The investigation of the postoperative infection which occurs in succession for the operation on the chronic otitis media was performed at ten university hospitals in Japan. The operating case of 258 patients was registered from January 1994, to June 1994. The cases who had an otorrhea preoperatively were 13.1% in these 258 cases. A postoperative infection was detected in 2.3%. This frequency was small in comparison with the past reports. From these results, it was found out that a postoperative infection happened easily in the case who had an otorrhea preoperatively. It was also found out that postoperative infection happened easily in the case that a pathology was advanced. It is important to control an otorrhea preoperatively to make a postoperative infection decrease. Also it is important to use the New Quinolone of the antimicrobial agent postoperatively to make a postoperative infection decrease. When an otorrhea exists preoperatively, it is important to use an antimicrobial agent in accordance with the sensitivity of the bacteria detected in the otorr hea.

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Incidence of postoperative focal infection in 363 cases with chronic sinusitis was studied. Functional endonasal sinus surgery was done in 308 out of 363 cases, and antibiotics were administered postoperatively in almost all cases. As the result of this study, no focal infection was detected in all cases. Methods for protecting from focal infection after sinus surgery were discussed.

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The post operative infection fregnency have been reported in 10-20% of digestive tract surgery, because of contamination from gut. The progress in antibiotic therapy hoped to diminish the incidence of postoperative infection, but in the otherhand, extended operative indication to aged people, compromised host and increased lymphonode dessection made no significant difference in incidence of postoperative infection. Moreover, MRSA made a new aspect of surgical infection and nosocomial infection from late half of 1980's in choice of antibiotics.

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A case of thymic cyst removed transcervically is herein reported. The patient was a 27-year-old woman with an asymptomatic neck mass. The physical examination revealed a soft mass located above the sternal notch. MRI showed a diffuse mass with low intensity signal in T1 weighted image and high intensity signal in T2. The tumor was surrounded by bilateral common carotid arteries, internal jugular veins, and brachiocepharic veins. On February 24 1992, she underwent en bloc resection performed transcervically with an usual collar skin incision. The tumor filled with the serous fluid measured 5 .5×3.5×3.0cm. Histopathological examination revealed a cyst surrounded by normal thymic tissue. At 34 months follow-up, she showed no recurrence of tumor. The pathogenesis of the thymic cyst and the usefulness of transcervical surgical procedure are discussed in this paper.

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In the use of radiotherapy for pituitary tumors, high-dose irradiation applied to the pituitary from outside of the focus has been known. Recently, we introduced that instead of using high-dose irradiation, a very low dose radiotherapy emitting chiefly β-ray has been used, inserted directly into the tumor. The radioisotope is inserted and into the tumor via the sphenoid sinus of the nose by puncturing the sella turcica. This therapy has been attempted, we applied this therapy to a 51-year-old woman and 40 male both with chief complaints of headache, disturbed visual acuity and a disturbed visual field, symptoms associated with elevated intracranial pressure. They had transfrontal craniotomy for pituitary tumor in the department of neurosurgery. The patient was subsequently referred to our clinic because the tumor recurred again. The patients responded well to this therapy, the symptoms disappeared after new method and returned to normal life until now. Long follow-up revealed a very good outcome and no recurrence of tumor. This new treatment is easy to apply, safe and effective and is considered to be particularly suitable for elderly or physically weak patients, patients with recurrence after craniotomy, and those who are afraid of surgery.

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Treating a parapharyngeal tumor is still a challenge for Otolaryngologists, as the anatomical condition of parapharyngeal space prevents a surgeon to access this space easily.For a large parapharyngeal tumor, the mandibular swing approach is the method of choice because of wide surgical field and low morbidity. But this approach demands midf acial skin incision including lip splitting giving a grave cosmetic effect. Our new mandibular osteotomy consisits of the lower condylar osteotomy and temporary posterior marginal resection of the ramus. That proedure enable the mandible to be retracted anteriorly like a sliding door that assure wide operative field from the skull base to the bottom of the parapharyngeal space. We had an excellent surgical result in a 39-year-old man with a large (9x8x6 cm) parapharyngeal basal cell adenoma. We think this method is one of the ideal approach to the large and/or malignant parapharyngeal tumor without a obvious facial scar.

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