This paper describes multidisciplinary treatment incorporating neoadjuvant chemotherapy for head and neck cancer, especially focusing on maxillary sinus carcinoma (MSC) and nasopharyngeal carcinoma (NPC). For MSC, neoadjuvant chemotherapy included CDDP+PEP, ADR or THP-ADR+CDDP+PEP and CDDP+5-FU. The 5-year survival rate was 55% in 28 patients treated with this therapy and this group had a higher preservation rate of maxillo-facial functions and structures, compared with other treatments. However, the survival rate for T₄ cases was very poor, so other therapeutic approaches are required. For NPC, neoadjuvant chemotherapy included CDDP+PEP, ADR+CDDP+PEP and ADR+CPA+PEP. The 5-year survival rate was 44% in 21 patients treated with this therapy, which was higher than that in patients who received other treatments to date. However, the frequency of distant metastasis did not always decrease in this group.

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A follow-up study was conducted on cases of so-coiled low tone sudden deafness. The patients were limited to those who had visited our clinic within three weeks after the onset.
The incidence was the highest in females aged from 20 to 40 years old. The patients were younger than those with other types of sudden deafness. Patients were divided into three groups according to the post-treatment course of hearing loss: 1) cured 2) showing recurrence or fluctuation and 3) unchanged type. Recurrence was characteristic in this disease, because it was rarely observed in other types of sudden deafness. It was specurated that some cases of recurrent were associated with cochlear hydrops or endo-lymphatic hydrops without vertigo. A few cases of low tone sudden deafness were caused by a retro-cochlear lesion.

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To examine the efficacy of collagen implant (atelocollagen) on patulous eustachian tube, 9 ears of 7 patients were treated by the injection of collagen into the pharyngeal orifice of the tube. Under the endoscopic observation, injection was repeated every one to four week until both the subjective and objective signs had disappeared. After the treatment, complete relief was obtained in all ears. Recurrence was observed in two ears at 3 and 4 months respectively, but it was controlled by additional injection. No side effect was observed in any of the ears. These results indicate that injectable collagen was useful for the treatment of patulous eustachian tube.

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A pyrethroid system anti-mite agent was used for 10 children with HD nasal allergy of 9 families. The numbers of mites in the house dust were counted before use, and 2 weeks, one month and 2 months after use. We examined the clinical symptoms with a diary for nasal allergy.
Eight mites were identified, and the family pyroglyphidae was the major family, accounting for more than 90%. The number of pyroglyphidae before use of the antimite agent varied from 100 to 4, 906 per 1g of fine dust among 9 homes, but it ranged from 16 to 14, 404 when a 10m² area was measured. The coincidence between the decrease of the number of mites and the improvement of the clinical symptoms was highest at 2 weeks after treatment. However, the numbers of mites in some homes increased at 4 weeks after treatment, and so the effect of the agent seems to be decreased. The number of mites in a tatami room was less than that in a carpeted room.
A pyrethroid system anti-mite agent is easy to use and safe, therefore, it seems to be useful for eliminating the antigen of HD nasal allergy.

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We report a case of neurinoma of the nasal septum with multiple spinal tumors. The patient was a 21-year-old female. She had undergone resection of multiple neurinomas of the spine at the age of 18, and her father had also undergone resection of multiple spinal neurinomas and neurofibromas.
She visited our hospital because of right nasal obstruction and rhinorrhea of 2 years duration. Anterior rhinoscopy revealed a mass in her right nasal cavity. CT scanning showed a soft tissue density mass in the posterior part of the nasal cavity. Nasal cavity tumor was diagnosed and the tumor was resected through a transantral approach under general anesthesia. Operative findings revealed that the tumor developed from the nasal septum. Histopathological finding of the tumor was Antoni A and B type neurinoma.

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We measured the level of cold hemagglutinin (CHA) in 129 cases of chronic paranasal sinusitis (CS) without bronchial involvement and 31 cases of sinobronchial syndrome (SBS). We also measured the level of CHA in 43 healthy subjects without any apparant hematologic, respiratory or liver disease as a control group.
The level of CHA in CS was significantly higher than that in the control group (p<0.05) and was significantly higher in SBS than in CS (p<0.05). A positive correlation was observed between the severity of chronic sinusitis and the elevation in the level of CHA.
These results suggest that CHA elevation is caused by chronic inflammation of the upper and lower respiratory tract, and that an autoimmunine mechanism plays a role in the pathogenesis of CS and SBS.

