Three male patients were found to have acute sensorineural hearing loss after exposure to rock and roll music. They were about 30 years old and complained of hearing impairment with tinnitus. Two patients had unilateral, severe, flat-type hearing impairment which did not improve, and one patient had bilateral, C⁵ dip type, mild hearing impairment which later improved.
The clinical features of this disease were studied in 12 patients, including the three mentioned above.
Most of the patients with hearing impairment and tinnitus were men in the third and fourth decades. They could be divided into two groups, one with unilateral, flat-type severe hearing impairment and a poor prognosis, and the other with bilateral C⁵ dip or C⁵C⁶ dip type, mild hearing impairment with a good prognosis.
As for the cause, it is supposed that when people who, for some reason or other, have become highly susceptible to sound injury are exposed to loud noises such as sounds at rock concerts or in discotheques, the damage occurs.

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Clinical studies have reported that, in cases of sudden deafness, the severer the hearing loss, the less the chance for complete recovery of hearing.
However the prognosis of sudden deafness has not been fully studied in relation to the type of deafness.
Therefore a study carried out in 64 patients with severe sudden deafness who were seen by one of us within 14 days of the onset.
The prognosis was worse in patients with vertigo and deafness, and 28.6% of those with no vertigo recovered completely.
Therefore, so-called “sudden deafness” does not seem to be single disease, but should be divided into at least two groupes, one with and one without vertigo.

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A 10-year-old girl had non-organic bilateral hearing loss of perceptive type of about 35 to 75dB inconsistent in pure tone audiogram. Bekesy audiometry showed a type V pattern. ABR and impedance audiometry were very useful in elucidating this type of hearing loss. Psychological investigation revealed considerable conflict in her home situation.
Sudden auditory impairment of the perceptive flat loss type in school children may have an emotional cause, so psychological factors should be considered.

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Since it is difficult for many patients with severe neurological disorders to sit, it would be advantageous for such patients to have neuro-otological examinations in the supine position.
We devised a new visual stimulator which can hang from the ceiling. With this device, oculomotor functions such as smooth pursuit, saccade and optokinetic nystagmus can be evaluated in both the horizontal and vertical directions with the patient lying supine.
Patients with central nervous system disorders or acute peripheral vestibular disorders can be evaluated easily with this device.

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Phleboliths were found in the cheek of one patient and in the submandibular region of another. Including these two cases, 50 cases of phleboliths in the region of the head and neck have been reported from 1930 to 1972.
Our first patient was a 7-year-old child who had a few nodules in the right cheek. There were a few palpable nodules the size of a rice grain and some fluctuation. Phleboliths of the cheek were suspected. The postoperative histological diagnosis was phlebolithiasis in a buccal hemangioma.
The second patient was a 70-year-old woman with a painless submandibular tumor on the left side, which she had first noted about two weeks earlier. Many calcifications seemed to be dispersed at random throughout an area corresponding to the tumor on roentgenography, so salivary calculi of the submandibular gland were suspected at first. However, the submandibular gland seemed to be compressed anteriorly by the tumor and no narrowing or obstruction of the duct was seen on sialographic examination. The tumor in the left submandibular region was removed surgically, and microscopic examination revealed a phlebolithiasis which originated at the base of a cavernous hemangioma.

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The two patients were males, 26 and 21 years of age.
The clinical manifestations were fever, sore throat, cervical lymph node enlargement and severe tonsillitis. Atypical lymphocytes, over 10 percent, were found in both patients' peripheral blood. Both had impaired liver function and positive Paul-Bunnell tests (high titer of heterophile agglutinin), with a specific Davidsohn reaction. The suspected etiology was Epstein Barr virus, since the titers of anti-V. C. A. (viral capsid antigen) antibody were 1:40 and 1:160.
There was little response to antibiotics and steroids, but both patients gradually improved.

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A 12-years-old male with a swelling in the submandibular area was treated with non-steroid, antiinflammatory agents, and the tumor regressed 20% in size.
The diagnosis was eosinophilic granuloma.
Then radiation therapy in a total dose was 30Gy was administened, and candida desensitization was given during irradiation.
The titer of IgE was 12, 000u/ml prior to treatment, and after complete regression of the tumor, it decreased to 4000u/ml.
Eosinophils in the peripheral blood numbered 46.5% before and 11% after treatment.
These findings suggest that this was a case of type I hyperseneitivity.

