Four seasons have passed since sublingual immunotherapy was released in 2014 for patients with Japanese cedar pollinosis. However, it is often unclear how its treatment should be performed in clinical practice. We reported results of similar survey we conducted in 2016 and 2017. This time, we again investigated, after the end of pollen scattering period in 2018, the clinical usage level, subjective treatment effects, adverse effects, satisfaction level and sense of burden in treatment by using self-written questionnaire for 431 patients who began treatment from 2014 to 2017. The age distribution shows bimodal distribution in the 10s and 40s. The portion of patients who were aware of treatment effects tends to be higher after the second season than the first season, therefore it is suggested that it is preferable to continue for at least two seasons. The portion of patients who complained adverse reactions in the first season was 23.4% and it decreased to 5.6%, 5.0%, 1.2% in the second, third or fourth season respectively. If it can be continued for one season, it is unlikely that it will be a problem for the continuation of treatment after the second season. Some patients do not want to continue the treatment in the fourth season, and when to end treatment is needed to consider in the future.

　For nystagmus testing, infrared videonystagmography has come to be commonly used, rather than Frenzel's glasses. Nystagmus images are not only observed on monitors, but can also be stored in video devices, etc. When they are saved as video images, it is also very important to find a way to record the information of the head positions on the video.

　We developed a Windows video capture software which generates head animations from information on the head positions and places the animations on the captured nystagmus images. Information on the head positions can be set with the keyboard or the mouse of the PC. Information can also be set automatically using the motion sensor unit.

　Recently, integrated circuits, such as sensors, have reduced drastically in price and size, with much improvement also in their performance. Even amateurs like us can assemble a motion sensor unit with a small number of parts and at a low cost.

　We show the Windows software which captures the eye images with information on the head positions and handles the captured videos. We also show how to assemble a motion sensor unit to obtain information on the head positions automatically.

　Work style reform of physicians is a hot topic in Japan, since it has been legislated by law. The majority of head and neck surgeons in Japan can be considered as overworking and their work style reform is an urgent issue. Increase in both surgical and chemotherapeutic modalities, in addition to increase in the prevalence of head and neck cancer patients may be the reasons for head and neck surgeons being overworked. Task shifting and/or sharing with co-medical workers and medical oncologists would seem to be effective and necessary.

　In recent years, the number of patients with allergic rhinitis (AR), including Japanese cedar pollinosis (JCP), has increased. Dr. Baba conducted epidemiological surveys in 1998 and 2008 to investigate the prevalence of AR in Japan, using questionnaires for otolaryngologists and their families. We carried out same questionnaire survey to investigate the changes in the prevalence of JCP, perennial allergic rhinitis (PAR), and pollinosis other than JCP in 2019. The results of our survey revealed a prevalence of AR of 49.2%, and a prevalence of JCP of 38.8%. These rates represented marked increases over the previously recorded results. Furthermore, a marked increase in incidence of JCP was observed in the younger age groups.