I compiled and analyzed 112 patients in whom 182 sides of diffuse chronic sinusitis were subjected to endoscopic endonasal ethmoidectomy with the creation of a large communication between the maxillary sinus and frontal sinus. These initial sinus surgical cases have been followed up postoperatively for periods ranging from 1 year to 5 years and 9 months. The age range was from 15 to 70 years, with a mean of 35.8 years.
The improvement rate of clinical symptoms by questionnaire, the improvement rate and the postoperative period required for cure of maxillary sinus lesion, and also the postoperative conditions of the ethmoid sinus, nasofrontal duct, fontanelle and maxillary sinus are analyzed.
The subjective nasal symptoms improved in more than 99% of the patients. However, nasal discharge and postnasal discharge persisted in a few cases.
The overall improvement rate in the objective endoscopic findings after surgery was 90-95%. Complete cure was not able to be obtained in 5-10% of the cases. They apparently require another treatment or surgical procedure.
Endoscopic endonasal sinus surgery enables a precise technique and facilitates the prevention of serious surgical complications, thereby improving the final results.

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The authors report the techniques of opening the frontal sinus through the frontonasal duct in endoscopic microsurgery of the ethmoid sinus. The first step is the exposure of the fovea ethmoidalis and the anterior ethmoid artery, the second step is the exposure of the lamina papyracea, the third step is the exposure of the medial wall of the ethmoid sinus, the fourth step is the opening of the frontonasal duct and the final step is the enlargement of the frontal ostium. Preoperative CT scan revealed frontal sinus disease in 69 cases out of 190 cases with chronic sinusitis or in 36%. The frontal sinus was opened in 177 sinuses or in 57%. Patent nasofrontal duct was confirmed in 32 sinuses or in 18% during the postoperataive observation. There was no case that developed any symptoms of frontal sinusitis during the study period of six years, which indicates that late closure of the frontonasal duct is rare with this technique.
Intranasal endoscopic opening of the frontal sinus in inflammatory diseases is shown to be a safe and reliable technique, which can be performed under clear visualization and without major complications.

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This report concerns with the impairement of the patients with vertigo. Seventy-nine patients were studied with respect to their disability in their daily lives after their vertigo. The disability means that they cannot perform the action on that they feel difficulty in performing it. They were asked about disability in performing twelve actions; seeing small objects, seeing the objects moving rapidly and slowly, seeing on TV what moves rapidly and slowly, seeing on TV what moves slowly, seeing a curtain with vertical stripes, going up and down the stairs and operatiing word processors or computers. Though twenty-five out of seventy-nine had no disability on all items after vertigo, the other fifty-four felt disability in some of the actions. The twentyseven of them felt disability to see small objects, thirty of them, to watch rapidly moving objects, twenty-two of them, watch rapidly moving objects on TV, thirty of them, to act rapidly, twenty-one of them, to walk fastly, twenty-three of them, to go up and down staires, nineteen of them, to see a curtain with vertical stripes and fififteen of them, to operate word processors or computers. It is important that about seventy percent of the patients had disability in their lives. The evaluation of their disability is necessary to make effectvie rehabilitation of the patients with vertigo.

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There are many reports about hearing changes according to aging. But few are available after JIS standard was revised in 1982. Hearing test was done for 6992 people (13844 ears) who came to Division of consultation, center for general health care, the Jikei university school of medicine for medical check-up. Pure tone hearing level of air conduction is analysed. Mean, standard deviation, mode, and median of hearing level are calculated and evaluated.
Thresholds at each frequency was elevated in older people. But the hearing change by aging is less at medium and low frequencies.
Mean, mode, or median has some merits and demerits to represent the level. Mean and standard deviation are often greater than those of other reports, but are much the same. Mode sometimes shows twin peaks especially at advanced age and high frequency.

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Nowadays MRI (magnetic resonance imaging) is clinically regarded as one of the quite useful means for diagnosis in the field of the head and neck.
During the past 14 years, 12 malignant melanoma cases were experienced in our ENT department, and two cases of them, who were originated primarily in the lacrimal sac (57-year old female) and the mandibular bone (56-year old male) seemed to be unusual cases not only in our clinical experience but also in the literature. In addition, in these two cases, MRI exibited its more advantageous ability for topographic information of the tumor invasion and prediction of the preoperative safety margin of the tumor than X-ray CT.

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Vowels and consonants of onomatopoetic expressions of tinnitus were investigated in view of the relationship to the pitch and the nature of tinnitus. The subjects were 370 tinnitus ears without hearing loss or associated with cochlear deafness.
The results obtained were as follows;
(1) The most frequently used vowel in onomatopoetic expression was the “I” (64.3%), followed by the “A” (20.3%).
(2) The most frequently used consonant in onomatopoetic expression was the “Z” (31.1%), followed by the “K” (22.2%).
(3) It was suggested that the vowel of onomatopoetic expressions of tinnitus be related to the pitch of tinnitus and that the consonant be related to the nature of tinnitus.

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[in Japanese]

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