Statistical and prognostic studies were made on 102 patients who suffered from rotatory vertigo without any sign of cochlear symptoms. They visited the Department of Otolaryngology, Kurashiki Central Hospital from 1971 to 1976. The following results were obtained:
a) Statistical observations:
1) Among 1, 977 vertiginous patients, 102 showed rotatory vertigo without any sign of cochlear symptoms, the rate being 5.2%.
2) The development of the vertigo of this type was more marked in females than in males, the ratio being 2:1.
3) The development of the vertigo of this type was marked in those aged from the twenties through the forties, the peak being in the thirties.
4) Patients with the vertigo of this type consulted our clinic within 2 years after the first attack, with a rate of 70%.
5) The positive signs of vestibular disorders detected were more marked in the patients with Meniere's disease than those with vertigo of this type.
6) Patients tended to show one or more recurrences of vertiginous attacks within one month. However, some of the patients developed only one recurrence with an interval of several years.
b) Prognostic observations derived from the questionnaires:
Among the above-mentioned 102 patients, 49 responded to our questionnaires with the following results:
According to vertiginous attacks and cochlear symptoms, these 49 patients were divided into the following three groups:
1) The first group still had vertiginous attacks and developed cochlear symptoms for the first time. About one-third of the 49 patients belonged to the first group.
2) The second group had only vertiginous attacks without any sign of cochlear symptoms. About one-third of the 49 patients belonged to the second group.
3) The third group ceased to have vertiginous attacks and developed no signs of cochlear symptoms. The remaining one-third of the 49 patients belonged to the third group.
From these findings the following conclusions were drawn:
The rotatory vertigo with no cochlear symptoms differs from Meniere's disease with regard to the neural background. However, it is possible that the condition turns into Meniere's disease, although such a tendency is not very marked.

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Forty-three patients with sudden deafness were examined by equilibrium tests and electrocochleography during the early stage of the onset (within two weeks). We estimated the role of the tests about the prognosis of sudden deafness. The results were as follows.
1) In complete recovery, the wave forms of AP response were high amplitude and the -SP appeared. The latency of AP response was almost within normal limit (1.35-1.75msec). Examined by equilibrium tests there were no abnormal findings in all patients but one.
2) In remarkable improvement, the wave forms of AP response were low amplitude and those of the -SP were same. In a large number of the cases latency of the AP delayed at 85dBHL (>2.0msec).In thirteen of sixteen cases the equilibrium tests revealed abnormal findings.
3) In slight improvement and no change, there were some cases of no response of AP and -SP. Examined by equilibrium tests it seemed to indicate that the neural regions were impaired.
As above-mentioned it was concluded that the electrocochleography and equilibrium tests were very helpful in estimating the prognosis of sudden deafness during the early stage of the onset.

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Of the 1, 094 patients with Bell's palsy we treated in the past 15 years, 49 or 4.5% had bilateral or recurrent palsy. These 49 patients were classified into the following four groups according to their clinical courses: 1) bilateral simultaneous Bell's palsy (5 patients, 0.5%), 2) bilateral recurrent Bell's palsy (1 patient, 0.1%), 3) bilateral alternating Bell's palsy (21 patients, 1.9%) and 4) unilateral recurrent Bell's palsy (22 patients, 2.0%). Distributions by sex and age of onset of the above groups were compared with those of 481 patients with fresh, single Bell's palsy. Statistically significant difference was found with respect to the distribution by sex between bilateral palsy and unilateral recurrent palsy as well as between fresh single palsy and unilateral recurrent palsy. Close similarity was noted with respect to the distribution by the age of onset between bilateral and single fresh palsies. Unilateral recurrent palsy tended to occur at a younger age. Different pathogeneses were suggested for unilateral recurrent palsy and other forms of palsy.

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Neurofibroma in the parotid gland is a rare disease. We recently experienced the disease in a 33-year-old male. Surgical removal resulted in permanent facial palsy, although the main trunk of the facial nerve was not included in the tumor isolated from the superficial lobe of the parotid. The necessity of preoperative estimation of such a complication in the parotid surgery was emphasized.

