Three cases are presented in detail.
Patients complaining of vertiginous symptoms were evaluated using the three popularly adopted neuro-otological methods, i. e. the caloric, eye tracking and opto-kinetic nystagmus tests. The data from the caloric test suggested possible involvement of the vestibulo ocular reflex pathway, whereas those from the eye tracking and optokinetic tests indicated involvement of the horizontal eye movement pathways, namely the saccade eye movement and smooth pursuit eye movement pathways.
Final diagnosis was made by studying the common region shared by the above tests.
The above methods were applied to approximately 100 patients and were found to be very useful.

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Using “Equilibrium tests for neurotic vertigo” (Hinoki et al 1976), 117 patients with head and neck injury were examined with the following results:
(1) Of the above-mentioned 117 patients, 25 showed ataxia of Type A. The remaining 92 showed ataxia of Type B. The former type of ataxia is considered to be of psychosomatic origin. The latter type of ataxia is considered to be mostly of non-neurotic, particularly non-psychosomatic origin, although a certain group of mental diseases, such as neurosis and masked depression, possibly shows ataxia of Type B.
(2) The appearance of ataxia of Type A was significantly more marked in the patients with neck injury of whiplash type than in those with head trauma.
(3) In the patients with head trauma the following facts were noted. That is, the development of ataxia of Type A was more marked in the patients with little evidence of cerebral involvement than in those with moderate and severe cerebral symptoms at the time of accident. These symptoms included cerebral concussion, cerebral confusion and intracranial haemorrhage.
(4) Opposite tendency was found between the above-mentioned two types of ataxia (Types A and B) with regard to the facts described in (2) and (3).

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A case of right sensorineural deafness and left peripheral facial palsy due to mumps is reported. A 36-year-old male suddenly noticed right-sided hearing loss on Feb. 6, 1980. Three days later mumps occurred followed by weakness of the left facial muscles after about two weeks. No response of the right ear was obtained in the pure tone audiogram but the left facial paralysis was mild in the nerve excitability test. Complete recovery occurred in the facial palsy early on but no improvement was shown in the hearing impairment.

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A case of vibratory tinnitus due to tubal muscular contractions was presented. There contractions of the tube were observed through the nasopharyngeal fiberscope and recorded using tympanometry. Recording at static pressure showed muscular perturbation. The tinnitus was attributed to the contraction of the tensor veli palatini muscle because it was stopped when the mandibular division of the trigeminal nerve was blocked. The effects of transection of this muscle were described.

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A case of bilateral congenital choanal atresia is presented. The patient was a 16-year-old girl who had suffered from thick, mucoid discharge and complete nasal obstruction since birth. Although she gradually learned to breathe through her mouth, she often encountered respiratory distress with cyanosis in the early stages of life. A diagnosis of choanal atresia was made when a catheter failed to pass through the nose into the pharynx. The nasopharyngography confirmed the posterior nasal obstruction.
Surgical correction was performed by a transpalatine approach under general anesthesia. Following exposure of the posterior choanal region via the transpalatine approach, the membraneous tissue which occluded the choanae was excised. Silicon tubes were left inserted into the opened choanae for 2 weeks. No remarkable complication has been observed postoperatively. The choanae are still open and the patient breathes satisfactorily through her nose.
From 1923 to 1979, 45 cases of congenital choanal atresia have been reported in the Japanese literature. These cases are analyzed in terms of sex, laterality, type and concomitant anomalies. Our present report is the 45th case of congenital choanal atresia to be reported in Japan.

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A rare case of congenital external parotid grand fistula was seen in a fourteen-year-old girl admitted with the complaint of salivation from a small hole in the left cheek. The salivation continued without stopping and increased especially after a meal. Stenon's foramen was situated at the normal position in her oral cavity and salivation was normal. She had no other congenital deformity.
On physical examination, a cyst of 1.5cm in diameter was palpable at the back of the fistula. Sialography clearly revealed a cyst and fistula.
A surgical procedure of extraction of the cyst which had an abnormal salivary duct was performed and the fistula on the left cheek was closed.
The postoperative course was good and at present, 10 months after the surgery, sialography shows no fistula and she is free from any recurrence of the problem.

