The gustatory function in patients with Bell's palsy is sometimes observed to decreased after electrogustometry, not only on the affected side but also on the normal side. When we examined the taste function of 111 patients with Bell's palsy, 42% of them also showed a decreased taste function on the normal side. In addition, about 90% of all patients who showed a decreased taste function on the normal side also presented almost the same course as on the affected side. We considered that this fact might have been caused by the possibility of either a subclinical lesion on the normal side of the patients with Bell's palsy, technical problems or psychological factors.

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The vestibular evoked myogenic potentials (VEMP) by air conduction (AVEMP) are absent when the air-bone gap is more than 15dB. In these cases, the VEMP by bone conduction (BVEMP) are usually utilized instead of the AVEMP. The best stimulation frequency in the BVEMP was evaluated for 9 frequencies (75Hz-8,000Hz). At three frequencies (500, 700 and 1,000Hz), BVEMP was present in all test subjects. No statistical differences were observed among the amplitudes of the BVEMP at these three frequencies. These findings suggested the stimulation frequency from 500 to 1,000Hz to therefore be appropriate for BVEMP.

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We performed an analysis of the clinical features of sensory neural hearing loss (SNHL) patients, consisting of 52 patients and 57 ears. Some of the SNHL patients were positive for the glycerol test and such patients tended to demonstrate either high tone hearing loss or no laterality. We presumed that there were several patients likely expressed Endolymphatic hydrops. However, 44% of the glycerol test positive patients showed an improvement after isosorubide treatment. Conversely, some of the negative patients showed a good response to the isosorubide treatment. We should therefore more actively perform the glycerol test for SNHL patients whose disease is not suspected to be a more common variation of Endolymphatic hydrops, such as Meniere's disease and low tone sensory neural hearing loss. We therefore recommend that patients showing a positive finding for the glycerol test should thus be treated for Endolymphatic hydrops using isosorubide.

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We evaluated the safety and efficacy of coblation-assisted uvulopalatoplasty (CAUP) in the treatment of sleep-disordered breathing (SDB). Ten patients with SDB were included in this study. In addition to CAUP, sub-mucosal coblation was performed on the soft palate, tongue base, and tonsils according to the obstruction patterns as determined by dynamic MRI or fiberscopy. Postoperative pain was assessed using a visual analogue scale until 14 days after surgery, and compared among the CAUP-treatment group, UPPP-treatment group, simple tonsillectomy group, and simple(sub-mu-cosal) coblation group. The snoring score and the Epworth sleepiness scale (ESS) were measured before and at least 12 weeks after the completion of each treatment. No significant difference was observed in the pain between the CAUP-treatment group and the UPPP-treatment group from 3 days to 14 days after surgery. Postoperative pain in the simple coblation group was significantly reduced in comparison to that in the UPPP treatment group (p<0.01) for 1 day after surgery. After the completion of CAUP, the ESS was significantly (p<0.05)improved from 12.6±5.7 to 7.6±4.9. In addition, the snoring score significantly (p< 0.01) decreased from 8.1±0.9 to 3.4±1.3. The overall satisfaction from the CAUP procedure was 70% (7/10). In conclusion, CASUP was thus found to be a safe and effective treatment for SDB, especially for the treatment of simple snoring and mild OSAS.

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A case of craniometaphyseal dysplasia (CMD), which is one type of inborn cranium dysplasia, is herein reported. A 4-year-old boy visited our clinic complaining of a facial spasm. Although the pure-tone audiometry findings were with the normal range, elongations in the latencies of both the I- and V-waves, and of the I-V inter-peak latency were observed in ABR. Both external canals had become narrow but the eardrums could be observed and showed no significant problems. On a temporal bone CT scan, however, cranium cortical hyperplasia, the disappearance of the paranasal sinus, and the stenosis of both external and internal auditory canals were noted. The patient revisited our clinic at 6 year of age with a complaint of a progressive hearing loss that was confirmed by pure tone audiometry. Neither side of both eardrums could be observed due to progressive stenosis of the external canal. A re-examination of the temporal bone CT findings showed progressive stricture in both the external and internal auditory canals. The widened metaphyses of the long bones of the upper arm and the crura was observed, thus leading to a diagnosis of CMD. A bone conductive hearing aid was therefore applied to improve his hearing loss. The symptoms in such cases have been reported to progress after operative intervention. In addition, no post-operative long-term findings have yet been reported. In the follow-up, neither infection nor cholesteatoma have been observed.

