A 59-year-old female developed a sudden perilymphatic fistula due to overexertion when passing stool. Because of severe dizziness and hearing loss, the patient underwent a surgical exploration of the tympanic cavity 4 days after onset. During surgery, the level of the anesthesia became low and the patient started to demonstrate retching which resulted in a clear visualization of the perilymph leak from the round window. Although her dizziness disappeared completely, her hearing recovered but later once again deteriorated. We, thus, believe that a probe tympanotomy is advisable when perilymphatic fistula is suspected in cases of sudden deafness.

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This is a case report of a child who suffered from post-traumatic dizziness and was observed for seven years. The patient was an eleven-year-old boy who suffered a head injury due to a traffic accident. His dizziness started about a year after suffering the accident. A MRI obtained shortly after the accident showed high density areas in the callosum, the right middle cerebral peduncle and the left mastoid. Treatment with Bifemelane HCL was effective, however, when he stopped taking this medication the dizziness recurred. As a result, he has, therefore, had to continue using this drug. The results of an eye tracking test and an optokinetic nystagmus pattern test indicated a gradual improvement in the symptoms. The involuntary eye movements seen on the gaze nystagmus test at the first consultation disappeared five years after first suffering the accident. The dizziness in this patient is, thus, considered to be caused by a circulatory insufficiency as a result of a healed lesion in the middle cerebellar peduncle. A long term observation is, thus, required in cases of post -traumatic dizziness affecting children with lesions in the brain stem.

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We measured distortion product otoacoustic emissions (DPOAEs) in cases with functional hearing loss and got good responses in all cases. In addition, we also measured the DPOAEs in the cases with normal hearing and sensorineural hearing loss and analyzed them. The higher the average air conduction threshold of the 5 frequencies became, the lower the DP level became. DPOAEs were thus found to be useful for evaluating the cochlear function.

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Epidermoid cysts appear due to an aberrant ectoderm all over the body, especially in the ovaries and the rectum. In the head and neck region, it is mainly reported to appear on the floor of the mouth and the base of the tongue. However, it is rare for such tumors to appear in the nasal or sinus region. In this manuscript, we report the findings of a case in which such a tumor appeared in the maxillary sinus and also destroyed the maxillary bone and thus was mistaken for a malignant tumor.

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CO₂ laser surgery was performed on 68 patients with severe perennial allergic rhinitis. We evaluated the effectiveness of CO₂ laser surgery in 40 cases based on a questionnaire survey. The inferior turbinates were vaporized with a defocused beam at 5 W under local anesthesia. The effective short-term was 65% for sneezing, 75% for nasal discharge, 81% for nasal obstruction and 80% for nasal symptoms overall. However, excellent effective rate was low in the patients who suffered for a long time. There were few complaints of pain in the patients who underwent CO₂ laser surgery. In addition, many patients also hoped to undergo CO₂ laser surgery again. In conclusion, CO₂ laser surgery was found to be a safe and useful treatment for severe perennial allergic rhinitis, however, a long-term follow-up is necessary to evaluate the effectiveness of this operation.

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Schwannoma is rare in the oral cavity, although this tumor can occur in virtually in any part of the human body. We, herein, report two cases of Schwannoma which originated in the tongue. The first case was a 33-year-old male who visited our hospital with the chief complaint of a mass and pain on the right side of his tongue. A firm submucosal tumor with a smooth surface was found on the right side of his tongue. The tumor was removed with a YAG LASER under general anesthesia in February 1993. The tumor measured 20×15×15mm in size. A histological examination showed the tumor cells to have a palisading cellular arrangement of Antoni type A cells which were positive for S-100 protein. This tumor was thus diagnosed to be a Schwannoma in the tongue. The second case was a 47-year-old female who presented with a mass on the left side of her tongue. The tumor was removed under local anesthesia in June 1996. The tumor measured 22×17×13mm in size. It was also histologically diagnosed to be a Schwannoma in the tongue. After surgery no evidence of tumor recurrence has been seen for 5 years in the first case and for 20 months in the second case.

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An oncocytoma consists of large cell bodies with eosinophilic granular cytoplasm. This tumor is very rare and generally originates from the salivary gland. The cytoplasm is characterized by abundant mitochondoria electoronmicroscopically. We, herein, report a 73-year-old man who presented with a left mass in the parotid region. MRI scanning showed a high or low density area and the accumulated Gd in the solid mass was quickly enhanced. The accumulated sodium pertechnate Tc^99m of the tumor showed a high contrast. Both recurrences and malignant changes in these tumors have occasionally been reported. A surgical excision with an adequate safety margin is thus considered to be necessary for the effective treatment of such cases.

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We studied fleroxacin for its utility in four patients with chronic sinusitis at sinectomy. After the oral administration of 300mg of fleroxacin, the serum and maxillary sinus concentrations were determined. The mean serum concentration was 2, 56μg/ml at 2 hours after administration, 1-69μg/ml at 6 hours after administration, and 0.78μg/ml at 24 hours after administration. The mean concentration of maxillary sinus mucosa was 2.99μg/g. Based on the above results, fleroxacin is thus considered to be rapidly absorbed after oral administration and is also well distributed into the maxillary sinus mucosa. lts clinical efficacy was also found to be good in all four patients and no side effects were observed in any of the patients. We therefore considered fleroxacin to be a safe and useful drug for chronic sinusitis at operation.

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A rare case of pharyngolaryngeal stenosis after the conservative therapy of laryngeal cancer is reported. A 69-year-old male visited our hospital complaining of stridor, hoarseness and dysphagia. He have had a laser excision and radiotherapy for laryngeal carcinoma 8 years before, and a microlaryngeal surgery using laser for laryngeal stenosis a year before. Flexible fiberoptic laryngoscopy and fluoroscopical examination revealed the adhesion of epiglottis to bilateral wall of the mesopharynx and extreme stenosis of the aerodigestive tract. This case was repaired using the pedicled epiglottic mucosal flap.

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A 40 year-old man had suffered from breathy hoarseness for 6 years since left parapharyngeal vagal neurilemoma was extirpated. Paralytic vocal fold was fixed between the median to paramedian position. Although the left vocal fold was slightly abducted (paradoxical movement) when raising his voice, the posterior glottis was closed during sustained phonation. He was performed thyroplasty type I because of atrophy of the paralytic vocal fold and little positional difference in vertical direction between the bilateral vocal fold. His voice was improved after the operation. However, he complained of dysphonic vocal onset. Videostroboscopic examination revealed more prominent paradoxical movement of the left vocal fold than that before the operation. Therefore, we consider that the combination of thyroplasty type I with transection of the recurrent laryngeal nerve branch of the posterior cricoarytenoid or the muscle itself is required to eliminate paradoxical movement of the paralytic vocal fold.

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Lateral cricoarytenoid muscle (LCA) pull operation has developed by Iwamura for unilateral vocalfold paralysis. This operation has conducted through the thyroplasty window created just anterior to the oblique line. Several pieces of stitches are passed and tied at different points of the LCA bundle. This is an easy procedure to approach the arytenoid cartilage. 6 patients of unilateral vocalfold paralysis underwent LCA pull operation from April 1997. The post-operative results were satisfied in 5 cases. The remaining one underwent thyroplasty type I three mounts after the first operation.

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