The character of vertigo suffered by patients is various.There are not only typical rotatory sensation but unsteadiness, dizziness and black out.In order to standardize the methods to get an objective evidence of these kinds of vertigo, the following study was carried out.
Otologists can induce vertigo by experimental labyrinthine and optokinetic stimuli. Ataxia ac- companied by experimental vertigo was observed by means of cephalograph, writing test, discus throw- er position, nystagmus and electroencephalography. The relationship between the character of vertigo and distinctive character of ataxia was investigated.
A) Studies on relationship between experimen- tally induced labyrinthine vertigo and ataxia.
1) On the relationship between vertigo and ataxia caused by rotatory stimulation.
2) On the relationship between vartigo and ataxia caused by thermic stimulation.
3) On the relationship between vertigo and ataxia caused by galvanic stimulation.
4) On the relationship between vertigo and ataxia caused by linear movement.
B) Studies on relationship between experimen- tally induced optokinetic verigo and ataxia.
As the result of these studies it was found that the vertigo induced by labyrinthine stimuli is various in character depending on whether it is induced by rotatory, caloric and galvanic stimula- tion and or by linear movement. Rotatory stim- ulation induced sensation of rotation (Drehschwin- del), thermic stimulation induced unsteadiness, weakness or dizziness, galvanic stimulation induced sensation of falling and linear movement induced unsteadiness or dizziness (Schwankschwindel). Corresponding with to these varieties of character of vertigo, the nature of ataxia differed in appear- ance as indicated by observations of swinging of the body, labyrinthine deviation, arm-tonus-reaction and nystagmus. Therefore, in order to get objec- tive evidence of various kinds of vertigo suffered by patients, tests of righting reflex, labyrinthine deviation and nystagmus are necessary.
Optokinetic and postrotatory vertigo and nystag- mus in these subjects showed that labyrinthine vertigo was the complaint while postrotatory nys- tagmus was occuring, but optokinetic vertigo was present when optokinetic nystagmus had diminished in spite of continued stimulation. Namely, the relationship between optokinetic nystagmus and vertigo is opposited to the relationship between postrotatory nystagmus and vertigo.

抄録全体を表示

In development of middle ear, the pneumatization of the mastoid cellulae is well known.
While the pneumatization of the tympanum is rarely discussed, tympanum itself has to pneum- atize.
The author studied the relationship between the pneumatization of the temporal bone and thal of the tympanum, in vertical parallel section to pyramis in 50 cars of 50 cases.
Dimensions of the tympanum was measured by the planimeter, and compared with the rate of the radiographical pneumatization of the temporal bone.
Furthermore, the author observed the influence of the pneumatization of the tympanum to the facial canal wall.
The results are as follows:
1) High correlation between dimensions of the tympanum and pneumatization of the temporal bone was seen.
Namely, the better the pneumatization of the temporal bones, the wider their dimensions, howe- ver the degree of repression, did not show more narpowing.
2) The development of tympanal cellulae had a high correlation with the radiographical appearance of the temporal bone.
3) Themore developed the tympanum, the thinner was the facial canal wall.
This consequence is due to the absorbtion of bony tissue in pneumatization mechanism.
In 24 cases out of 41, the facial canal wall defect was recognized in the portion of sinus tympani.
From the result of(3), the cause of the facial paresis in tympanoplastic procedure was discussed.
The author notes that when the tympanoplasty is employed in caseof a well developed pneumatization of the temporal bone extreme care must be taken.

抄録全体を表示

Lately in Japan, the registration system has been established.Therefore, statistical study of laryngeal cancer cases is now possible.
In order to carry out the present study, many interviews of patients were made. Following are the main post-operative complications.
1. permanent loss of speech function.
2. naarowing of tracheostoma.
3. dryness and crust formation in the region of tracheo-cutaneous junction and the upper
tracheal area.
4. diminished of smell sense.
5. abnormal taste sense.
6. tendency to have frequent common colds.
7. increased amount of sputum and occasional
coughs.
8. potential danger and inconvenience due to
the location of newly created tracheal opening in the neck.
9. shortness of breath.
These post-operative complications beside No.1 were investigated on totally laryngectomized patients and the following reports were made.
(1) Temperature on the mucosal surface of trachea and bronchi:
Totally laryngectomized people must breath through the newly created opening in their neck. Generally speaking, the temperature on the mucosal surface is lower than normal and not stable.In addition, quick adjustment seems to be necessary to the sudden changes of enviromental temperature.
(2) Histo-pathological study on tracheal and bronchial wall tissue.
On autopsy, consecutive sections were made
from tracheal and bronchial tissue of totally laryngectomized patients.Complete epithelial degener-ation, hyaline-like hyperplasia of basilar membrane and cell infiltration with fibrous proliferation took place in the upper portion of the trachea and carina where the changes of temperature were greater in degree.
These histological changes correspond to the duration of tracheal respiration after surgery.
(3) The usage of stoma cover on totally lar-yngectomized patients.
In general, the tracheal opening incovered by 4 sheets of gauze (so-called apron) in order to protect the respiration. This stoma cover is effe-ctive in regulating surface temperature on tracheal and bronchial mucosa.
In order to evaluate possible disturbances by using this stoma cover, pneumotachography was carried out which revealed no significant effects in function.
(4) Smell sense:
Smell test is carried out by intravenous inje-ction of Alinamin (B1 preparation), smell bottle and positive pressure nebulizer. All 7 cases show total loss of smell sense or highly reduced smell sense.
(5) Taste sense :
It seems to be difficult to summarize the con-dition of taste sense only by the conventional tests because taste disturbance is more complicated and delicate in nature. However, it is clear that 4 out of 5 show remarkable disturbance of taste sense.
(6) Enlargement of tracheal opening:
Narrowing of tracheal opening is not a common complication. Slight narrowing brings uncomforta-ble feeling but highly narrowed opening results in difficulty in breathing.In order to reduce this difficulty, partial removal of anterior portion of tracheal rings is performed.This operation shwos relatively good results.

