Vestibulo-ocular reflex (VOR) generates smooth eye movements that are compensatory for head movements to ensure gaze stabilization during head rotations. VOR consists of the semicircular-ocular reflex (ScOR) and the otolith-ocular reflex (OOR). The ScOR induces eye movements that compensate for rotations of the head, whereas the OOR produces eye movements that compensate for linear head movements, so that visual images remain relatively steady on the retina.
During normal visual-vestibular interaction, cooperation between the VOR and vision result in stabilization of the retinal image. Adaptive VOR recalibration occurs whether visual-vestibular mismatch arises through the manipulation of visual feedback during head movement or by lesion-induced modification of vestibular input. Current models of the VOR contain separate gain elements for the ScOR and the OOR.
In this article, we describe our experiments to investigate the plasticity of the ScOR and OOR using OVAR and a linear sled to clarify visual-vestibular interaction. We also further addressed the relationship between adaptive change in the ScOR and the OOR.

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Recently, it was shown that acute low-tone sensorineural hearing loss (ALHL) can be recurrent and occasionally associated with Menieres disease. However, it is thought to be extremely rare for ALHL to progress to severe hearing loss. The diagnosis of ALHL is based on hearing symptoms showing an acute onset and pure-tone audiometry findings at the first examination. Based on these criteria, the possibility of other diseases being diagnosed as ALHL during their clinical course is as predictable as in that of sudden hearing loss.
We report three cases that were compatible with a diagnosis of ALHL at the first visit, but were finally diagnosed as various other disorders on further clinical observation and examination.
Case 1 experienced multiple attacks of low-tone hearing loss, and achieved recovery after steroid treatment. Then she showed bilateral progressive hearing loss that reached the middle and high tone. This case finally developed severe bilateral hearing loss and was diagnosed as idiopathic bilateral sensorineural hearing loss. Case 2 experienced a couple of recurrences followed by recovery of hearing. Then she additionally complained of dizziness and headache in a standing position during the third recurrences. Her complaints disappeared following epidermal blood patch performed three times by a neurosurgeon under a diagnosis of intracranial hypotension syndrome. Case 3 obtained complete recovery, however screening MRI indicated acoustic neurinoma in the inner ear meatus.
Our literature review indicated that perilymph fistula, genomic hearing loss and some other disorders also might be diagnosed as ALHL at the initial stage. Some cases diagnosed as ALHL, showing an atypical course such as the development of severe hearing loss and vestibular dysfunction, may actually be other hearing disorders. At the initial diagnosis and follow up of ALHL, the possibility of the disorders described above should be considered.

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We studied 10 patients with acoustic neuroma who had been followed conservatively for more than 3 years. There were 3 males and 7 females, ranging from 32 to 82 years old (mean age 62.8 years). The first medical examination demonstrated inner ear tumor, with a diameter less than 10mm in all cases. The tumor diameter increased in 2 cases, diminished in 1 case and remained unchanged in 7 other cases. Chief complaints were hearing difficulty and tinnitus in 8 cases and dizziness in 2 cases. As for the hearing level on the affected side, 2 cases showed severe deafness, 2 cases showed moderate deafness and 6 other cases had mild deafness. Changes in the hearing level by more than 10dB occurred in 4 cases.
Considering the findings of the present study and those reported in the literature, it was thought that decisions regarding treatment policy including conservative management are necessary.

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A 12-year-old boy with congenital right ossicular anomaly underwent surgery and 3-dimensional computed tomograph (3D-CT) was obtained before and after the ear surgery.
His anomaly was observed intraoperatively and showed dehiscence of incus long process and stapedial head along with dislocation of the anterior crus. TORP was used for reconstruction of air conduction hearing. Hearing improvement of 34dB was achieved.
Imaging with 3D-CT clearly showed the ossicular anomaly preoperatively and the position of TORP after reconstruction. Our case indicates that 3D-CT is a very useful imaging modality for both preoperative observation of the middle ear and postoperative observation of the reconstructed status.

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Pyogenic granuloma is a benign rapidly growing hemorrhagic lesion that involves the skin and mucosa. As pyogenic granulomas often occur on the oral mucosa during pregnancy, they are called pregnancy tumors. The author encountered a case of pyogenic granuloma involving the right nasal septum.
A 29-year-old woman, 6 weeks after delivery of a baby, presented with spontaneous right-sided epistaxis that had started in the 32th week of pregnancy. Physical examination demonstrated a dark-red mass that bleed easily at the front of the right side nasal septum.
Since the mass did not show any decrease in size, excision of the lesion under local anesthesia was performed about 8 weeks postpartum. Histologic examination demonstrated pyogenic granuloma. There has not been any recurrence for 7 months postoperatively.

