Influenza testing was performed using an artificial intelligence (AI)-equipped medical device (market name：Nodoca). The concordance rate between this test and the conventional rapid test was 75.4%. In the relatively early stage from the onset of illness to testing, both cases that were negative according to the conventional rapid test due to insufficient viral growth as in the previous report and were "detected" by this test was 9.6%. In contrast, in 15.1% of cases, the rapid test was positive, but the device failed to detect the virus, suggested that improving the accuracy of AI-equipped medical devices is essential to ensure their widespread use in clinical practice. Most operators (80-90%) had favorable opinions, noting that testing with this device was easier than conventional testing, leading to better understanding; however, opinions were divided regarding influenza types (A and B). An examination with this device was relatively easy, with suffocation only noted in 15.3% and pain in 10.5%, but there were three cases in which the tongue was stiff, and pharyngeal findings could not be obtained. This device seemed to be effective in early-onset cases (especially within 18 h) and in those who refused nasopharyngeal wipes.

Two-jaw surgery is a surgical procedure performed for jaw deformities, which is associated with a high rate of postoperative vocal cord paralysis. In the present study, we statistically analyzed the frequency of vocal cord paralysis after two-jaw surgery and discussed the causes. A total of 133 patients who underwent two-jaw surgery at our hospital's Department of Oral Surgery between September 2019 and July 2022 were retrospectively analyzed. Of the 133 patients, 13 (9.8%) had postoperative vocal cord paralysis. The improvement rate was 100%. In various reports, the frequency of postoperative vocal cord paralysis after two-jaw surgery was 0.03-0.2%. In addition, laryngeal granulation was observed in 6 of 20 patients who complained of postoperative hoarseness. It was considered that the surgical operation involves a large amount of mechanical stimulation to the larynx due to the movement of the intubation tube during the surgical operation, and stimulation of the vocal cords is one of the causes of vocal cord paralysis. In some cases, submucosal hematomas were observed in the hypopharynx and larynx, which may have caused vocal cord paralysis due to compression of the tissue surrounding the recurrent nerve and the recurrent nerve nutrient vessels, resulting in hypoperfusion. In the future, it will be necessary to inform the medical and dental communities of these cases.

Malignant lymphoma is a general term for malignant tumors of lymphoid cells that develop in lymphoid tissue. It may show clinical symptoms similar to other malignant tumors of the head and neck and inflammatory diseases, and it may also cause airway obstruction, so a prompt and appropriate diagnosis and treatment are necessary. To clarify the clinical picture of malignant lymphoma and enact more appropriate decisions on treatment policy, a clinicopathological study was conducted among 163 patients with symptoms in the head and neck region and a pathological diagnosis of malignant lymphoma was made in those patients who visited our department over a 6-year period from 2016 to 2021. The median age of the patients was 71 years old, 74 were male, and 89 were female. The biopsy sites included the nasopharynx, mid-pharynx and other Waldeyer's pharyngeal rings in 42 cases, cervical lymph nodes in 103 cases, nasal cavity, and paranasal sinuses in 10 cases, salivary glands in 2 cases, thyroid gland in 2 cases and hypopharynx and larynx in 3 cases. The median soluble IL-2R value was 1,956 U/㎖, and the median LDH value was 258 U/ℓ, both of which were above the normal upper limit. Two cases with respiratory distress at initial presentation were also reported, both with airway stenosis due to lesions, and therefore it was considered that starting treatment after a definitive diagnosis was made could thus be fatal. After consultations with the Department of Hematology, steroid therapy was started before a definitive diagnosis was made after the collection of histopathological specimens, which thereafter led to a definitive diagnosis and treatment. Malignant lymphoma in the head and neck region progresses quickly, and in some cases it can be fatal due to airway obstruction. For a prompt diagnosis and treatment decision, it is important to perform not only a tissue diagnosis, but also tests, such as sIL-2R and LDH evaluations, and cooperate closely with other departments.