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Computed tomography was performed on 5 patients with paranasal sinus diseases with unilateral exophthalmos, i. e., mucocele of the frontal sinus, mucocele of the anterior ethmoidal sinus, posterior ethmoidal and sphenoidal cysts, postoperative maxillary cyst and maxillary carcinoma.
Computed tomography showed the position of these lesions, their extension into the orbital cavity and the defect of the bony wall more clearly than plain rentogenography and tomography. These findings were confirmed at operation.
Computed tomography is useful for diagnosis of paranasal sinus disease, especially posterior paranasal sinus disease, postoperative maxillary cyst and carcinoma, as well as for the follow-up study of paranasal sinus disease.

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The classification of benign fibro-osseous lesions is not unequivocal. It is especially difficult to distinguish ossifying fibroma from fibrous dysplasia. We report two cases of these benign fibro-osseous lesions here.
The first case was a 37-year-old female complaining of right-sided exophthalmus and nasal obstruction. Radiographically, the border of the lesion was well defined. This lesion was totally removed while preserving the orbital contents and histo-pathologically was diagnosed as ossifying fibroma.
The second case was a 15-year-old male complaining of painless swelling of the right cheek. Radiographically the border of the lesion was not well defined. He underwent curretting and histopathologically this lesion was diagnosed as fibrous dysplasia.
These two lesions were analyzed with respect to clinical, surgical, radiographical and histopathological features. As a result of the analysis, we conclude that ossifying fibroma was not identical with fibrous dysplasia.

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A study was made of recurrent maxillary cancer in 74 of the 178 patients who were treated in our hospital for the past 13 years and 7 months.
In the traditional therapy composed of total maxillectomy and radiotherapy, initial treatment is of particular importance and must be carried out thoroughly. In contrast, the current combined therapy consisting of surgery, radiotherapy and regional chemotherapy places stress on the importance of the treatment at the time of recurrence.
In the latter case, the lesion tends to recur in the anterior wall as well as the superior wall of the antrum and particular care should be paid to make particular examination of such regions.
With immediate and adequate treatment at the time of recurrence, preservation of the structure and function of the diseased region may be successfully controlled.

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Two cases of idiopathic glossopharyngeal neuralgia are reported. Case 1 was a 43-year-old female, who visited our hospital with the chief complaint of attacks of severe pain located deep in the left ear, which lasted about 10 seconds and had been occurring more than ten times a day during the preceding 10 days. She was diagnosed as having the otitic type of idiopathic glossopharyngeal neuralgia classified by Bohm and Strang. Case 2 was a 71-year-old female, who visited our hospital because of the severe pain attacks which had begun 2 days previously. The pain initiated around the left tonsil, radiating deeply to the left ear, lasting approximately for 30 seconds and occurring dozens of times in one day. Its cause was also unknown and the patient was diagnosed as having the oropharyngeal type of the neuralgia of the same classification. Tegretol (carbamazepine) and other drugs were given and transoral glossopharyngeal nerve blocking with Xylocain (lidocaine hydrochloride) was performed on both patients without remarkable effect. Transtympanic injection of Xylocain, the so-called tympanic nerve block was then performed. The patients responded dramatically to the therapy and the symptoms have not recurred since then for more than 5 years in the case of the first patient and for 1 year and 9 months in the case of the second patient. It is, thus, emphasized that this new conservative technique should be applied once to glossopharyngeal neuralgia of any type at least in cases where operative therapy is not intended.

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Nine patients with postintubation granulomas of the larynx were evaluated clinically and pathologically in the last seven years.
Their ages ranged from 30 to 58 years with an average of 45. There were seven females and two males. They received such operations as thyroidectomy, parotoidectomy etc. under intubation anesthesia.
Postintubation granulomas of the larynx developed unilaterally in four patients and bilaterally in five patients. These granulomas were all removed by the use of laryngeal forceps or a laryngeal snare under the modified neuroleptanalgesia except one patient. Extracted granulomas were examined microscopically. Pathological findings of these tissues were charactalized by the development of nonspecific granulation with invasion of small numbers of lymphocytes and eosinophiles as well as edema and small-vascular dilatation in the submucosal layer.
We discussed the etiology of postintubation granulomas of the larynx and their process in this paper.

