To optimize chemotherapy for head and neck malignant tumors in the elderly we compared patients older than 70 years of age with those younger than 69. Toxic reaction was comparable between the two age groups, except that hematologic and mucosal reactions in the head and neck region were more prevalent in the elderly. However, the response rate and chemosensitivities were similar between the two groups.
Our findings indicate that chemotherapy for the elderly should based on a performance status under 3 grade, instead of age, and that anti-cancer drugs not affecting immunological function should be selected.

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A case of fibromuscular dysplasia with bilateral severe sensorineural hearing loss is reported.
A 6-year-old girl visited our clinic complaining of bilateral hearing loss of acute onset.
Clinical examinations revealed extremely high blood pressure of 290/210mmHg and hypopotassemia. Fibromuscular dysplasia was diagnosed by hormonal examination and selective kidney angiography. The hearing level moderately improved with the improvement of hypertension and inorganic imbalance of blood serum. This hearing impairment was thought to be due to the hypertension and hypopotassium resulting from fibromuscular dysplasia.

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In order to clarify the factors influencing the prognosis of otitis media with effusion in children, we correlated the duration of middle ear effusions with five items: sex, age, laterality, the area of the mastoid air cells and the hearing level of air conduction. We examined 317 ears of 250 children with otitis media with effusion. Each ear was decided to have improved or not improved on the basis of tympanometric findings. No significant difference was found between the two sexes. Younger children showed less improvement than older ones, and those with bilateral involvement had poorer results than those with unilateral otitis media. No correlation was found between the area of mastoid air cells and the duration of effusion. Ears with severe hearing impairment were less apt to recover. It was concluded that age, laterality and the hearing level at the first visit can be used as prognostic factors in this disease.

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To clarify whether or not a common pathogenic factor exists between the affected and contralateral ear in patients with cholesteatoma, we performed the measurement mastoid pneumatization and a inflation-deflation test in 92 contralateral ears.
About 70% of the contralateral ears showed abnormal findings of the ear drum. The majority of the contralateral ears showed poor pneumatization. Therefore, we considered these cases to reflect impaired tubal function in childhood. The conditions of the contralateral ears were similar to those of the affected ears, suggesting a common pathogenic factor in this disorder.

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A questionnaire survey on treatment and nasal symptoms during pregnancy was conducted in 47 patients with nasal allergy. Seventy percent of the patients developed nasal allergy within two years after the delivery. Nasal symptoms in patients with pernnial allergy worsened during pregnancy, but those in patients with seasonal allergy significantly improved during pregnancy compared with that before pregnancy.

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A 42-year-old man with anosmia, who had been intermittently exposed for 16 years to the solvent vapor of perchioroethylene (tetrachioroethylene) soaked into clothes, is described.
A standard olfactory acuity test indicated anosmia. An intravenous olfaction test with 2ml of alinamine® showed a prolonged latent time and short duration time, which indicated severe olfactory disturbance. X-ray examination revealed obstruction of the bilateral olfactory clefts and bilateral severe ethmoidal sinusitis. Endoscopy showed that the olfactory clefts were obstructed by edematous swelling of the nasal mucosa and retention of mucous discharge.
The olfactory disturbance was not relieved by the treatment with steroid hormones in the form of nasal drops or oral administration of lysozymes for 3 months.
It is speculated that the inhalation of perchloroethylene for a long time caused the severe olfactory disturbance.

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In recent years, adult tonsillectomies have tended to increase, and with more adult patients there has been increased bleeding during the operation, as well as a tendency for postoperative taste disorders and numbness of the tongue, presumably because the operative field is fixed with a Davis mouth-opening device in pediatric tonsillectomies, and unnecessary compression is applied to the tongue.
The authors have devised the Kinki mouth-opening device which combines the advantages of the Whitehead and Davis devices. AA comparison between the Kinki and Davis devices showed that the mouth opening angle and the space between the teeth and the root of the tongue were all greater with the Kinki device than with the Davis device, indicating that the mouth was opened wider with the Kinki device. The postoperative changes in taste were measured with an electric gustometer, and the Davis device caused more loss of taste than the Kinki device. The incidence of tongue numbness was also greater with the Davis device than with the Kinki device. The Kinki mouth-opening device appears to be ideal for adult tonsillectomies.

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The authors evaluated the clinical course and the effect of tonsillectomy in 12 patients with IgA nephropathy and tonsillitis.
Ten patients had clinical episodes of acute tonsillitis associated with hematuria or proteinuria in their clinical course of IgA nephropathy.
Five patients had high serum ASO titers. Provocation tests of the tonsils caused positive results, including hematuria and proteinuria in 90.9% of the patients.
Reduction of hematuria or proteinuria occurred in 91.7% of the patients after tonsillectomy; serum levels of IgA decreased in 60.0%, and the number of IgA-bearing lymphocytes in the peripheral blood fell in all the patients tested.
These results suggest that IgA nephropathy may have a tonsillar origin and be improved by tonsillectomy.

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A case of hypopharyngeal lymphangioma is reported. A 48-year-old female visited our clinic complaining of ill-sensation in neck portion. The laryngoscopic examination revealed a gray-brown colored mass in the left pyriform sinus. Other examinations, including CT and contrast medium roentgenography, showed that the mass was located only in the pyriform sinus.
Surgical removal of the mass was done by means of lateral pharyngotomy. Pathological examination revealed the cavernous lymphangioma.

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Magnetic resonance imaging (MRI) was performed in 30 patients with head and neck diseases. These included 12 nasal and paranasal diseases, eight parotid tumors, six nodular goiters and four carcinomas of the tongue and oral floor. For obtaining diagnostic information about histological type, MRI findings on peripheral parts and internal architecture of the lesions were considered to be more valuable than those on signal intensity in MRI. The use of surface coils improved the imaging of the deep structures in the parotid gland and thyroid lobe. MRI was useful for differential diagno-sis of some conditions in head and neck disease.

