This study focuses on cases in which hearing impairment was identified during pre-school and school health screenings and subsequently confirmed through a hearing examination at the Kumamoto Prefecture Welfare Consultation Center. The study cohort consisted of 29 patients (18 male and 11 female) who were referred for detailed hearing evaluations following preschool and school health screenings. Of these, 13 received a diagnosis of hearing impairment. All 13 cases were children in preschool or lower grades of elementary school. Within this group, seven patients were diagnosed with unilateral hearing impairment, excluding those with middle ear infections. Four additional cases of bilateral hearing impairment were identified, all of which exhibited mild sensorineural hearing loss. Unilateral hearing impairment and bilateral mild hearing impairment often manifest as limited self-awareness in affected individuals, making it challenging for those around them to detect the condition. This study underscores the importance of preschool and school health screenings in the early detection and management of hearing impairment.

Congenital ear canal atresia is a congenital disease that occurs in 1 in 10,000-20,000 individuals. In the present case, we encountered a case of unilateral external auditory canal atresia complicated by cholesterol granuloma. The patient was a four-year-old boy. At 4.5 years old, computed tomography showed a soft shadow of the mastoid cavity with bony destruction of the posterior cranial fossa, which led to the suspicion of cholesteatoma and referral to our department. After a close examination, he was suspected of having cholesterol granuloma or cholesteatoma with external, middle, and inner ear malformations and underwent tympanoplasty and mastoidectomy. During the surgery, a granuloma was found in the mastoid cavity and removed. A thick bony septum that appeared to be an atresia plate was removed to secure a ventilation route toward the eustachian tube. One year and nine months after surgery, computed tomography showed good aeration and no recurrence. In cases such as this one of cholesterol granuloma of the middle ear in which external auditory canalplasty is not indicated, it is important to secure a ventilation route in the direction of the eustachian tube.

Congenital cytomegalovirus (cCMV) infections can cause congenital or progressive hearing loss and delayed language development. However, cCMV has not been reported to be associated with congenital cholesteatoma to date. Our patient was a 4-year-old girl. She was born without any perinatal abnormalities, and she passed a newborn hearing screening (NHS). Cochlear implant surgery and cholesteatoma surgery were performed on two separate occasions. Speech was observed approximately 10 months after surgery. It is important to note that even if newborn passes NHS, cCMV may cause delayed progression of hearing loss and delay the diagnosis of hearing loss.

Sphenoid sinus fungus ball (FB) is a relatively rare disease. However, its incidence is increasing. As the sphenoid sinus is located in close proximity to anatomically important structures, surgical removal of the fungal mass should be performed as early as possible. We herein describe the cases of patients with sphenoid sinus FB. One case was cured by outpatient treatment, while the other was treated surgically because the disease persisted after outpatient treatment. We also compared these two cases with 18 cases of sphenoid sinus FB that were treated in our department in the past 5 years. In sphenoid sinus FB, when the natural ostium of the sphenoid sinus is enlarged or fungal masses are present outside the natural ostium or in the posterior ethmoid sinus on imaging, the sphenoethmoidal recess should be observed closely with endoscopy. Removal of the fungal mass outside the sphenoid ostium may improve aeration in the sphenoid sinus, which may facilitate spontaneous healing or alleviate inflammation in the sphenoid sinus, as occurred in one of our cases.

The nasal and paranasal sinus regions contain a wide variety of tissues, including the skin, mucous membranes, and cartilage, which are the primary sites of origin for a wide variety of benign and malignant tumors. In many cases, blood sampling, immunohistochemistry, and a chromosomal analysis are insufficient for their diagnosis. In the present case, multiple biopsies were performed for a patient with nasopharyngeal swelling, and HE staining, immunostaining, flow cytometry, and chromosome analysis were conducted. However, a definitive diagnosis could not be established. Genetic testing was performed, and a diagnosis of peripheral T-cell lymphoma of unspecified type was made. If malignant lymphoma is suspected, genetic testing for TCR monoclonality may be useful in differentiating it from other diseases.

Background：Most malignant tumors that occur in the pharynx are epithelial in origin, as typified by squamous cell carcinoma, and malignant tumors of submucosal origin are rarely observed. We herein report a case of synovial sarcoma originating in the submucosal region of the hypopharynx. Case：A 50-year-old man consulted a physician complaining of pharyngeal pain. Imaging tests suggested a retropharyngeal space abscess. Transoral incision and drainage were performed, during which a solid lesion was observed in the retropharyngeal space, and a tissue biopsy was performed. A definitive diagnosis of synovial sarcoma was made, and the patient was referred to our department. Because the tumor was highly malignant, we performed laryngopharyngeal and cervical esophagectomy to ensure a sufficient safety margin. He developed pulmonary metastasis in the early postoperative period, and despite multiple resections of the pulmonary lesions and continued chemotherapy, the disease became uncontrollable. He ultimately died of primary disease approximately five years after the initial surgery. Conclusion: Malignant tumors that develop under the pharyngeal mucosa are difficult to detect. This disease should always be considered as a differential diagnosis in cases of pharynx-related chief complaints, and an early imaging diagnosis should be actively considered.

Swallowing rehabilitation based on the results of swallowing function tests was performed for dysphagia 17 years after radiotherapy for laryngeal cancer, and its effectiveness was objectively evaluated. Rehabilitation of patients with late-onset dysphagia after prolonged radiation therapy is also considered effective if the swallowing function has not been abolished, such as in cases of dysphagia, and if a certain degree of function remains, based on a thorough understanding of the pathology through swallowing function tests.

In thyroid surgery, a careful surgical technique is required to preserve the recurrent laryngeal nerve. In rare cases with an abnormal origin of the subclavian artery, the recurrent laryngeal nerve may become a non-recurrent inferior laryngeal nerve (NRILN). A NRILN branches directly from the vagus nerve. We experienced a case involving a thyroid tumor with an NRILN and an abnormal origin of the right subclavian artery. A 68-year-old woman was admitted to our hospital with a mass located in the anterior neck. A benign thyroid tumor (e.g., follicular adenoma) and cyst were listed as differential diagnoses. Hemithyroidectomy was performed. Although we evaluated the thyroid tumor, cervical and mediastinal lymph nodes, and lung lesions, we could not confirm the course of the aorta and subclavian artery. During the operation, we found that the NRILN branched directly from the vagus nerve. Reconfirmation of CT revealed the abnormal origin of the right subclavian artery. When performing thyroid surgery, in addition to the evaluation of the tumor and lymph nodes, surgeons should routinely check for vascular malformations such as visceral inversion and abnormal origins of the subclavian artery.

Malignant tumors in the lacrimal sac are rare, and their initial symptoms often resemble those of dacryocystitis, leading to a delayed diagnosis. We herein report a case of squamous cell carcinoma originating from the lacrimal sac and progressing into the nasal cavity. The patient was a 30-year-old Vietnamese woman who presented with complaints of right nasal obstruction and discharge at 28 weeks of pregnancy. A biopsy confirmed the diagnosis of squamous cell carcinoma of the right nasal cavity. Considering her young age and pregnancy, we consulted with obstetricians and performed Caesarean section at 35 weeks of pregnancy. The tumor seemed to have invaded the orbital cavity, and although surgical resection of the tumor, including the eyeball, was initially discussed as an option, the patient opted for concurrent chemoradiotherapy to preserve her appearance. The tumor was considerably reduced in size but not eliminated. The remarkable reduction in the tumor size allowed us to perform tumor resection while preserving the eyeball. The skin defect was reconstructed using a forehead flap. At present, one year and nine months have passed since the surgery, and no signs of recurrence or metastasis have been observed.