A survey on neonatal hearing screening in Fukuoka prefecture was conducted using a questionnaire administered to the related facilities for screening, diagnosis, and education. The questionnaire was estimated to cover about 51% of all newborns in Fukuoka prefecture. Neonatal hearing screening was done for 81% of newborn infants. Among the infants who were diagnosed to require a referral, 31% could not be followed after leaving the first facility. More than half of the referred infants were not introduced to the ENT. Definite diagnosis of a hearing impairment was made by non-otorhinolaryngologists in 32% of the cases. In addition, 10% of the referred infants visited the clinic more than 3 months after the screening. To provide both post-screening care for the mother and early intervention for the infants, a system to control the overall data with the consensus by all participating facilities needs to be established.

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We evaluated the effectiveness of surgeries including a cricopharyngeal myotomy in 12 patients who suffered from dysphagia, and re-evaluated the indications for undergoing such surgery based on the findings of ineffective cases. Three of the 12 cases showed ineffective results, and videofluorography of these cases showed the poor coordination in the elevation of the larynx, the contraction of the pharynx, and the opening of the pharyngoesophageal junction, and such symptoms are typical of aphagia. We therefore should strictly consider the indications of this surgery based on a precise evaluation of the swallowing initiation by means of preoperative videofluorography.

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A medical imaging processing system provides the capability for an otolaryngologist to independently perform a real-time image diagnosis on temporal bone lesions. This system was used to produce simulation pictures of tympanoplasty and cochlea implantation and they are presented as representatives of temporal bone surgery. Because these simulation pictures were produced by a medical imaging processing system rather than a computer-based image simulator, there were various limitations. However, this system provided valuable information on the temporal bone surgical anatomy for each individual case to ensure that these operations could thus be conducted safely. Therefore, this system provides a useful simulation system to both teach and improve the surgical techniques of otolaryngologists.

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We developed a new grading system to understand the complicated pathological changes of cholesteatoma in comparison to those of chronic otitis media. This grading system, based on the extent of the cholesteatoma and the surrounding pathlogical changes, is able to simply express the entire pathological condition of the ear with cholesteatoma. Using this grading system, we analyzed the ears of 48 children with cholesteatoma, who underwent tympanoplasty over the past ten years. Their ages ranged from 2 to 15 years with an average age of 8.5 years. The attic and mesotympanic cholesteatomas were associated with greater pathological changes than those observed in postero-superior quadrant cholesteatomas. The degree of the pathological change in the area surrounding the cholesteatoma appears to correlate with the degree of extention of the cholesteatoma. This system is thus considered to be useful for evaluating the improvement in the pathological conditions before and after surgery in patients with cholesteatoma.

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The CyberKnife (CK), a medical device for stereotactic radiotherapy, is composed of a linear accelerator (Linac), a robot manipulator and a TLS (Target locating System). This system has been applied for the treatment of cranial diseases (intracranial tumors, arteriovenous malformations). In addition, this system has been used for the treatment of head and neck tumors (nasal cavity, paranasal sinus, nasopharynx, mesopharynx, and oral floor), and spinal lesions. Between November 2002 and December 2005, 6 patients with nasal cavity and paranasal sinus malignant tumor were treated using this system. The primary lesions were located in the nasal cavity, ethmoidal sinus, frontal sinus, sphenoidal sinus, maxillar sinus, and intracranial lesion. Histopathologically, these 6 cases were categorized as squamous cell carcinoma, olfactory neuroblastoma, malignant malanoma, papillary carcinoma (metastasis of thyroid cancer), and cylindrical cell carcinoma. The average CK dose was 23 Gy. Among the 6 cases, 3 cases were CR and the others were PR. The response rate (CR×PR) was 100%. Adverse effects, such as olfactory anesthesia, pigmentation and skin inflammation were seen in 3 cases. Optic nerve dysfunction was not seen. The Gamma Knife (GK) requires a frame to fix the patients head, but CK does not. This allows the CK to deliver the radiation to a wider area than the GK. In addition, because the CK can deliver highly conformal radiation to lesions with a high accuracy, there is a significant reduction in the adverse effects. CK could be effective for the treatment of malignant tumors of the nasal cavity and paranasal sinus without affecting the function of these tissues, while also improving the QOL of the patients.

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The number of patients with mycosis of the paranasal sinuses is increasing due to the frequent administration of antibiotics or adrenocorticosteroids. Recently a case of aspergillosis of the paranasal sinus which spread to the orbit and the base of the skull was observed. The patient was a 76-year-old man with diabetes mellitus. He was diagnosed to have aspergillosis of the left maxillary sinus, and the patient underwent surgical treatment in this hospital. However he experienced headaches and cheek pains continually after the operation. Six months of the first treatment, he returned to the hospital following the development of acute visual impairment in his left eye. He was treated with a combination of surgical therapy, including ophthalmectomy and anti-fungal chemotherapy, however, he died due to cerebritis about two months postoperatively. Because invasive aspergillosis is so aggressive and the prognosis is very poor, it is critical that patients with this disease receive treatment immediately with combined therapy, including an ophthalmectomy.

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We herein report a case of a glomus tympanicum tumor occurring in a 57-year-old female who presented with right pulsatile tinnitus and hearing loss. An otoscopic examination revealed a reddish mass in the tympanic cavity through the tympanic membrane. Myringostomy was performed and severe bleeding was observed. The CT and MRI findings showed a tumor occupying the mesotympanium. The angiographic findings revealed the tumor-feeding artery to be the ascending pharyngeal artery. The tumor was completely resected using a transmetal approach without embolization. In order to resect the tumor safely utilizing this approach, it was important to secure a broad working space in the middle ear using extended standardized incisions of the meatal skin. The micro bipolar coagulater was therefore found to be very useful for controlling blood loss.

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Fifty-three patients who complained of a foreign body sensation of the larynx were treated with suplatast tosilate (IPD) between January 2004 and April 2005. The final subjective efficacy of IPD in the fifty three patients evaluated were as follows: excellent, nine patients ; effective, twenty seven patients; good, six patients and; poor, eleven patients. The effectiveness rates, inclusive of excellent, effective, and good efficacy comprised 79% of the patients. The efficacy of IPD was evident in an average of 2.3 weeks, and there were no remarkable adverse effect. It was therefore speculated that IPD is effective for the treatment of foreign body sensation of the larynx, mainly attributed to the suppression of IL-4 or IL-5 production from the Th2 type cell of the mucosa.

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