An honorable presentation entitled “Clinical and Fundamental Studies on the Eustachian Tube” was reported at the annual meeting of Japan Society of Otolaryngology in 1980. In this presentation, the function of the Eustachian tube was discussed fundamentally and clinically, although we found that various clinical problems still remain in our practice on this tube.
The following points should be considered;
1) Are Eustachian tube problems functional or organic?
2) The location of the lesion.
3) Patency.
4) Reversibility of dysfunction.
5) Clearance function of fluid and air through the tube.
6) Relationship between this tube and peritubal lesion in the pharyngeal ostium, tympanal ostium, parotid gland and submaxillar joint.
7) Choice of therapeutic methods and evaluation of the result.
When these problems are solved, the diagnosis of the Eustachian tube function will be made clearly. Tubo-tympanoaerodynamic graphy, tympanometry, cndoscopic and electromyographic findings will be useful for this purpose. Physical and anatomical research should also be performed.

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In unilateral deafness with an intact eardrum, usual pure-tone audiometry does not always reveal the actual threshold of bone conduction, because of cross hearing to the contralateral normal ear. Thus it becomes difficult in some cases to judge whether it is conductive or perceptive deafness. Through impedance audiometry, differential diagnosis of deafness could be simply and objectively made. When normal middle ear reflex was elicited from the affected ear by contralateral stimulation, the ear was judged to be perceptively deaf, because the reflex arch had no relation to the perceptive region of the tested ear. On the other hand, negative middle ear reflex indicates several types of deafnesses besides a conductive one. In the group with negative reflexes, diagnosis should be made based on the result of both middle ear reflex and tympanometry.

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Accurate demonstration of normal and pathologic anatomies of the facial nerve was investigated using high resolution computed tomography, CT/T 8800. In the preliminary experiment, coronal and horizontal scannings were made of dry bone, infusing yttrium oxide (Y₂O₃) into the Fallopian canal and painting the stapes with yttrium oxide. Visualization of the Fallopian canal on coronal scanning was better demonstrated than on horizontal scanning. In the presence of a disease suspected to be facial neurinoma, high resolution CT has some merit in demonstrating bone changes in the Fallopian canal, and this target imaging is an effective means of studying patients with facial nerve disorders.

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Goldenhar's syndrome is considered to be a rare congenital malformation resulting from abnormal development of the first and second branchial arches. It consists of ear, eye and vertebral column anomalies and is an oculo-auriculo-vertebral dysplasia.
Some cases of Goldenhar's syndrome are reported to be accompanied by cardiovascular system anomalies, but few have central nervous system anomalies.
This paper deals with an 18-year-old female, who was diagnosed as having Goldenhar's syndrome on the basis of bilateral accessory auricular appendages and epibulbar lipodermoid, coloboma of the right upper eyelid, and synostosis of cervical vertebrae. She also had left sensori-neural hearing loss, stenosis of the left internal auditory meatus, a congenital intracranial dermal sinus, and unliateral hypoplasia of the mandible.
We considered that this hearing loss was closely related to the stenosis of the internal auditory meatus.

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Olfactory neuroblastoma is an uncommon malignant tumor originating in the olfactory epithelium of the roof of the nose.
Only 22 cases with the same disease have been reported in the Japanese literature.
The purpose of this paper is to report one additional case.
A 71-year-old man presented himself to our department in February 1981 with unilateral epistaxis and nasal obstruction.
The diagnosis was eventually made three months later by electron microscopy. The most consistent fine structual findings were the presence of intracytoplasmic neurosecretary granules and neuritic processes.
The patient was treated successfully with irradiation and partial resection. Bilateral cervical lymph node involvement soon set in and he died 8 months after initial treatment.

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A rare case of multi-follicular dental cysts in a 21-year-old woman was reported. She had four follicular cysts at the bilateral maxillary and mandibular regions. Roentgenographic examination revealed that they were related to four unerupted teeth of maxillary and mandibular third molars. Both maxillary cysts were surgically removed because of painful swelling of the cheeks. The follicular cyst at the left mandibular ramus then became infected, probably due to decreased vital resistance on account of pregnancy. As she suffered a marked trismus, the left mandibular cyst was removed in the fifth month of pregnancy.
Close following up of follicular dental cysts seems necessary even if they produce no symptoms.

