We performed a statistical analysis of 9995 new outpatients seen at Kamio Memorial Hospital during the past two years. The number of new outpatients was similar to that of a university hospital. About 60% of the patients were between the ages of 20 and 60 years, 15% were over 60, and 20% were under 20 years of age. Patients with diseases of the ear, nose, and throat accounted for 41%, 35%, and 24%, respectively. Although 15% of the patients lived near the hospital, most came from outlying areas.

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The 8546 operations performed in Kamio Memorial Hospital during the past 12 years were analyzed statistically. The number of operations has been increasing each year, as has the number of patients over 50 years of age. The incidence of ear surgery increased significantly, and the incidence of nasal surgery increased moderately during the period. However, the incidence of operations on the throat has remained unchanged.

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The role of attending physicians in Kamio Memorial Hospital was analyzed. In 1989, there were 20 attending physicians at the hospital, all of whom were ENT specialists. About 300 patients, or 6% of all patients, were referred to the hospital by the attending physicians. Attending physicians performed 40 operations during the year, accounting for about 5% of all operations done in the hospital.

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The effects of body temperature changes on the I to V interwave latency of the auditory brainstem response were studied in 115 comatose patients. The body temperature of the patients was 32.7°C at the lowest and 44°C at the highest. The I to V, I, to III and III to V interwave latency were examined in relation to body temperature. It was found that the higher the body temperature, the shorter the latency. Inversely, body temperature was observed in relation to the I to V interwave latency. It was found that the longer the latency, the lower the body temperature. The relationship between body temperature and the I to V interwave latency was examined according to sex. The higher the body temperature, the shorter the latency in both men and women. This shortening of latency was greater in women. The relationship between body temperature and the I to V interwave latency was studied according to prognosis. The higher the body temperature, the shotrer the latency in both cases of good prognosis and cases of death. The body temperature-induced shortening of latency was greater in patients who died than in those with good prognosis. Patients who died appeared to be more susceptible to the influence of body temperature.

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We studied 23 cases of acoustic tumors presenting as trigeminal neuralgia (TN). Patients were complaining of hearing loss or disequilibrium previously, but none of them had the diagnosis established until the onset of TN. Even after the onset of TN. symptoms of it were usually typical, and it made doctors difficult to do differencial diagnosis. Most of them were ditected by CT scan as the preoperative examination for microvascular decompression.

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To elucidate patients' difficulties in facing presbycusis, the Hearing Handicap Inventory for the Elderly (HHIE) and the Cornell Medical Index (CMI) were given to 51 patients who visited private practitioners' clinics. These are self-assessment questionnaires. The HHIE comprises a social and emotional subscale, and the CMI is a psychological test. Results of the emotional subscale of the HHIE did not always correspond to those of the CMI, and those of the social scale showed that most patients with moderate or severe presbycusis faced social difficulties. Our study suggests that the HHIE is a convenient tool for busy clinics to explore patients' difficulties in presbycusis.

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A repectful comment on Helmholtz's theory. The author found that Helmholtz's theory of hearing was based on the mathematical solution to his dynamical differential equation for the motion of the basilar membrane. His mathematical level provides us with a strong sense of his high level of mathematics as compared with the present level, although his mathematics is one hundred years ago and his mathematical conclusion is different from Bekesy's observation. The author found this reason as follows: Helmholtz mathematical solution has two possibilities in term of resistance i. e. high or low resistance of the basilar membrane. However, Helmholtz took up only one possibility i. e. that of infinitesimal resistance and arrived at a multiresonant membrane. On the contrary, his conclusion would have been near Bekesy's observation if he took high resistance in the two possibilities.

