The recent advances in ultrasonography, especially improvements in close-range spatial resolution in the last two decades, make it possible to gain much more information from the body, by allowing visualization of tissue constructions, organ movements and fine blood flow. These improvements could contribute to rapid improvement of head and neck ultrasonography.

Ultrasonography has many advantages over other diagnostic imaging modalities: it is non-invasive and radiation-free, it does not require troublesome pre-treatment preparations, it allows the possibility of real-time dynamic assessment and portability, it provides accurate guidance for interventional procedures, and it is cost-effective.

Based on our long experience and numerous studies of the clinical application of ultrasonography, we focused on the standardization of head and neck ultrasonography, systematic ultrasound examination methods, usefulness of ultrasonography in the primary care of patients presenting with neck mass or swelling, and the importance of ultrasonography in the diagnosis of salivary duct tumors and lymph node metastasis from head and neck cancer.

Maternally inherited diabetes and deafness (MIDD) is a rare subtype form of diabetes caused by a mitochondrial DNA defect associated with m.3243A>G mutation. More than 90% of MIDD cases suffer from bilateral progressive sensorineural hearing loss. Here, we report two cases of MIDD with bilateral profound hearing loss that were successfully treated with cochlear implantation.

Case 1 was a 61-year-old man who complained of bilateral progressive hearing loss since the age of 40 years old and who visited our department seeking treatment. He was diagnosed as having MIDD based on a genetic analysis of mitochondrial DNA that revealed a 3243 A to G substitution. Cochlear implantation (CI) was performed for the right ear, which exhibited profound hearing loss. At 5 years after the CI, the patient had acquired hearing function enabling more than 90% of spoken words to be discriminated. Case 2 was a 44-year-old woman who had suffered from diabetes and deafness since the age of 24 years and who had a 3243 A to G substitution in her mitochondrial DNA. She visited our department for cochlear implantation because hearing aids had never improved her hearing. At 6 years after the CI, she had acquired good speech discrimination. We suggest that CI might be a useful treatment for profound hearing loss in patients with MIDD.

We report a case with a nasal vestibule abscess occurring about fifty years after a rhinoplasty involving a silicone implant. An 83-year-old woman was admitted to our hospital because of crusting of the nasal vestibule. She initially withheld information about having undergone breast enlargement surgery and rhinoplasty involving a silicone implant about fifty years earlier. Nine months later, we diagnosed the patient as having a complication from rhinoplasty. We proposed having the materials used in the rhinoplasty surgically removed as soon as possible, but she refused to undergo the surgery. One year and eight months later, she finally agreed to undergo the surgery. We removed the silicone, and her physical condition improved. Here, we discuss the treatment of chronic infections associated with cosmetic surgery based on the presently reported case and referring to medical literature.

Amyloidosis is a disease characterized by abnormal deposition of a particular protein called amyloid in various tissues of the body. Amyloid protein can be deposited in a localized area, without any harmful impact or affecting only a single tissue of the body. This form of amyloidosis is called localized amyloidosis. Amyloidosis that affects tissues throughout the body is referred to as systemic amyloidosis. Systemic amyloidosis can cause serious changes in virtually any organ of the body. Amyloidosis is associated with diverse symptomatology, with no characteristic symptoms, so that early diagnosis is often difficult. Herein, we report two cases of systemic amyloidosis encountered by us. The first visited us with the chief complaint of swelling of the tongue, and died of cardiac failure caused by cardiac amyloidosis two months later; the other visited us with the chief complaint of swelling of the submental region and was diagnosed as having systemic amyloidosis secondary to multiple myeloma.

We present a summary of the two cases, with a focus on the clinical findings and diagnosis.

Small round cell tumors are histopathologically characterized by proliferation of small, round, relatively undifferentiated cells. Small round cell tumors are generally malignant tumors, such as Ewing’s sarcoma, peripheral neuroectodermal tumor, rhabdomyosarcoma, synovial sarcoma, non-Hodgkin’s lymphoma, and Wilms’ tumor. Histopathological examination is usually to make a definitive diagnosis of this type of tumor.

In this paper, we report the case of a one-year-old male infant with a benign tumor (pilomatrixoma) who was brought to our hospital with swelling of the right parotid region. Fine-needle aspiration cytology led to the suspicion of a small round cell tumor; however, biopsy of the tumor revealed findings suggestive of pilomatrixoma. Therefore, under the tentative diagnosis of a benign tumor, operation was performed. This case presented that diagnosis of small round cell tumor is difficult, and to avoid unnecessary surgery or examinations, we should not forget the possibility of benign tumors such as pilomatrixoma.

