Disfunction of Balance system, such as dizziness, may cause by multiple factors including unknown reason. It is well known that insomnia is associated with increased psychological symptomatology and perceived stress, higher predisposition to arousal, and greater impairments to quality of health. The relationship between dizziness and stress is well documented, but that between dizziness and insomnia is unclear. In this series, we focus on the Ménière's disease, which is characterized by fluctuating and progressive hearing loss, aural fullness, tinnitus, and intermittent attacks of vertigo, an illusory sensation of movement resulting from dysfunction of the labyrinth and cochlea, to investigate the relation between sleep disorders.

　In our previous report, we first found that sleep quality of Ménière's disease patients was impaired. Ménière's patients have longer total sleeping time, lack of deep sleep stages, increased arousal, and were occasionally combined with obstructive sleep apnea syndrome and/or periodic limb movement disorder. Poor quality of sleep may cause additional stress and lead Ménière's disease patients to a negative spiral of symptoms. Furthermore, poor sleep quality may result in Ménière's disease patients being refractory to medical management. Therefore, prospective treatment focusing on the sleep disorders of, not just Ménière's disease but possibly dizziness symptoms, may become an additional new strategy for terminating the negative spiral of symptoms and reduce exacerbations.

　Postoperative bleeding is sometimes encountered after tonsillectomy, and without prompt and appropriate therapy. However, few studies have been carried out on postoperative bleeding after tonsillectomy.

　We investigated the data of 9 patients (5.1%) who developed postoperative bleeding after tonsillectomy and required procedures under general anesthesia, out of the 177 that underwent tonsillectomy at our institution over the last past 3 years. The patients ranged in age from 5 to 68 years, and all were male. The bleeding occurred from the right side in 6 cases and from the left side. The precise site of bleeding varied among the cases. We used bipolar electrohemostasis in all cases, and sutured the anterior palatine arch and posterior palatine arch in 4 cases after the bleeding had been controlled.

　The central causes of bleeding after tonsillectomy are considered to be inadequacy of the procedure and incomplete healing of the operative wound. In addition, as the number of elderly undergoing the procedure has increased as compared to that in the past, it is important to pay attention to whole-body management, including blood pressure control, during the perioperative and postoperative periods.

　Objective: To identify the clinical profile of patients who underwent endoscopic sinus surgery, and of cases of chronic rhinosinusitis with/without asthma at our hospital (Saku city, Nagano prefecture, Japan).

　Method: A retrospective study of 627 patients (1,038 sides) who underwent endoscopic sinus surgery from September 29, 2009 to July 1, 2015.

　Results: Chronic sinusitis (81.0%) was the most commonly encountered disease, and nasal obstruction (43.8%) was the most commonly encountered symptom in the patients who had undergone endoscopic sinus surgery. Pansinus surgery (61.8%) was the most commonly performed, while deviatomy was performed in a total of 70.5% of the patients. A navigation system was used in 9.9%, emergency operation was performed in 1.4%, sight disorders were present in 1.5%, and complications of the operation occurred in 1.4% of all patients. Of the patients with chronic sinusitis, 17.0% had asthma. In the patients with asthma, nasal obstruction (59.7%) and dysosmia (24.7%) were significantly more likely to be present, opacities in all sinuses on CT images were significantly more likely to be found, bilateral surgery (96.1%) and pansinus surgery (86.1%) were significantly more likely to have been performed, and the number of cases of revision surgery was significantly greater (23.2%).

　Conclusions: Various data of cases of endoscopic sinus surgery from our hospital were revealed. Furthermore, we found that the symptom profile, CT findings and frequency/types of operation differed significantly between patients of chronic rhinosinusitis with asthma and those of chronic rhinosinusitis without asthma.

　Lemierre's syndrome is a systemic infectious disease characterized by the development of thrombophlebitis of the internal jugular vein after an oropharyngeal infection, which can eventually be complicated by sepsis and/or organ abscesses in distant areas. With the wide use of antibiotics in clinical practice, this disease is regarded as extremely rare, however in recent years, the number of domestic reports on the disease has been increasing. We report a case of sepsis caused by Fusobacterium necrophorum, which was considered as a case of Lemierre's syndrome, as the patient initially presented with a left peritonsillar abscess, and subsequently developed pulmonary embolism, pyothorax and disseminated intravascular coagulation (DIC).

　Odontogenic keratocysts need not only to be fenestrated, but also removed completely. The cysts show a high rate of recurrence and occasionally show malignant transformation. Herein, we report a case of odontogenic keratocyst in which we performed endoscopic modified medial maxillectomy (EMMM) for complete removal of the cyst. The patient was a 65-year-old female who was diagnosed as having an odontogenic keratocyst by sinus CT and MRI, and was treated by EMMM for complete removal of the cyst under a bright field. She had a good postoperative course and the condition of her sinus mucosa returned to normal.

　Until now, EMMM has been used mainly for the treatment of papillomas, however, we believe that it is also useful for the treatment of odontogenic keratocysts. In conclusion, we suggest that this endoscopic procedure is effective for obtaining direct and wide access into the maxillary sinus to accomplish complete removal of maxillary odontogenic keratocysts.