We retrospectively examined the findings from upper pharyngeal endoscopy in cases of acute epipharyngitis in which there was clear evidence of the involvement of a bacterial infection. The subjects included 235 patients with acute epipharyngitis who were treated at this hospital from 2014 to 2015. The endoscopic findings suggested that the cases could be categorized into three groups：(1) cases with pus adhesion localized to the tubal elevation, (2) cases with pus adhesion localized to the posterior wall of the epipharynx, and (3) cases with pus adhesion over the entire epipharynx. These cases were considered to have resulted from a bacterial infection of the lymph tissue present in the tubal elevation and the posterior wall of the nasopharynx. Many aspects of the pathology of acute epipharyngitis involving bacterial infection still remain unknown, and further studies will be needed in the future.

Fifty-three patients (36 males, 17 females) with maxillary sinus cancer were treated at Kyushu University Hospital during 2000-2013. They were classified by T classification as T2 (n=7), T3 (n=14), T4a (n=26), and T4b (n=6). The 3-year cause-specific survival rates were 71.3% for all patients. The 3-year cause-specific survival rates were 62.5% for patients treated with intra-arterial infusion of 5-FU via superficial temporal artery with concomitant radiotherapy between 2000 and 2003, 74.6% for patients with oral S1 or superselective intra-arterial infusion of CDDP and docetaxel with concomitant radiotherapy between 2004 and 2008, and 75.9% for patients with chemo-radiotherapy following surgical resection and reconstruction after 2009. Chemo-radiotherapy following surgical resection improved the cause-specific survival rates.

Laryngeal cleft is a particularly rare congenital deformity of the larynx. The symptoms vary and range from asymptomatic cases, to cases in which respiratory symptoms such as stridor, aspiration and hoarseness are observed immediately after birth. Benjamin and Inglis classified laryngeal cleft as types 1 to 4 according to the depth of the cleft. We experienced 2 case of type 1 laryngeal cleft in patients in whom aspiration was the main complaint. In both of the type 1 cases, the symptoms improved over a follow-up period of several years. Laryngeal cleft is difficult to diagnose during childhood. We herein report the method of diagnosis and the clinical course of two cases.

A deep-neck abscess can be deadly or lead to life-threatening conditions such as necrotizing descending mediastinitis if not treated with appropriate surgical drainage. We herein report a case of parapharyngeal space abscess caused by tooth extraction successfully treated by surgical drainage. A 39-year-old man with athetoid-type cerebral palsy was referred to our hospital because of a fever and left submandibular swelling after tooth extraction. Because it was difficult to perform enhanced computed tomography (CT) with peripheral intravenous contrast infusion, we used a central venous catheter for contrast infusion with the cooperation of a physician. The CT findings confirmed the diagnosis of a parapharyngeal space abscess, and surgical drainage was carried out under general anesthesia. After the surgery, antimicrobial therapy and saline cleansing were performed. The patient was prone to involuntary movements because of the cerebral palsy, especially when under increased mental strain. Diazepam was used in such situations, after consulting with his physician. We also enlisted the help of speech therapists to recommend diet modifications and physical and occupational therapists to prevent disuse syndrome. This multidisciplinary collaborative approach enabled the patient to recover and leave the hospital relatively quickly.

Kikuchi's disease was first described by Kikuchi in 1972. We herein report two cases of Kikuchi's disease. The first patient was a 27-year-old female, she visited our hospital with the chief complaint of neck swelling in the right cervical region. The second patient was a 17-year-old male, whoe visited our hospital with the chief complaint of neck swelling with tenderness in the right cervical region. A blood examination showed a low level of WBC and a slightly high serum LDH level. US showed the presence of cervical lymphadenopathy in the bilateral region. We performed a fine-needle aspiration biopsy which thus resulted in a diagnosis of Kikuchi's disease. We treated both patients with oral steroids and the cervical lymphadenopathy disappeared after 1 month in both cases. Although Kikuchi's disease generally demonstrates a good prognosis, it can nevertheless sometimes show a fatal course. When we encounter patients whose cercical lymphnodes are swollen, then it is important to include the possibility of Kikuchi's disease in the differential diagnosis.

Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS) is the most representative subtype of mitochondrial diseases. However, the pathogenesis of the stroke-like episodes remains unknown. We experienced a patient with MELAS and her first stroke-like episode with a lesion in the left temporal lobe at 31 years of age. Our data indicated that hearing thresholds did not change before and after the stroke-like episode；however, her hearing level for speech in the right ear declined markedly the day before the stroke-like episode. We suspect that the decline in the hearing level for speech might be related to the symptom of the stroke-like episodes.