Masking has recently drawn a special attention as a new method of tinnitus treatment. However, there are still many unsolved problems concerning its physiological mechanism, its effective use and its possible influence on the auditory organs. A review of the relevant literature takes these problems into consideration.

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A 14-year-old boy with Bruns-Cushing nystagmus and ocular dysmetria was found to have dysplastic gangliocytoma of the cerebellum. A nuclear magnetic resonance CT revealed a high intensity area in the right cerebellar hemisphere, midbrain and pons. Two months postoperatively there was no change in the neurological findings. The neuro-otological aspects of cerebellar tumor are discussed.

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There are two types of bilateral sudden deafness: simultaneous and first one side and then the other. Both are very rare. We treated a patient who had diabetes mellitus for 15 years and developed sudden deafness of the right ear in August 1980 and of the left ear in March 1984.

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Transtympanic injections of 1ml of 4% lidocaine (40mg) and/or 0.4% dexamethasone (4mg) into the middle ear cavity were performed in 96 patients (109ears) with cochlear tinnitus.
1) Tinnitus was completely abolished or markedly decreased in 20 ears (18%), moderately decreased in 26 ears (24%), and slightly decreased or not changed in 63 ears (58%).
2) Cochlear tinnitus caused by trauma showed the best results.
3) Side effects due to transient loss of peripheral vestibular function after labyrinthine anesthesia occurred in almost all cases, but recovery was complete after a short time.
In conclusion, transtympanic injections of these drugs were effective in about 40% of patients with cochlea.r tinnitus, and there were no significant complications.

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Two cases of Mondini maldevelopment with recurrent meningitis are described. Cerebrospinal fluid leakage was observed to be coming from the anterosuperior margin of the oval window in one case and from a bone defect in the center of the footplate in the other. Removing the stapes and obliterating the vestibule with muscle, fascia and Lyodura proved to be satisfactory treatment. High resolution CT scanning of the temporal bone has brought definite diagnostic progress in finding ear anomalies. Congenital ear anomalies and fistula of the oval window should be included in the differential diagnosis of recurrent meningitis.

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Thirteen patients with previously untreated maxillary sinus carcinoma were treated with intraarterial infusion of adriamycin, simultaneous radiotherapy and partial resection of the maxilla. Adriamycin was administered in a dose of 10mg/d to a total of 50-170mg. For radiotherapy, the patients received 30-45Gy by ⁶⁰Co. The 2- and 5-year survival rate calculated by Kaplan-Meier's method was 65.9%. The 2-year survival rate of patients whose tumor invaded mainly backward (50.0%) was lower than that of patients with tumor invasion in other directions. When the primary effect was evaluated by histopathological examination according to Shimosato's criteria, the effective rate (grades III and IV) was 53.8%. The primary effect of adriamycin seemed better than that of other directions. Although intraarterial infusion of adriamycin produced side effects such as stomatitis, nausea, alopecia and leucopenia, they were temporary and reversible.

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Malignant hemangioendothelioma of the buccal region was diagnosed. Light microscopy with hematoxylin and eosin stain, reticulin stain, periodic acid Schiff stain and factor VIII-associated protein stain by the peroxidase antiperoxidase technique showed different characteristics in different areas of the same tumor, such as hemangioendotheliomatous and hemangiopericytomatous areas with fibrosis. It was thought that this tumor was an immature vascular tumor, and it was called a “cellular hemangioma”.

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Postoperative hypothyroidism was investigated in 75 patients with various thyroid diseases.
(1) The incidence of postoperative hypothyroidism after total thyroidectomy was 100%, after subtotal thyroidectomy 83%, after hemilobectomy 68% and after partial lobectomy 33%.
(2) In cases of malignant tumor postoperative hypothyroidism was more frequent than in cases of benign tumor treated with the same mode of thyroid surgery presumably because of the greater damage to blood vessel caused by neck dissection.
Postoperative hypothyroidism may be caused not only by destruction of the thyroid but also by circulatory disturbances.

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The ototoxicity of gentamicine is well-known. Ototoxic abnormalities were examined by electrocochleography in adult rabbits after daily gentamicin injections of 0.05mg/kg (group I), 0.1mg/kg (group II), 0.25mg/kg (group III), 0.5mg/kg (group IV), and saline (control) into the cerebrospinal fluid space. Electrodes were implanted in the middle ear, and action potential (AP) responses to clicks were recorded. AP changes, especially input-output function curve changes were observed daily. The general condition and changes in equilibrium of the rabbits were also noted. The cochleas were then examined histologically.
1) AP changes: No changes were seen in the controls or group I. In one of the four rabbits in group II, AP amplitude decreased and then AP disappeared. In the other three no changes were observed. In all rabbits in groups III and IV, AP decreased rapidly and disappeared. The total dose of gentamicin was 2.5mg/kg in group III and 3.1mg/kg in group IV. The input-output curve changes of gentamicin-damaged rabbits were; early disappearance of L-curve and persistence of H-curve only. This change suggests that the stimulation function represented by the L-curve is more vulnerable to damage by gentamicin than in the H-curve.
2) General condition and equilibrium disturbance: No abnormalities were seen in the controls or group I rabbits. The rabbit which showed AP changes in group II and all group III and IV rabbits showed weight loss, reduced activity, and equilibrium disturbances, including positional abnormality, indicating vestibular damage.
3) Histological findings: Rabbits in which the AP disappeared were examined histologically. Marked changes were seen in the cells of the organ of Corti. The stria vascularis and the spiral ganglion cells were normal. Almost all the inner and outer sensory hair cells of all the cochlear turns were damaged.

