A total of 65 ears from 45 patients with otosclerosis who underwent stapes surgery at our institute are herein reported. Regarding the type of operation, 44 ears underwent a stapedotomy while 21 ears had a stapedectomy. Children under 10 ears (15.4%). Successful ears, which were considered to be those which showed a 15dB or more hearing gain, or a reduction of air-bone gap within 15dB, or hearing levels within 30dB, postoperatively, and included 56 of the 65 ears (86.1%). In addition, 42 ears in which the air-bone gap was closed to within 10dB were considered to show a significant improvement. Most of the successful ears showed an improvement within 1 to 3 months after the operation and thereafter remained continuously stable. No apparent difference in the improvement in the hearing levels between stapedotomy and a stapedectomy were recognized, but the former modality did demonstrate fewer complications than the latter. A professional rock drill operator lost his hearing in one ear due to oval window fistula which had been caused by chronic vibration 3 years postoperatively. As a result, cases who have an opportunity to come in contact with chronic and hard vibrations, such as the above patient, should teherfore be carefully examined over a long period of time for the presence of oval window fistula after operation.

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A 64-year-old male visited our hospital complaining of a sore throat with tonsillitis, along with pain and swelling of the right face and neck region. A CT scan showed a gas-forming abcess in the right face and neck region. A facial and deep cervical infection thereafter rapidly spread to the surrounding tissue within a short time. The patient was immediately treated with antibiotics and surgical drainage of the deep neck abcess. Thereafter, he rapidly recovered from his symptoms and fully recovered by 7 weeks after the onset of the disease.

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A 62-year-old man with angiotensin converting enzyme (ACE) inhibitor-induced severe angioedema is herein reported. This patient with a history of hypertension was treated with enalapril, and the edematous lesions on the tongue, and laryngeal tissue on the submandibular area suddenly occurred about one week after the start of the treatment. The symptoms resolved after acute symptomatic supportive therapy and the withdrawal of enalapril. The literature on the ACE inhibitor-induced angioedema is also briefly reviewed.

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Hotyuekitou proved to be effective in treating three cases suffering from snoring, hoarseness and dysphagia. Case 1. A 75-year-old male had been suffereing from hoarseness and difficulty in phonation for 1 year. A slit formation between his vocal cords on phonation was observed. His voice was slightly breathy and maximum phonation time was 15 seconds. After he took Hotyuekitou for one month, his hoarseness recovered, and the maximum phonation time increased to 25 seconds and the slit formation between the vocal cords on phonation disappeared. Case 2. A 48-year-old female suffered from snoring without sleep apnea. She did not have either a nasal obstruction nor upper respiratory tract obstruction. As a result, her snoring was considered to be due to muscle tension weakness of soft palate and tongue during sleep. After she took Hotyuekitou for 1 week, her snoring remarkably decreased. Case 3. A 71-year-old female suffered from snoring without sleep apnea, languid sensation of limbs and a sleepy feeling after meals. She also complained of dysphagia for 3 months duration. Her dysphagia was considered to be due to her old age. All the symptoms decreased after she took Hotyuekitou for 2 months. Hotyuekitou is said to intensify both muscle tension and contraction. In these three cases, muscle tension and contraction in the soft palate, tongue, pharynx and larynx all were strengthened by Hotyuekitou, which thus led their symptoms to either decrease or disappear.

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Salivary gland hemangiomas in the adult are uncommon tumors and have been rarely reported in the submandibular gland. In Japan, only two cases of hemangioma originating in the submandibular gland have so far been reported. In this report, a case of cavernous hemangioma in the submandibular gland of a 50-year-old man is presented. Although the clinical features appear to be chronic sialadenitis with cystic degeneration, a benign tumor originating in the submandiblular gland was radiologically suspected. A well-defined vascular cystic tumor was surgically identified within the submandibular gland. The surgical specimen revealed cavernous hemangioma with chronic sialadenitis. Since surgery, the patient has shown a favorable prognosis.

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We investigated the relationship between an abnormal sensation of the the pharynx and larynx (ASPL) and gastroesophageal reflux (GER). We examined GER using the RI method, since this method can diagnose the disease both physiologically and objectively. GER was recognized in 31 of these 46 cases who showed no signs of improvement despite regular medication under a diagnosis of ASPL. We made four conditions for the RI examination as follows ; (a) a sitting position before meals,(b) a supine position before meals,(c) a sitting position after meals, and (d) a supine position after meals. GER occured most frequently in the sitting position after meals (c) as a result. GER measuring more than 20cm in length was also the most frequently observed, particularly in condition (c). The reflux showed a spike pattern in the sitting position, and a delayed pattern in a supine position in many cases. Concerning local findings, GER was found in 5 of these 6 cases who demonstrated a retention of saliva in the pyriform sinus, when all were in condition (a). On the other hand, GER was found in 11 of these 13 cases who presented with redness of the arythenoid, and it occurred after meals in 10 of these 11 cases since GER measured more than 20cm in length in 5 of these 10 cases, we thought that the reflux could reach the inferior pharynx and larynx. Moreover, GER measured more than 20cm in length in all 3 cases in the supine position after meals (d) in which a delayed pattern appears. We therefore think that the longer that the reflux contents stagnate, the more it may harm the mucosa and thus eventually resulting in ASPL.

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Although the sensory conflict theory has been used to clearly explain the occurrence of motion sickness, the following questions remain to be elucidated: Is the classification of conflicts possible? Does it fully elucidate the mechanism of autonomic reactions? Is it true that the vestibular system is indispensable for motion sickness ? Based on my findings, the answers to these questions are all no. In contrast, my findings indicate that an equilibrium disturbance plays an important role in motion sickness.

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1) In order to clarify the characteristics of the ear fullness, the epidemiological study of the cases with ear fullness was carried out in comparison with that of the cases with tinnitus. The cases with ear fullness are predominantly seen in, unilateral, female, with conductive deafness cases such as chronic otitis media and exudative otitis media, with mild hearing loss, and with low tone deafness. In addition, there are juvenile cases. 2) In fifteen fresh sudden deafness cases (hospitalized patients), the prognosis and the correlation of hearing level and hearing loss, tinnitus, and ear fullness of the visual analogue scale (VAS) were analyzed. Most of these cases complained of tinnitus and ear fullness. There are no correlation between hearing level and VAS of tinnitus and ear fullness. However, there is some correlation in VAS of tinnitus and ear fullness.

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