The relationship between the feeling of ear fullness and audiograms was analyzed in cases of unilateral sudden deafness in 227 ears comprising 47 ears with acute low-tone sensorineural hearing loss, and 180 ears with sudden deafness. Changes in the feeling of ear fullness based on a prognosis of hearing were also observed by following the course for up to two months after the fixation of hearing. As a result, the incidence of a feeling of ear fullness at the first medical examination was about 80% for all types of hearing. In addition, no significant difference was observed between the types of hearing, nor way any association with the hearing level found. The rate of concomitant feeling of ear fullness tended to be higher at the first medical examination in cases with a good hearing prognosis. However, the feeling of ear fullness in such cases showed a high rate of disappearance and such a feeling also tended to decrease quickly. The above results suggest that the feeling of ear fullness does not directly reflect the degree of degeneration and destruction of hair cells but it is instead an indirect phenomenon.

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Tracheoesophageal diversion is a good technique for patients with severe difficulty in swallowing and intractable aspiration pneumonia. In 1984 Krespi described this method for the treatment of the patients with pre-existing tracheostomies. Our method is a modification of Krespi's procedure, and is designed for patients who have undergone an upper level tracheostomy. We performed this procedure on two children and no post-operative complications were observed. Thanks to the effectiveness of this procedure, the patients were thereafter able to resume normal oral feeling and thus were able to achieve an improved quality of life.

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We herein report a case of cervical and mediastinal emphysema caused by a closed tracheal injury sustained during a Kendo (Japanese Fencing) match. A 13-year-old female was accidently injured on her neck during a Kendo match. After being injured, she continued to do Kendo because there were no symptoms at that time. Two hours after the injury, pain in both the neck and chest developed gradually. After admission, computed tomography showed neck and mediastinal emphysema. Both the pain and mediastinal emphysema improved gradually with rest and the administration of antibiotics during a 7-day period after admission. Patients who received a closed injury on the neck must therefore be carefully observed even if neither signs nor any immediate symptoms are observed.

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We experienced 3 cases of Castleman's disease (three different histopathological types) occurring in the head and neck region. Case 1 was a 70-year-old male with plasma cell type Castleman's disease in the right neck. Case 2 was a 20-year-old female with hyaline-vascular type disease in the right submandular region, and Case 3 was a 72-year-old male with mixed type disease in the right neck. Clinically, Case 1 was atypical while Case 2 was typical. As for Case 3, it was difficult to distinguish it from cervical metastasis of lung cancer. The second most common region of this disease is the head and neck region following the mediastinum. Although it is difficult to diagnose this disease preoperatively, we should take this disease into consideration whenever we diagnose head and neck masses.

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We investigated the relationship between a median dislocation of the superior horn of the thyroid cartilage and an abnormal sensation of the pharynx and larynx in 24 cases. A median dislocation of the superior horn was found on the right side in many cases, which did not always correspond to the region of the abnormal sensation of the pharynx and Iarynx-These symptoms usually decreased after the administration of a minor tranquilizer. Consequently, we concluded that a median dislocation of the superior horn of the thyroid cartilage is hardly related with an abnormal sensation of the pharynx and larynx.

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We report a 10-year-old male with neurinoma of the nasal septum. He complained of nasal discharge and left nasal bleeding. On anterior rhinoscopy, the left nasal cavity was filled with a mass. CT and MRI examinations showed a restricted mass in the anterior part of the left nasal cavity. Although a biopsy of the mass was attempted, we could not make a diagnosis. We therefore performed a surgical resection using a transnasal approach. The tumor was located in the left nasal cavity and originated from the anterior part of the nasal septum. The histopathological examination revealed typical findings of Antoni A and B type neurinoma.

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Neuroendocrine carcinoma and olfactory neuroblastoma of the nasal cavity, which contains neurosecretory granules, are extremely uncommon tumors. We herein report three cases of these tumors. Case 1: A 50-year-old man who presented with the chief complaint of right nasal bleeding was admitted to our hospital. A polypous mass between the right middle meatus and the nasal septum was detected. Immunohistochemical studies showed positive staining for NSE (neuron specific enolase), S-100, EMA (epithelial membrane antigen), and cytokeratin. From the results of immunohistochemical investigations, neuroendocrine carcinoma was highly suspected. The patient was treated by surgery, chemotherapy and radiotherapy. Case 2: An 80-year-old woman who presented with the chief complaint of right nasal bleeding and anosmia was admitted to our hospital. A brown tumor was seen in the right nasal cavity. Immunohistochemical studies showed positive staining for NSA and S-100. From the results of immunohistochemical investigations, the diagnosis was olfactory neuroblastoma and the patient was treated by surgery and radiotherapy. Case 3: A 73-year-old man who presented with the chief complaint of a right nasal obstruction and bleeding was admitted go our hospital. The right nasal cavity was filled with a polypous mass. Immunohistochemical studies showed positive staining for NSE, S-100, EMA and cytokeratin. From the results of immunohistochemical investigations, we diagnosed neuroendocrine carcinoma. The patient was treated by radiotherapy.

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The effectiveness of cetirizine prophylactic treatment for the health-related QOL for Japanese cedar pollinosis was investigated by a SF-36 questionnaire during peak pollen exposure periods. This study was performed in 3 areas of Japan: Osaka, Tokushima and Okayama over a two-week period from March 5 to 19, 2001. Patients who had taken 10mg of cetirizine once daily prior to entering this study were classified as the Treated group, while the patients without any previous treatments were classified as the Non-treated group. Seventy-three for the Treated group and 210 for the Non-treated group were selected for this study. As a result, all SF-36 subscales for the Treated group were higher than for the Non-treated group. The RP, VT, and RE scores for the Treated group were significantly higher than for the Non-treated group. In the Treated group, the patients with less than one week of treatment showed a lower score in most subscales, thus indicating that the longer the treatment period, the higher the QOL score. These results therefore showed cetirizine prophylactic treatment for Japanese cedar pollinosis to effectively improve patient QOL.

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