Basic and clinical studies on the definition, cause, mechanism, severity, diagnosis and treatment of tinnitus were reviewed. It was concluded that research on tinnitus should be carried out with consideration to its treatment.

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Thirty four children with microtia and meatal atresia (unilateral 30, bilateral 4) were examined to determine their hearing ability and language development.
The 30 with unilateral abnormalities showed a conductive hearing loss of 45.0-72.5dB in the affected ear. The nonaffected ear in 21 out of the 30 children showed normal hearing (a loss of less than 20dB) and in 9 the hearing loss was more than 30dB in the normal ear.
Eight children with unilateral microtia and a hearing loss of more than 40dB had delayed language development.
The four children with bilateral microtia showed no language retardation despite a hearing loss of 40.0-76.0dB in both ears because of the early use of hearing aids.
Bone-conduction-hearing aids were more effective than air-conduction-hearing aids for children with microtia.

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In recent years, abnormal eye movements in patients with cerebellar disturbances are receiving the attention of many workers.
We think that rebound nystagmus is an indication of these relationships and is one of the most representative of the cerebellar signs which cause abnormal eye movements. We treated 11 patients with Vertical Rebound Nystagmus (VRN) disected upwards following a rapid shift from downward gaze to forward gaze. This was confirmed by ENG. We conclude that rebound nystagmus is a form of intention tremor affecting eye movements.
It appears only in bilateral disturbances of all these structurs nucleus dentatus and its efferent pathway (superior pedunculus), nucleus fastigii and vestibulo cerebellum.

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Thirty eight patients with vestibular neuronitis who had visited the Kitasato University Hospital from July, 1971 to February, 1984, were re-examined. Twenty two patients complained of vertigo (whirling sensation), and sixteen had a floating sensation and unsteadiness of gait. Twenty four patients were relieved of vertigo within 3 months (63%); three patients suffered from a dizzy sensation for over one year.
Spontaneous nystagmus, positional and positioning nystagmus remained in 78% of patients. Twenty five patients showed reduced caloric responses. Five of 30 patients showed a normal caloric test.
One patient had three vertiginous attacks; the others only one. One patient had positional vertigo of the benign paroxysmal type when in the supine position with the right ear down. These findings suggest that the etiology of vestibular neuronitis is not yet certain. Further follow-up surveys are needed. The statokinesigram recorded with the patient to be useful in evaluating the degree of ataxia in patients with vestibular neuronitis.

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Adenoid vegetation has been considered to be one of the causes of otitis media with effusion (OME), but our clinical experience and studies by other researchers have revealed that adenoidectomy is not always effective in the treatment of OME. In this study, an attempt was made to assess the effect of adenoidectomy upon hearing. Forty-five children with OME (76 ears) ranging in age from 3 to 9 years were treated by adenoidectomy, insertion of tympanostomy tubes, myringotomy, or a combination of these procedures, and followed for 6 months.
Children treated with adenoidectomy and insertion of tympanostomy tubes and children without adenoid hypertrophy treated with insertion of tympanostomy tubes showed marked improvement of hearing, but in children with adenoid hypertrophy treated with either insertion of tympanostomy tubes or adenoidectomy hearing was not improved. The hearing of children with adenoid hypertrophy treated with adenoidectomy and myringotomy grew worse for 2 or 3 months but then improved.
This study indicates that children with OME and adenoid hypertrophy should be treated with adenoidectomy as well as insertion of tympanostomy tubes.

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The efficacy of adenoidectomy in the treatment of serous otitis media was evaluated by tympanograms of 54 patients (107 ears) recorded before and after adenoidectomy and adeno-tonsilectomy.
1) About half the B-type and most of the C-type tympanograms improved to A-type after surgery.
2) Clinical progress was more favorable when myringotomy preceded surgery.
3) The results were less favorable in children under 5 years of age.
4) Better results were noted in patients treated with tonsilectomy in addition to adenoidectomy.
5) A favorable clinical course was noted in patients with (+)-(++) cloudiness on X-rays of the para-nasal sinuses.
6) Improvement of the tympanogram was observed frequently 1-2 months after operatlon.

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A case (43-year-oldmale) of osteoma with cholesteatoma in the external auditory canal is reported. Osteoma and cholesteatoma were removed surgically, and a satisfactory hearing gain without recurrence was observed 3 years after surgery.

