Using guinea pig, pressures in the external ear canal, in the middle ear and in the perilymph were registered simultaneously, while pressure was applied to the external ear canal using an impedance audiometer. In the first experiment, applied pressure was changed in the range from 200mmH²O to -200mmH²O with and without the opening of the otic bulla. The change in the perilymphatic pressure with the opening was smaller than that without the opening. The result indicates that the external ear pressure is transmitted to the perilymph not only via the ossicular chain but also via the middle ear cavity without the opening, while it is exclusively transmitted via the ossicular chain with the opening. Pressure transmission to the perilymph was significantly impaired either by disrupting the ossicular chain or by closing the round window niche, especially by the latter. Thus the middle ear cavity itself plays an important role in pressure transmission from the external ear canal to the perilymph mainly via the round window. In the second experiment, applied pressure to the external ear canal was changed in the range from 1000mmH2O to -1000mmH²O after the Eustachian tube being closed. Between 400mmH²O and -200mmH2O, the middle ear and perilymphatic pressures paralleled well with the applied pressure. Beyond these levels, the middle ear pressure increased or decreased in response to the applied pressure but the perilymphatic pressure reversed against the middle ear pressure. Communication between perilymph and cerebrospinal fluid via the cochlear aqueduct is thought to be a major factor causing this reversal which, in turn, aggravates pressure gradient between the middle ear and the perilymph. The author assumes that the round window membrane ruptures when the resultant pressure gradient expands beyond a certain tolerable level.

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This study aims to ascertain whether sensorineural hearing loss occurs after the decompression of the facial nerve. Nine patients have undergone decompression of the facial nerve (limited to the vertical segment) by the transmastoid approach were selected as the subjects of this study because the influence of disinfectants and surgical trauma on the inner ear seems to be less severe in this operation than in tympanoplasty. Additionally, this approach seems to be more suitable for judgement of the effect of the drilling noise induced acoustic trauma on the inner ear than tympanoplasty.
Though high tone abrupt sensorineural hearing loss was occured in the operated ear in seven patients, no changes in hearing level were found in the contralateral side ear. Bekesy audiometry performed in only one case revealed Jerger II which suggested some disorder in the cochlea.
Not only acoustic trauma induced by the drilling noise but also labyrinthitis occurred via the opened facial canal and the internal ear canal seemed to be the cause of sensorineural hearing loss following the decompression of the facial nerve.

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Human normal vestibulocochlear and facial nerve trunks were cut off near the brain stem of the individuals whose ages ranged from 24 to 93 years old. For this study, the discriminative staining method (Luxol fast blue-periodic acid-Shiff-hematoxylin triple stain) was adopted. It is admitted that the vestibulocochlear nerve medial to the internal auditory canal histologically resembles to the central nervous system in the rat. In order to confirm the fact in human, the intervening glial cells among nerve fibers were observed in the transverse section of vestibulocochlear and facial nerves. Schwann cells and microglia were observed among nerve fibers, but oligodendroglia. And the number of the glia was counted. The glial ratios related to the transverse nerve areas and the number of axons were calculated, and were examined in relation to aging. We found that there were more Schwann cells than microglia on both vestibulocochlear and facial nerves, facial nerve had more Schwann cells than vestibulocochlear nerve, and the number of Schwann cells per single myelinated fiber increased with age in the facial nerve. A quantitative study has not been included in the literature on the number of glia in the peripheral nervous system. Then, a quantitative study of human normal glia may be essential to elucidate pathogenesis regarding peripheral neuropathies, nerve injury or nerve sheath tumors as distinguished from the normal aging process.

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Obliteration of the right endolymphatic sac was performed by Kimura's method in 57 guinea pigs with normal hearing and vestibular function. However, 43 animals exhibited postoperative cerebellopontile disturbance and labyrinthitis detected by gait test, ABR test and histological examination.
The remaining 14 guinea pigs were evaluated periodically by the trapezoid rotation test.
Two weeks after the operation, 11 of these 14 guinea pigs exhibited prolonged right beating nystagmus based on the labyrinthine preponderance of impaired side (Lpi).
In addition, endolymphatic hydrops was histological detected in the labyrinth on the operation side.
A positive relation was observed between the degree of endolymphatic hydrops and the degree of Lpi.
Lpi at 4 weeks after the operation was markedly lower than that at 2 weeks (P=0.05). Therefore, the degree of Lpi was thought to be influenced by the rate of hydrops development.
These results corresponded with the clinical, findings that the degree of Lpi increases prior to vertiginous episodes in Meniere's patients.

