We studied the hearing aid use and communication methods in 43 children with hearing loss and multiple disabilities who visited the Fukuoka Welfare Center for rehabilitation between April 2012 and March 2013. Sixteen of the patients used their hearing aid in limited places, and 13 of them had stopped using the hearing aid. As a means of communication, some children were able to use spoken language, and had hearing loss between a mild level and severe level. The children who had profound hearing loss used sign language. The children with profound mental retardation did not use either spoken or sign language. Most of the children communicated using characters, pictures, photographs, gestures, pointing, etc. In the case of the children who had profound mental retardation and were unable to express themselves, the parents or caregivers tried to communicate by observing the child's movements and eyes.

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A retrospective review was performed on 27 patients with primary hyperparathyroidism who were initially treated at our hospital between 2009 and 2012. The 27 patients ( 4 males, 23 females) ranged in age from 23 to 82 years. Histological examinations revealed 26 parathyroid adenomas and one parathyroid hyperplasia. Ultrasonography, computed tomography and ^99mTc Sestamibi scintigraphy were useful modalities for accurately diagnosing the localization of the parathyroid gland tumors. When parathyroid gland tumors were not detectable by ^99m Tc Sestamibi scintigraphy, ²⁰¹TL-^99mTc subtraction scintigraphy was useful for diagnosing the localization. A resection of the enlarged gland was performed in 23 patients, a hemithyroidectomy and parathyroidectomy was performed in three patients and bilateral parathyroidectomy (two glands) was performed in one patient. The serum intact PTH concentration degreased in 16 patients during the operation. Twenty-six of the 27 patients were normocalcemic,however, the other patient had persistent hypercalcemia after the operation. This analysis suggests that measuring the serum intact PTH concentration during surgery is useful. Recurrent laryngeal nerve palsy was not observed in any of the patients, but the tetany and hypocalcemia were noted after the operation in six of the 27 patients.

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In recent years, there have been advances in endoscopic equipment, and endoscopy with narrow band imaging (NBI) has become useful for detecting hypopharyngeal cancer at an early stage. Among otolaryngologists, the use of endoscopic observation of the hypopharynx with the Valsalva maneuver has become widely spread, and the technique has been reported to offer a good perspective using a nasal endoscope while performing the Valsalva maneuver, allowing gastroenterologist to observe of a wide field, from the postcricoid hypopharynx to the posterior wall of the esophageal orifice. Recently, it has been reported that further examinations using a curved laryngoscope under general anesthesia allow the physician to obtain a wide perspective of the hypopharynx to the esophageal orifice. We herein report that this technique is useful for detecting hypopharyngeal cancer by combining the Valsalva maneuver with neck rotation.

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Mohs' paste is a histopathological fixative with zinc chloride as the primary ingredient. It has been applied in chemosurgery of skin tumors. In recent years, Mohs' paste has been reported to be very effective for controlling various symptoms of skin metastasis, such as pungent odors and/or hemorrhage, in the field of palliative care among patients with inoperable advanced cancer. A 56-year-old male suffered from repeated bleeding from an ulcer of cervical metastasis. Following application of Mohs' paste, coagulation of the ulcer relieving the patient's distress. No severe complications were observed, and his quality of life was remarkably improved. Mohs' paste is thus considered to be a potentially useful treatment for advanced head and neck cancer patients suffering from repeated bleeding and malodorous discharge and is useful for improving the quality of life in such patients.

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Otolaryngologists experience many cases of oral, pharyngolaryngeal and esophageal diseases in their daily work. Pemphigus vulgaris is autoimmune disease that leads to the formation of blisters in the skin, leading to mucosal lesions. This disease is intractable and has a poor prognosis. It is important to make a diagnosis and start medical treatment as soon as possible. We experienced a case of mucosal-dominant pemphigus vulgaris in oral,pharyngolaryngeal and esophageal lesions. At the beginning of the medical treatment, an inflammatory disorder was suspected, and the patient was treated accordingly. It took three weeks to make a definitive diagnosis. After we increased the dose of steroid being administered, the mucosal condition in the oral and pharyngeal lesions improved. When otolaryngologists treat oral and pharyngolaryngeal diseases, it is necessary to keep in mind the possibility of pemphigus vulgaris, which is rare and intractable. In addition, when treating this disease, it is important to perform cooperative treatment with other specialists, such as dermatologists, to ensure that the best outcome is obtained.

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[in Japanese]

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[in Japanese]

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