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A study for an objective evaluation of the esophageal voice is described in this paper.
Judging from the auditory impression, the voice samples of the vowel /a/ of 27 esophageal speakers were ranked by the paired comparison method. A standard of quality for the esophageal voice was obtained in this procedure.
We also compared the rank of these voices with their age and period of esophageal speaking using Spearman's coefficients of rank correlation. There was no significant correlation between the voice quality and these two factors.
This procedure is simple and useful in examining the relation between the quality of the esophageal voice and other factors, as well as in evaluating alaryngeal voicing methods.

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Between 1977 and 1986, 15 cases of tracheobronchial foreign bodies in infants and children were treated. The ages ranged from 6 months to 2 years and 5 months. The most frequent foreign body was peanuts (8 cases). The location of foreign bodies was mostly in the right main bronchus (8 cases). The most common chief complaints were stridor and cough.
For the management of respiration, ventilating bronchoscopy was used in 6 cases, tracheotomy in 3, high-frequency positive pressure breathing in 2 and spontaneous respiration in 9. Some of the methods overlapped. We recommend combined use of modified-neuroleptanesthesia and topical anesthesia under spontaneous respiration for removal of the tracheobronchial foreign body in infants and children.

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We encountered 2 cases of tuberculosis of the parotid gland and 2 of cervical lymph nodes between 1986 and 1988.
All diagnoses were confirmed by postoperative histological findings of tumor formation or metastatic lymph nodes. Since all cases exhibited a number of features in common, it may be possible to make a definite diagnosis without biopsy of the lesion.
Drug therapy after surgical resection should be given for at least one year.

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The present expeiments examined the influence of anoxia on spontaneous discharges of cochlear single units in guinea pigs; in several animals the combined effect of anoxia and sodium salicylate was observed. Anoxia was induced by stopping the respirator. Following the induction of anoxia, there was an initial increase in the number of spontaneous discharges in 19 of the 34 cochlear single units tested, after the amplitude of the discharges gradually decreased. The remaining 15 neurons displayed no increase during anoxia, although the same final disappearance of discharges was observed. Neurons showing high frequencies (over 100sp/sec) during normal respiration showed increase during anoxia. In 5 animals pretreated with sodium salicylate, a remarkable increase in the spike rates of spontaneous discharges were noted following the induction of anoxia.

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Three hundred and sixty-four patients with cleft palate were examined with respect to deformity in the nasal cavity, sinusitis, nasal airway resistance and olfactory acuity.
Septal deviation in bilateral and unilateral cleft palate was supposed to develop in fetal life due to the defect of the base of the septum or hard palate. Septal deviation in incomplete and submucous cleft palate was thought to develop after birth. Hypertrophy of the inferior turbinate was observed mainly on the concaved side of septal deviation.
The incidence of nasal sinusitis in cleft palate patients reached a peak between 3 and 5 years of age. According to Nakosi's clinical classification of sinusitis, “restricted infection” was more frequent in cleft palate patients than in normal subjects. Nasal mucociliary transport was impaired in cleft palate patients and this impairment was thought to be one of the causes of the hight incidence of nasal sinusitis in cleft palate patients. Nasal sinusitis had an adverse effect on the middle ear of cleft palate patients.
Nasal resistance was significantly higher in cleft palate patients than in normal subjects because of high incidence of septal deviation, hypertrophy of the inferior turbinate and nasal sinusitis. The degree of sensation of nasal obstruction correlated well with the value of nasal resistance. Olfactory acuity was disturbed in cleft palate patients because of the obstruction of rima olfactoria by nasal sinusitis.

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Electrical pacing of vocal cord adduction was attempted in five dogs. Unilateral recurrent laryngeal nerve of each dog was artificially paralyzed. Electromyographic activity of the cricothyroid muscle was detected, amplified, and used as a trigger of vocal cord adduction. It was interfaced with a muscle stimulator attached to an electrode which was placed in the paralyzed laryngeal adductor muscles (thyroarytenoid muscle and lateral cricoarytenoid muscle). Under electrical pacing, the movement of vocal cords was videotaped simultaneously with electromyographic discharge of the trigger muscle, trigger-on time, and voice.
Electrically paced adduction of the paralyzed vocal cord, synchronous with phonation, was clearly demonstrated. This represents a preliminary step in the development of an alternative approach to the patient with unilateral recurrent laryngeal nerve paralysis.

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Tsumura-Sairei-to was given orally for 4 weeks to 47 children (87 ears) and 17 adults (28 ears) with otitis media with effusion (OME). Pure tone averages improved 10dB or more in 30.5% of the children's ears and in 22.2% of the adults' ears. The tympanograms changed from type B to type A or C, or from type C to type A in 34.2% of the children and in 26.3% of the adults. In the treatment of OME, response rates to Sairei-to in children were similar to the reports described previously and slightly better in children as compared to adults.

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Sixty-six patients with perennial allergic rhinitis were treated with azelastine hydrochloride.
Based on the global improvement, two weeks after the beginning of the treatment, “moderate improvement or better” was observed in 42% of the patients, and “slight improvement or better” in 79%, and four weeks after, “moderate improvement or better” was observed in 55% of the patients, and “slight improvement or better” in 89%. On the records of diary for allergic rhinitis, sneezing, nasal discharge and nasal obstruction were improved in all patients.
These results indicate that azelastine hydrochloride is highly effective in the treatment of perennial allergic rhinitis.

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