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Pleomorphic adenoma, which is also called mixed tumor is considered to occur favoritely in major salivary glands such as parotid and submandibular glands, and rarely in the nasal cavity, pharynx, larynx, trachea, and lacrimal gland. We reported here a rare case of pleomorphic adenoma (2.9×2.2×1.7cm³) developed from the lateral wall of right nasal cavity in a 43-year-old woman. Statistical observation of pleomorphic adenoma of the nasal cavity in Japan was made and comparative study was also made between such adenoma and that in the parotid gland.
In Japan, 41 cases of pleomorphic adenoma originated in the nasal cavity have been reported so far including ours. These cases had age of onset of 16-74 years, averaging 44.6 years. Sex ratio showed female predominance. No significant difference was noted in affected sides sites. Chief complaints were represented mostly by nasal obstruction (29 cases; 71%) and nasal bleeding (23 cases; 56%). Tumors were surgically extirpated in all cases. One recurrent case (2.4%) was reported and another malignant case (2.4%) was also reported. 4 cases (9.8%) were originated in the lateral wall of nasal cavity and all of the other cases were in the nasal septum. In comparison with pleomorphic adenoma developed in parotid gland in Japan, sex ratio was 1:1.8 compared with 1:2.1 for parotid gland with almost similar tendency. Age of onset averaged 44.6 compare with 32.8 years for parotid gland, with a little advance in age. In the nasal cavity, there appears symptom comparatively early due to the anatomical narrowing of nasal cavity associated with an increase in the tumor and there is no important architecture such as facial nerve for parotid gland, and these make thce extirpation easy. Recurrence rate (2.4%) is lower than that (8.8%) of parotid gland, being 2.4% compared with 4.9% for the rate of malignant change.
In Japan, recurrence rate and the rate of malignant change of pleomorphic adenoma of the nasal cavity are 2.4% and 2.4%, respectively. However it is riskful for us to conclude at present that it has no tendency to recure nor change into malignancy, and that is why we think it necessary to make an extensive extirpation and subsequent careful long term observation in the postoperative course.

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In order to determine auditory reaction time, different test methods for central conducting modes (simple reaction, choice reaction, simultaneous reaction and time lag reaction) were carried out on normal subjects. As test sounds, pure tone, white noise and Japanese vowels were employed.
The following results were obtained.
1) The results were simple reaction time 186ms, choice reaction time 283ms, simultaneous reaction time 288ms and time lag reaction time 370ms (delay time 50ms), 361ms (delay time 100ms), 298ms (delay time 200ms) and 273ms (delay time 400ms).
2) Simple reaction time by stimulus sound pressure level of over 40dB sensation level was almost a certain value, the determination of reaction time of about 40dB sensation level was considered to be suitable.
3) In each sound and each examination method, no significant differences between reaction times according to left and right ears were found.
4) According to examination method, the tendency of significant shortening was found only in white noise. This was considered to be due to broad frequency component of white noise or its tonenality, accordingly if it was used as test sound, it needed to be loudness balanced with other test sound.
5) In simultaneous reaction and time lag reaction, such acoustic psychological problems as binaural fusion, interaural attentional switching mechanism and warning effect of preceding sound needed to be considered.
6) In the subjects having normal auditory function, it might be estimated that identification time may be about 100ms and discrimination time may be about 70-80ms.
7) Auditory reaction time includes the time required in central information conducting process as direct real time, and conbeniency of its examination items were superior to the other methods. Also, the analyses of identification time and discrimination time were considered to be applicable for the diagnosis of quantitative auditory function of the central auditory handicapped persons in future.

