In the treatment of hypopharyngeal cancer, radical irradiation or laryngeal preservation surgery is selected for the purpose of preserving the larynx for early cancer. On the other hand, surgical treatment is the main treatment for advanced cancer, but laryngectomy is often inevitable. Therefore, when conserving the larynx, induction chemotherapy or concurrent chemoradiation therapy is selected.

　Patients with hypopharyngeal cancer often have esophageal cancer. If radiation therapy has already been performed for esophageal cancer, it may not be possible for hypopharyngeal cancer. Therefore, laryngeal preservation surgery is an important tactic in the treatment of hypopharyngeal cancer. In recent years, trans-oral surgery and endoscopic laryngo-pharyngeal surgery have been increasing. On the other hand, open laryngeal preservation surgery is rarely performed. Since 2004, we have performed 46 open laryngeal preservation surgery, and were able to obtain a 5-year disease-specific survival rate of 90% and a laryngeal function preservation rate of 83%. Since it was pointed out that it was difficult to determine the resection range, we decided to determine the appropriate resection range using an endoscope. Then, we devised a method of performing a pharyngeal mucosal incision endoscopically and removing the tumor by approaching it from the neck. In this method, complete pathological resection of all cases is obtained, which is considered to be a useful tactic.

　A 34-year-old man presented to our otorhinolaryngology clinic with a 3-month history of hearing loss in his left ear. He had undergone stapes surgery in his right ear at another hospital 13 years ago. Physical examination showed no specific findings, and the tympanic membrane was intact, with no sign of any previous infection. Pure-tone audiometry revealed a mean hearing threshold of 47.5dB, with an A-B gap. Computed tomography revealed decalcification of the bone surrounding the cochlea, vestibule, and semicircular canals, suggestive of bilateral retro-fenestral otosclerosis. Stapes surgery was performed based on the diagnosis of otosclerosis. Intraoperatively, disruption was noted between the stapes superstructure and the footplate. Due to the immobility of the stapes, a small fenestration was made in the footplate of the stapes, and a 0.6-mm Schuknecht wire-piston prosthesis was inserted. Subsequently, the incudo-stapedial joint was dislocated, the stapedius tendon was cut, and the stapes superstructure was removed. Pathological examination showed bone resorption and many empty osteoclast lacunae in the removed stapes superstructure. The patient showed a good postoperative course without complications, and his hearing level recovered to almost the same level as that of the healthy ear. In our case, the ossicular chain disruption was thought to be caused by the otosclerosis, since there was no history of infection, no anatomical abnormality suggestive of ossicular malformation, and no characteristics of van der Hoeve syndrome, such as a history of spontaneous fractures or blue sclera. It is necessary to carefully evaluate the ossicular chain as part of the surgical plan prior to stapes surgery.

　A 87-year-old woman was referred to our hospital for the treatment of right exudative otitis media. She gradually developed facial and recurrent nerve palsies and died 1 year 8 months after her first visit, leading to an autopsy. The cause of death was thought to be bilateral vocal fold paralysis due to chronic infiltrating sinus mycosis, starting with right sinus mycosis.

　In the head and neck region, histological diagnosis can often not be confirmed for lesions at sites where removal of the lesions is difficult. If there is sinus mycoses in the background, we should consider treatment for invasive sinus mycosis using serologic support for diagnosis.

　Descending necrotizing mediastinitis (DNM) is a serious infection arising from deep neck infection and spreading downwards into the mediastinum. We encountered a case of successful treatment of DNM by CT-guided mediastinal abscess drainage.

　A 79-year-old woman with no significant past medical history presented to her neighborhood doctor with the chief complaints of sore throat and swollen neck. She was diagnosed as having DNM with gas production and was urgently transported to our hospital. We performed transcervical incision and drainage. Subsequently, she developed an abscess in the mediastinum and posterior neck, which were treated by CT-guided abscess drainage. She resumed oral intake on the 65th day and was transferred to a rehabilitation hospital on the 141st day. CT-guided drainage is a less invasive and effective treatment for mediastinal abscess.

　Pharyngeal and laryngeal mycosis is an opportunistic infection that develops in patients with a weakened immune system. Mycosis of the larynx, which is rare, may manifest as hoarseness and/or dyspnea.

　We encountered a case of pharyngeal and laryngeal candidiasis that presented with dyspnea. The 41-year-old man visited our department with the complaint of dyspnea. The pharynx and larynx were furred, and the larynx was edematous. We recommended hospitalization, but the patient did not wish to be hospitalized. We did mycological tests of the culture isolated from the pharynx, and treated the patient with amphotericin B.

　There is the risk of dyspnea occurring due to laryngeal edema and granuloma formation. If the initial treatment is not successful, the antifungal drugs need to be switched depending on the drug sensitivity of the bacterial species.

　Medial meatal fibrosis (MMF) is a disease characterized by thickening of the fibrous tissue between the outer epithelial layer and intermediate layer of the tympanic membrane. Various risk factors have been reported, and surgery is the mainstay of treatment. We encountered a 66-year-old woman with idiopathic medial meatal fibrosis. Surgery was performed by referring to previous reports. The epithelial layer of the tympanic membrane was incised and lifted up as a flap to remove the lesion. The epithelial and intermediate layers of the tympanic membrane were preserved as much as possible. To prevent lateralization of the tympanic membrane, the sliced cartilage was used as the graft material to repair the perforation and anterior aspect. Histopathological examination of the removed tissue showed thickened and fibrotic stroma. After surgery, favorable epithelialization was observed, and the air-bone gap on pure-tone audiometry improved. Since the cartilage graft is expected to remain fixed to the intermediate layer of the tympanic membrane and not turn over anteriorly, it is unlikely to cause lateralization and is thereby considered as a useful graft material for surgical treatment of medial meatal fibrosis. As the disease commonly recurs, long-term follow-up of the patient is necessary.