Important information can be obtained by performing play audiometry in infants, but it is necessary to obtain data that are as reliable as possible within a short period of time. We investigated how the difficulty in employing these techniques and the reliability of the testing in children were affected by the age (classified as <3 years, 3 to <6 years, and ≥6 years old) and the developmental level (classified as normal development, developmental disorder, and intellectual disability), based on the time required to perform audiometry and the consistency between the results of hearing tests and the reactions to actual sound as an indicator of performance.

　Among the children with normal development, the reliability was 58% in those less than 3 years old, 88% in those aged 3 to <6 years old, and 95% in those ≥6 years old. In contrast, the time required to perform audiometry became considerably shorter as the age increased. When the consistency was investigated in relation to development, it was 41% in children less than 3 years old with intellectual disability, 58% in those with normal development, and 50% in those with developmental disorder. Among children aged 3 to <6 years old, the reliability of testing was 88% in those with normal development, 75% in those with developmental disorder, and 73% in those with intellectual disability. Among the children who were ≥6 years old, the reliability of testing was higher than 90% in both those with developmental disorder and those with normal development, but only 77% in those with intellectual disability. Among the children who were less than 3 years old, the degree of mental development had no influence on the time required to perform audiometry. However, among children aged 3 to <6 years old and those aged ≥6 years old, the time required to perform audiometry was significantly longer in those with intellectual disability than in those with developmental disorder or those with normal development.

　In conclusion, these findings revealed that good skills and considerable time may be required to perform audiometry in children less than 6 years old. In addition, a longer time and more advanced techniques may be required to perform this test in children with developmental disorder or intellectual disability.

　Because muscular dystrophy progressively causes respiratory failure, tracheotomy is necessary in most cases. Scoliosis and chest deformity are associated with deformation of the trachea resulting in complications occurring during tracheal cannulation. Herein, we present a case of Duchenne-type muscular dystrophy who developed an enlarged tracheostoma and deformation of the vertebrae during long-term ventilatory management. Careful supervision of tracheal cannulation, such as fixation per se of the tracheal cannula, selection of the proper tracheal cannula and dispersion of the cuff pressure was required for his care at home.

　We encountered an adult patient with pneumonia and concurrent acute epipharyngitis caused by Mycoplasma pneumoniae; this appears to be the first case report, as we could not find any previous reports in the literature from Japan or elsewhere.

　A 21-year-old female patient presented with a 39°C fever, sore throat and headache, with subsequent exacerbation of cough. Her general condition was favorable. Although a large amount of pus was found coating the epipharynx, the patient's white blood cell count was normal, although her serum C-reactive protein level was elevated. A plain chest X-ray revealed a cloudy shadow in the lower right lung fields, characteristic of M. pneumoniae pneumonia. M. pneumoniae was isolated from the epipharynx. In patients exhibiting a clinical course, general condition, and laboratory findings similar to those in the present case, acute epipharyngitis and pneumonia caused by M. pneumoniae should be suspected, and appropriate testing must be performed.

　Soft palate myoclonus is characterized by rhythmic involuntary muscular contractions in the soft palate, mainly at rest, which may extend to the eyeballs or even the pharyngolaryngeal, diaphragm. In this paper, we present the case of a patient who had objective tinnitus associated with soft palate myoclonus.

　Administration of a minor tranquilizer and muscle relaxant proved ineffective, therefore, we administered an anticonvulsant in an attempt to control the symptom, however, the symptom persisted. No effective treatment for soft palate myoclonus has been reported so far.

　In recent years, soft palate myoclonus has come to be categorized as a kind of shaking, and in one report, it is classified as a tick. The former is caused by a reduction in the levels of dopamine, and the latter is possibly caused by excessive dopamine. Soft palate myoclonus may be caused by excessive dopamine in the basal nuclei. Elucidation of the dopamine generation and distribution in the basal nuclei may pave the way for the development of an appropriate treatment modality for soft tissue myoclonus in the future.