Twenty-three Japanese patients with bilateral acoustic tumors were examined at Tokyo University Hospital during the period of 1960-1978. Clinical signs, symptoms, auditory and neurootological findings were reported in Practica Otologia Kyoto, Vol. 70 and 72.
The data that follows were derived from a series of 11 patients with bilateral acoustic tumors. Investigations were made from the standpoints of vertical diameters of the internal auditory canal and their shape by petrous bone tomography. The data were compared with those obtained in 19 patients with unilateral acoustic tumors who were examined at Tokyo University Hospital during the period of 1974-1978.
The maximum of the vertical diameter measured in each internal auditory canal ranged from 6 to 13mm with an average of 9.4mm in the bilateral acoustic tumors and 4 to 14mm with an average of 6.9mm in the unilateral acoustic tumors. There was a difference in the vertical diameter between the bilateral and unilateral acoustic tumors.
The canals were separated in the following: straight when the variation in the vertical diameter was less than 1mm all along its length, oval when the medial and lateral ends of the canal were more than 1mm smaller from the middle diameter, and funnel-shaped when the medial diameter was greater than any other portion of the canal. In the bilateral acoustic tumors, 82 percent of the canals were oval, but in the unilateral acoustic tumors, 68 percent were funnel-shaped. This discrepancy may be accounted for by the different behavior between the bilateral and unilateral acoustic tumors. The tomograms of the internal auditory canal as well as the auditory and neurootological findings showed that the etiology of the bilateral acoustic tumors differs from that of the unilateral acoustic tumors.

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We report about the otoneurological findings in 31 patients with brain stem lesions and comparison of the results between the standard auditory examinations and the vestibular examinations. The 31 patients were diagnosed as follows; acoustic tumors, 14; meningiomas in cerebellopontine angle, 3; trigeminal neurinoma in CPA; 1; cholesteatoma in CPA, 1; fibroblastoma in CPA, 1; brain stem glioma, 8; brain stem hemorrhage, 3. The abnormal findings of the auditory brain stem responses in these patients were divided into two patterns. In one pattern, the latency of the fifth wave was delayed. In the other, the fifth wave was not apparent. The vestibular findings suggested brain stem disturbance in patients in whom the auditory brain stem responses were also abnormal.

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From 1976 to 1978, 1995 patients with a hearing problems were statistically analyzed in the Department of Otolaryngology of Kumamoto University Hospital.
One thousand one hundred and fifty-six had a sensorineural hearing loss. The causes of sensorineural hearing loss were Meniere's disease (7.1%), noise-induced deafness (7.0%), drug-induced deafness (4.3%), sudden deafness (4.8%), etc.; as for 60.5% of sensorineural hearing loss, the exact cause was unknown.
Eight hundred and thirty nine had a conductive hearing loss. The causes of conductive hearing loss were chronic otitis media (60.0%), acute otits media (13.0%), serous otitis media (19.3%), congenital malformation of external and middle ear (3.1%), etc.

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Auditory brainstem electric response (ABR) is generally recorded as the potential difference between the electrode on the ear lobe and on the vertex [Lobe-Vertex recording]. Among the five waves recorded the latency and the presence or absence or Wave I and V are particularly important factors.
The purpose of the present study was to obtain a clear appearance of Waves I and V even at the low intensity of sound by simultaneous performance of Lobe-Vertex and Membrane-Vertex recordings. As the tone stimulus is decreased toward the subjective threshold in Lobe-Vertex recording, each wave becomes smaller, and the waves, except for Wave V are frequently undetectable near the threshold.
On the other hand, in the recording of the potential difference between the electrodes on the posterior marginal portion of the tympanic membrane and on the vertex [Membrane-Vertex recording], Wave I is larger and Wave V smaller than that of Lobe-Vertex recording, and the clearly detectable Wave I can be obtained by the tone stimulus near the subjective threshold. Namely, the detectability of Wave I and V depends on the site of the recording electrode and there is no statistical difference between the two recording methods regarding latencies of the two waves.
Typical wave patterns recorded from three patients were demonstrated: two of acoustic tumor and the other of a C-P angle tumor.
In one patient with an acoustic tumor and the one with an C-P angle tumor, although no waves were detected in Lobe-Vertex recording, Wave I was clearly detected in Membrane-Vertex recording.
In the other patient with an acoustic tumor, Waves I and V were not so clearly detected in Love-Vertex recording, but in Membrane-Vertex recording, Waves I and V were clearly detected and the prolongation of the latency interval between Waves I and V could be measured.
From these results, it is suggested that the simultaneous Lobe-Vertex and Membrane-Vertex recording technique in ABR is most useful for the detection of cochlear nerve and the brainstem disorders.

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Waardenburg described in 1951 the syndrome with which his name is associated.
The main components of the syndrome are:
1) Dystopia canthi medialis lateroversa
2) Hyperplasia radicis nasi
3) Hyperplasia supercilii medialis
4) Poliosis—White forelock
5) Heterochromia iridum
6) Unilateral or bilateral neural deafness
Waardenburg's syndrome is inherited as a Mendelian dominant but the various features are not always found together in any given case, according to the penetrance and expressivity of the genes.
In this case, a 4 year old boy has pale blue eyes without any other eye anomalies and in our E. N. T. clinic, he was also found to have a congenital neural deafness on the right side, by E. R. A. system.
In addetion, he also had the characteristics of 1) and 3) listed above.
The latter 2 characteristics were also evident in the grandmother, mother and one of the uncles.
They do not, however, show any other anomalies.
This syndrome is considered to be transmitted through the maternal genes.

