The aim of this study is to assess the efficacy of treatment with second-generation antihistamines and physician-patient communication using an original questionnaire for Japanese cedar pollinosis patients throughout the high-pollen season of 2009. Two hundred two patients were enrolled in this study. The patients ranged from 7 to 73 years of age (mean 32.5 years). The treatment was based on "Practical Guideline for the Management of Allergic Rhinitis in Japan" with minor modifications. The second-generation antihistamines were divided into two groups ; effect consideration type (olopatadine hydrochloride, cetirizine hydrochloride) and reduced drowsiness type (fexofenadine, loratadine etc). The effect consideration type of antihistamines provides greater relief of the nasal symptoms but with some CNS associated side effects (sleepiness, drowsiness). The antihistamines with reduced drowsiness relieve nasal symptoms with little or no CNS side effects. The effect consideration type of antihistamines treatment was selected for patients who chose to use them. The reduced drowsiness type of antihistamine treatment was selected for the patients that complained of CNS side effects. The questionnaire revealed that 61.2% of 202 patients selected the effect consideration type, whereas 32.2% of the cases selected the less drowsiness type. The effect consideration type was selected by 55% of 67 patients with mild to moderate nasal symptoms, whereas the effect consideration type was selected in 37% of those cases. In the effect consideration type was selected in 65% of 75 patients with severe nasal symptoms, whereas the effect consideration type was selected in 29% of those cases. The patients' satisfaction was excellent in 37%, satisfactory in 35%, N/A in 14%, relatively unsatisfactory in 12%, and unsatisfactory in only 2 %. This study showed that the original disease specific Questionnaire is a useful treatment tool and also demonstrated that Japanese cedar pollinosis patients were significantly satisfied with their treatment.

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The nutrition support team (NST) was established at our institution in 2006, and the otolaryngology department includes this eating / deglutition / oral care team. Patients with dysphagia often have problems with malnutrition, and often experience a corresponding decrease of ADL [Author : define], an increase in infection, and an increased risk of becoming bedridden. Therefore, it is necessary to ensure the cooperation of physicians from various departments in order to ensure that patients receive proper nutrition. This report presents the types of intervention intended to restore oral intake by the eating / deglutition / oral care team and the final outcomes. The subjects were 141 patients who requested a swallowing examination and were encouraged to resume oral intake from January 2008 to December 2008. Methods : We classified the patients as severe, a medium, mild grade, and normal swallowing after an initial swallowing examination and gave them instructions on how to resume oral intake. Results: With regard to the nutrient means at discharge, there was oral intake in 94 cases (66.7%), enteral feeding in 29 (20.6%), and intravenous nutrition used by 8 (12.8%). When pneumonia developed after the intervention, the likelihood of oral intake at discharge was decreased. It was important to prevent the onset of pneumonia after the intervention to enable oral intake.

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This study investigated the characteristics of patients with balance disorder referred by emergency medical technicians (EMTs), especially those injured by a fall. Eight hundred seventy-nine patients were treated from October to December in 2008. Eight percent and 7 percent of them called an ambulance due to falling and equilibrium disorder, respectively. The main cause of falling was a stumble. Nineteen of seventy patients that had fallen had a bone fracture. Nine required surgical treatment. Half of all patients that required surgery could not go directly home. It is important to evaluate balance disorders in order to prevent the occurrence of fall in an aging society. Otorhinolaryngologists should therefore play an active role in preventing a fall by evaluating patients' equilibrium.

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Bacteriological culture and sensitivity examinations were conducted in 88 cases of severe acute epipharyngitis in adults. A total of 115 strains, including 8 strains of β -hemolytic streptococci (7 %), 3 strains of S. pneumoniae (3 %), 11 strains of S. aureus (9 %), 39 strains of H. influenzae (34%), 33 strains of H. parainfluenzae (29%), 2 strains of H. parahaemolyticus ( 2 %) and 19 strains of M. catarrhalis (16%), were isolated. Four of the bacterial species, i.e. β -hemolytic streptococci, H. influenzae, H. parainfluenzae and M. catarrhalis, exhibited a favorable sensitivity to cefditoren, with an MIC₉₀ of 0.5 μg/ml or less.

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A clinical pathway is a schedule beginning with patient education, followed by clinical examinations, surgery, medication post-operative treatment, and meals during hospitalization. The goal of the pathway is the improvement in the medical quality, effective use of medical resources, and the informed consent of the patient. The clinical pathway for a laryngomicrosurgery was, therefore, established at the Fukuoka University Hospital Otorhinolaryngology Department in April in 2002. Fifty-three cases treated for benign disease from April 2008 to March 2010 were selected at random. A comparison of the indications for surgery after the introduction of the clinical pathway showed that the period of antibacterial treatment, the duration of hospitalization and normal dietary food intake were significantly decreased by the use of the clinical pathway.

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Gradenigo syndrome is a relatively rare complication of otitis media characterized by trigeminal neuralgia and paralysis of the 6^th cranial nerve. This report presents a case of Gradenigo syndrome associated with pregnancy. A 41-year-old pregnant female experienced left ear discharge following acute otitis media for 2 months, but received no pertinent antibiotics. She suddenly felt severe pain in her left temporal region in addition to diplopia. An urgent CT scan revealed poorly pneumatized cells in the left petrous apex, and MR showed suspicious inflammation extending to the apex from the middle ear. She was diagnosed with Gradenigo syndrome, and was treated by 300 mg CFPN-PI orally for 12 days. The temporal ache quickly diminished, so no further treatment was administered. The 6^th cranial nerve paralysis recovered completely after 3 months. A follow-up CT was scanned after normal delivery, but showed yet no pneumatization in the apex. This suggests that the 5^th and 6^th cranial nerve disorders were probably induced by dural edema in the petrous apex even without the formation of an abscess. The present case emphasizes the clinical significance of this classic syndrome, and the appropriate use of antibiotics is essential even in the case of a pregnant female.

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This report presents the case of a 71 year-old female with oral cancer involving the lower left side of the lip extending to the skin and mandible (T4N2bM0). The patient received combination therapy of 60 Gy radiation and intra-arterial injection of CDDP 100 mg once a week for 4 weeks and underwent resection of the lower left lip and a part of the left mandible. The patient subsequently underwent reconstructive surgery of the mandible. Seven days after the surgery, the patient developed insulin-resistant hyperglycemia. Electrocardiographic findings showed increased ST signals associated with T-wave inversion. Echocardiography reversed a typical takotsubo-shape heart, confirming the diagnosis of cardiomyopathy. This case suggests that the stress caused by the surgery resulted in takotsubo cardiomyopathy. Otolaryngologists therefore should be aware of the potential complications of this disease associated with head and neck surgeries.

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