Forty-eight children with cholesteatoma underwent tympanoplasty with canal wall reconstruction over the past ten years. Their ages ranged from 2 to 15 years (average age, 8.5 years). To evaluate the postoperative results, our new grading system for analyzing pediatric cholesteatoma was applied. Residual cholesteatoma was found in five cases (10%) during the second operation. Four of those five cases demonstrated mildly extended cholesteatoma at the first operation. On the other hand, reccurent cholesteatoma was found in two cases (4%) after the first operation. Both of these cases demonstrated severely extended cholesteatoma at the first operation. Reaeration of the middle ear cavity after the operation was obtained in 17 (59%) of 29 cases with severely extended cholesteatoma. Reaeration was significantly better in children less than 10 years of age in comparison to those over 10 years of age. Therefore, the postoperative results were better in children with mildly to moderately extended cholesteatoma or in those younger than 10years of age. In addition, the present results indicate that even in children over 10 years of age with severely extended cholesteatoma, tympanoplasty with canal wall reconstruction is therefore considered to be a safe and effective treatment modality which makes it possible to achieve stable ears with better hearing.

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The fine structures of the inferior turbinate mucosa were examined using Narrow Band Imaging (NBI) to identify any changes following the administration of 0.02% epinephrine spray (Bosmin Spray). 1) A well developed capillary network was noted over the surface of normal inferior turbinate mucosa. 2) The capillary vessels showed an ansate or wavy pattern of coursing in the anterosuperior end of the inferior turbinate. 3) The capillary networks of the surface of the inferior turbinate mucosa and of the nasal septum constrict about 3 minutes after being treated with Bosmin spray. 4) The capillary network on the surface of inferior turbinate mucosa begins to dilate after a lapse of 4 minutes after the administration of Bosmin spray in some cases. As a result, it is therefore advisable to to observe the surface of inferior turbinate mucosa for 3 minutes after administering Bosmin spray.

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Basal cell carcinoma is the most common malignant tumor arising in elderly people. It often occurs in the midface region, especially the nose. The main treatment of basal cell carcinoma is primarily a surgical resection. The removal of the tumor usually results in a defect, which thus affects the QOL of the patients. However, a defect of the nose is difficult to reconstruct due to both functional and aesthetic problems. We herein describe the case of a 54-year-old male with basal cell carcinoma of the nose. We successfully used an auricular helix free graft to reconstruct the defect of the nose after performing a resection of the carcinoma.

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At Takarazuka Municipal Hospital, Burow's solution has been prepared by two methods. These preparations have been shown to have a high antibacterial action in vitro, however, so far there has been little information available regarding the efficacy of this solution in clinical use. In this study, the effects of two Burow's solutions on the treatment of suppurative ear disease was examined. The number of subjects, who were treated with Burow's solution, included 26 ears of 19 patients in the Department of Otolaryngology at Takarazuka Municipal Hospital. Sixteen (61.5%), 7 (26.9%) and 3 (11.5%) ears were “cured”,  “improved”  and  “unchanged”,  respectively. No difference in the preparation methods and use were detected. All of  “unchanged”  cases had chronic perforative otitis media due to MRSA. In addition, no toxicity was observed in response to this treatment. These results suggest that Burow's solution is a safe and effective treatment for suppurative otitis.

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Background) Nasal obstruction is mainly caused by CysLTs and this most disturbing symptom is often observed in patients with Japanese cedar pollinosis. In this study, pranlukast, a cysteinyl-leukotriene receptor antagonist was administered to patients with Japanese cedar pollinosis as a pre-seasonal drug to investigate the therapeutic effects. Methods) Twenty-nine patients (10 male ; 19 female, mean : 43.8 year-old) were enrolled and divided into 2 groups, including a pre-seasonal medication group and an in-seasonal medication group. The pre-seasonal medication group using pranlukast was started 1 week before the beginning of the pollen season. In contrast, the other group used pranlukast plus epinastine hydrochloride, a selective H₁ -antagonist, without receiving any pre-seasonal medication. The symptoms, QOL and Symptom medication scores were thereafter compared between those two groups. Results) All nasal symptoms of the pre-seasonal medication group were observed to significantly decrease in comparison to the in-seasonal medication group for the first 4 weeks of the pollen season. The symptom medication score of the pre-seasonal medication group was also significantly lower than that of the in-seasonal medication group during the pollen season. The QOL scores for outdoor activities, social activities and sleep of the pre-seasonal medication group were also significantly lower than those of the in-seasonal medication group during the pollen season. Conclusion) These data suggest that pranlukast might therefore be a useful pre-seasonal drug for patients with Japanese cedar pollinosis.

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It is important to select a drug that enables patients to maintain good compliance for the treatment of allergic rhinitis. The most commonly used oral anti-allergic drugs must be taken once or twice daily. In the present investigation, we compared the medication compliance of once-a-day and twice-a-day doses for perennial allergic rhinitis based on the findings of patient questionnaires. Although compliance with both types was good and no significant differences were observed, females either tended to forget to or intentionally did not take the medicine in the morning while, in contrast, young patients tended to forget to do so in the evening. The reasons given for forgetting in the morning were being reported to be that they were too “busy” and some also did not take the drugs because they did not eat breakfast. On the other hand, the main excuses for forgetting in the evening was due to either “drinking” or “dining out”.

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