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The authors present five cases of mucormycosis of maxillary sinuses treated at Ebetsu City Hospital from May 1987 to November 1988, including a very rare case bilateral maxillary sinus involvement.
The patients were treated surgically, the prognosis appeared to be good. The pertinent literature is reviewed.

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We encountered a case of maxillary carcinoma with intracranial invasion complicated by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) which occurred following carbamazepine administration for meningitis. A 55-year-old female with maxillary carcinoma with intracranial invasion had been treated for increased intracranial pressure by steroids and glycerol. The antidiuretic hormone level was not suppressed by hypoosmolality of the plasma and alpha-human atrial natriuretic poly-peptide was within the normal range. She did not regain consciousness and died of cachexia four months later.

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We reviewed 64 cases of peritonsillar abscess treated at our clinic between May, 1975 and March, 1988. The patients consisted of 42 males and 22 females, aged 3 to 68 years. The abscess was on the right side in 35 cases, on the left in 28 cases and bilateral in 1 case. Bacteriological study of the abscess revealed a high percentage of α-streptococcus and β-streptococcus in aerobic culture, and Bacteroides sp., Peptostreptococcus sp., and Peptococcus., in anerobic culture. All patients were treated with antibiotics. Removal of abscess by puncture was performed in 23 patients, and incision for drainage was perfomed in 41. Interval tonsillectomy was perfomed in 3 patients and immediate tonsillectomy was perfomed in 1 patient. Recurrent peritonsillar abscess was observed in one patient who had not undergone tonsillectomy. Puncture of abscess, incision for drainage and administration of antibiotics are essential in the treatment of peritonsillar abscess.

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We report a case of cervical Bronchogenic cyst coexisting with thyroid cancer. A 50-year-old female visited our clinic complaining of pharyngeal discomfort of 6 months duration. X-ray and physical examinations showed a thyroid tumor with calcification and a cystic lesion behind the left lobe of the thyroid. During an operation for thyroid cancer, a cyst was found connecting with the larynx. Microscopically, the cyst was lined with ciliated pseudostratified columnar epithelium. The wall contained fibrous connective tissue interspersed with normal bronchial elements. The cyst was histo-pathologically diagnosed as a Bronchogenic cyst.

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We designed a new procedure for creating a tracheoesophageal fistula for insertion of a voice prosthesis. Under local anesthesia, a balloon catheter is inserted through the nasal cavity into the esophagus until the balloon is palpable at the level of the stoma. The tracheoesophageal wall is excised cylindrically by rotating a Dispopunch® toward the balloon. The end of the catheter is pulled out through the tracheoesophageal opening and a dummy prosthesis is connected with the catheter by a string. Withdrawing the catheter from the nasal cavity leads the dummy prosthesis into the fistula.
By this simple procedure, we were able to safely produce good fistulas in 5 laryngectomized patients. At their follow-ups of from 4 to 10 months, there were no problems with the fistulas.

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A 17-year-old girl with spontaneous mediastinal emphysema is reported. She complained of pain during swallowing of sudden onset. Chest and neck X ray films showed air in the mediastinum and cervical subcutaneous layers but fluororadiography revealed no abnormalities. She recovered rapidly without any complication.

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The apnomonitor (May-715) is a computerized system for monitoring and recording nasal flow, respiratory sound, and pulse rate. For the screening of obstructive sleep apnea syndrome (OSAS), subjects suspected of having OSAS were given an apnomonitor to monitor their sleep at home. We analyzed the data the following day. Sixty OSAS patients (54 men, 6 women) who were examined with both apnomonitor and respigraph were evaluated, and the apnea index (AI) obtained with the two methods were compared. The AT obtained with an apnomonitor correlated with that obtained with the respigraph (r=0.66, P<0.01). OSAS was defined as AT of more than 10/hour. Sensitivity of the screening method using the apnomonitor was 75.5% and specificity was 85.7%. The apnomonitor was useful for the screening patients with OSAS.