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Experimental sinusitis was produced by repeated injection of the staphylococcus aureus 209 P strain in the maxillary sinus of 25 rabbits three times a week. They were then sensitized with the intramaxillary administration of 2.5% egg albumin.
The animals in this study were divided into the following four treatment groups: group 1 was composed of three rabbits which received the inactive Seaprose; group 2, five animals were given Serratiopeptidase in a dose of 20mg/kg; and group 3 and 4 consisted of the animals which were treated with Seaprose in a dose of 40mg/kg in 5 cases and in a dose of 60mg/kg in 12 cases, respectively.
The subjects in each group were given the above drugs through a gastric tube once a day for a period of two weeks. The macroscopic and morphological changes of the mucous membrane of the sinus of each experimental group were compared.
The results obtained were as follows.
In groups 1 and 2, a decreased number of cilia, abnormal giant cilia and abundant secretory cells were observed, but these pathologic changes were less prominent in groups 3 and 4. Seaprose demonstrated superior efficacy on the mucosal pathology of sinusitis in group 4. Moreover, there was a clearly significant difference between group 4 and the other three groups.
From the above results, Seaprose was considered to be a useful enzyme for some kinds of sinusitis.

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A clinical study of PSK (protein-bound polysaccaride) was carried out in 169 patients with head and neck malignancy and the following results were obtained.
1. PSK was administered to 82 (48.5%) out of the 169 cases basically treated by irradiation and/or surgery.
2. The one year survival rate (95.0%) of patients with laryngeal cancer treated by irradiation combined with chemotherapy with or without PSK was better than that (45.2%) of patients solely treated by irradiation. On the other hand, the effect of antitumor agents including PSK on the malignant tumor of nose and paranasal sinuses was not evident.
3. The 18-month survival rate (63.6%) of patients with pharyngeal cancer who received supplementary administration of 5-FU or FT-207 combined with PSK was higher than that (16.7%) of patients treated only with 5-FU or FT-207. A similar effect of PSK was observed in the analysis of patients with oral cancer; the 18-month survival rate of patients supplementally treated with 5-FU or FT-207 combined with PSK was 66.7% and that of patients who received no PSK was 16.7%.
4. No side-effects of PSK were found in this series.
The present study indicates that various antineoplastic therapies for treatment of head and neck malignancy may produce good results when PSK is continuously administered concomitantly.

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In order to clarify the processes of the tubal opening, and to examine the pump-like clearance function of the tube, contrast roentgenographic studies of the tube were conducted in 7 monkeys and 10 human beings. Experiment 1: Cineradiographic studies of the tube during selective stimulation of the levator and the tensor muscles were carried out in 4 monkeys. The levator stimulation produced a dilation of the pharyngeal orifice, but no tubal opening. On the other hand, tensor stimulation produced complete opening of the tube by outward displacement of the lateral wall of the tube. Experiment 2: During swallowing, simultaneous recording of the cineradiogram of the tube with an EMG of the tubal muscles was carried out in 3 monkeys. It was revealed that synchronously to the tensor activity, the cartilaginous tube opened for a very short time (ca. 250msec) by outward displacement of its lateral wall. On the other hand, the pharyngeal orifice of the tube dilated for a relatively long time (ca. 450msec) synchronously to the levator activity. This time lag between the two parts of the tube seemed to help its pumping function. Experiment 3: Serial roentgenography of the tube using a film-changer was carried out in 10 patients with perforated ear drum caused by chronic otitis media. First, it was revealed that the opening process of the tube in human beings was exactly the same as that observed in animals. Second, the slit-like tubal lumen was a little oblique at rest, and it opened through outward displacement of the lateral wall of the tube. Third, the so-called isthmus of the tube was obscure in many cases. Experiment 4: Cineradiography of the tube during swallowing was carried out in 10 patients in the same way as experiment 3. It was found that the tube had a pump-like function to pool fluid in it during the tensor contraction, and to expel it at the end of contraction in the pharynx.
It was concluded that the tube opened by the tensor contraction and closed by its relaxation. At the same time combination of contractions and relaxations of the tensor caused the pump-like function of the tube to expel any foreign body in the tympanum toward the pharynx.

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