Pediatric deep neck abscesses are a relatively rare and can lead to critical or life-threatening situations. However, the clinical characteristics of pediatric deep neck abscesses are not fully understood in Japan. We conducted a retrospective study of the clinical characteristics of children presenting with pediatric deep neck abscesses at our hospital. All pediatric patients were diagnosed with deep neck abscesses on the basis of the clinical findings and computed tomography (CT) scanning of the neck between April 2009 and March 2014. The incidence, initial examining department, sex, age, presenting signs and symptoms, physical findings, duration between onset and admission, timing of CT scanning, abscess location, causative organism, and method of treatment were determined from the medical records.
　We identified a total of 20 pediatric patients with deep neck abscesses, with a mean incidence of 4.0±1.9 cases per year. Pediatric deep neck abscesses were more common during winter and spring. Most patients initially presented to the pediatric department before consulting an otolaryngologist. Fourteen (70%) patients were male and six (30%) were female, with no obvious peak age of onset. The mean duration between onset and admission was 7.2±3.9 days. The mean timing of CT scanning was 8.1±3.6 days after onset. The most commonly involved area was the retropharyngeal space in nine (45%) and the retro-cervical space in eight (40%) patients. The most frequent causative organism was Staphylococcus aureus (20%), with no cases of antibiotic-resistant bacteria infection observed. Majority of the children were initially managed with conservative treatment. Five patients who failed to improve within 48 h of treatment subsequently underwent surgical drainage. No significant complications such as descending mediastinitis and septic shock were observed in any of the patients.

　Globus sensation is a common symptom seen daily in ear-nose-throat (ENT) clinics. Globus is affected by multiple factors, and of these, gastroesophageal reflux disease (GERD), has been recognized as a relatively more manageable cause of globus than the other causes. However, we still commonly encounter globus patients with unclear backgrounds who require multiple diagnostic and therapeutic modalities. To provide an appropriate treatment approach and create favorable situations for these patients, we developed and applied an intramural algorithm to manage globus considering GERD, laryngeal allergy, and psychological problems as major factors of this pathology.
　Twenty-six patients with globus sensation who visited our voice clinic from June 2012 to March 2015 were enrolled in this study. All these patients had undergone general ENT examinations, including naso-pharyngo-laryngeal endoscopies and cervicothoracic computed tomographic scans. Upper gastrointestinal endoscopy revealed 2 cancers. Further study classified 23 patients into the GERD group and 1 patient into the allergy group. Proton pump inhibitor (PPI) therapy was successful in 11 patients of the GERD group (response rate, 47.2%). Improvement in subjective symptoms of globus were measured by the scores of questionnaires, including the F scale and Reflux Symptom Index. Significant improvement in these scores were observed 1 month after PPI prescription in the PPI-responder group in this study. Further assessment of medical history as well as the scores of questionnaires to measure the severity levels of depression (Self-rating Depression Scale) and anxiety (State-Trait Anxiety Inventory-Form JYZ, STAI) proved that relatively longer lasting symptoms (≥4 months) or relatively higher anxiety scores (STAI≥50 points) were predictive of PPI resistance. Our study results suggested that the pathology of globus is affected by multiple factors and that a multidisciplinary team approach is required for better management of this disease.

　Immunogloblin A (IgA) vasculitis is the most common systematic vasculitis disorder characterized by leykocytoclastic vasculitis , for example, purpura with white blood cell destruction vasculitis caused by allergic mechanisms. The main symptoms of this disease are purpura, arthritis, abdominal pain, gastrointestinal bleeding, and nephritis.
　We report the case of a 66-year-old man with IgA vasculitis. He was diagnosed with hypopharyngeal cancer and underwent radio-chemotherapy at our department. On the following day, he underwent tracheotomy because of recurrent laryngeal nerve paralysis associated with cancer treatment.
　His wound infection remained after the tracheostomy, and he complained of purpura on both legs. On the basis of these clinical courses we diagnosed IgA vasculatis caused by wound infection. This case illustrates that it is important to consider the possibility of IgA vasculatis if skin eruption is observed concurrent with wound infection.

　Chondroma of the head and neck are commonly found in the nasal cavity, paranasal sinus, or larynx but rarely at other sites. Here we report a rare case of nasopharyngeal chondroma arising from the Eustacian tube. The patient was a 55-year-old male with chief complaints of nasal obstruction and left ear fullness. Nasal observation showed a white mass lesion filling the area extending from the left Eustachian tube to the nasopharynx. Computed tomography and magnetic resonance imaging of the pharynx showed a mass lesion occupying the nasopharyngeal cavity. We performed surgical excision of the nasopharyngeal tumor via the endoscopic endonasal approach. Histopathological examination performed at our hospital led to the diagnosis of chondroma. As of this report, 4 months have passed since surgery and the patient has not experienced a relapse. Although chondroma is a benign tumor, local recurrence or malignant transformation is possible. Therefore, these patients should continue to be followed up regularly.

　Detecting changes in the physical characteristics of the eardrum by ocular inspection is difficult. Herein, we propose an alternative method for the quantitative detection of such changes using an acoustic conductance tympanogram, termed as G tympanograms, which exhibit the real part of acoustic admittance.
　The middle ear, including the eardrum, can be modeled using a mechano-acoustic system with physical parameters comprising mass, spring, and friction, and we have developed a procedure to numerically evaluate these parameters. We report the results obtained thus far and discuss their significance and implications.
　Specifically, we performed pure tone audiometry, 226-Hz tympanometry, and rigid endoscope otoscopy on 175 children aged 5-13 years. Of 350 total ears, we selected 248 ears with normal hearing levels, type A tympanogram, no effusion in the middle ear, non-retracted eardrums, and no eardrum calcification. We measured the distortion product of otoacoustic emissions (DPOAE) and performed four-frequency (i.e., 226, 678, 800 and 1000 Hz) tympanometry. From the latter analysis, we extracted G-tympanograms, which enabled us to calculate the above-mentioned parameters, the spring constant in particular, for each of the 248 selected ears. We classified these ears into three groups: group I (68 ears), which showed no evidence of acute otitis media (OMA) or otitis media with effusion (OME); group II (68 ears), which showed evidence of OMA but not of OME; and group III (112 ears), which showed evidence of OME and OMA.
　We found that ears in group III had reduced spring constants, even after apparently recovering from OME. We also found a strong correlation between the spring constant and OAE value, which suggests that eardrums with low OAE values tend to have reduced spring constants. Because DPOAE-measurement is much easier to perform than four-frequency tympanometry, we suggest that DPOAE is a practical means of detecting reduced spring constants.