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Soft tissue responses to Ceramic Ossicular Replacement Prostheses (CORP) were evaluated histologically in animals (rabbits) and humans. CORPs were surrounded by a layer of fibrous tissue without any foreign body giant cell, histiocyte or inflammatory cell infiltration after 3 months, although there were severe inflammatory and foreign body reactions at one week, and some inflammatory responses one month after implantation. CORPs implanted into the human middle ear were observed to be covered by a thin layer of connective tissue at revision surgery. Our satisfactory clinical results in humans without placing cartilage between the CORP and the fascia graft can be explained by the histological findings (excellent soft tissue compatibility of CORP) obtained in this study.

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The distribution of various immunogloblin containing cells in the human inferior nasal turbinate was investigated by an immunoenzyme technique (PAP method) applied to 25 inferior nasal turbinates removed from patients with nasal allergy or hypertrophic rhinitis.
Anti-IgE, -IgG, -IgA, -IgM antibodies were employed as first antiantibodies, and the antibody containing cells in the human inferior nasal turbinates were studied microscopically.
In all cases, immunoglobulin containing cells were found in the human inferior nasal turbinate and were classified as follows; largely membranous and cytoplasmic types, and minutely linear, granular, homogeneous and lumpy patterns.
IgE containing cells easily recognized in the nasal mucosa of patients with nasal allergy and showed various types and patterns, but membranous type cells were most numerous.
This study suggests that IgE is connected not only to mast cells, but may also combine with other cells in the human nasal turbinate.
The number of IgE containing cells was closely related to the level of RAST, but not to the serum IgE level (RIST).
The greatest number of IgA containing cells was observed in the nasal mucosa. This finding suggests that the nasal mucosa plays an important role in local immunity against viruses and bacteria.

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A study was made of the efficacy and safety of Sisomicin (Extramycin: Bayer) nebulizer in 31 patients with sinusitis treated with 25mg twice a week for 4 weeks or longer and 16 patients with laryngitis were treated with the same dose twice a week for 2 weeks or longer.
1. The Sisomicin concentration in the blood was 0.08μg/ml or less in all cases after the nebulizer treatment.
Accumulation of Sisomicin in the blood was not observed.
2. Subjective symptoms were relieved in 74.2% of the patients with sinusitis, objective signs were relieved in 67.7%, bacteria were eradicated in 52%, and the rate of usefulness was 74.2%.
3. Subjective symptoms and objective signs were relieved in 100% of the patients with laryngitis, bacteria were eradicated in 77.8%, and the rate of usefulness was 100%.
4. No side effects were observed in any of the patients in these experiments.

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Fundamental and clinical studies of ASPC administered by intramuscular injection showed the following results.
1) When 1g of ASPC was injected i. m. in patients with suppurative otitis media, the maximum concentration in the otorrhea fluid was 3.91-10.94μg/ml 2 hours later. It was still maintained 1.12-2.06μg/ml after 4.5-8.0 hours. After IV injection, the concentration in the otorrhea fluid reached its maximum (5.09-29.69μg/ml) at 0.5-2 hours.
2) The minimum inhibitory concentration (MIC) of ASPC was tested with 10⁶ cells/ml. The peak MIC was 3.13μg/ml against S. aureus and ≤0.05μg/ml against S. pyogenes and S. viridans.
The distribution of MIC against E. coli, S. pneumoniae and S. nonhaemolyticus was less than 6.25μg/ml.
3) ASPC was given to 32 patients with otorhinolaryngological infections, including 14 with acute tonsillitis, 9 with paranasal sinusitis and 5 with suppurative otitis media. The clinical effect was excellent in 15 cases, good in 8, fair in 3, poor in 4 and unknown in 2. Thus, the efficacy rate was 76.7%.
4) No side effects or abnormal laboratory findings were noted.

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Sulpiride 300mg/day, was administered to 32 patients with foreign-body sensation in the throat. The subjective effect of this drug was evaluated by questioning the patients.
The effect was excellent in 16 cases, good in 9 cases, fair in 6 cases and poor in 1 case. It was concluded that Sulpiride, an antidepressant drug, is clinical effective in patients with foreign-body sensation in the throat which can not be attributed to any organic cause. Consequently, it was assumed that depression may play some role in foreign-body sensation in the throat.

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