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A patient with jugular foramen syndrome was treated surgically. The histological diagnosis was neurinoma arising from the vagus. The differential diagnosis between jugular foramen syndrome and acoustic neurinoma was made on the basis of neuro-otological and neuroradiological data.
The patient was a 49-year-old female who complained of tinnitus and hearing impairment, which was followed by hoarseness, dysphagia and weakness of the right sternocleidomastoid muscle. Neurological examinations showed disturbances of cranial nerves VIII, IX, X, and XI.
Neuro-otological examinations revealed sensorineural hearing impairment in the low frequency range, no nystagmus response to caloric stimulation on the right, and slightly decreased high velocity gain of optokinetic responses toward the side contralateral to the lesion.
Polytomography of the jugular foramen showed enlargement of the right jugular foramen. Retrograde jugularography showed complete occlusion of the right jugular vein. The tumor was totally removed and histologically confirmed to be a neurinoma originating in the Xth cranial nerve.
In the previously published literature, neurinomas arising from the jugular foramen were difficult to differentiate from acoustic neurinomas, especially in the absence of lower cranial nerve signs. Therefore, Polytomography of the jugular foramen and jugularography provide valuable data in the differential diagnosis between acoustic neurinoma and the jugular foramen syndrome.

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The patient was 60-year-old female who had had painless tumor in the right anterior neck for about 20 years. Malignant tumor of the thyroid gland was highly suspected on the basis of the clinical findings and results of laboratory examinations: ¹²³I-thyroid scintigraphy, ²⁰¹Tl-thyroid scintigraphy and cervical CT scan. Histopathological examination of the tumor removed by surgery revealed that it consisted of two parts: the posterior one a non-functioning parathyroid carcinoma and the anterior one a follicular adenoma of the thyroid. The literature on parathyroid carcinoma is reviewed, and the possible etiology of the combined tumor is discussed.

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Four cases of disseminated intravascular coagulation (DIC) occurred in our hospital following surgery for head and neck cancer. Two patients were successfully treated with heparin therapy, but two died because of delay in starting the appropriate treatment. From these cases we learned that it was most important to recognize the complications that might cause DIC and to perform frequent hematological examinations. Fistula formation, abscess, necrosis of the flap and bronchopneumonia were the risk factors for DIC in our experience.

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The effect of methyl B₁₂ on cochlear injury after noise exposure and that of topical antibiotics on cochlear function were examined.
I. Forty-five albino guinea pigs were exposed to white noise of 100dB SPL for 2.5 hours, and 27 of the animals with temporary threshold shift (NITTS) were treated with methylcobalamin (methyl B₁₂) in doses of 500/μg/kg for two weeks. Animals were killed at various intervals up to two weeks following acoustic stimulation. Cochlear morphology and function were evaluated by scanning electron microscope (SEM) and auditory brain stem response (ABR). The efficiency of methyl B₁₂ for both functional and morphological recovery from cochlear damage was proved.
II. Nineteen albino guinea pigs were given intratympanic antibiotics or isotonic saline: 7 received gentamicin, 9 cefsulodin and 3 isotonic sodium chloride (control group). Cefsulodin sodium solution (600mg/kg), gentamicin solution (30mg/kg) and iso-tonic sodium chloride solution 0.2ml were instilled into the tympanic cavity through a silicon tube in the retroauricular region for 4 days.
There was no decrease in audioresponses (ECoG-threshold) or cochlear injury on SEM in the cefsulodin or control groups, but audioresponses were markedly disturbed in the gentamicin group.

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DiGeorge syndrome is characterized by partial or complete absence of the thymus gland which is often associated with other developmental anomalies particularly of the structures arising from the third and fourth pharyngeal pouches. The temporal bone findings in three cases of DiGeorge syndrome are presented. Patients with this syndrome have a high incidence of Mondini dysplasia in both ears, sometimes with other anomalies of the external or middle ears. The hearing may range from normal to profound deafness and may manifest sensorineural, conductive or mixed losses of varying degree.

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Rotational testing by Computerized Rotary Chair System was carried out on 48 patients.
1) Patients with disturbances of the vestibuloocular system showed phase lag distortion. Patients with cerebellopontine angle tumor, postlabyrinthectomy patients, and those who were suffering an attack of Ménière's disease showed phase lag shifts in the range of 0.01 to 0.08Hz. On the other hand, patients with Ménière's disease in remission, and those with otitis media, benign paroxysmal positional vertigo or psychotic dizziness showed phase lag shifts only in the lower frequencies of 0.01 to 0.02Hz.
2) Labyrinthine preponderance correlated positively with subjective symptoms. Labyrinthine preponderance shifts improved gradually from high frequencies, but continued to be abnormal at 0.01Hz for a long time after subjective symptoms had been relieved.
3) The Rotary Chair system is very useful in the evaluation of vestibular function in dysequilibrium patients. The patterns of phase lag and labyrinthine preponderance, while they do not provide pathognomonic data, do give precise additional information that is useful in confirming other test results.