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This study examined the effects of histamines and steroids on guinea pigs with immunologically-stimulated endolymphatic sacs.
The administration of histamines caused spontaneous nystagmus in 3 of 38 guinea pigs with immunologically-stimulated endolymphatic sacs. The three guinea pigs with spontaneous nystagmus displayed severe edema of the stria vascularis. Guinea pigs subjected to both histamine administration and immunological stimulation of endo-lymphatic sacs showed a greater degree of endolymphatic hydrops than those received either treatment alone. This suggests that histamines increased the capillary permeability of the stria vascularis. Rupture of Reissner's membrane was seen in the second cochlear turn of a guinea pig exhibiting 2-hour spontaneous nystagmus attack. It was suspected that Meniere's disease are caused by an increased concentration of potassium in the pen-lymphatic space.
Guinea pigs treated with steroids prior to or immediately following an induced immunological reaction displayed better hearing and balance functions than untreated controls. Steroids inhibited the formation of endolymphatic hydrops in the cochlea and saccule, and of soft granulation tissue in the endolymphatic sac. It was speculated that early administration of steroids inhibits immunological reactions in the endolymphatic sac and disturbances in endolymphatic absorption.

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It has been well known that patients with cleft palate have a high incidence of middle ear disease. Etiology of the ear disease however is still obscure. Dysfunction of the eustachian tube which accompanied by cleft has been considered to be one of the etiological factors of frequent ear disease in cleft palate patient.
To clarify the association between middle ear disease and eustachian tube, otological, endoscopical and functional studies of the eustachian tube were carried out in 263 cleft palate patients (526 ears).
The results were as follows:
1. Otitis media with effusion was most common (33%) in cleft palate cases, but neither the type of cleft, side of cleft nor velopharyngeal insufficiency had any correlation with the incidence of middle ear disease, suggesting that cleft palate patients had common pathological conditions to both eustachian tubes.
2. A variety of abnormal movements were seen in pharyngeal orifices of the eustachian tube. More than half of them showed no dilation of the tube, indicating either hypofunction of the tensor muscle or abnormal pathway of the levator muscle.
3. The mean opening pressure of the tube was lower in OME patients with cleft palate than those without cleft, indicating that decreased closing force was a pathogenic factor of OME in the cleft palate cases.
4. Almost all ears of OME, and more than half of the normal ears in cleft palate patients could not equilibrate applied negative middle ear pressure during swallowing. Thus disturbance of dynamic ventilatory function of the tube seemed to be prevalent in the cleft palate cases, causing a high incidence of middle ear disease.
5. Ciliary function of the tube in cleft palate patients was generally good with less etiologic significance.

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We carried out evoked electromyographic and histochemical studies on the canine arytenoid muscle.
The canine arytenoid muscle consisted of a ventricular muscle and a transverse arytenoid muscle. When a unilateral recurrent laryngeal nerve was electrically stimulated, muscle action potentials were bilaterally detected in ventricular muscles. In the transverse arytenoid muscle, no action potential was elicited by contralateral stimulation. Histochemical studies on the arytenoid muscle were made twelve weeks after sectioning a unilateral recurrent laryngeal nerve. Atrophy of the muscle was noted only in the transverse arytenoid muscle.
The results suggest that the ventricular muscle of the canine larynx is bilaterally and the transverse arytenoid muscle is ipsilaterally innervated by the recurrent laryngeal nerve.

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Ketotifen nasal spray was administered into the nostrils in experimental animals (rabbits) and man in order to investigate the effects on mucus cilium function. Test preparations used were Ketotifen nasal spray (0.1 mg/puff), placebo nasal spray and saline.
In rabbits, there were no significant differences among the three groups as to trans-portation speed or beating frequency of the mucus cilia at the end of 1 and 4 weeks of continuous administration. The Ketotifen group displayed no pathohistological differences from the other two groups at the end of 4 weeks. In man, the transportation time of the nasal mucus cilia was determined by the saccharin method; no significant differences were observed among the three groups.
Ketotifen nasal spray does not seem to influence nasal mucus cilium function in man or in rabbits.

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45 cases of nasal polyp were treated with hydroxypropylcellrose containing beclomethasone dipropionate (BDP) powder. Nasal polyps were classified into 4 stages according to their location: Stage 1, in the middle meatus; Stage 2, between the middle and inferior concha; Stage 3, beyonds the inferior concha without nasal obstruction; Stage 4, completely filling the nasal cavity.
Before treatment, the mean stage was Stage 3 with a standard deviation of 1. 13.
After the treatment, it was Stage 2, with SD of 1.29.
Our result suggest that the drug was effective for the nasal polyps.

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