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One third of avial of Histaglobin with 2ml of distilled water was given by nebulizer to patients suffering from Japanese cedar pollinosis 2 or 3 times a week. This treatment was started preseasonally and continued during the pollen season for an average of 53.2 days. The records of nasal symptoms of 12 patients were analyzed by scoring the symptoms: number of days with severe nasal discharge or sneezing; comparison with previous year's experience, when the pollen counts were much lower than during the year of this trial; and the amount of other drugs used in 6 cases.
A good effect was obtained in 5 of the 7 patients who were able to continue the nebulizer more than twice a week throughout the observation period. Of the other 5 patients who had less frequent treatment 3 reported a good effect. These results suggest that this nebulizer could be useful prophylactically in a large number of patients with Japanese cedar pollinosis.

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A 27-year-old female had low plasma cholesterol, very low high density lipoprotein (HDL), and yellow isolated lymphoid follicles in the retropharyngeal region. The pathological characteristics of the isolated lymphoid follicles were enlarged germinal centers, proliferation of the follicles and a large number of foam cells. These characteristics are consist with Tangier disease.

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Acute suppurative parotiditis is said to be caused by Staphylococcus aureus, but the role of anaerobic bacteria has not yet been fully investigated. The authors detected anaerobic bacteria in one case of suppurative parotiditis and three cases of submaxillaritis. The anaerobes isolated were Peptostreptococcus, Peptococcus and Bacteroides. Clindamycin or Cefhletazol therapy resulted in prompt subjective and objective improvement. The appearance of four cases of anaerobic sialadenitis in as short a time as eight months suggests that anaerobic bacteria play an important role in suppurative sialadenitis.

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Laryngeal function was evaluated in six patients after treatment of laryngeal trauma. The patients were all male, aged 18 to 61 years (average age 41.0 years). The injury in three patients was caused by automobile accidents, in two patients by industrial accidents, and in one patient by contusion due to being kicked in the neck. Treatment included tracheostomy, repositioning of fragments, grafting, arytenoidectomy, trough method, cricopharyngeal myotomy, upward fixation of the hyoid bone and thyroid cartilage, and introduction of silicon rubber T-tubes.
The six patients answered questionnaires concerning their laryngeal symptoms: hoarseness, dyspnea, and dysphagia. Five patients were examined by phonation analyzer (PS-77, Nagashima Co.) and automatic analyzable system for pulmonary function (autospiror HI-498, Chest Co.)
Two patients still complained of severe hoarseness, and four of moderate or slight hoarseness. Two patients still complained of slight dyspnea and four of slight dysphagia.
The curve of the phonation analyzer in all patients demonstrated by fundamental frequency and intensity a disappearance of normal vocal cord vibration.
The flow-volume curve of the autospiror showed decreased peak expiratory flow plateau formation in three patients.
All patients except one with a gait disturbance, returned to work with only slight laryngeal symptoms.
In the follow-up of laryngeal function in patients with laryngeal injury and in advising them about rehabilitation, the newly developed phonation analyzer and respirometer are very useful.

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The patient was a 49-year-old female who was admitted to the Dept. of Internal Medicine of Osaka Medical College with sore throat and sustained fever.
Laboratory examination revealed granurocytopenia, and treatment was begun immediately, but her sore throat presisted, and she developed dyspnea.
She was transferred to the Dept. of Otolaryngology and a diagnosis was made of laryngitis phlegmonosa acuta. Tracheostomy was perfomed and conservative therapy was continued. However, antibiotics could not be administrate deffectively because of the possibility that antibiotics were the cause of the granulocytopenia.
Sore throat and fever receded 5 weeks later, but fistula from the vallecula to the lower neck appeared, and part of the hyoid bone was ejected spontaneously.
The fistula was closed operatively and the disease was cured with some deformity of the larynx. She was discharged 2 months later with no dysphagia or hoarseness.
Since laryngitis phlegmonosa acuta is rare disease in the era of antibiotic therapy, were ported this unusual case.

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This report is based on our experience with 21 cases of tuberculous cervical lymphadenitis treated in the Department of Otolaryngology, Mie University Hospital during the last 12 years from 1973 to 1984.
The patients ranged in age from 2 to 75 years (average 41.4 years). Most of them had a painlesss welling in the neck. Pulmonary tuberculosis was found on chest X-ray in 9 patients. Surgical resections performed in all 21 cases showed pathohistological evidence of tuberculosis. Anti-tuberculous chemotherapy was administered in 18 cases.
It was difficult in some cases to differentiate tuberculosis from malignant neck tumor, because the nodular appearance sometimes resembled tumor formation. Histopathological studies are necessary for a difinitive diagnosis.