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127 cases showing low tone sensorineural deafness of rapid onset were seen during recent 2 years. A study of the cases revealed following characteristics. 1. This disease is more common than expected. 2. The incidence was the highest in female aged from 20 to 29 years old. 3. The patients complained of ear fullness, tinnitus and dizziness in 84%, 46% and 30% of the cases respectively. 4. 39 cases (31%) showed low tone deafness bilaterally. 5. Although in most cases hearing loss recovered to normal shortly after treatment, in 35 cases recurrence or hearing fluctuation was noted. It was specurated that some cases of recurrence or fluctuation were associated with endolymphatic hydrops, and some cases of complete improvement were considered to be a similar entity to sudden deafness.

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The results of a questionnaire survey on subjective changes in hearing were correlated with changes in pure-tone hearing level, speech reception threshold (SRT) and maximum discrimination score (MDS) in 144 patients before and after tympanoplasty. In most patients, pure-tone hearing level, SRT and MDS were correlated with the self-assessment of hearing changes However, hearing level, SRT and MDS were not correlated with the self-assessments of patients whose changes in hearing level were slight or whose subjective assessments were vague.

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Hearing changes in seven frequencies (125 to 8000Hz) in air conduction threshold were studied at one month and at six months after tympanoplastic surgery in 863 ears. The hearing improvement in ears that received type I tympanoplasty with good ventilation in the epitympanic space was greater in the low frequencies than in the middle frequencies. The rate of improvement in the low frequencies was nearly 100% at one month after surgery. Increased threshold was observed at 8000Hz in ears that received type I tympanoplasty with or without good ventilation in the epitympanic space. This increment, however, had disappeared by the six months' hearing test. The cause of this transient increment in the hearing threshold at 8000Hz was probably due to impedance changes in the middle ear caused by surgery. Threshold changes with modified type III and modified type IV tympanoplasty were similar. That is, threshold improvement at the low and middle frequencies was of the same degree and no transient increment at 8000Hz was observed.

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To clarify the effectiveness of stapes mobilization, the hearing level was investigated in 11 ears with otosclerosis before and after surgery. As a control, the hearing level before and after surgery was also investigated in 12 ears undergoing stapedectomy and 4 ears undergoing stapedotomy.
Significant hearing improvement was obtained at all frequencies after stapes mobilization and stapedotomy. Although significant hearing improvement was obtained at the low and middle frequencies after stapedectomy, hearing deteriorated significantly at high frequencies. These results suggest that stapes mobilization may be a useful surgical approach for otosclerosis.

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A fitting test for hearing aids i. e. easily operable and short period of clinical use is presented. Hearing aid thresholds are of a field hearing. These are measured by a SPL audiometer with a speaker. The test results are plotted on SPL audiogram. Speech for a long time has been analyzed at SPL per frequency by some acoustical engineers as called average speech spectrum. This has been found common among different languages. The author selected one of them as a standard for fitting in the SPL audiogram. Thus, the adequate fitting levels for the speech spectrum can be determined experimentally in cases of sensorineural and conductive deafness, respectively. A hearing aid is prescribed as a fitting aid for the subject by getting his aided thresholds to the adequate fitting levels after adjusting the gain control and the frequency charateristics of a hearing aid.

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The role played by inputs from the dorsal neck muscles in maintaining eye and body equilibrium in human subjects discussed.
Cervico-ocular and cerbico-spinal responses were induced by dorsal neck vibratiion that mainly stimulated the muscle spindles of the dorsal neck muscles. Nystagmus was clearly demonstrated by this vibratory stimulation of the dorsal neck, not only in patients with peripheral vestibular lesions or neck muscle disorders, but also in normal subjects. Neck vibration also modulated caloric nystagmus. In addition, neck vibration induced clear anterior body sway, but only slight lateral body sway even in normal subjects. From these findings, it can be said that proprioceptive input from the dorsal neck muscles plays an important role in maintaining human equilibrium.