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We evaluated the effectiveness of cetirizine in 17 patients with perennial allergic rhinitis who consulted the otolaryngology department at Kurume University from March 2001 to May 2002. We assessed the changes in the nasal symptoms and the eosinophil counts in nasal secretion before and after the treatment with cetirizine 10mg for 4 weeks. Our findings showed that three principle symptoms of allergic rhinitis, namely sneezing, nasal secretion and nasal congestion, all significantly improved after the treatment in comparison to baseline values. Furthermore, the eosinophil counts in the nasal secretion decreased significantly after the treatment. Regarding the relationship between the nasal symptoms and the eosinophil counts, although no signicant correlation was seen between the nasal symptoms and the eosinophil counts, or between the improvement in the nasal symptoms and the changes in the sosinophil counts, the nasal congestion score and the improvement in nasal congestion tended to correlate with the eosinophil count.

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The present study was undertaken to evaluate the effectiveness of ebastine (Ebastel®) in patients with Japanese cedar pollinosis, using the Japan rhino-conjunctivitis quality of life questionnaire (JRQLQ). The subjects of this study consisted of 524 patients who visited our hospitals and clinics during the peak pollen exposure season in 2004 (between March 1 and 14). After excluding any patients falling under the exclusion criteria, the patients who had taken ebastine once daily prior to entering this study were classified as the treated group, while the patients without any previous treatment were classified as the non-treated group. As a result, the treated-group consisted of 138 sub-jects while the Non-treated group comprised 198 in our analysis. Nasal and ocular symptoms (nasal discharge, sneezing, nasal congestion, nasal itching, ocular itching and lacrimal hypersecretion) were all significantly less severe in the treated group than in the non-treated group. Regarding the QOL (17 items), all items except for “difficulty in going out” were significantly more favorable during the peak pollen exposure season in the treated group than in the non-treated group. In analyzing the scores of each QOL category (daily living, outdoor activity, social activity, sleep, physical condition and mental condition), the score of each category was significantly better in the treated group than in the non-treated group. In addition, in an assessment using the facial scale (the total combined scores of the nasal symptoms, ocular symptoms and QOL), the score was also significantly better in the treated group. These results therefore showed that ebastine prophylactic treatment for Japanese cedar pollinosis resulted in a significant alleviation of the clinical symptoms and also demonstrated a significantly improvement in the patient QOL based on the findings of the JRQLQ.

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The existence of Cryptomeria fortunei, which has the same genus and the same family as the Japanese cedar, has been demonstrated by a DNA analysis. Moreover, our observations showed, for the first time, a case of cedar pollinosis caused by Cryptomeria fortunei. Our investigation was the first to identify a Japanese man who showed symptoms of pollen allergy caused by Chinese cedar, namely Cryptmeria fortunei. This finding verifies that both Cryptomeria japonica and fortunei have the same origin.

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We investigated the effectiveness of fexofenadine in 32 patients with perennial allergic rhinitis based on the nasal rhinoscopic findings, a questionnaire regarding nasal symptoms, and the Japanese Allergic Rhinitis Standard Questionnaire (JRQLQ). After the two-week administration of fexofenadine (60mg) daily, both the nasal symptoms (sneezing, rhinorrhea, and nasal obstruction) and the nasal findings significantly improved. Moreover, the patients' general state and 4 of 17 categories (reduced productivity and work/home, poor mental concentration, impaired sleeping, tiredness) in the JRQLQ all significantly improved. These results suggest that fexofenadine therefore appears to effectively improved both the QOL and the nasal symptoms associated with perennial allergic rhinitis.

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