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A survey was conducted of 123 patients with 3 groups of vertigo: 1. Dizziness only, 2. vertigo with hearing loss or canal paresis, and 3. Meniere's disease.
A questionnaire was sent to each patient requesting subjective estimation of the degree of severity (normal, moderate or bad) of the vertigo and other ear or generaized symptoms.
Several oto-neurologic tests (audiogram, caloric test, stepping test, CMI test, etc) were also performed, and the results were classified into 3 grades.
By multivariate analysis techniques (Hayashi's method I and III), the subjective estimations and test results were correlated for each group.
In the first two groups (the dizziness only group and the vertigo with hearing loss or canal paresis group) no clear correlation was bund; however in the Meniere's disease, there was a close relationship (r=0.999) between the subjective estimation of vertigo and ear or generalized symptoms and the test results.
Therefore, oto-neurologic tests are useful only in patients with advanced disease.

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New parameters of nystagmus (smoothness and kurtosis) were adopted for detailed analysis of nystagmus. Smoothness is related to the degree of fluctuation of the fixation point, and kurtosis reflects the sharpness of the turning point in nystagmus. These parameters were used to study optokinetic nystagmus under vestibular stimulation.
The frequency and amplitude of nystagmus were increased from middle to high speed range, and a marked increase of the optokinetic adaptation limit was recorded. Increased smoothness in the slow phase and kurtosis at the terminal point of the quick phase were also observed. The labyrinth supports optokinetic nystagmus by making a subject catch optokinetic stimulise parately. This supporting effect is observed even at the low speed range of optokinetic nystagmus.

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The surface of the organ of Corti of guinea pigs was examined with a scanning electron microscope. The sensory cilia showed an orderly gradation in height and diameter along the length of the cochlea. The cilia were taller and thicker at the apex and shorter and thinner at the base. The number of cilia on the outer hair cells increased with the distance from the apex of the cochlea. However, there was no significant change in the number of inner hair cells. The angle of the arrangement of the sensory cilia was wider at the base and narrower at the apex. These morphological findings suggest that there maybe an additional fine frequency analysis system built into the organ of Corti in addition to the basilar membrane.

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Glycoconjugates in cat, monkey and human nasal mucosa were studied histochemically. With PAS-AB and HID-AB methods, light microscopy showed much sulfomucin in the goblet cells lining the surface epithelium. Most of the mucous cells in the upper area of the human nasal mucosa were stained with HID and the deeper cells were stained with AB. A large amount of sulfomucin was found in the mucous cells in the cat nasal mucosa as compared with the monkey nasal mucosa. The glycoconjugates of serous cells seemed to be composed mostly of neutral glycoprotein.
Electron microscopic cytochemistry of the monkey nasal mucosa showed secretory granules of glycoprotein could be classified by their PTS staining into four types in the serous cells and three types in the mucous cells. The cilia, microvili, apical plasmalemma and basolateral membranes of several cells were stained positively with the PTS method. The results of DI and HID methods were also demonstrated in this study.

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A study was made of the efficacy and safety of Fosfomycin (FOM) ear drops in the treatment of chronic purulent otitis media and its acute exacerbations.
1) The overall clinical effect was excellent in 13 cases, good in 8, fair in 6, and poor in 1. The clinical effectiveness rate was 75.0%.
2) Bacteria isolated before treatment were eradicated in 88.0%, which is a satisfactory bacteriological response.
3) No side effects were observed in any cases.
4) The over all clinical usefulness rate was 75.0%.
5) The results of this study indicate that FOM ear drops ar every effective and safe.

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Ketotifen 2mg in two doses a day was administered to 45 patients with nasal allergy for 4 consecutive weeks.
1) The rate of subjective improvement was 61.9% and of over-all improvement was 66.7%.
2) The three major symptoms of nasal allergy were reduced almost equally: 68.9% had fewer sneezing attacks, 72.1% less nasal discharge, 72.5% fewer attacks of nasal obstruction, and 60.0% less chronic nasal obstruction.
3) The onset of the therapeutic effect was within 2 weeks in 94.6% of all the improved cases. Patients with sneezing and nasal discharge noted greater improvement within 1 week than did those with nasal obstruction.
4) As side effects, drowsiness was noted by nine patients (20.0%), and two of them could not continue this drug.
5) Ketotifen was useful in 64.4% of this series for all types of nasal allergy.

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Studies of Ceftriaxone (CTRX), a new broad spectrum semisynthetic cephem antibiotic fed to the following conclusion:
The serum level of CTRX in 3 healthy adults given 500mg reached a maximum of 96.3μg/ml 15 minutes after intravenous injection and a clinically effective serum CTRX level of 27.3μg/ml was still demonstrable 8 hours later. The tissue concentration of CTRX was 7.5μg/g in human palatine tonsils and 7.1μg/g in the mucous membrane of the maxillary sinus one hour after intravenous injection, when the serum level was 66.3μg/ml and 67.4μg/ml, respectively.
These concentrations are higher than those other cephem antibiotics after intravenous injection of 500mg.

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