Paraganglioma in the head and neck region is relatively uncommon, being particularly rare in the larynx. We report a case of laryngeal paraganglioma that we treated by resection after preoperative embolization.

A 63-year-old female patient was detected to have a supraglottic submucosal mass during a routine gastrointestinal endoscopy performed during a health examination. Contrast-enhanced CT and MRI revealed a highly enhancing tumor, suggestive of a paraganglioma. Digital subtraction angiography identified the superior thyroid artery as the feeder artery. Furthermore, the results of endocrine examinations, including elevation of the serum level of noradrenaline, revealed that the tumor was a functional paraganglioma.

After embolization of the feeding artery, we performed tumor resection via the extra-laryngeal approach. During the operation, there was little bleeding, so that the embolization provided a bloodless surgical field. There were no postoperative complications, such as paralysis of the vocal cord or dysphagia.

Until now, a year since the surgery, there has been no evidence of recurrence.

We report a case of herpes zoster of the larynx in a 75-year-old man who presented with sore throat, dysphagia and singultus. At presentation, flexible fiberoptic laryngoscopy revealed white coating and swelling and erythema localized to the left epiglottic and supraglottic regions, but there was no evidence of soft palate paralysis or vocal cord paralysis at the first visit. With a strong suspicion of varicella-zoster virus (VZV) infection, the patient was treated with acyclovir. Nine days after admission, however, we found left soft palate paralysis and left vocal cord paralysis. The patient was initiated on treatment with corticosteroids, which led to complete recovery within 5 days. It was suspected that inflammation caused by VZV re-activation affected the vagus and glossopharyngeal nerves. In cases with acute onset of unilateral vocal cord paralysis, steroids and antiviral therapy should be considered.

Primary squamous cell carcinoma of the thyroid gland (SCCTh) is a very rare disease, occurring in less than 1% of all thyroid cancer patients. The treatment of primary SCCTh is not well established, and the disease usually has an aggressive clinical course. Therefore, primary SCCTh is associated with a very poor prognosis.

We report a case of mixed squamous cell carcinoma and papillary carcinoma of the thyroid gland. A 77-year-old man visited our hospital complaining of a swelling of the anterior cervix, and he underwent a total thyroidectomy under a suspicion of thyroid cancer. After surgery, the patient developed paralytic ileus of unknown cause. The patient’s overall condition deteriorated because of bone metastasis and pleural effusion, and he died 8 months after the surgery. A pathologic dissection revealed a thoracic spinal metastatic lesion that had invaded the vagus nerve and was considered to have caused the gastrointestinal movement disorder.

Although renal cell carcinoma is well known for its propensity for multiple metastases, even many years after surgical treatment, metastasis to the head and neck region, including the thyroid, is rare. Herein, we report a case of metastasis in the thyroid gland and tumor in the internal jugular vein, with no increase of the serum thyroglobulin level, and also local recurrence of the carcinoma, 12 years after nephrectomy in a patient with a history of renal cell carcinoma. All the lesions appeared on the left side. Total thyroidectomy and neck dissection were performed. Histopathological examination indicated that the metastatic tumor in the thyroid was attributable to the thrombus formation and growth of the carcinoma in the veins of the thyroid gland as well as the internal jugular vein. The venous drainage from the kidney anatomically reaches the left lobe of the thyroid through the paravertebral venous plexus and internal jugular vein. Therefore, the possibility of metastasis from renal cell carcinoma to the thyroid should be considered when a thyroid tumor in the left lobe is encountered in a patient with a history of nephrectomy for renal cell carcinoma, even when the serum thyroglobulin level is in the normal range.

We developed a new phototubometry system containing a photo sensor reacting only to a certain range of near-infrared light. This system can detect the light reaching the external ear canal through the Eustachian tube from the light source at the pharyngeal orifice when the tube is open.

This system was tested in healthy adults without ear disease to clarify its clinical usefulness in the evaluation of Eustachian tube function. Significant increase in the amount of the light was detected with every swallowing movement in all subjects. The click-like sound simultaneously recorded through the ear during swallowing was considered to be closely related to the opening of the Eustachian tube, since the sound always coincided with the increase of the light. Changes in the quantity of light passing through the tube were also detected when the subjects sniffed and phonated /a:/.

Considering these results, we concluded that this phototubometry system is a promising tool to evaluate tubal function or diagnose tubal insufficiency.