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Posturography is considered to be useful for analyses of equilibrium disturbance. There are various ways of analyzing body sway. Recently the author measured the deviation of body sway to evaluate the roles of proprioceptors of the neck and extrinsic eye muscles and examined the velocity of body sway to observe the characteristics of equilibrium disturbance in general.
(1) The relationship between the direction of the head and the deviation of body sway was observed. When a subject turned his head to the right, the center of his body sway often deviated to the left. Similarly, when he turned his head to the left, the the center of his body sway often deviated to the right. This tendency was observed frequently in sportsmen, but scarcely observed in normal subjects.
(2) Smilary, the relationship between the direction of eyes and the direction of body sway was observed. The center of body sway often deviated to the opposite side of the direction of eyes.
(3) The velocity of body sway to the back was faster than to the front in the majority of healthy people with eyes closed, but in patients with labyrinthine disorder, the velocity to the front was faster than to the back.
(4) Severe stimulation with an air caloric system (24°C, 40sec.) on labyrinthines of healthy people with eyes closed increased the velocity to the back, but weak stimulation (30°C, 5-10sec.) often increased the velocity to the front.

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In order to evaluate the clinical efficacy and safety of AM-715 on acute suppurative otitis media (ASOM) and acute exacerbation of chronic otitis media (AECSOM), a double blind trial was carried out comparing with ABPC as the control drug.
800mg/day of AM-715 and 2, 000mg/day of ABPC were administered four times a day.
Results obtained were as follows:
1. Clinical effectiveness
(1) The effectiveness rates for the patients with ASOM evaluated by the attending physicians and the evaluation committee were 76.9% and 65.4% in the AM-715 group and 76.7% and 73.3% in the ABPC group.
(2) The effectiveness rate for the patients with AECSOM evaluated by the attending physicians and the evaluation committee were 55.2% and 42.9% in the AM-715 group and 41.5% and 34.1% in the ABPC group.
(3) In the cases of AECSOM, the AM-715 group was significantly superior to the ABPC group in the single infections and in improvement of swelling of the tympanic cavity mucous membrane.
2. Bacteriological effect
(1) The bacteriological effect of the AM-715 group was significantly superior to the ABPC group.
(2) In the rate of eradication of S. aureus in single and mixed infections, the AM-715 group was significantly superior to the ABPC group.
3. Adverse reactions
Adverse reactions were observed in 8 of the 147 cases (5.45%) of the AM-715 group and in 17 of the 151 cases (11.3%) of the ABPC group. The incidenec of adverse reactions for the AM-715 group was less than that for the ABPC group (P<0.10).
No abnormal laboratory findings were observed in either of the groups.

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A fundamental and clinical study of AM-715 was carried out with the following results.
1. AM-715 was administered to 78 patients with infection in the field of otorhinolaryngology. The effective results were obtained as follows: 100% in acute suppurative otitis media, 78% in acute exacerbation of chronic otitis media, 70% in sinusitis and 80% in tonsillitis.
2. The antibacterial activity of AM-715 was superior to that of pipemidic acid against S. aureus, β-Streptococcus Group A, S. pneumoniae and P. aeruginosa.
3. The peak level of AM-715 in aural discharge was 0.47μg/ml four hours after a single oral dosing of 200mg and 0.64μg/ml three hours after a single oral dosing of 400mg.
4. Vertigo was observed in 2 (2.5%), nausea and diarrhoea in 1 (1.3%) of the 78 patients treated with AM-715.
5. AM-715 is a useful antibacterial agent in the field of otorhinolaryngologic infections.

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Fuji-Bitol (composed of 13 kinds of medicinal herbs) was administered for 4 to 15 weeks to 35 patients who have been operated on for chronic sinusitis in our hospital.
The result was effective in 32 patients and slightly effective in 3. The rate of effectiveness was 91.4%.
Compared with the effect on the patients we have treated with antiphlogistics or proteolytic enzymes in other studies, Fuji-Bitol was considered to be a more effective drug for the improvement of general symptoms than antiphlogistics or proteolytic enzymes.

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