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Clinical and mycological studies of 122 cases of oto-mycosis were performed. The results were as follows: 1) The patients were distributed from 1 to 81 years of age, and showed sex predominance (males: 48 cases, females: 74 cases) and ear laterality (right ear: 59 cases, left ear: 45 cases, both sides: 18 cases) 2) To obtain the correct clinical diagnosis, examination of the earwax surface using an operation microscope to reveal the existence of the conidium of fungi is essential. 3) Cultures of earwax specimens showed Aspergillus terreus in 69 cases (56.6%), A niger in 29 cases (23.8%) and A. flavus in 14 cases (11.5%). 4) The sensitivity of a topical anti-mycosis drug and a disinfectant were evaluated by measuring MIC and MBC, with popidoniod showing fair sensitivity.

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To elucidate the relationship between nasal blood flow and nasal airway resistance, we measured nasal blood flow (BF) by the hydrogen clearance method, nasal airway resistance (NAR) by the anterior method with a rhinomanometer, mean arterial pressure (MAP) and heart rate (HR) with an automatic sphygmomanometer in patients with nasal allergy, before and after various stimulations such as nasal challenge with alpha-stimulant, beta-stimulant, choline agonist and histamine, and caloric stimulation (47 and 37° for five minutes and 0° for one minute) to the legs.
Both BF and NAR decreased following nasal provocation with alpha-stimulant, but did not change after nasal provocations with beta-stimulant and choline agonist. On the other hand, BF decreased but NAR increased following nasal provocation with histamine when no sneezing occurred, whereas BF, NAR, MAP and HR all increased in response to nasal provocation with histamine when sneezing was induced. BF increased but NAR decreased with warm caloric stimulation (43° for five minutes), but BF decreased and NAR increased with cold stimulation (0° for one minute). In contrast, MAP and HR changed concomitantly with both warm and cold stimulations.
The reason for the inverse changes in BF and NAR with histamine and caloric provocations is unknown. Thus we are unable to evaluate BF by measuring NAR and vice versa.

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We reported a tendency for the cedar pollinosis patients to out-grow of their symptoms, with increasing age. 1 The morbidity of cedar pollinosis was 1525 out of 9753 persons (15.6%). 2 Thirty patients (1.97%) consider to be out-grow their symptoms without any immunotherapy. 3 It seems that high age of onset, having no familial histories and no diathesis of the allergic diseases might be good possibilities in patients' “grow out” of their symptoms.

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Electro-coagulation therapy using high frequency currents utilizes Joule heat generated by the concentrated current on the treatment electrode. Intense heat is produced when the current is strong or the area between the electrode and tissue is small. In contrast, mild heat is produced when the current is weak or the contact area is large, enabling mild coagulation without sparks, fumes or an odor of burning. Utilizing these characteristics, the authors have devised various types of electrodes during the past 12 years, and have obtained good results in following conditions.
(1) epistaxis,(2) nasal polyps,(3) hypertrophic rhinitis,(4) allergic rhinitis,(5) various types of cysts,(6) chronic tonsillitis,(7) hypertrophy of lingual tonsil,(8) aphtous stomatitis,(9) otitis media with effusions and (10) small benign tumors.

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A 26-year-old man was admitted to our hospital with sore throat and discomfort of the throat of one month's duration. Laryngoscopic examination revealed a spherical tumor in the pharyngeal space. The tumor was partly excised and a leio-myosarcoma was diagnosed. Wide local excision of the leiomyosarcoma was performed. After surgery, 50Gy of radiation therapy was given. No recurrence is evident two years and eleven months after treatment.

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We consider that sexual well-being is a very important factor in the quality of life, so we formed a sexual therapy clinic to treat individuals who were troubled by sexual problems.
In this report I firstly introduce the sexual disorders encountered and the therapeutic procedures used at Kamio Memorial Hospital.
In addition, case histories of patients (12 males and 6 females) who have come to our clinic are presented. Among these patients with sexual disorders, there were many cases of primary impotence who had unconsumated marriages. Primary impotence is more severe than secondary impotence, but these patients can still respond to sexual therapy.

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