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The regeneration of rabbit gustatory papillae was studied by SEM. Adult rabbits weighing about 3kg were anesthetized by intraperitoneal pentobarbital sodium and the surface of the tongue was corroded with 8Mol. potassium hydrate (KOH) for 1, 5 or 10 seconds. At various intervals, the tongues were removed and examined by SEM. Specimens obtained from normal adult rabbits served as controls.
1) As the corrosion reached the deeper layers, regeneration of the gustatory papillae tended to develop slowly.
2) Regardless of the depth of corrosion, fungiform papillae (FP) showed complete regeneration.
3) On the other hand, when the deep muscle layer was corroded, regenerated filiform papillae (Fi) varied in size and were irregularly arranged. Occasionally the tips of the Fi were split.
4) Regeneration of Fi preceded that of FP.
5) FP in early stages of regeneration were small. The surface of the papillae was always lower than that of the surrounding epithelial mantle.
6) The average diameter of FP in the later stages of regeneration was larger than in the early stages. The surface of FP in the later stages was higher than that of the epithelial mantle.
7) It is assumed that the regeneration of FP depends on nerve factors, such as innervation of nerves to the taste buds.

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It is well-known that attacks of vertigo are frequently caused by fluctations of blood pressure. Dihydergot was given to patients with vertigo of unknown origin to evalute its effect. Subjective improvement and Schellong's test were used as criteria of effectiveness. The results of Schellong's test were compared before and after the oral administration of Dihydergot, 6mg day for 2 weeks. Difference between them was evaluated by the criteria proposed by the committee on orthostatic disturbances. In the positive group, vertigo was usually relieved immediately. However, no significant difference was found between the positive and negative groups as to tinnitus, nausea or nystagmus. These suggest that of Dihydergot is effective in the treatment of vertigo of unknown cause.

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The effect of disodium cromoglicate was observed in how many patients with goldenrod-induced allergic rhinitis (13-62 years of age, mean 35.0 years; male: female=6:4)
Disodium cromoglicate was given to these patients from one month before to one month after the pollen season
(1) Signs and symptoms of allergic rhinitis were decreased after the administration of disodium cromoglicate (80mg/day)
(2) The administration of disodium cromoglicate did not effect clinical laboratory examinations
(3) Side effects (headache, etc.) occurred in only one patient and these were mild and did not require the discontinuation of therapy
(4) The excellent usefullness, usefullness, slightly usefullness, and no effective was 30%, 30%, 30%, and 10% respectively.
The effectiveness was considered to be excellent in 30%, good in 30%, fairly good in 30% and poor in 10%.

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The therapeutic effect of “Kakkontoka senkyushini” was tested in 24 children with chronic sinusitis. Symptoms, nasal findings and X-rays were compared before and after treatment of 13 boys and 11 girls with an average age of 6.5 years. The dose was 2.0g per day given for 4 months. Results were very good in 5 cases (20.8%), good in 13 cases (54.2%) and poor in 6 cases (25.0%). Although the mechanism of Chinese drugs is not completely understood, these results suggest that “Kakkontoka senkyushini” is effective in chronic sinusitis in children. No side effects were observed in any of the patients in these experiments.

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A study was made of the penetration of Bacampicillin (BAPC) into the tonsillar tissue of 20 patients treated by tonsillectomy for chronic tonsillitis. And bacteria in throat cultures of out-patients were tested for sensitivity to Ampicillin (ABPC).
1. ABPC concentration in the tonsil was determined in 20 cases of tonsillectomy after BAPC administration. Good tissue penetration was found, with peak concentration 2 to 3 hours after administration.
2. When BAPC was administered to 9 patients with acute tonsillitis, the results were excellent in 2, good in 6, and poor in 1 (88.9% improvement).
3. Throat cultures showed that many bacteria, such as β-streptococcus, S. pyogenes, S. faecalis and H. influenzae, were very sensitive to ABPC.
These results indicate that BAPC is useful in the treatment of bacterial throat infections

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