Stabilometry is commonly implemented in the clinical treatment of vertigo, but conventional methods are not always satisfactory for detecting abnormalities. Accordingly, 70 patients, who presented at Kurume University School of Medicine, Department of Otolaryngology with the chief complaint of vertigo, received stabilometry after first undergoing either head shaking or altering the body position, in order to determine whether preparing the patients in such a manner improves the efficacy of detecting abnormalities.
The discovery of an imbalance increases after head shaking and altering the body position in Benign Paroxysmal Positional Vertigo patients, after only head shaking in Meniere disease patients (with head shaking nystagmus) and after only altering the body position in Vetebro-Basilar Insufficiency patients, respectively. Stabilometry was also found to be more valuable in diagnosing vertigo when head shaking or altering the body position is performed before stabilometry

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Nevocellular nevi represents about 20% of all benign tumors in the external auditory meatus (EAM). However, it is rare for such cases to occur in the bony part of EAM. We experienced a case of nevocellular nevi in the bony part of EAM. The diagnosis was based on the findings of a pathological study and it was thus excised. The patient is now under observation at the outpatient clinic and there has so far been no evidence of recurrence.

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A traumatic transection of Stenon'duct in a 36-year-old man is herein reported. The patient complained of multiple lacerations and salivary fistula on his left cheek which were caused by a shattered windshild in a traffic accident. Sialo-CT and X-ray examinations showed stenosis of Stenon's duct and a glass-like body located at the stenotic portion. Under general anesthesia the pieces of glass were removed by an external incision on the left cheek. A silicon tube was inserted into Stenon's duct to prevent stenosis of the duct and the transected region was then sutured with nylon sutures. The silicon tube was removed 21 days after the operation. The surgery was successful and neither sialorrhea nor sialocele have been observed up to now.

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Sialadenosis is defined as a non-inflammatory, non-neoplastic enlargement of the salivary glands. This disease is widely recognized to usually affect the parotid glands as recurrent bilateral swelling and is also accompanied by either endocrine or metabolic disorders in a large number of such cases. In contrast to the majority of reports on sialadenosis, we experienced one non-typical case of sialadenosis. This patient presented with a solid, tumor-like mass in the unilateral parotid gland without any general disorders. We initially considered this to be a benign parotid tumor until a histological diagnosis was performed after the tumor was resected.

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We experienced 2 patients who were treated for posttraumatic enophthalmos. They had both been treated for facial bone fractures immediately after a traffic accident at another hospital. However, after the initial treatment they suffered from enophthalmos and thus visited our hospital. An orbital CT scan revealed a fracture of the medial orbital wall and a lateral rotation of the zygoma. There was an increase in the orbital volume on the injured side. An ophthalmologic examination showed almost normal findings except for right enophthalmos in the first, but horizontal dystopia and right enophthalmos were both observed in second patient. Calvarial grafts were inserted into the orbital cavity to obtain volume reduction. The enophthalmos was successfully corrected in both patients and they were satisfied with their features. In addition, the dystopia was also corrected in the second patient.

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Thirty-five cases with malignant parotid tumors were retrospectively investigated regarding treatment modalities and treatment outcomes. As a result, the overall three-year survival rate as determined by Kaplan- Meier method was 64%. As for the T categories, thethree-year suvival rate of Tb was 47%, whereas that of Ta was 100%. Regarding the major histopathologic types, three-year survival rate of adenocarcinoma was 65%, while that of mucoepidermoid carcinoma was 60%.
Regarding the treatment modalities, T1 and T2 cases whose tumors were located in the superficial lobe without facial nerve invasion could be satisfactorily treated with only a superficial lobectomy which conserved the facial nerve. In the T2 cases with facial nerve invasion, the major stem of the facial nerve should be transected and removed. A total parotidectomy with a total removal of the facial nerve, however, is necessary for T3 and T4 cases. A radical neck dissection including at least an upper neck dissection may be necessary for N0 cases. In addition, radiotherapy and chemotherapy after surgical treatment are also thought to be effective for some malignant parotid tumors.

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Mucoepidermoid carcinoma is a rare tumor of the head and neck area which is composed of both a mucous cell part and an epidermoid cell part. Twenty-one patients with mucoepidermoid carcinoma were retrospectively reviewed regarding sex, origin, treatment, histopathologic grading and treatment outcomes. The carcinoma originated in the major salivary gland in 12 cases, in the oral cavity in 3 cases, in the paranasal cavity in 3 cases and in the oropharynx in 3 cases. Of these 21 patients, 19 underwent curative treatments and thus were investigated in detail. The overall 3 year survival rate was 66 percent. Histopathologically, this carcinoma has been classified into well, intermediate or poorly differentiated types. All 19 of the above cases also demonstrated a high grade type carcinoma.

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The efficacy of pemirolast potassium for allergic rhinitis was evaluated. Patients with cedar pollinosis were divided into two groups consisting of: a prevention group (35 patients) who received the drug before pollen dissemination started (20 pollen particles/cm²/day) and a treatment group (12 patients) which received the drug only after the manifestation of symptoms after the beginning of the pollen season. Both nasal and other symptoms were scored. In the early stage after the pollen season started, the symptoms were significantly milder in the prevention group, thus indicating the efficacy of early treatment. The efficacy rate was 23% (“markedly effective”) and 43% (“markedly effective” + “moderately effective”) in the prevention group, compared to 17% (“markedly effective”) and 25% (“markedly effective” + “moderately effective”) in the treatment group. The improvement rate also tended to increase in the perennial allergic rhinitis patients with nasal and other symptoms as the oral treatment with pemirolast potassium was continued. The global improvement rate was “markedly improved” in 15% of these patients and “moderately improved” in 8%. Adverse reactions occurred in 2 of 94 evaluable patients. Based on these findings, Alegysal® was thus shown to be a useful drug for the treatment of allergic rhinitis especially when taken before the beginning of the pollen season.

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The clinical efficacy of pemirolast potassium (Alegysal®) for cedar pollinosis was evaluated in patients who received it before the start of the pollenseason (defined as 20 or more grains of cedar pollen per cm² per day), and those who received it after the season had already started. The nasal symptoms, activities of daily living scores (ADL), symptom scores (SS), and symptom medication scores (SMS) were all evaluated in 90 evaluable patients. At the beginning of the season, sneezing, runny nose, SS and SMS were all significantly less marked or reduced in the patients who received the drug within 4 weeks before the season than those who only received it after the season had already begun. However, the degree of nasal congestion was similar in the two groups at the beginning of the season, however, the symptoms were significantly less marked in those patients receiving the drug within 4 weeks before the pollen season began. The global improvement rate (either markedly improved or moderately improved) was 52% in the preseason group and 46.6% in the post-season group. Slightly adverse reactions were also reported in 2 of 129 patients evaluated for safety. Based on these findings, Alegysal® is thus considered to be effective for the treatment of cedar pollinosis, especially when administered 4 weeks before the start of the pollen season.

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