We experienced a case of perilymphatic fistula with pneumolabyrinthine caused by old temporal bone fracture. A male in his 30s visited our hospital with a complaint of dizziness and left hearing impairment after blowing his nose. He had a history of old temporal bone fracture due to head trauma. Pure tone audiometry revealed a 53-dB hearing level with mixed hearing loss. Right horizontal and rotary mixed type nystagmus was observed. Temporal bone computed tomography showed a bone fracture line at the right temporal bone and a low-density area in the right utricle. Closure of perilymphatic fistula was performed at 13 days after the first symptom onset. A bone fracture line was noted between the prominence of the lateral semicircular canal and just lateral to the horizontal part of the facial nerve canal and anterior semicircular canal. Although the vestibular symptoms disappeared post-operatively, transient hearing loss occurred. His hearing level gradually recovered and improved to 33 dB.

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An 80-year-old man visited our hospital due to nasal obstruction. Endoscopy revealed a tumor in the right nasal cavity obstructing the choana. The tumor had numerous blood vessels and bled easily. We performed a biopsy of the tumor. The pathological examinations revealed glomangiopericytoma arising from the right nasal cavity. The patient underwent endonasal surgical resection without any complications. We herein report a case of glomangiopericytoma arising from the nasal cavity. Endoscopic resection was useful for treating glomangiopericytoma of the nasal cavity.

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Hemorrhage from the parathyroid tissue is a relatively rare phenomenon. We herein report our experience with a 43-year-old woman who experienced hemorrhage from parathyroid adenoma that was initially thought to be a neck abscess. Pain and swelling developed in the anterior region of neck, which was exacerbated over time, and on the 11th day after visiting our hospital for treatment, the patient experienced fever and dyspnea. A hematological examination revealed a high inflammatory response；based on the course of the disease and the imaging findings,the possibility of a neck abscess could not be ruled out, and we performed emergency operative treatment. The intraoperative findings revealed a tumoral lesion with a clear coating on the dorsal side of the thyroid；the inside of the tumor was filled with dark reddish-brown effusion. Based on histological findings, we diagnosed intratumoral hemorrhage of parathyroid adenoma. The postoperative course was favorable, and the patient was discharged on postoperative day 10. Hemorrhage from the parathyroid tissue is an important condition that should be differentiated when patients show swelling of the neck.

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We treated a 57-year-old man with allergic parotitis caused by onion. For years, the patient had experienced episodes of recurrent swelling of the parotid gland, and presented an anaphylactic reaction with parotid gland swelling, urticaria of the palms and dyspnea after eating a curry that contained onion. CT revealed no abnormalities other than the swelling of the parotid glands and the dilation of the main salivary duct. The saliva from the parotid gland was clear and a large number of eosinophils were observed on saliva smears. Recurrent parotitis in association with allergy is known as sialodochitis fibrinosa and is defined by recurrent salivary gland swelling with eosinophil-rich mucus plugs from the salivary duct. Our case did not meet this definition ; we therefore diagnosed the condition as allergic parotitis. IgE antibody tests were positive for onion, dermatophagoides pteronyssinus and Japanese cedar pollen. An onion tolerance test showed an allergic reaction in the parotid glands, we concluded that his allergic parotitis was caused by onion. The patient has remained in a good condition by avoiding onion and taking antihistamines as needed. Although cases of food-dependent allergic parotitis have been reported, there are very few cases in which the allergen can be identified.

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My own tinnitus cerebri, which I have experienced for 20 years, was treated with a fibrinolytic enzyme, lumbrokinase, which is extracted from a type of earthworm. The tinnitus clearly decreased over a few days, and disappeared almost completely when the dosage was increased. Thrombotic microangiopathy at the Wernicke area should be considered as a treatment for tinnitus cerebri. This anoxic condition at the tripartite synapse results in the constant overflow of glutamic acid (due to the decreased function of the astroglia), causing glutamine – glutamic – acid recycling. The neurons are then constantly excited, resulting in tinnitus without audio stimulation.

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