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The authors examined degree of faucial tonsillar hypertrophy for 7190 pupils of elementary schools in nine different areas in Japan. The frequency of the third degree of tonsillar hypertrophy, based on Mackenzie's criteria, decreased gradually from 6.9% of the first-year pupils to 2.9% of the sixth-year pupils with a mean of 4.8%. We also studied the relation between the degree of tonsillar hypertrophy of each pupil and the reply to the questionnaire from his or her teacher regarding various aspects of his or her school-life. The third degree of tonsillar hypertrophy of each pupil and the reply to the questionnaire from his or her teacher regarding various aspects of his or her school-life. The third degree of tonsillar hypertrophy seemed to affect school-life of pupils. For example, the frequency of pupils whose speech can be clearly recongnized, was less in pupils with the third degree of tonsillar hypertrophy than in pupils without any tonsillar hypertrophy. Pupils of higher grades with the third degree of tonsillar hypertrophy were classified into two groups. One was the pupils whose school-life was not altered by tonsillar hypertrophy. The other was the pupils who were often absent from school due to chronic or acute tonsillar inflammation.

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The effects of Newcastle disease virus infection on the nasal mucociliary dysfunction after the mechanical stimulation, dehydration and cocain application were investigated in the nonanesthetized in vivo chicken.
Mucociliary transport rate and mucociliary wave frequency were measured simultaneously using the video monitor systems and electrophotometer connecting to the otomicroscope by the direct vision through the palatine cleft of the chicken which were placed in a specially designed plastic holder with mouth opener.
Mucociliary transport rate was accelerated on the postnasal fossa adjacent to the mechanically stimulated side of the palatine cleft. The dehydration for 96 hours produced progressive decelerations of mucociliary transport rate, but not mucociliary wave frequency. Topical application of 20% cocain to the postnasal fossa caused the ciliary paralysis within 5 minutes for more than one hour. The topical inoculation of Newcastle disease virus into the postnasal fossa induced the deceleration of mucociliary transport rate after 4 days and mucociliary wave frequency after 3 and 6 days significantly.
We studied the effect of mucociliary transport rate and mucociliary wave frequency on the topical Newcastle disease virus inoculation after the mechanical stimulation, dehydration, and the application of 20% cocain. Mucociliary transport rate in dehydration and cocain groups were decelerated significantly 4, 7, 10, 13 days after inoculation, but not in the mechanical stimulation group. Mucociliary wave frequency in the dehydration group were decelerated significantly 3, 6, 12 days after inoculation, but not in the cocain and mechanical stimulation groups. Therefore, the results suggest that the mucociliary dysfunction may increase and prolong the severity of viral infection.

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A clinical study was made of 131 patients with laryngeal cancer treated in our department during 13 years from 1975 to 1987. The mean age of patients was 64.8 years, and the male-female ratio was 20.8:1. There were 87 cases of the glottic type, 42 of the supraglottic, and 2 of the subglottic type. Cases in the early stages (stage I, II) predominated in the glottic type, whereas advanced stage tumors (stage III, IV) were predominant in the supraglottic type (x²-test, p⟨0.01).
Hoarseness was the most frequent complaint in the patients with glottic cancer. The proportion of complaints other than hoarseness, such as sore throat, on the other hand, was significantly higher among patients with supraglottic cancer (x²-test, p⟨0.01). There was no significant correlation between stage and duration of complaints until visits to our department.
The overall five-year survival rate was 73.8%. The five-year survivals for the glottic and supraglottic type were 84.3 and 54.3% respectively, and for stage I through stage IV were 94.6, 73.7, 58.6, and 36.4%, respectively. In patients classified as T1 or T2, the following treatment is recommended as basic policy: radiotherapy as initial treatment and, if unsuccessful, secondary salvage surgery should be performed. In patients classified as T3 or T4, however, total laryngectomy is recommended as initial treatment.
Metastases to cervical lymph nodes were observed in 6 patients with glottic cancer and 14 with supraglottic cancer, and the incidence of cervical lymph node metastases was significantly higher in the supraglottic type (x²-test, p⟨0.01). In patients diagnosed as having cervical lymph node metastases during the pre-treatment examination, neck dissection should be performed as a part of initial treatment.

