The measurement of mucosal blood flow is important for assessing condition in the nose, pharynx, larynx and middle ear. Recently the measurement of mucosal blood flow has been made very accurate by the development of new methods of measurement (e. g. Laser-Doppler flowmeter, RI clearance method, spectrophotometric analyzer).
Earlier works on the assessment of mucosal blood flow in the nose, pharynx, larynx and middle ear are reviewed.

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In pure tone audiometry, as the level of the test sound given to the test ear increases, the level of the sound transmitted to the nontest ear also increases with a certain amount of attenuation, resulting in more danger of cross hearing. So it is natural and reasonable to increase the noise level of masking simultaneously by the same amount when the test sound is increased.
This paper describes a method of masking which uses the minimum noise level necessary to avoid cross hearing according to the above principle. The test procedure proposed is similar in air and bone conduction audiometry;
1) Obtain the no masking threshold with the nontest ear closed by the masking earphone.
2) Set the test sound to the level 15dB under the no masking threshold, and the masking noise, which is calibrated to the effective masking level, to the level of the air conduction threshold of the masked ear.
3) Obtain the masked threshold, changing both the test tone and the masking sound simultanuously by the same amount.
This procedure has the following advantages;
1) The undesirable effects of masking noise, such as unpleasant sensations of the subject or central masking are restricted to a minimum.
2) We need not repeat the threshold measurement by changing the masking level.
3) The test procedure is relatively simple and easy to understand.

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With the use of a dual channel variable filter, 10 echo responses to click stimuli, pass-filtered by a 100 Hz step of pass-bandwidth in the frequency regions from 1.0 to 2.0kHz, were recorded in 30 normal subjects, one patient with Meniere's disease and one patient with sudden deafness.
Usually normal subjects had one or several echoes in all frequency ranges. In 77% of them the latency of main echoes was frequency-dependent, shortening with increasing frequency. The main echo revealed maximum response in the 1.5-1.6kHz band, and the amplitude of the main echoes decreased in both the lower and higher frequency bands. In patients with Meniere's disease or sudden deafness, the 100Hz narrow-band EOE did not show a normal pattern, in either latency or amplitude.

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Spontaneous nystagmus was investigated in patients with Ramsay Hunt syndrome weaing Frenzel glasses. The direction of nystagmus was towards the affected side in half of the patients, and towards the opposite side in the other half. No change of direction of nystagmus was observed during the course of the disease. It was thought that these characteristics of nystagmus originated mainly from the affected organ, such as vestibular endolymphatic space, sensory cells, ganglion and brain.

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The stepping test was performed on an inclined floor (3°) in 8 normal subjects and 32 patients with problems of equilibrium. In the normal subjects, the inclined floor changed the relationship between the information of pression on the right and left portion of the body through the cutaneoplantar senses, and the goniometric information from the tibioperoneotarsal joint through the Ruffini sensory endings, stabilized their equilibrium a little. In the subjects with labyrinthine disorders, the inclined floor did not change the results of the stepping test. On the contrary, in patients with disorders of the central nervous system (i. e. head injury, etc.) or central or peripheral disorders of the proprioceptive system (i. e. whiplash injury), the inclined floor decreased the angle of rotation of the stepping test. Therefore, the stepping test on an inclined floor is useful as a routingc test in the differential diagnosis of patients with problems of equilibrium.

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While patients with multi-electrode cochlear implants can distinguish vowels well, it is hard for them to recognize consonants, especially voiceless plosives. To find out why they are not able to distinguish the three voiceless plosives /p/, /t/, /k/, we examined the simultaneous electrical pulses of each electrode of a cochlear implant with the input of the consonant-vowel syllables /pa/, /ta/, /ka/ in detail, using a computer and an analogdigital converter. The rate of electrical pulses caused by the voiceless plosives was lower than that caused by vowels. The intensity of electrical pulses was similar. And then we synthesized sounds which simulated the consonant-vowel syllables with multi-electrode cochlear implants. Each synthesized sound was so different from normal syllables that we could not recognize them as consonant-vowel syllables. The results show that more information of consonants must be translated through a cochlear implant for better recognition of consonants.

