Hyperacusis and tinnitus often occur in the same patient. It is unclear whether hyperacusis and tinnitus are separate phenomena or possess the same etiology. This study analyzed 80 tinnitus patients and 24 hyperacusis patients who had no hearing disturbance. These patients underwent an SISI (short increment sensitivity index) test, MCL/UCL (most comfortable loudness level/uncomfortable loudness level) test, Bekesy audiometry and Metz test, and were examined the positive rate of the recruitment phenomenon. The positive rates of recruitment phenomenon were 25-63% and 33-38% in tinnitus and hyperacusis patients, respectively, showing no differences. The positive rate in the symptomatic ear was slightly higher in the hyperacusis ears (15.5%) than in the tinnitus ears (10.3%).

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A retrospective comparative study was conducted of patients using betahistine mesilate and those using a combination of betahistine and isosorbide jerry. Patients with Ménière's disease or suspected Ménière's disease based on their clinical symptoms were included in the study, and received 36 mg/day of betahistine or the same dose of a combination of betahistine and isosorbide jerry for three months. The basic dosage of isosorbide jerry was 90 g/day t.i.d, but the dose was reduced as appropriate according to improvement or drug compliance. Travelmin tablets were given in advance to be taken at the onset of vertigo attack. The outpatients that visited the hospital due to acute vertigo attack received intravenous drip infusion of 7 % sodium bicarbonate solution, and were temporarily hospitalized for treatment. The number of patients receiving Travelmin, the number undergoing drip infusion and the number of hospitalizations due to vertigo attack were significantly lower, and the reducereduction in the number of vertigo attacks was higher with the concurrent therapy with betahistine and isosorbide jerry in comparison to the betahistine monotherapy. These results showed that the long-term concurrent therapy with betahistine and isosorbide jerry was an effective treatment for prevention of vertigo attacks in clinical practice.

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Clavulanic acid/amoxicillin (1 : 14)(CVA/AMPC ⟨1 : 14⟩) was administered for 5 days to 642 children with acute rhinosinusitis complicated by acute pharyngitis, judged to be severe according to the “Guidelines on the Diagnosis and Treatment of Acute Rhinosinusitis”, to investigate the efficacy of this drug combination. The response rate was 67%. An analysis of the clinical efficacy in terms of patient age revealed that the response rate was significantly higher for children age 3 years or older (73%) than in children under age 3 (57%). A bacteriological investigation isolated 1050 strains of bacteria from the mucopurulent nasal discharge, with S.pneumoniae (286 strains, 27%) and H.influenzae (501 strains, 48%) together accounting for 75%. The MIC₉₀ of CVA/AMPC (1 : 14) was 1 μg/ml for S.pneumoniae and 16 μg/ml for H.influenzae, and the response rate for this drug combination was significantly higher for S.pneumoniae detected independently than for H.influenzae detected independently. The adverse drug reaction of diarrhea occurred in 34% of patients. There were cases with penicillin-resistant S. pneumoniae (PRSP) that did not respond to CVA/AMPC (1 : 14), and their courses therefore need to be monitored carefully while paying close attention to any changes in the drug susceptibility of S.pneumoniae, including PRSP.

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This study evaluated the indications for a medial shift of the vocal cords for the improvement of swallowing dysfunction due to unilateral vocal cord paralysis with dysphasia before. The method was a minimally aggressive, and there was a low frequency of complications, associated with aspiration. However, swallowing pressure did not improve it even in the cases with other hypostatic cranial nerve neuropathy Constrictor pharyngeus muscle shrinkage strengthened only glottic closedown, however, the effect was limited, and it was thought that laryngeal suspension or cricopharyngeal myotomy should be considered as alternattive therapeutic methods.

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Gore-Tex migration from a window in medialization thyroplasty was prevented by using an outer perichondrial flap of the thyroid ala. A relatively large flap of the outer perichondrium was elevated before a window usually opened. After a strip of Gore-Tex was inserted to fold down, the perichondrial flap was then sutured to close the window and to fix the Gore-Tex. This method was performed in sex senile patients, and a satisfactory result was obtained. Although Gore-Tex is easily fixed in young patients using a Nylon string and a connected needle, an ossified thyroid ala makes needle penetration difficult in elderly patients. Therefore, fixation of the Gore-Tex with a perichondrial flap is useful, especially in medialization thyroplasty for senile patients.

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Amyloidosis is a clinical disorder caused by the extracellular deposition of particulate proteins, called amyloid, in systemic tissues. The deposition of amyloid proteins in a localized organ is known as localized amyloidosis. Amyloidosis is a rare disease, especially cases originating in the larynx. Therefore, the guidelines for amyloidosis have not yet been established. This report presents the case of a patient with localized amyloidosis of the larynx. A 75-year-old female underwent surgery for laryngeal amyloidosis at another institute. She developed recurrent hoarseness five months after the first operation and a right supraglottic mass was revealed by endoscopic examination. She was diagnosed to have immunoglobulin light chain (AL) amyloidosis of the larynx following a histopathological examination. She underwent laryngeal microsurgery using microdebrider^® curettage. Microdebrider curettage allows the removal of amyloidosis safely and precisely. This case suggests two important points; 1) amyloid deposits should be excised as much as possible. Remnant amyloidosis may grow over a comparatively short period. 2) Microdebrider curettage may be beneficial for removal of amyloidosis, while preserving the original laryngeal structure.

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Tracheoesophageal speech using a voice prosthesis has many benefits, such as, facility of acquisition and natural phonation. However, patients with voice prosthesis sometimes become vocally disabled. This may be caused by stricture of the pharynx, and therefore the resolution of such stricture may restore the natural voice for such patients. A patient with a voice prosthesis became voice disabled after an operation for the prevention of aspiration. This disability was thought to be due to the presence of remnant cricoid lamina cartilage which had thus caused stricture of the pharynx. The surgical removal of the cartilage restored the tracheoesophageal speech for this patient. The removal of the thyroid and cricoid cartilage during the initial surgery for the prevention of aspiration may thus be preferable for patients who use a voice prosthesis because this can help to avoid post-operative stricture. Furthermore, surgery to remove any remnant cricoid cartilage is recommended to provide hope for patients with-stricture after the initial operation.

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