With advances in drug therapy, the indications for chemo-radiation therapy (CRT) for head and neck carcinoma have expanded, and at the same time, the frequency of salvage surgery at recurrence has increased. Complications after salvage surgery include wound infection, fistula, and wound dehiscence, sometimes leading to fatal complications, such as total flap necrosis and carotid artery rupture, which are generally more frequent than in cases of initial surgery. We herein report a case of massive bleeding from a pseudoaneurysm in a branch of the lingual artery as a postoperative complication of salvage surgery after CRT. Previous reports have suggested a history of irradiation, surgery, and inflammation associated with ulceration as potential causes of pseudoaneurysm formation, which should be kept in mind as a possible postoperative complication in patients with such histories.

Granulocyte colony-stimulating factor (GCSF)-induced aortitis is a rare disease that occurs in the relatively acute phase after GCSF use and is diagnosed by computed tomography (CT) in many cases. The prognosis is generally good, and patients can be followed up without treatment, but if there is an aortic aneurysm or if the imaging findings worsen, consultation with a cardiovascular surgeon is necessary to prevent rupture of the aortic aneurysm. It is often difficult to differentiate GCSF-induced aortitis from other diseases, such as infectious aortitis. A 67-year-old man with laryngeal cancer T2N2bM0 Stage IVa had been treated with pegfilgrastim, a sustained-duration GCSF, during induction chemotherapy. Blood test two days after the administration of pegfilgrastim showed an unexplained high C-reactive protein (CRP) level. The patient was diagnosed with GCSF-induced aortitis after CT revealed periaortic inflammation. The high CRP level and periaortic inflammatory findings revealed by CT resolved spontaneously with no treatment. Long-term persistence of inflammation in the aorta leading to aortic dissection has been reported, so this is a disease requiring caution.

Open laryngeal trauma is a rare condition, but it requires prompt airway clearance and appropriate treatment to preserve the laryngeal function. We herein report a case of successful two-stage repair for open laryngeal trauma treatment. A 43-year-old man sustained an injury while at work when an iron rod from a concrete crusher pierced his throat. He was transferred to our hospital with median separation of the thyroid cartilage and transverse process fractures of the cervical vertebrae. The mucosa was extensively damaged from the anterior wall of the larynx to the posterior wall of the hypopharynx. Following the creation of a laryngocutaneous fistula, two-stage repair was performed. The tracheostomy was closed after surgery, and he regained his voice and a normal swallowing function.

I herein report four cases of severe motion sickness. All cases were extremely prone to sickness in cars and buses. One case was more prone to sickness on boats and planes than in cars and buses. The level of sickness on trains differed among the four cases. One case experienced sickness when driving his own car. In two cases, there was no phenomenon of becoming accustomed to the motion. I conducted a questionnaire survey on the cases' nausea other than motion sickness. All cases exhibited nausea when on revolving playground equipment and swings in amusement parks, and exhibited nausea when rolling forward on a mat or horizontal bar. Three cases reported that they started to feel unwell when riding an elevator. Two cases exhibited nausea when watching cinema or television screens. Motion sickness is related to disequilibrium. It can be inferred that individuals, who are prone to nausea and vomiting readily suffer from motion sickness. Further studies on severe motion sickness may elucidate the mechanisms that underlie the condition.

Introduction: Stuttering begins in early childhood, and its onset may be related to language development. However, there have been no reports on the application of the LC scale, which can assess the degree of language development, for the assessment of children who stutter. Therefore, we aimed to determine the rate of comorbid language developmental delay in children who stutter. Methods: We compared the LC index, frequency of stuttering, and comorbidities in 20 infants diagnosed with stuttering and administered the LC scale at our hospital. Results: The mean LC index of children who stutter was 95.5 for verbal expression, 99.5 for verbal comprehension, and 105.5 for communication, with no clear decrease in any of the domains and no significant differences between domains. There was no relationship between stuttering frequency and the presence of comorbidities. However, 20% of the children showed delayed language development. Discussion: The LC scale was effective in detecting language developmental delays hidden by stuttering, which would facilitate the provision of better speech and language therapy for children who stutter.