Following four experiments were performed on the reconstruction of injured trachea.
1) The anterior wall of two to three rings of the cervical trachea of dogs was resected to create a defect of 10mm in length and 10mm in width. Four kinds of autografts were used to repair the defect. They were; a) nasal septal cartilage with mucosa, b) tracheal cartilage without mucosa and perichondrium, c) auricular composite graft, d) skin graft. No subcutaneous or mediastinal emphysema was observed in all dogs. The animals were sacrificed 7 days to 3 months after the operation. The results were evaluated from the gross fihdings, microscopic examination and the scanning electron microscopic observation. The most satisfactory graft was nasal septal autograft, and then followed by tracheal, auricular and skin graft. In skin grafting, stricture and fistula formation were observed in a few dogs, because of the lack of supporting tissue.
2) 5-0 nylon suture was rather appropriate in end to end anastomosis than silk suture, because the formation of granulation tissue was not observed.
3) Circumferential resection of the trachea was performed by resecting a segment of 2.0cm in length from the cervical trachea and immediately reimplanted, The reimplantation was followed by the stricture associated with granulation tissue and necrosis.
4) In the anterior aspect of the cervical trachea, two windows (10mm in length and 10mm in width) were created. The upper tracheal autograft and the lower one were exchanged and transplanted in the reverse direction. Postoperative course was uneventful.

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In order to study the effect of the cervical symathetic nerve on the oxygentension of the perilymph, cervical sympathetic nerve was cut at the central part from the upper cervical sympathetic ganglion, and was stimulated by an electric current. Oxygentension of perilymph was not affected. Cervical sympathetic nerve was stimulated by the electric stimulator, when oxygentension of perilymph was increasing by inhalation of 90% O₂ + 10% CO₂ gas mixture.
Increase of oxygentension was inhibited and it appeared again after cessation of the electric stimulation. Intravenous injection of Phenoxybenzamine caused low blood pressure and low oxygentension of perilymph, but oxygentension recovered after dropping in the first stage. This reaction suggest the blocking effect of the α-receptor. I speculated the presence of sympathetic control that α-receptor is predominant.

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Chronic sinusitis is one of the most prevalent nasal illnesses in Japan, but the pathogenesis of chronic sinusitis has not been fully understood yet. Recent advances in immunology have provide convincing evidence that secretory immunoglobulins may have an important role in mucosal defense mechanism.
Fifty six specimens of maxillay mucosae and 17 of nasal mucosae were obtained by surgery from the patients with chronic sinusitis and studied in order to obtain information about the local immune mechanism. Immunofluorescent microscopic studies were undertaken to determine the presence and distribution of different immunoglobulins (IgA, IgM, IgG and IgE) and secretory component (SC) in nasal and maxillary mucosae. Additionally, the relationship between the histopathological types of chronic sinusitis and local immunoglobulins were studied.
Following results were obtained.
1) There was no difference in the location or production of immunoglobulin bearing cells and extracellular immunoglobulins between the infiltrative and edematous mucosae in histopathological type. In fibrotic type, fluorescent activity could not be established.
2) IgA and IgM bearing cells were demonstrated in the surface lamina propria and around the grandular tissue of maxillary mucosa. In the nasal mucosa, IgA and IgM bearing cells were localized around the grandular tissue. A small number of IgG bearing cells weae noted in lamina propria in maxillary and nasal mucosae. No IgE was noted.
3) Extracellular IgA and IgM were mostly localized in intercellular space of the mucosal epithelial cells, subepithelial interstitium and around the glands. In maxillary and nasal grandular cells, IgA and SC were localized in the apical portion of glandular cells and intercellular space of the grandular epithelia. IgG was predominantly distributed in the interstitium of most specimens, especially in the surface lamina propria but not seen in the grandular cells.
4) As inflammation became severer in the maxillary mucosae, IgA and IgM bearing cells were increased considerably, and especially, extracellular IgG was seen more brilliantly.
5) Although SC was detected in 82% of nasal mucosa examined, it was detected in 30% of the examined maxillary mucosae. These results indicated that there is immunological dissociation between nasal and maxillary mucosae.
The results suggested that the increase of IgA and IgM bearing cells could be due to an acceleration of local immune response, and the bulk of IgG derived from serum. The production of SC and polymeric IgA were lost in some infected maxillary mucosae. In these SC defficiency and/or decreased secretory IgA production and combined with IgG local immune reactions may contribute to enhancement and perpetuation of inflammation in the naso-maxillary system.

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Shaking of the head may be followed by nystagmus in some instances. There has been no established theory about the way of head shaking or the responsible site for the resulting nystagmus. Thus, the author tried to establish the effective way to head shaking and to clarify the responsible site for development of nystagmus following head shaking in search of proper treatment for vertigo or disturbed sense of equilibrium.
Horizontal head shaking performed by the author as a clinical test failed to cause nystagmus in healthy subjects. From the result on experiments in rabbits and in clinical study in which the subjects were stimulated on their inner ear and on the cervix either separately or simulatenously, development of head shaking afternystagmus (HSAN) was possibly triggered by stimulation of the peripheral labyrinth. In HSAN test, however, the patient's neck is also twisted by head shaking and this caused the marked change of the peripheral blood flow of the vertebralbasilar artery, That was probably the reason why HSAN more frequently developed in insufficiency of the vertebral-basilar arterial circulation than in disturbances of the peripheral labyrinth.
It means that the site which should be regarded as the most important responsible site for development of nystagmus following head shaking would be the vertebral-basilar artery, followed by the peripheral labyrinth, the cerebral stem and soft tissues at the cervix. The test adopted by the author was simple and useful for establishment of the responsible site for vertigo and disturbed sense of equilibrium as well as for observation of the patient's clinical progress.