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Chondronecrosis of the laryngeal cartilage following radiation therapy is a rare but serious complication.
We report herein a case of post-radiation chondronecrosis and discuss factors predisposing to its development.
A 67-year-old man received telecobalt therapy for cancer of the right vocal cord. A year after the radiation therapy given in a dose of 7, 000r, the patient developed dysphagia and dyspnea. Following tracheotomy, he underwent total laryngectomy. The surgical specimen showed no cancer but chondronecrosis of the cricoid cartilage was present. After laryngectomy he developed progressive soft tissue necrosis of the neck and died following a carotid hemorrhage.

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We gave OK-432, a preparation made from a low virulent strain of streptococcus hemolyticus, to 68 patients with head and neck cancer by intramuscular injection and 2 patients were treated with local application. Anatomical site of the tumor in 70 cases was as follows; nose and paranasal sinus 22, nasopharynx 17, base of oral cavity and tongue 14, mesopharynx 8, larynx 6 and miscellaneous 3. We administered OK-432 mainly as an adjuvant immunotherapy after radical surgery or radiotherapy. The daily dose of OK-432 was 0.2KE, then the dose was gradually augmented and the maintenance dose was 3-5KE. The longest duration of OK-432 administration was 3 years and 6 months. We evaluated OK-432 from the point of view of the immunological parameters and the recurrence rate. Complement level (CH₅₀) and tuberculin reactivity were measured as possible indices of the humoral and cell-mediated immune status. “The six stage classification after CH₅₀ and tuberculin reaction” as suggested by Nishioka was employed and an analysis carried out.
The results obtained were as follows:
1. OK-432 had no tumor-reducing effects in advanced or recurrent cases.
2. Immunological findings suggested that OK-432 had prophylactic effects against recurrence and metastasis.
3. The recurrence rate of OK-432-treated group was almost the same as that in the control group, however, the recurrence rate of OK-432 and FT-207 treated groups was 26%, this rate being considerably lower than that in the control group. We concluded that adjuvant chemo-immunotherapy was more effective than adjuvant immunotherapy alone for prevention of recurrence and metastasis.

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It is generally accepted that ATP markedly improves cerebral blood flow and inner ear metabolism, and depresses vestibular responses. The antivertiginous effects of ATP were evaluated in a single controlled study in 82 patients with vertigo and/or dizziness.
The clinical subjective signs and symptoms in these cases were evaluated every two weeks both by the doctors and the patients themselves. The objective symptoms in the equilibrium and auditory examinations were also evaluated at the first examination before prescribing treatment, the second after two weeks, and the last after four weeks, by the same doctors. Dosage was 300mg of ATP daily for four weeks.
The global comparative judgement of the subjective and objective clinical findings showed antivertiginous drug effects in 46 out of 81 patients (56.8%) after four weeks ingestion. When the effects of ATP after two weeks ingestion were compared with those after four weeks, there was a significant improvement in the latter.
Side-effects were minimal, and only three patients reported occipital headache, thirst and fatigue.

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Using the method of heterotransplantation of human tumors in nude mice first performed by Rygaad and Povlsen, we have succeeded in transplanting hypopharyngeal cancer. No previous success in hypopharyngeal cancer transplantation has been reported. During nine successive transplants, we measured tumor growth rate and studied the changes histologically using light and electron microscopy.
The rate of growth and mutation increased sharply in the first three transplants. However, in the fifth to ninth transplants, we did not observe remarkable changes either in histology or growth rate. These results do not conform to the findings reported by Povlsen that the tumors maintained in nude mice retained the cytological and histological appearance of the inoculated human material.

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Using scanning and transmission electron microscopes, human middle ear mucosae, 6 normal, 3 with chronic inflammation, 11 obtained during second stage tympanoplasty were investigated with respect to regeneration of the mucosa. The normal mastoid mucosa was lined with a layer of non-ciliated and ciliated cells which were tightly connected by desmosomes. The ciliated cells were scattered in the non-ciliated cells. The area occupied by the ciliated cells measured less than 6%. In the mastoid with chronic inflammation, ciliated cells disappeared or decreased in number.The epithelia showed metaplasia into the stratified squamous epithelium. Exposure and rupture of the basement membrane were often observed. The mucosae obtained during the second stage tympanoplasty carried out six months or more after the first operation showed: 1) Almost normal mucosa regenerated where the inflammation had cleared and the aerated tympanic cavity was reconstructed. 2) Even if there was a residue of small cholesteatoma, the mucosa regenerated normally where the inflammation had subsided. 3) The epithelium regenerating after removal of granulation showed a closer proximity to the normal than that after removal of cholesteatoma. 4) The middle ear epithelium was in the process of regeneration and differentiation six months after the first operation.

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