Stylohyoid syndrome is a rare syndrome that presents with a variety of symptoms and is often difficult to diagnose and treat. We reviewed the background characteristics and outcomes of 10 patients with stylohyoid syndrome who underwent surgical treatment. Six patients underwent surgery via extraoral access (7 sides) and 4 patients underwent surgery via intraoral access (4 sides), and the improvement rates were 67% and 75%, respectively. There was no significant relationship between the preoperative length of the styloid process and the symptom improvement rate. Although surgical treatment may be useful for patients with stylohyoid syndrome, since it is difficult to predict cases that will not respond to surgery before the surgery, a thorough preoperative explanation is necessary. In cases in which the surgical treatment was unsuccessful, there may have been an element of nociplastic pain, characterized by altered nociceptive function.

　 We conducted a questionnaire survey of patients on sublingual immunotherapy (SLIT) with cedar pollen in 2022. A total of 442 patients who received SLIT with cedar pollen were enrolled in this study (128: 95: 133: 86, in the order of the 1st to 4th year of treatment; 219 males; age: mean 23.9 ± 16.2 (range, 5-68) years). During the peak season of cedar pollen dispersal, the general symptoms were investigated using a 100-mm VAS and a face scale (FS; 5-point scale from 0 to 4). After the dispersal period, the impression of the patients on SLIT was surveyed on a 5-point scale (very good to bad) and a 100-point scale. Overall, the survey revealed the following impression of the patients on SLIT: significantly improved, 193 cases (43.6%); improved, 128 cases (28.9%); better than before the treatment, 108 cases (24.4%); no change, 12 cases (2.7%); worse, one case (0.2%). The mean score on the 100-point scale was 78.5 ± 19.2. The mean FS was 1.5 ± 0.8, and the mean VAS score for general symptoms during the pollen dispersal phase was 30.5±24.6 mm. All the indices of the outcome were significantly better with increasing years of treatment (p<0.01). There was a correlation between the symptoms during the pollen dispersal period and the impression of the patients post-dispersal period, and a significant correlation was observed between the VAS score and score on the 100-point scale. Most answers on the FS and treatment impressions were consistent, but they differed by 2 or more grades in 20.9% of patients. In the cases with mismatched answers, patients had good impressions even about the symptoms during the dispersal period. The majority of cases were in their first year of treatment. Sublingual immunotherapy is associated with a high level of patient satisfaction. Significantly better results, both in terms of the symptoms during the dispersal phase and the patient impressions, were obtained as the number of years of treatment increased.

　 Recent advances in optical imaging technology have enabled obtention of high-definition and magnified images of the tympanic membrane. However, an accurate diagnosis from imaging findings of the tympanic membrane requires much experience and is not always easy in the absence of clinical findings. In this study, we attempted to create a machine-learning program to automatically diagnose middle ear diseases using endoscopic images of the tympanic membrane collected in our hospital. The images of the tympanic membrane were classified into five diagnostic categories (normal, acute otitis media, exudative otitis media, chronic perforating otitis media, and cholesteatoma), based on the diagnosis by a skilled otolaryngologist. Neural Network Console^® provided by SONY was used for the learning, evaluation, and calculation of the accuracy. VGG-11 and InceptionV3 were used as the learning models; a total of 544 images were collected, and the program yielded a 74% accuracy rate for the five diagnostic categories. In our study, the model using VGG-11 without fine-tuning yielded the highest accuracy. Establishment of an automated tympanic membrane diagnostic program is a potential tool to aid non-ENT physicians to diagnose otitis media, but more images would be needed to further improve the accuracy.

　 Psychogenic dysphagia is defined as food avoidance and excessive fear of eating without identifiable anatomic or functional swallowing abnormalities. No unified diagnostic criteria or disease concept have been established for this condition. Although cognitive-behavioral therapy has been reported as being effective in many cases, there is no consensus on the most suitable modality of treatment. We report on a case of psychogenic dysphagia in a school-aged child in whom biofeedback using visual information from swallowing videofluorography proved effective.

　 An 8-year-old girl patient was referred to our department with the chief complaint of dysphagia. We suspected psychogenic dysphagia because the symptoms appeared after she heard an episode of an accident in which the child choked to death on a piece of bread. Swallowing videofluorography was performed in the presence of the parents to rule out organic disease, since the parents also reported a weight loss in the patient of 3 kg, along with vomiting and difficulty in drinking; the patient's symptoms improved following the test.

　 Experience with psychogenic dysphagia in a child who was considered as having benefitted from swallowing videofluorography as a diagnostic procedure.

　 Swallowing videofluorography can be a useful management tool in children with psychogenic dysphagia as it provides direct visualization of the oropharyngeal swallowing mechanism. This can be used to provide visual reassurance and biofeedback to patients and parents.

　 We conducted a clinical study focusing on the olfactory cleft findings on CT imaging in patients with COVID-19. The 96 patients were divided into two groups: those with and those without obstruction of the olfactory fissure on CT images. We compared the age, sex, number of days from the date of diagnosis of COVID-19, and length of time from the date of olfactory disturbance to the date of consultation (hereafter referred to as “days from onset to consultation”), presence/absence of anosmia, and severity of the olfactory disturbance in the two groups. Olfactory tests included the visual analogue scale (VAS), the self-administered odor questionnaire, T&T olfactometry, the Alinamin test, and the odor stick identification test for Japanese (OSIT-J). In addition, predictive factors for improvement of olfactory dysfunction were explored in 23 patients who were followed up. The olfactory fissure occlusion (on CT) group showed more severe olfactory dysfunction than the group without olfactory fissure occlusion. In the 23 cases who were followed up, the days from onset to consultation was identified as a predictor of the prognosis. The severity of olfactory dysfunction was greater in the patients with olfactory cleft occlusion than in those without olfactory cleft occlusion. The major prognostic factor identified in this study was the days from onset to consultation, suggesting that early treatment is of importance, or that patients with prolonged olfactory dysfunction are often refractory to treatment.