The endoscopic approach to treatment has become the standard of care, not only for inflammatory diseases and morphologic abnormalities of the nose and sinuses, but also for extirpation of benign sinonasal tumors using minimally invasive techniques. Application of this approach to malignant tumors is controversial, in large part due to concerns that the ability to achieve adequate resection might be compromised by the use of less-invasive techniques. We received approval for a multicenter study entitled “Standardization of endoscopic skull base surgery for sinonasal malignancies” from the Japan Agency for Medical Research and Development (AMED), aimed at putting forth a proposal for standardization of endoscopic endonasal surgery for sinonasal malignancies. In the current study, we conducted a questionnaire-based survey and investigated the present state and future issues in the surgical treatment of sinonasal tumors in Japan, particularly in relation to endoscopic surgery. The questionnaire was sent to 633 institutions accredited by the Oto-Rhino-Laryngological Society of Japan, and 433 facilities (68.4%) returned responses to the questionnaires. In 390 of these facilities (90.1%), an endoscopic approach was used for the extirpation of inverted papillomas in the nasal cavity and sinuses, while an open surgical approach was adopted for tumors of the maxillary and frontal sinuses. In 95 of the facilities (21.9%), skull base surgery was performed for sinonasal malignant tumors, and in 82 of these (86.3%), a purely endoscopic approach, or an endoscopic approach in combination with the craniofacial approach was used. In the emerging field of endoscopic surgery for sinonasal malignancies, we believe that it is important to put forth a proposal for safe and standardized treatment, and multi-institutional clinical trials of the recommended techniques will serve the interests of the population in Japan and worldwide.

　Recently, with the advances in the treatment of HIV infection, patients with HIV infection are living longer. The frequency of non-AIDS-defining cancer, including head and neck cancers, in these patients has increased. There are few reports on head and neck cancer patients with HIV infection in our country. In this study, we investigated the characteristics of head and neck cancer patients with HIV infection. Four patients were included in this study: two with oropharyngeal cancer, one with laryngeal cancer, and one with tongue cancer. All patients were male and relatively young. The cancers in all four patients were responsive to the primary treatments employed, such as chemoradiotherapy, but could easily recur locoregionally and worsen the prognosis. During the CRT or RT, the CD4+ cell count decreased in all the patients, -however, no severe adverse events or AIDS were encountered.

　Pulsatile tinnitus could have diverse etiologies; it is important to exclude organic diseases when evaluating this symptom. We report a case of transverse-sigmoid sinus dural arteriovenous fistula who presented with the chief complaint of pulsatile tinnitus. Confirmation of change in the severity of the tinnitus by compression of the neck blood vessels and auscultation are very important to diagnose pulsatile tinnitus. Magnetic resonance imaging (MRI), especially magnetic resonance angiography (MRA), is the diagnostic modality of choice. When looking for a cerebral or basilar artery aneurysm using maximum intensity projection (MIP) imaging, the dural vasculature may be overlooked; it is important to check the original MRA images for abnormalities in the dura and elsewhere. Dural arteriovenous fistula is a rare, potentially curable entity, and a possibility of this condition should be kept in mind in patients presenting with pulsatile tinnitus.