Concerning the primary operation of cleft lip and cleft palate the author has studied the time of operation, the treatment of gnathoschisis seen in cases of cheilognathopalatoschisis and the method of operation of cleft lip and cleft palate based on his experiences (1950-1960) of 1, 383 cases of cleft lip and 683 cases of cleft palate and with reference to recent literature. As for the time of operation of cleft lip, the period of 3 months after birth was considered suitable in view of the condition of the patient and of the standpoint of the operator and the patient's family. For cleft palate, the period of several months to 2 years after birth was considered to be most suitable in view of maxillary growth and correction of speech.
The effects of the treatment of these diseases ought to be judged by the degree of the patient's adaptability to society. The treatment of the patient, not the treatment of the diseases, ought to be aimed at.
The author has emphasized, from this standpoint, the necessity of the team approach by the cooperation of otorhinologists, dentists, plastic surgeons and speech therapists.

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[in Japanese]

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Three Patients, from 11 to 30 years old, with congenital meatal atresia accompanied by microtia were successfully treated by the authors. One of them had bilateral atresia. By plastic formation of new auricles and myringostapediopexy the authors obtained following results.
1. Hearing gains after operations were as follows:
a gain of 48 decibels to a 37 decibel level,
a gain of 63 decibels to a 27 decibel level,
a gain of 25 decibels to a 25 decibel level and
a gain of 33 decibels to a 38 decibel level in speech range.
2. The new auricles were constructed by means of rib cartilage implant that had been buried in the subcutaneous tissue at which the new auricles are to be constructed.
Although the new auricles thus constructed are by no means satisfactory ones for the authors, they seem to have better appearance than those which are constructed by means of tube graft.

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Otitis media has been relatively disregarded as the focus of focal infection. Fifty cases of chronic otitis media including cholesteatoma were examined with ECG before and after the operation.
In 11 cases, namely 22%, the ECG before the operation revealed abnormality; mostly changes of ST segments except in one case with elongation of QRS complexes. Three of the 11 cases, namely 27.3%, regained normality within 50 days after the operation.
As the changes of ECG due to provocation and negation by way of the middle ear have not yet been examined, it cannot be said that this problem is completely resolved. But it may be inferred that otitis media plays no small role as the focus of focal infection.

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The author examined otorhinologically 22 cases of hemiplegia who visited the Osaka Association for Prevention of Adult Diseases during the 18 months (September 1959-February 1961) with the following results.
1. Hearing loss was observed in 11 out of 22 cases of hemiplegia. The loss was observed on the non-paralyzed side in 7, on both sides in 2, and on the paralyzed side in 2.
2. Twelve of these patients revealed spontaneous nystagmus, the direction of which was mostly to the non-paralyzed side in the early stage of seizure and mostly to the paralyzed side after the lapse of time.
3. Seventeen cases revealed positional nystagmus. In the early stage of seizure the directionfixed nystagmus or the nystagmus seen merely in a unilateral position was predominant, while in cases of slow seizure or in cases of improved paralysis after the lapse of time the nystagmus directed to upward in both unilateral positions was predominant.
4. Spontaneous deviation mostly occurred to the paralyzed side in the early stage of seizure and to the non-paralyzed side in cases of improved paralysis.

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The author has recently experienced a relatively large median anterior maxillary cyst, 3.0×2.0×1.5cm³, in a boy of 16, youngest of the 20 cases ever reported in Japan.
From the round shadow in the roentogenogram, the cylindrical epithelium of the wall of the cyst and the swelling towards the lip, the author concluded that the tumor grew from the area near the nasal side of the canalis incisivus.

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The author reported a case of maxillary osteofibroma in a woman aged 26. The lesion began with swelling of the left cheek and the gingiva when the patient was at the age of 4. The tumor was successfully removed by oral approach, which weighed 30g. Following the surgical treatment the patient has recovered uneventfully without recurrence at 6 months after the operation.

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The author reported a case of malignant degeneration of mixed tumor arising from the hard palate on the right side, which was successfully treated by surgical extirpation through an intraoral incision.

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Ein 57 jahriger Bauer verschluckte sein kunstliches Gebiss des Oberkiefers im Rausch und besuchte am darauffolgenden Tag unser Ambulatorium. Laryngoskopisch sah man ein grosses Gebiss im Hypopharynx eingekeilt. Durch die Rontgenaufnahme erwies sich, dass das Gebiss in der Frontalebene mit seinen nach oben gerichteten Haken eingekeilt war.
Zuerst versuchte der Operateur, den Fremdkorper unter der indirekten Laryngoskopie mit der Kehlkopfzange zu entfernen, aber es gelang ihm nicht. Der zweite Versuch wurde unter der Schwebelaryngoskopie ausgefuhrt, trotz aller Bemuhungen aber gelang es dem Operateur auch auf diese Weise nicht, den linken Rand des Gebisses von der Hypopharynxschleimhaut loszulösen.
Schliesslich wurde das Gebiss durch die Pharyngotomia lateralis von der Submandibulargegend aus entfernt. Dabei zeigte sich, dass der linke Haken des Gebisses die seitliche Hypopharynxsch-leimhaut durchbrochen hatte und dass das grosse Zungenbeinhorn an diesen Haken hangen geblieben war.
Das entfernte Gebiss war 6.0×5.5×1.5cm gross und hatte je einen Haken an beiden Enden. Das kunstliche Gebiss drang wegen seiner seltenen Grosse nicht in die Speiserohre ein, sondern blieb im Hypopharynx stecken.

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We reported a case of reticulosarcoma of the right tonsil in a man aged 16, in whom combined retrograde radical neck dissection and tonsillectomy were performed and postoperative administration of toyomycin was made. No sign of recurrence are recognized at pressent, 50 days after the operation. At the same time we made the statistical observation of tonsilar sarcoma in recent 7 years period (1955-1961).

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