抄録全体を表示

The common problems encountered in the surgery for chronic otitis media and chronic paranasal sinusitis were discussed in this articles.
"Preservation of the mucous membrane", "Communication of these cavities with the proper nasal cavity or with the external auditory meatus", and "Obstruction of these cavities"
As the result the author has been lead to conclude that it is unnecessary to remove the mucous membrane because the change of the mucous membrane is a result of inflammation and not a progressive pathological process. Therefore, removal of the mucous membrane is not jastified unless the membrane itself is the cause of clinical symptoms such as rhinorrhea, otorrhea and hearing impairment. Consequently, the routine dissection of the mastoid cells in tympanoplasty is notperformed by the author.
Although it is rational to communicate the sinuses with the proper nasal cavity in sinuectomy, it is not reasonable to open the middle ear cavities, tympanum and mastoid cells to the external auditory meatus, as taught by a meager history of the middle ear sugery.
Attempt to obliterate only one of the middle ear and paranasal cavities, the frontal sinus or the mastoid cells for example, is meaningless from the point of whole treatment of chronic inflammation of these cavities, because the ethmoidal sinus can not be obliterated in sinuectomy and the tympanum should not be obliterated in tympanoplasty.

抄録全体を表示

A case of psychogenic deafness was reported.
A twenty-two year old female complained of bilateral severe deafness after psychological trauma.
In spite of subjective hearing loss, on EEG test auditory evoked responses were clearly observed suggesting her normal hearing. She was completely cured by the test and suggestion of recovery.
Some tests for psychogenic deafness were reviewed and our case was discussed from previous literatures.

抄録全体を表示

The authorsl reported the statistical observations of maxillary osteomyelitis (14 cases) in the neonatal period and infancy in past 5 years.
The results were as follows :
1) All cases were within 3.5months after birth.
2) They were considered to be due to nasal or maternal infection before birth.
3) The bacterial examination showed chiefly Staphylococcus aureus.
4) Chloramphenicol or Erythromycin were used with success.
5) The facial deformities due to the disturbance of maxillar development by operation were not formed.
6) The deficit of milk teeth were recognized in the canine, 1st and 2nd molar tooth, particulary in the canine tooth.
7) The best treatment would be considered to be not only the energic administrations of chemotherapeutics according to sensitivity test but also early complete removal of lesions.

抄録全体を表示

Recent advances in audiology have made it possible to determine locus of pathologic lesions in the auditory pathways. However, attention should be paid to examine hearing of head blow patients.Because two or more areas from the middle ear up to the auditory cortex are frequently involved.We have examined 90 cases of head blow with special attention in finding retrocochlear lesions, by combining several audiometric procedures.
The following auditory tests were performed in all cases, in addition to routine examinations of otoscopic finding, X-ray photography pure tone audiometry, vestibular tests and EEG.
1) Speech Audiometry
Discrimination scores were made by a speech audiometry with and without filters which cut off frequencies higher than 1700 cps or lower than 1200cps.
2) Bekesy Audiometry
Frequencies of 1000cps and 4000cps were used in this test. Tone decay was examined after an exposure of 80dB for a minute.
3) Directional Hearing Test
A device was made to measure threshold of the interaural time difference which produced a shift of the tone image, by placing two microphones apart from 0 to 1.2 msec (0 to 42cm). A value over 0.06msec (2cm) was considered to be pathological.
Speech audiometry frequently helped us in diagnosis of retrocochlear deafness in cases of poor discrimination scores with an excellent pure tone threshold. Bocca and Calearo devised an apparatus to avoid patients " being accustomed " in conventional speech audiometry. In our series of examinations, we employed 1200cps low pass filter and 1700cps. high pass filter to obtain discrimination scores Control experiment in normal person showed 50 to 70% in each test at 80dB above threshold, whereas in patients of suspected retrocochlear deafness poor scores were obtained. The sum of scores tested with filters did not exceed that without filters.
Many authors have reported that the recruitment phenomenon is present in head blow patients.A narrow amplitude in Bekesy audiogram is often observed in patients with positive recruitment.Tone decay is suggestive of retrocochlear lesion.An effective test for demonstrating retrocochlear lesion is to measure threshold of the interaural time difference. Matzker states that a lesion, higher than the crossing-over of the auditory system in the brain stem, showed a high value in the directional hearing test.
By combining Bekesy audiometry, filtered speech audiometry, and a directional hearing test, it is possible to determine retrocochlear lesions in the auditory system.

抄録全体を表示