A cartinoid tumor is a tumor whose origin is mainly observed in the celenteronderived organs including the digestive tract, trachea, bronchus, etc., and such tumors occur very rarely in the middle ear. Only 9 reports have been previously made on such cases in Japan. In our case, a 60-year-old female visited our hospital with major complains of hearing difficulty and an occlusive feeling in her left ear. The patient was suspected to have a tumor or cholesteatoma in the middle ear and a tumor in the left tympanic cavity was thus extracted. A prompt pathological examintion, which was conducted during the operation, diagnosed the tumor to be a ceruminoma but an examination of a permanent specimen indicated a middle ear cartinoid tumor. The findings of this case suggest the necessity to include middle ear cartinoid tumors in the differential diagnosis when any tumors or lesions are observed in the middle ear.

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Traumatic perforations of the tympanic membrane is a common occurrence but little attention has so far been paid to the resulting audiometric changes. We studied changes in the bone conduction thresholds in 5 cases immediately after the onset of trauma and after recovery. On average, sensorineural hearing loss of about 18dB was found in all of the measured frequency ranges. Hearing loss showed a partial recovery, and the recovery was larger in the lower frequencies. We postulate that such hearing loss is due to a temporary or permanent threshold shift (TTS or PTS) caused by sudden and vigorous physical pressure applied to the cochlea.

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Anomalies of the middle ear without any congenital anomalies of the external ear has not been frequently observed. We encountered 14 ears with a congenital anomaly of the middle ear without any external ears and maxillofacial anomalies. They were classified into three groups as follows: 1) an anomaly of the long limb of the incus, 2) Fixation of the base of the stapes, and 3) A loss of the bottom structure of the stapes. The average preoperative hearing level of each groups was as follows: group 1 was 42dB, group 2 was 55dB and group 3 was 71dB. All 14 patients underwent operations for these anomalies. The results were satisfactory and the postoperative hearing improved to about 20dB in all 3 groups. These findings demonstrate that skillful and careful surgical procedure can thus result in an improvement in the hearing of patients with such middle ear anomalies.

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The incidence of retropharyngeal abscess has decreased thanks to advances in antibiotic treatment. We recently experienced the case of a retropharyngeal abscess in a 32-year-old man whose main complaint was peritonsillitis. Ten days after being treated for peritonsillitis, he complained of neck pain and a restricted neck movement while rotating his neck. A diagnosis of retropharyngeal abscess was made from the findings of a CT scan and antibiotics were thus administered intravenously. The patient recovered from the disease within a week without any incision. We reviewed 52 cases of retropharyngeal abscess, including our own case, that have been reported in Japan since 1988. We discussed the age, causes, bacterial examination, usefulness of a CT scan, and the optimal treatment for this disease.

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A 65-year-old male, who had a history of radiotherapy to the neck for cervical metastasis of nasopharyngeal carcinoma 8 years previously, newly complained of severe throat pain and dysphagia. He was found to have diffuse pharyngitis and pharyngo-cutaneous fistula. A CT examination showed a necrotic shadow of the thyroid cartilage. A recurrence of the carcinoma was ruled out based on the findings of a biopsy specimen. Both the clinical course as well as the local and histologic features led to a diagnosis of delayed radionecrosis of the larynx. The necrotic thyroid cartilage was resected and the pharyngocutaneous fistula was closed using a deltopectoral flap and, as a result, the laryngeal functions were preserved.

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Recurrent laryngeal nerve (RLN) paralysis is sometimes caused by thyroid malignancy, but it is rarely found in preoperative case of benign thyroid disease. A 65-year-old woman complained of an anterior neck swelling at the initial medical examination. Two weeks later, she complained of anterior neck pain, hoarseness and dyspnea, and left RLN paralysis was thus diagnosed. CT scans revealed a huge cystic mass in the left paratracheal region. Fine -needle aspiraion (FNA) was performed and the fluid aspirate was dark-brown and clear. An emergency operation was therefore performed. The RLN paralysis completely recovered within 2 months after the operation. The measurement of thyroglobulin concentration in the fluid aspirate was 24,000,000ng/ml and the pathological diagnosis was a thyroid cyst. The possible mechanisms of RLN paralysis are thus considered to be compression and stretching of the RLN due to the cyst and inflammation spreading from the cyst to RLN.

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Endolymphatic hydrops was surgically created in guinea pigs. The eighth cranial nerve Compound Action Potential(CAP)for click sounds of altered polarity were measured chronologically. At the early stages after surgery, the latency for condensation sounds became longer, and the latency sounds for both condensation and rarefaction sounds became longer at the later stages. However, the difference in the latency for rarefaction and condensation sounds(rarefaction minus condensation)became larger by the first week after surgery, but no more changes were noted thereafter. As a result, we postulated that hydrops occurs in the early stages after surgery resulting in a downward displacement of the basilar membrane. Furthermore, the downward displacement of the basilar membrane by condensation is more restricted than the upward displacement by rarefaction, thus causing the longer latency for condensation. At the later appear to occur very slowly. Compared with latency, the changes in the amplitude of the CAP were rather rapid and progressive with respect to time, thus suggesting the involvement of damaged outer hair cells.

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growth of neuronal cells in spiral ganglion cells (SGC). Neurotrophic factors such as brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4) are known to both independently and synergically affect the survival of SGC in culture. In addition to neurotrophins, interleukin-6(IL-6)has also been reported to participates in the survival and growth of many nervous systems such as the dorsal, motor neuron and autonomic systems. However, the effect of IL-6 in the auditory nervous system still remains obscure. We therefore consider it to be important to investigate the survival effect of IL-6 on SGC. In the present study, we used C57BL/6j mice (5 days after birth). The SGC were cultured in DMEM with IL-6 and/or NT-3. The count of the survival cells in culture with IL-6 increased significantly compared to the controls. The survival cells in culture with both IL-6 and NT-3 together showed significant increases compared to IL-6 alone. These results suggest that IL-6 clearly the survival of SGC along with other neurotrophic factors.

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We tried to investigate the effectiveness of Faropenemsodium (FRPM) in the treatment of infections otorhinolaryngological disease. FRPM was administered to 91 patients. Clinical efficacy was 65.5% (21/32 cases) n ear diseases, 81.8% (18/22) in nasal diseases, 78.8% (26/33) in pharyngeal and laryngeal diseases, 75% (3/4) in other diseases (acute parotitis 1/1, lymphadenitis 2/3). The total clinical efficiency was 74.7% (68/91). All patients were divided into 4 groups in order to evaluate the additional effects of treatments other than FRPM as follows: 1) 55% (11/20) received FRPM alone 2) 84.1% (37/44) received FRPM and analgesics 3) 80% (8/10) received FRPM and local treatment 4) 70.6% (12/17) received FRPM as well as both analgesics and local treatment. Side effects were only observed in two cases who developed diarrhea, however, no serious side effects were seen. Bases on these findings, we consider FRPM to be a useful chemotherapeutic drug for the treatment of infections disorders in the field of otorhinolaryngology.

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