation in human subjects because it has been shown to be efficacious in relieving glottic insufficiency. The application of a bioimplant material for this purpose raises the question of the permanence of the correction. Injectable collagen has been shown to undergo some degree of resorption. Injection of 3% atelo-collagen (Koken Co.) has been conducted in 9 cases of sulcus vocalis. One of nine patients required re-injection only 2 months after the first treatment. We employed a flexible therapeutic laryngofiberscope for the second injection. This technique was available in a case which required short term re-injection of collagen because of its resorption and could be done under local anesthesia without hospital admission.

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Lomefloxacin (NY-198) is a new synthetic pyridonecarboxylic acid antibacterial agent. A multi-center double-blind clinical trial was conducted for an objective assessment of the efficacy, safety and utility in suppurative otitis media of 0.3% and 0.5% otic solutions of NY-198. Another objective of this study was to determine the optimum concentration of NY-198. The evaluation of the clinical efficacy of NY-198 by the doctors in charge and the evaluation committee in 160 cases gave high ratings to both 0.3% and 0.5% otic solutions, with no significant difference between the two concentrations. Concerning bacteriological efficacy, however, a higher elimination rate was obtained in the 0.3%g roup than in the 0.5% group.During this clinical trial, no side effects were found in either group, suggesting that NY-198 has no unusual safery problems.Based on the above results, we have concluded that further investigation of this drug should be conducted using 0.3% NY-198 otic solutio.

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The efficacy, s afety and utility of lomefloxacin (NY-198) otic solution in chronic suppurative otitis media were evaluated by a well-controllecd omparative study using cefmenoxime (CMX) otic solution as a control.(1) Clinical effect: Whether based on the doctor's evaluation or the committee evaluation, no significandt difference was found between the NY-198 group and the CMXg roup. However, according to the doctor's evaluation, the NY-198 group tended to be superior in moderate cases.(2) Bacteriological effect: The NY-198 group tended to be superior in the elimination (%) of P. aeruginosa and was significantly more effective against gram-negative bacteria as a whole.(3) Side effects:Whereas side effects developed in 2 cases (2.0%) in the CMX group, no side effects were found in the NY-198 group.(4) Utility: The NY-198 group tended to be superior. Based on the above results, it was concluded that NY-198 otic solution would be a highly effective, safe and useful topical therapy for chronic suppurative otitis media.

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Eighteen patients with ear infections were clinically evaluated after the administration of 0.3% NY-198 ototopical solution. NY-198 was administered twice daily for a period of four to ten days. Clinical effects were as follows: 1. Clinical results were excellent in 3 cases (16.7%), good in 12 cases (66.7%), fair in 2 cases (11.1%), and poor in 1 case (5.6%). 2. No side effects were seen in any patients. 3. These results indicate that NY-198 ototopical solution is a useful medication for the treatment of localized ear infections.

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1) Using 65 guinea pigs, 0.2ml of 0.3% NY-198 was topically administered into the middle ear cavity. The concentrations of NY-198 were measured in brain, middle ear mucous membrane, cochlear perilymph, and serum. The peak concentrations of NY-198 were 0.074ug/g of brain, 1995.717ug/g of middle ear mucous membrane, 57.621ug/ml of perilymph and 0.160ug/mk of serum. 2) The concentration of NY-198 in brain was lower when given by topical rather than oral administration (20mg/kg). Central nervous system side effects are expected to be very low by topical administration.

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