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The prognosis and complications of OME in patients with cleft palate are still unclear in contrast to OME in patients with normal palates. Among 172 ears of OME patients with cleft palate, 100 ears treated with insertion of ventilation tubes and followed for more than 1 year were analyzed, and the prognosis and complications of OME with cleft palate were considered.
1. Only 27 OME ears (27%) were healed after one tube insertion, much fewer than the ears of patients without cleft palate. There was a high incidence of recurrence.
2. There was no tendency to heal with aging.
3. Adhesive otitis media was seen in 2 ears, perforated ear drum in 11 ears, and cholesterin granuloma in 4 ears -a comparatively high incidence of sequelae.

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Pleomorphic adenoma (so-called mixed tumor) is only rarely seen arising from the nasal septum. Recently we treated two patients with pleomorphic adenoma arising from the nasal septum. The first was a 67-year-old woman who complained of nasal stuffiness; a tumor was found on the right side of the nasal septum. The second was a 33-year-old woman who had noted a mass in the nasal cavity; a tumor was found on the left side of nasal septum. Biopsies on their first visit to the clinic showed pleomorphic adenoma. The patients were admitted and the tumors were resected en bloc through the nostril. There have been no signs of recurrence.
So far 35 cases of pleomorphic adenoma arising from the nasal septum have been reported in Japan. The literature was reviewed with respect to the age and sex of the patients, the chief complaint, side of lesion, treatment, etc.

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In order to study the development of speech in infants with cleft palate, we investigated the development of consonant articulation in two cases (A, B) with cleft soft palate and in two cases (C, D) with cleft lip and palate before and after palatoplasty. We taperecorded their consonants in meaningful speech sounds and transcribed them.
We made the following observations: (1) The frequency of consonants in meaningful speech sounds did not vary with the type of cleft or the timing of palatoplasty, and increased radically in the latter half of the second year and the first half of the third year. (2) Glottal stops occurred in the pre-palatoplasty periods but had almost disappeared three to ten months after palatoplasty in cases A, B, and C, whose velopharyngeal function was competent. (3) The speech sounds of these three cases were judged to be intelligible when the numbers of glottal stops decreased, the numbers of voiceless stops accounted for over 50% of all stops, and bilabial voiceless stops [p] appeared.

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Hemangiopericytoma is a rare tumor in the head and neck, especially in the parapharyngeal space. A 55-year-old man with parapharyngeal tumor was found to have hemangiopericytoma. He died of local recurrence and pulmonary metastasis. Only adriamycin caused a partial remission. It is difficult to predict the prognosis from the histopathological appearance. We emphasize that it is very important to observe the behavior of this tumor for appropriate treatment.

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The diagnostic efficacy of MRI (magnetic resonance imaging) was compared with that of CT (computed tomography) in 5 patients with tumors at the base of the skull.
Tumors in the areas surrounded by bones at the skull base were clearly imaged without the artifacts seen in CT scans.
Multiplane imaging can be obtained easily with MRI. Sagittal sections are of great use in visualizing vertical expansion of the tumor. Loss of the black rim of the compact bone at the skull base and loss of the high signal intensity of the fatty bone marrow were comfirmed at surgery to be signs of skull base destruction. The authors stress that MRI is very valuable in planning the treatment of tumors of the skull base.

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To clarify the functional and morphological influence of profound deafness on the development of the auditory system, the responses of the inferior colliculus to electrical stimulation of the cochlea were investigated in chinchillas.
In the normal animals, hundreds of responses were recorded from inferior colliculus with tonotopic organization. On the other hand, few or no responses were recorded in the animals deaf from birth or deafened as adult despite small histological changes in the inferior colliculus.
These results imply that the functional integrity is more affected than the morphology by the deprivation of hearing in the central auditory system.