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In clinical practise, Tolperisone hydrochloride, (Muscalm) a central muscle relaxant drug, is administered to patients with spasticity of the neck and shoulder muscles.
The antivertiginous effects of Tolperisone were evaluated in a single controlled study in 29 patients who had vertigo and/or dizziness, especially that due to cervical vertigo, head injuries, and the traumatic cervical syndrome. The clinical signs and symptoms in these patients were evaluated at two points of time both by the physicians and the patients themselves. The objective symptoms in terms of equilibrium and auditory functions were evaluated firstly before treatment and secondly after medication by the same doctors.
The drug dosage was 300mg of Tolperisone daily for four or six weeks.
The global, comparative judgment of the subjective and objective clinical findings showed antivertiginous drug effects in 20 out of the 29 patients (69.0%) after four or six weeks of medication.
With respect to antivertiginous effects of this drug, vertigo and/or dizziness were particularly suppressed in 23 out of the 29 patients (79.3%), especially in cervical vertigo.
No side-effects were observed during the treatment. Therefore, the authors concluded that Tolperisone had antivertiginous effects in patients with cervical vertigo and head and neck injuries.

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The therapeutic effects of Cerocral were studied on 15 patients with peripheral vestibular disturbances.
Cerocral was effective in 75% of patients. Of the subjective symptoms, vertigo and dizziness with nausea and/or vomitting were prominently improved. On the other hand, the effects on tinnitus and hearing impairment were limited. With regard to the objective symptoms, improvements were showed in results of cupulometry.

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Factors causing variability of the slow and fast phases of nystagmus in caloric testing are reviewed. The range of normal values is wide. This can arise from three different sources: technical variation in conducting the test, anatomical differences among temporal bones, and involvement of the central nervous system during caloric responses. A model for organization of the eye movement in vestibular testing is presented. Parameters based on the slow phase of nystagmus do not discriminate a peripheral lesion from a central lesion except for the following: (1) lack of visual suppression in light during caloric testing indicates a posterior fossa lesion and (2) decrease of slow-phase velocity in unilateral or bilateral optovestibular testing is suggestive of brain stem disorder. However, examination of the fast phase of nystagmus can provide additional information for differentiating a peripheral from a central lesion. A decrease of fast-phase velocity in caloric, optokinetic, and optovestibular testing is always a sign of central nervous system disease and frequently indicates a posterior fossa lesion.

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The electrophysiological study using cats was performed to determine whether or not noradrenaline derived from the locus coeruleus (LC) may act as an inhibitory transmitter or modulator on the auditory and vestibular transmission in the primary relay nuclei. The effects of LC conditioning stimulation on neuron activities in the dorsal cochlear nucleus (DCN) and lateral vestibular nucleus (LVN) were compared with those in the spinal trigeminal nucleus, where conditioning stimuli applied to the LC preceding the test stimulus to the trigeminal nerve markedly reduced the height of postsynaptic field potential and the orthodromic spike generation of relay neurons and type B interneurons. In the LVN, P, N₁ and N₂ waves of field potential and orthodromic spike generation produced by VIII th cranial nerve stimulation in monoand polysynaptic neurons remained unaffected with LC conditioning stimulation. In the DCN, the height of polysynaptic field potential and orthodromic spike generation in the neurons with long latency elicited by VIII th cranial nerve stimulation were significantly inhibited by LC conditioning stimulation. These inhibitory effects of LC conditioning stimulation on the DCN neurons were not obtained in the animals pretreated with reserpine, however, subsequent administration of noradrenaline into the lateral ventricle produced an inhibition of the spike generation with LC conditioning. Histochemical study demonstrated that nerve terminals (varicosities) with a catecholamine fluorescence were observed in the DCN of cats, but the terminals did not found in the LVN. These results indicate that the inhibitory effects of LC conditioning stimulation are produced in the areas where exist the noradrenaline terminals. It is strongly suggested that noradrenaline derived from the LC acts as an inhibitory transmitter or modulator on the auditory transmission in the DCN, however, the LVN neurons are not regulated with noradrenaline from the LC.

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In order to determine the effect of muscular contraction upon the opening processes of the Eustachian tube, cineradiographic and radiographic observations of monkeys' tubes were carried out. Electrical stimulation of the tensor and levator veli palatini muscles of four macaque monkeys were made. The tube was visualized by instillation of contrast medium through the perforated ear drum. The results were as follows. 1. Levator stimulation produced no opening of the tube. It only caused dilatation of the pharyngeal orifice by inward movement of the torus tubarius. 2. Tensor stimulation produced consistent opening of the tube by outward displacement of the tubal wall along its entire cartilaginous part.

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