[in Japanese]

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We herein report a patient who underwent the cochlea implant surgery for profound deafness due to the suicidal ingestion of permanent wave liquid. Bromate salt, which is the main constituent of the cold permanent neutralizer liquid, causes acute renal dysfunction, which may be fatal. Many such survivors suffer from irreversible and profound sensorineural deafness. In this case, the comprehension of oral language was fairly good immediately after starting a rehabilitation program, probably due to the short duration of deafness. During the 4 years of observation, the patient had no difficulties in daily conversations and was able to achieve a comnlete return to his original occupation.

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We herein report a case demonstrating a giant cell tumor of the external auditory canal. The patient was a 54-year-old male whose chief complaint was a sensation of fullness in the ear. The tumor was spherical and demonstrated no tenderness. We resected it under local anesthesia without recognizing any adherence to the bone. There has been no evidence of recurrence for a year after the operation. Giant cell tumors of the external auditory canal are extremely rarely observed, and only 3 such cases, including the present case, have been previously reported. We also describe the statistical data for the cases of benign tumors of the external auditory canal that we operated on in our hospital. The results are as follows; 1) There have been 39 such cases over the past 13 years. 2) epidermal cysts (11 cases) were observed most frequently. 3) The next most frequent cases were nevus (7 cases), papilloma (5 cases) and others.

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Allergic Rhinitis of children has generally been reported based on investigations at large hospitals until now. At this time, however, we investigated allergic rhinitis in children who has consulted general practice ENT clinics in the Osaka area based on a questionnaire survey. 155 children (110 boys and 45 girls) under 15 years of age were included in this examination. The onset of rhinitis tended to be earlier in boys than in girls. Over 60% of the cases had other atopic diseases in their past history. About 90% of all cases showed rhinorrhea and nasal obstruction, and 60% also showed ocular symptoms. The positive rates of allergens were 91.4% for house dust, 91.2 for mites, 45.6% for Japanese cedar 38.9% for Japanese cypress and 38.2% for orchard grass. There was no significant correlation between the specific IgE antibodies and the eosinophils in a nasal smear. These results were almost the same as those of previous findings based on studies conducted at large hospitals.

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Complications of squamous cell carcinoma and leiomyosarcoma, as well as the occurrence of leiomyosarcoma alone in the larynx are very rare. We herein report two cases that showed an asynchronous growth of these tumors in the larynx. Case 1 demonstrated leiomyosarcoma first and thereafter developed squamous cell carcinoma. Case 2 first displayed squamous cell carcinoma and was treated by irradiation, then he later demonstrated leiomyosarcoma, which thus was initially considered to be associated with the previous radiation treatment, however, this possibility was later ruled out because of the short duration between the irradiation treatment and the appearance of the second tumor. An accurate diagnosis of laryngeal leiomyosarcoma is often hard to make because of the difficulty in making probes or performing histopathological examinations, and this disease is usually resistant to both chemotherapy and radiotherapy, while also demonstrating distant metastasis. It is therefore recommended that leiomyosarcoma in the larynx should be quickly diagnosed and treated by surgery while carefully distinguishing it from squamous cell carcinoma which is sensitive to irradiation in strong contrast to the radio-resistant character of leiomyosarcoma.

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We herein report the efficacy of bite training for Duchenne's muscular dystrophy (DMD). The subjects consisted of 7 patients with DMD, with a mean age of 20.1 years (range: 16 to 28 years). The occlusal force before training was compared with that after 6 months of training. Thereafter, in 6 patients in whom training could be continued, we examined the changes after 12 months of training. For training, both thermotherapy and stretching were performed. For measurement purposes, we used the OCCLUSAL FORCE-METER GM10. The occlusal force in the patients with DMD was thus found to be markedly lower than that in healthy adults. Training for 6 months increased the occlusal force from 61.1±40.9N to 90.0±32.2N (p<0.001). After 12 months of training, the occlusal force in the 6 patients (80.4±38.6N) was significantly higher than that before training (56.0±42.0N)(p<0.05). This study suggests that bite training is therefore useful for improving the occlusal force in DMD patients.

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We tried to clarify the differences between two types of extraesophageal manifestations, cough and globus sensation, in gastroesophageal reflux disease by analyzing both the pre-treatment questionnaire and symptom diaries. Patients who were treated in various ways as gastroesophageal reflux disease and recovered from their symptoms were enrolled in the group of patients suffering form gastroesophageal reflux disease. The patients in the cough group (n=32), whose chief complaints were cough symptoms, had a significantly more frequent drinking habit (p<0.05) but less frequent experiences of heat burn in comparison to the patients in the laryngoesophageal group. In comparison to the patients in the cough group, the patients in the laryngoesophageal group (n=20), whose chief complaints were globus sensations, felt more frequent belching and more frequent regurgitation. However, the patients in the laryngoesophageal group also felt less frequent heart burn, even though the total number of heart burn experiences were found more frequently in this group. Both symptoms were observed in more than 75% cases in both groups. In addition, 93% cases in the cough group felt relatively-mild globus sensations in comparison to their chief complaints. In contrast, 41% cases in the laryngoesophageal group felt cough as well or worse severity of chief complaints. As the chief complaints improved, the other symptoms also tended to improve in more than 80% of all cases in both groups.

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We treated 23 male and 25 female patients (ranging from 22-87 years of age, 57 years in average) with an abnormal sensation in the throat (AST) possibly due to gastroesophageal reflux disease (GERD) using an oral proton pump inhibitor (PPI), lansoprazole 15mg/day, for 2 weeks. The complete cure rate for heart burn (a typical symptom of GERD) was 80% which was considered to be a satisfactory rate of success. However, the rate for AST was relatively low and limited to a 23% success rate. The efficacy of medication for heart burn therefore very weakly correlated with that for AST (Spearman's p=0.47, p=0.06). An increase in daily dosage of PPI or the prolongation of the medication period may possibly increase the complete cure rate for AST, as described elsewhere by other authors. As a result, the treatment of patients with AST and concomitant GERD symptoms by the administration of lansoprazole was therefore found to effectively improve their quality of life.

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Laryngopharyngeal reflux (LPR) is caused by the retrograde flow of gastric contents into the larynx and hypopharynx and then such contents come into contact with the tissues of the upper aerodigestive tract. In order to quantify these LPR symptoms, we used a scoring system based on the Reflux Symptom Index as proposed by Belafsky et al. The aim of this study was to discuss the advantages and disadvantages of using this scoring system to evaluate the effectiveness of acid suppression therapy in LPR patients.

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