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With ultrasonic tomography palatine tonsils (p.t.) and the paratonsillar regions were imaged in viva. The longitudinal and transverse measurements in 65 tonsils were compared with actual size of these tonsillar tissues after tonsillectomy. We also analyzed the images of the tonsils in 165 normal subjects and in 43 patients with palatine tonsillar diseases (39 with recurrent tonsillitis, one with acute tonsillitis and one each with peritonsillitis, peritonsillar abscess and paratine tonsillar tumor).
An ultrasonic apparatus, SSD-256 (Aloka Co. Ltd), and a 7.5MHz probe which were commonly used to examine the carotid arteries were employed. After setting the probe on the submandibular area, we analyzed the images of the p.t. The tissue of the p. t. appeared as a low density shadow, and the plugs in the p. t. as high density spots. In the paratonsillar region, the tongue, the superior constrictor muscles of the pharynx, and the tonsillar branches could also be demonstrated ; the images of the tongue and the sup. const. muscle of the pharynx were high density shadows, while the tonsillar branch appeared as a low density shadow.
There was a significant correlation between the ultrasonic measurements and the actual longitudinal and transverse diameters in the 65 tonsils.
In normal subjects, images of plugs were not visible or were very faint.
Patients with recurrent tonsillitis had many plugs, and the image of the tonsillar capsule was wide and clear from the inferior pole to the superior pole.
The image of a localized abscess was clear in the patient with peritonsillar abscess, and that of invasive tumor in the patient with tonsillar tumor.
Ultrasound imaging is expected to be useful in the diagnosis and therapy of palatine tonsillar disease.

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The therapeutic effect and the safety of AA-673 tablets were studied in 31 patients with intractable perennial allergic rhinitis who had not shown sufficient responses to other oral antiallergic agents administered for 3 weeks.
Each patient took one 50mg tablet of AA-673 three times daily for 4 weeks.
Evaluation of the final global improvement rate revealed “moderate to marked improvement” in 45% of the patients and “slight to marked improvement” in 74%.
In a comparison of the effects of AA-673 tablets in patients grouped according to the drug used previously, no differences in the final global improvement rates were noted among the groups.
Subjective improvement rates of sneezing attack was reported by 28%, of nasal discharge by 32% and of nasal obstruction by 29% of the patients.
Side effects of abdominal pain and diarrhea were observed in one patient, but they were mild and transient.
The above results indicate that AA-673 tablets are effective in many patients with intractable perennial allergic rhinitis.

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In an evaluation of the clinical usefulness of ambroxol hydrochloride (NA872) in the treatment of chronic paranasal sinusitis, a double blind trial was carried out comparing NA872 with Mecysteine hydrochloride (Mecysteine). The NA872 treated patients (N-Group) were given one tablet of NA872 (15 mg) and one placebo tablet orally after each meal, and the Mecysteine treated patients (M-Group) were given one tablet of Mecysteine (100 mg) and one placebo tablet orally after each meal for four weeks. 1) The number of patients with marked or moderate improvement was somewhat higher in the N-Group than in the M-Group, but the difference was not significant. 2) Side effects were observed in the six patients (6.3%) in the N-Group and in three (3.0%) in the M-Group. The side effects were not serious and disappeared soon after the medication was discontinued. 3) The number of patients in whom the effectiveness of treatment was judged to be excellent was higher in the N-Group than in the M-Group, but the difference was not significant. 4) Evaluation of subjective improvement (rhinorrhea, postnasal drip, drainage, postnasal drip and nasal obstruction) and of objective improvement (postnasal drip) showed moderate or greater improvement more often in the N-Group than in the M-Group, but the difference was not significant.
It is concluded that NA872 is as effective as Mecysteine in the treatment of chronic paranasal sinusitis.

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In recent years, the number of adults with acute deterioration of chronic otorhinolaryngological infections has been increasing.
Problems that we encounter in the treatment of chronic otorhinolaryngological infections include an increase of drug-resistant bacteria and unsatisfactory penetration of drugs into the tissues. The authors recently used Tarivide (ofloxacin), a new drug of the quinolone family, to treat 20 patients with acute deterioration of chronic otorhinolaryngological diseases (tonsillitis, nasosinusitis and tympanitis). The drug proved to be clinically effective in 95.0% and bacteriologically effective in 88.2% of the 20 patients. In 6 patients who were treated with this drug preoperatively, the blood and tissue concentrations of the drug were high.
These results indicate that ofloxacin can be useful for the treatment of chronic infections in the field of otorhinolaryngology.

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