Sublingual immunotherapy is used for patients with perennial allergic rhinitis caused by mite allergy. We studied the clinical efficacy, during the first year, of mite sublingual immunotherapy. Data of a total of 64 patients at a single clinic (38 male, age range 12-53 years, 20.5±10.8 years, on average) who were started on Miticure^® and followed up until the end of 2018 were analyzed. The clinical efficacy was evaluated by determining the symptom scores and the score on the face scale of the Japanese Rhinoconjunctivitis quality of life questionnaire No. 1 before treatment, after 6 months of treatment and after 1 year of treatment. Adverse events were recorded at every visit. The symptom severity scores prior to/at 6 months/at 1 year (mean±standard deviation) were 1.3±1.1/0.8±0.9/0.7±0.7 for sneezing, 1.6±1.2/0.8±0.9/0.7±0.6 for rhinorrhea, 1.6±1.2/1.0±1.1/0.8±0.8 for congestion, and 1.7±0.9/1.2±0.9/1.1±0.8 for the face scale. All items showed significant improvement after the start of mite sublingual immunotherapy. Significant improvement of the severity was noted in 26 patients (40.6%), mild improvement was noted in 26 patients (40.6%) and no change in the severity was noted in 12 patients (18.8%). Adverse events were reported in 42 patients (65.6%), although none of the adverse events required any treatments. Significant improvement of the nasal symptoms was observed at 6 months and 1 year after the start of mite sublingual immunotherapy.

　Cartilage conduction hearing aids are a new type of hearing device launched in November 2017. They are effective in patients with aural atresia, and therefore, a great choice for amplification in such patients. Although their use has spread gradually, they are still not well known, in general. In order to make them more popular, the information sources which motivate patients to try cartilage conduction hearing aids were investigated. A total of 45 patients from our hospital participated in the study until February 2019. The information sources were classified as Doctor, Media (website or television), Patients Association, Family/Friend, Teacher, and Hearing Aid Store. The survey was conducted every three months, and changes in the information sources over time were also evaluated. Furthermore, subjects with aural atresia or stenosis of the ear canal were divided into binaural and monaural disorder groups, while the others were considered as one group. The differences in the information sources among the groups were evaluated. The results showed that patient associations were the most frequently reported source of information, being confirmed by approximately one-third of all responses. As for changes in information sources over time, although doctors were rarely reported as a source of information in the first one year, the frequency dramatically increased during the last three months. Hearing aid stores were reported only in the first six months, indicating the need to provide the stores again with information about the new hearing aids. Comparison of the results between the binaural and monaural disorder groups revealed that patient associations were more frequently reported as the source of information by the monaural disorder group. In the monaural disorder group, the number of cases increased after the first six months. In this study, most subjects were under 20 years of age. Therefore, effective approaches to encourage the use of cartilage conduction hearing aids among adult patients with aural atresia must be considered in the future.

　Allergic fungal rhinosinusitis (AFRS) is caused by type I and type III allergy, and the T cell responses to the inhaled fungus established noninvasively. We performed 834 endoscopic sinus surgeries (ESS), and the diagnosis of AFRS was established in nine cases. We report the results of our retrospective observational study.

　While a positive fungal culture would be needed to establish the cause, previous reports have said that fungal culture test results are almost always negative. However, at our hospital, we succeeded in isolating Schizophyllum commune (S. commune) in six of the nine cases, using potato dextrose agar and sabouraud dextrose agar as the culture media.

　The method of treatment of AFRS is to first remove all allergic mucin and partition the walls in the sinuses by ESS. Then, a steroid is used postoperatively, along with nasal irrigation and an intranasal corticosteroid in order to control the local pathology. Recurrence was observed in two of the nine cases, but in both, the condition resolved with an oral steroid, without any need for recourse to reoperation.

　The postoperative prognosis of AFRS may correlate with serum total IgE and fungus-specific IgE titers. There have been no previous reports of investigation of the changes in the serum titers of S. commune-specific IgE with treatment, however, we considered that it was important to investigate it in order to evaluate the course of the disease. Our findings suggested that the actual number of cases in which AFRS is caused by S. commune may be more than previously thought.