Early stage malignant tumors in the external auditory canal are usually treated by surgical resection. In T1 and T2 (Pittsburgh staging) cases, either intracanalicular skin resection or lateral temporal bone resection is selected to eradicate the disease. The latter surgery sacrifices the hearing even if the inner ear is retained intact, because the surgical defect in the temporal bone has traditionally been covered by a muscle or fat graft. We herein report two cases who had their temporal bones resected while preserving their ossicles and tympanic membrane, and the external auditory canal was reconstructed using autologous cartilage and a free anterolateral thigh flap. Both patients had their hearing partially preserved. These cases indicated that hearing preservation is possible even after a malignant tumor is radically resected from the external auditory canal.

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We herein report three cases of nasal type natural killer T-cell (NK/T-cell) lymphoma. The patients visited our hospital with complaints of nasal symptoms. All three cases complained of nasal obstruction and two complained of epistaxis. The local findings showed that a mass occupied the nasal cavity of two cases and granulation was present in one case. We performed a biopsy for all three cases, and two cases were diagnosed with NK/T-cell lymphoma based on the first biopsy, while one case was diagnosed with NK/T-cell lymphoma based on the results of a second biopsy. Two of the three cases were treated with chemoradiotherapy at our hospital. The tumor responded well to radiation therapy followed by three courses of DeVIC (dexamethasone, VP16, ifosfamide and carboplatin) combination chemotherapy. After receivingthis therapy, the patients have remained free of any symptoms or recurrence. Concurrent chemoradiotherapy using the DeVIC regimen may therefore be effective for the treatment of NK/T-cell lymphoma. When natural killer T-cell (NK/T-cell) lymphoma invades surrounding tissues, it is often associated with a poor prognosis. Therefore, an early diagnosis and early treatment are important for this disease.

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There have been few reports about the synchronous occurrence of different types of thyroid carcinoma in a thyroid. We herein report a case in which follicular and papillary thyroid carcinoma were simultaneously found with bone metastasis. The case was a 69-year-old male with right omalgia. He underwent a medical examination in our orthopedics department, and was diagnosed to have a right humerus metastasis, which was found to be from thyroid carcinoma. The thyroid had three tumors, one in the right upper lobe, one in the right lower lobe and one in the isthmus, and all tumors were suspected to be papillary carcinoma based on the fine needle aspiration biopsy cytology. The metastatic bone tumor of the right humerus was removed first. In the histopathological examination,the bone tumor was diagnosed as a metastasis of follicular thyroid carcinoma. After the patient was transferred to our otorhinolaryngology department, we performed a total thyroidectomy and bilateral paratracheal lymph node dissection. According to a histopathological examination, the right upper lobe and isthmus tumors were diagnosed as papillary carcinoma, and the right lower lobe tumor was diagnosed as follicular carcinoma. Following the operation,we performed radioactive iodine therapy, and see him regularly for follow-up examinations.

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The WHO defines primary intraosseous squamous cell carcinoma of the jaw as squamous cell carcinoma arising in the jaw bone which has no continuity with the oral mucosa at an early stage, and it presumably arises from odontogenic epithelial debris and is not due to metastasis from other organs. Many reports have been so far published concerning this carcinoma in the field of oral surgery, but no such studies have been reported in the otorhinolaryngology field. We treated a patient with primary intraosseous squamous cell carcinoma of the mandible which was advanced at the time of detection. It was not controlled by surgical treatment with postoperative radiotherapy, and the patient died. This case is reported herein together with a discussion of the relevant literature.

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In May 2013 we adopted ADMENIC (Carina System Co., Ltd.), a surgery video recording/distribution system that uses a large-capacity 19 TB hard disk. The introduction of this system has made surgical images accessible from all PCs within the hospital. We also added Apple's FaceTime^® audio transmission function to enable in-hospital surgery conferences. As a result, the supervising surgeon is no longer required to be on standby in the operating room in order to instruct young physicians. Even if the operating surgeon needs guidance and instruction, the supervising surgeon can provide instructions to the operating surgeon through the PC in the outpatient department while examining patients. As a consequence, supervising surgeons no longer have to go to the operating room. For young physicians with an interest in seeing various procedures, in-progress surgeries have been made available for viewing in real time on any PC screen in the hospital at their own convenience, and with an increasing number of surgeries, the system is gradually being used to improve skills.

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