Sublingual immunotherapy (SLIT) for Japanese cedar pollinosis is known to be effective. However, better SLIT adherence is needed to improve its safety and efficacy.
　Purpose: The purpose of this study was to evaluate SLIT adherence and its influence on clinical outcome.
　Methods: We conducted a detailed survey of 132 patients who have been receiving SLIT for 2 years on adherence at each visit using both questionnaires and direct calculation from prescription. Questionnaires on total symptoms using the visual analog scale (VAS), face scale, and total nasal symptom medication score (TNSMS) were obtained at the peak season for Japanese cedar pollinosis.
　Results: Good adherence by prescription for 2 years was observed in 83.1% ± 11.7% of patients. The adherence in the second year (80.8% ± 13.6%) was lower than that in the first year (88.5% ± 9.8%). However, adherence by questionnaire was 13.5% higher than that by prescription. VAS of total symptoms and adherence did not correlate; however, evaluations by VAS, face scale, and TNSMS were significantly improved if the adherence cut-off value was set to 70% or 75%.
　Conclusion: Our results suggest that SLIT adherence for Japanese cedar pollinosis is high and adequate adherence is required for better efficacy.

　Although prevention of noise-induced hearing loss is important, the risk of exposure to high-level sounds is not well recognized at workplaces. Occupational health support centers are expected to provide care resources for workers, wherein the workers can see an otolaryngologist to prevent noise-induced hearing loss. The Committee of Occupational and Environmental Health in the Oto-Rhino-Laryngological Society of Japan was planned to promote cooperation with occupational health support centers by means of registration of otolaryngologists as occupational health advisors. The committee conducted a survey using a questionnaire about the occupational health advisor registration process. Subsequently, there was an increase in the number of otolaryngologists who participated as occupational health advisors, with registrations occurring in 20 of the 47 occupational health support centers in Japan. Cooperation between otolaryngologists and occupational health support centers appears to be proceeding reasonably well and is the first step toward a more widespread effort for the prevention of noise-induced hearing loss at workplaces.

　A 64-year-old woman with neurofibromatosis type 1 was admitted because of a sudden hematoma in her right neck and throat. To prevent an airway obstruction, tracheostomy was performed, but bleeding into the trachea persisted and was difficult to stop. Bleeding arose from a vessel lesion in the right parapharyngeal space, passed through the paratracheal space, and finally reached the tracheostomy wound. An arteriovenous fistula (AVF) in the maxillary artery was revealed by angiography. We diagnosed rupture of the varix resulting from venous high pressure caused by the AVF. The patient was treated by vascular interventional radiology (IVR). A large number of platinum coils were inserted and N-butyl-2-cyanoacrylate (NBCA) was embolized in the AVF and varix. Although innovative vascular IVR was better than surgery to treat AVF of the head and neck lesion, some problems were encountered. The cost for the provided medical services was high, and NBCA was not approved by the pharmaceutical affairs law in Japan.