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A method of reconstruction for lingual carcinoma after 1/2 or 2/3 resection of the tongue was described on 10 cases. Myocutaneous flap of M. pectoralis major or M. sternocleidomastoideus was used for this study.
As compared with the D-P flap which was used as the ordinal surgical operation, the method of myocutaneous flap was discussed on operative procedures, complications and post-operative functions. It was found that the method of myocutaneous flap was of great advantage to the follows;
1) Defective portions in the oral cavity and or opharynx was constructed primarily.
2) Transplantation of delay or free graft was not necessary.
3) It was a good method to prevent of post-operative salivary fistula or to hasten its natural closing.
4) As the floor of the oral cavity was kept in higher level, that disorders of speech or eating were reduced.

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We have applied the sternomastoid myocutaneous flap for head and neck reconstructive surgery as an island skin flap or as an osteomyocutaneous flap along with the clavicle. The flap offers certain advantages over the standard lateral neck skin fllap and was utilized more predictably to resurface some defects in the oral cavity and in the pharyngeal wall without delay procedure. Conclusions are as follows;
1. Being used as a superiorly pedicled myocutaneous island flap, a small skin paddle attached only to the tip of the muscle was likely to be necrosed. A larger skin paddle which covered more than inferior one-third of the muscle, however, was safely transfered.
2. Mandibuller bone defect was safely reconstructed with an osteo-myocutaneous island flap with the clavicle. Small skin paddle over the clavicle in this instance was effective to prevent the grafted bone exposed in the oral cavity.
3. Inferiorly pedicled flap was good enough to reconstruct the defect in the laryngopharyngeal wall, though the distance of its transfer is somewhat limited.
4. Uncomplicated healing was seen even though the neck skin and the sternomastoid muscle had been irradiated previously.
5. The muscle should carefully be elevated not to disturb its main blood supplies which enter the muscle superiorly and inferiorly.
5. When node metastasis was suspected high in the neck, this flap should not be used because the sternomastoid muscle can not be elevated beyond the level of the second cervical vertebra without endangering its viability.

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Postoperative headache in oto-rhino-laryngology was evaluated from the changes of the respiratory rate, pulse rate, the fever and blood PCO₂. The data obtained one day before the operations and that of 24 hours after the operations were compaired.
The operations performed were as follows; tympanoplasty, submucous resection (SMR), conchotomy, turbinectomy, tonsillectomy, polysinuectomy, maxillostomy, extirpation of nasal vestibular cyst and laryngo micro surgery.
Ninety-seven percent of the patients who complained post-operative headache were due to postoperative nasal obstruction. In these patients SMR, conchotomy and turbinectomy were performed. Eighty-four percent of the patients after SMR and seventy-four percent of the patients after concho-turbinectomy complained postoperative headache. In fifty percent of the patients after polysinuectomy complained headache but in these cases SMR, conchotomy and turbinectomy were also performed. In tonsillectomy and maxillostomy, eight percent of the patients had postoperative headache. Headache was not complained in patients after tympanoplasty and laryngo-micro surgery.
Analysis of the changes of the respiratory rate, pulse rate, fever and blood PCO₂, showed that the patients complained postoperative headache had respiratory excitation.
We concluded that headache after nasal operations were caused mainly from the postoperative hyperventilation.

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The daily change of the compound VIII nerve action potential(AP) caused by clicks during kanamycin(KM) treatment was observed especially in the input-output function curve and waveform, which were recorded in a manner very similar to that used in human electrocochleography.
Sixteen rabbits weighing about 3kg were used for this investigation. Rabbits were equipped with an electrode made of stainless steel wire tipped with a silver ball permanently implanted on the promontory near the round window. The reference and ground electrodes were taken on a part of the head terminal of the electric plug fixed on the skull by the stainless steel wire.
Rabbits were divided into two groups. One group was given daily intraperitoneal injections of KM 150mg/kg and the other was 500mg/kg. Electrocochleographic responses were recorded daily after KM injection in awake rabbits placed into a shielded sound-proof room. The stimuli used were clicks and presented at a rate of 10/sec directed from a TDH 49 receiver. The averages were set for an analysis period of 10msec. The amplified responses were averaged 1000 times and then recorded on an X-Y plotter. The cochlear microphonics were cancelled by alternating the polarity of every click.
The waveform of Ap became broad with multiple peaks as the KM injection continued.
The input-output function curve of Ap Nl in normal rabbits showed a two-segmented pattern, i. e, the L-curve and the H-curve much the same as man and the other animals. The change of Ap Nl input-output function curves during KM treatment was observed as follows. In an early period of KM(150mg/kg) treatment, despite of almost no change in the L-curve, the amplitude of the H-curve especially in high intensities decreased eminently. Secondly, the latency of the L-curve increased and then reduction of amplitude and increment of latency for both curves progressed gradually. Finally, with the elevation of threshold the L-curve disappeared progressively and only the H-curve was observed. In case of KM(500mg/kg) treatment, reduction of amplitude and increment of latency for both L- and H-curves were observed almost at the same time. Then the L-curve disappeared rapidly and only the H-curve was observed. The process of the change was different in accordance with quantity of KM, but finally with the elevation of threshold the L-curve disappeared and only the H-curve was observed.
Recruitment with long latency at threshold, disappearance of the L-curve and steep inputoutput function curve were present in three rabbits. It was noted that summating potential was observed in the same rabbit simultaneously with recruitment.

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