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Field potentials evoked by stimulation of the posterior semicircular canal nerve (PCN) were studied in the postcruciate dimple (PCD) in anesthetized cats. When weak stimulation was provided, field potentials composed of 3 components of small positive, large positive and large negative waves were observed on the surface of the PCD. The field potentials could be observed at the stimulus intensity weaker than 1.5×N¹T. The latencies of initiation of the 3 components were 2.32±0.75 (mean±S.D.; n=37), 3.75±0.92 (mean±S.D.; n=99) and 9.34±2.81 (mean± S.D.; n=101), respectively. The large positive wave of the maximum amplitude was recorded in the lateral part of the PCD. In this point, the large and small positive waves reversed their polarity at the layer III and V, respectively, which located about 500μm and 1000μm deep from the surface. Stimulations of the whole vestibular nerve (WVN) and the deep radial nerve (DR) shared response areas of field potentials. These findings agreed with the previous results as to a neuronal convergence of the somatic and vestibular inputs in the cat.

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The purpose of this study was to clarify the relationship between bacterial flora in tonsillar lacunae and antistreptococcal antibody in sera of the patients with pustulosis palmaris et plantaris (PPP).
Since the pustules develops or worsens after tonsillitis in many patients with PPP, a pathogenic role of tonsillar bacteria is suggested, but no significant association has been proven so far.
In this study, the aerobes in the tonsillar lacunae were identified and quantitated in 15 adult patients with PPP and 9 adult patients with chronic tonsillitis (CT). In addition, serum streptococcal antigen-specific antibody levels in 40 adult patients with PPP, 18 adult patients with chronic tonsillitis, and 11 healthy volunteers (controls) were examined by enzyme-linked immunosorbent assay (ELISA).
The results were as follows.
1. A total of 53 strains (17 species) of aerobes were isolated and identified from the tonsillar lacunae in patients with PPP, while 35 strains (12 species) of aerobes were found in the patients with CT.
2. S.salivarius and S.pneumonjae were the dominant aerobes isolated from patients with PPP or CT.
3. Although the rates of isolation for Staphylococcus and S.pneumoniae were lower in PPP patients than in CT patients, the rate for S.sanguis I was higher in PPP patients than in CT patients.
4. The percentage of α, γ-streptococci to total aerobes in PPP patients was higher than in CT patients.
5. The IgG antibody titers against S.sanguis and S.mitis, and the IgM antibody titers against all streptococci investigated in PPP patients were higher than those in both CT patients and controls.
6. Moreover, both the IgG antibody titers against S.pyogenes T4 and S.sanguis I and the IgM antibody titers against S.sanguis I and S.sanguis II of the patients in which PPP markedly improved after tonsillectomy were higher than those in which PPP showed less improvement postoperatively.
These results suggest that sensitization to S.sanguis in the tonsillar lacunae may lead to the specific production of anti-S.sanguis antibodies in patients with PPP, and that these may cause the occurrence of PPP.

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When ⁶⁰Coγ rays or high-energy X-rays are externally applied to treat laryngeal cancer, the absorbed dose at the laryngeal lumen is lower than given dose because of air space, which it should pass through, before reaching the lesion. Specially in case of high-energy X-rays, the loss of dose is considerable. Thus, the influence of the laryngeal air space on radiation dose was studied for ⁶⁰Coγ rays, 6MV X-rays and 10MV X-rays by thermoluminescent dosimetry using neck phantoms having an air cavity in the upper air way.
At the anterior commissure, absorbed dose are apt to be reduced with 6MV and 10MV more than ⁶⁰Co, but it is not affected by field size or anterior neck angle. In the vocal cord, the doses of 6MV and 10MV decrease in proportion to field size. In the posterior commissure, the reduction in dose varies according field size and anterior neck angle, but it is not related with radiation energy.
From the above results, it is concluded that ⁶⁰Co is the most suitable for radiotherapy of laryngeal cancer of these three rays, and, when high-energy X-rays above 6MV are applied, the loss of dose more than ⁶⁰Co in the anterior commissure and the vocal cord should be taken into account.

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