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We studied the long-term results (12-31 months) in 36 children with obstructive sleep apnea syndrome (OSAS) who underwent power-assisted partial adenoidectomy (PAPA) with an endoscope and tonsillectomy. We conducted a questionnaire survey and retrospectively analyzed changes in clinical symptoms; snore, apnea, tossing and turning, paradoxical chest and abdominal movement, sweating, nocturnal enuresis, orthopnea, arousal during sleep and state of being half awake, concentration, mood, somnolence, adenoid face and general fatigue during the daytime using Mann-Whitney's U test.
As a whole, various symptoms of OSAS were significantly improved after surgery. Only two patients had recurrent apnea during sleep one year last operatively. However, these results are better than those previously reported. The traditional adenoidectomy is liable to pose some problems such as re-multiplication of the adenoid, compared with this method.
PAPA with an endoscope and tonsillectomy for pediatric OSAS is very useful over the long term.

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Zygomatic arch fracture is a common facial fracture. The diagnosis of zygomatic fracture is usually performed by X-p, CT scan, and 3D-CT. During surgery, assessment is commonly performed by palpation only. Although the diagnosis and intraoperative assessment of zygomatic fracture by ultrasonography is not popular, ultrasonography is an easy, quick, and noninvasive method and is free from any risk.
We present the case report of a 38-year-old female with zygomatic body, arch, and maxillary fracture diagnosed by X-p, CT scan, and ultrasonography. To repair the zygomatic arch, temporal skin incision was made and closed reduction was performed following Gillies method. Ultrasonographic examination was performed during surgery to assess bone alignment.
The findings suggest that ultrasonography is a useful visualizing tool to assess the alignment of the zygomatic arch.

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Pleomorphic adenoma is the most frequent salivary gland tumor. Pleomorphic adenoma occurring from the allopatry salivary gland is particularly rare. We experienced a 28-year-old woman with pleomorphic adenoma thought to have occurred from the allopatry salivary gland on the ipsilateral side chin lower than the left parotoid pleomorphic adenoma for which one had undergone surgery eight years previously. Imaging (CT, MR etc) demonstrated an oval-shaped tumor located in the left lower chin without evidence of connection with the left submandibular gland and left parotid gland. Surgically, the tumor was completely removed and pathologically diagnosed as pleomorphic adenoma. Finally, we concluded that it was pleomorphic adenoma arising from the allopatry salivary gland. However, it could not be completely excluded that it was metastasis from the parotoid pleomorphic adenoma on the ipsilateral side from eight years previously.

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Severe airway stenosis due to acute upper airway infection is an emergent situation. Without prompt and appropriate treatment, the outcome may be fatal.
During the period from November 2005 to October 2006, we treated five epiglottic abscess patients. We examined the occurrence factors and their clinical courses. We divided these patients into two groups regarding their postoperative clinical courses in order to examine the retrospective necessity of tracheostomy.
One case had diabetes and chronic renal failure, but the other four had no past illness which might reduce immune function. We experienced two cases who showed advanced epiglottic abscess in spite of conservative therapy against epiglottitis.
We performed surgical drainage and tracheostomy in all five patients. Although upper airway stenosis improved satisfactorily after operations in two of the five (group I), epiglottic swelling was exacerbated again on the day following the operation compared with the epiglottic thickness immediately after the operation in the other three (group II). We investigated clinical differences between the two groups, and found that both the value of CRP and number of WBC in group II on the day when abscess diagnosis was made had a tendency to be higher compared with those in group I. And the number of hospitalization days of group II also had a tendency to be longer than that of group I.
Epiglottic abscess runs a risk of suffocation. In contrast, patients generally convalesce satisfactorily with appropriate airway management. Accurate diagnosis and prompt treatment are thought to be essential.

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The larynx, thyroid gland and cervical trachea are located in the anterior cervix. Thus isolated thyroid injury is rarely reported. We report a 75-year-old woman who was brought to our emergency room (ER) with dyspnea and cervical swelling after a fall. Fiberscopic examination identified partial occlusion of the trachea. Computed tomography (CT) scan of the neck showed a crushed left thyroid gland and massive hematoma extending from the paratracheal region to mediastinum. Therefore emergency intubation from her nose was performed using a flexible endoscope. The patient underwent tracheotomy. The hematoma disappeared on the 21st hospital day, and she recovered without complications. The patient was doing well at the twenty-month follow-up.

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Laryngo-tracheal separation or tracho-esophageal diversion (original Lindeman's method and our modified method) was applied in 26 patients with intractable aspiration in Kurashiki Central Hospital from September 1997 to February 2005. We evaluated the surgical results based on patient satisfaction. Surgery decreased the frequency of sputum suction in most of the patients, and prevented the incidence of aspiration pneumonia in all patients. In 12 of 18 patients every meal was cleared orally without difficulty following the surgery. Individual swallowing potency and level of consciousness significantly affected post-operative oral food intake. Minor postoperative complications such as fistula at the proximal tracheal edgeoccurred in 6 patients. Most of the problems could be controlled by conservative therapy or minor revision surgery. There was no difference between the outcomes of separation surgery and diversion surgery in this series. We concluded that laryngo-tracheal separation/diversion surgery definitely benefited the quality of life for the patients with intractable aspiration as well as their families.

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