Surgery for benign parotid tumors is one of the relatively frequent surgeries in the head and neck. However, considering the possibility of malignancy and complications, such as postoperative facial nerve palsy, proper diagnosis and surgical technique are necessary. Although the diagnosis is generally made by fine needle aspiration cytology and ultrasonography, it is necessary to recognize that even if a benign tumor is suspected preoperatively, based on the results of such tests, the possibility exists that a certain percentage of the tumor may be malignant. In terms of localization, it is difficult to accurately predict deep lobe tumors preoperatively, and the possibility of deep lobe tumors should always be kept in mind during surgery, especially when tumors are located superiorly or anteriorly. In terms of surgical techniques, the risk of postoperative facial nerve palsy is not particularly high, depending on the localization of the tumor, so we actively perform surgery using a facelift incision. Although each institution has its own technique for specific surgical procedures, there are several important points to be considered in dissection of the parotid gland and manipulation of the periprosthetic facial nerve.

With the widespread use of hearing screening tests for newborns, infants with mild to moderate hearing impairment have been detected more often than in the past. Parents often notice severe hearing loss children without requiring any test, but it is difficult to detect in cases with mild to moderate hearing impairment. Therefore, it is important to detect it at an early stage even in otolaryngology clinics. In order to verify an alternative method that can easily detect children with mild to moderate hearing impairment even in clinics, we investigated the correlation between the screening test “picture-book speech test” and hearing test. Based upon our findings, the whispering test exhibited a correlation with hearing and could detect hearing impairment.

However, although the whispering test can be used to detect children with mild to moderate deafness to some extent, the detection rate fluctuates depending on the set value of the pass line. In addition, it was considered more desirable to use the DPOAE together with the whispering test in the detection of children with moderate deafness. We believe that the spread of the “picture-book speech test” as a screening test for deafness at local medical institutions may increase the number of children with deafness who can be detected and undergo intervention at an early stage.

Objective: We investigated the therapeutic effect among patients who undergo sublingual immunotherapy (SLIT) for Japanese cedar pollinosis (JCP) at our hospital.

Methods: For patients who started SLIT for JCP between June 2015 and December 2019, we interviewed the patients after the end of the annual pollen season (June-August) using the Japan Allergic Rhinitis Standard QOL Questionnaire (JRQLQ).

Results: The amount of JCP scattered during the survey period ranged from a low of 2,032.8pcs/cm² (2020) up to 12,051.9pcs/cm² (2018). The difference in the amount of scattering between these two years was remarkable. We compared the “hardest symptoms of the past three years” that we interviewed the patients at the time of the first visit with the “hardest symptoms of the season” that we interviewed the patients after the end of the annual pollen season. As a result, both the clinical symptom scores and the QOL scores decreased significantly from the first year of treatment (p<0.05). From the second to the fifth year, the scores decreased significantly for most items.

Conclusion: SLIT for JCP was effective from the first year of treatment regardless of the amount of Japanese cedar pollen dispersed, and the effect continued thereafter. In the future, it will be necessary to increase the number of patients and consider how the subjective symptoms tend to improve with the number of years of treatment, and what to do with respect to the guidelines for the end of treatment.

The patient was a 14-year-old child who complained suddenly of pain of the left ear and underwent a check-up at the general hospital. The doctor found swelling of the left peri-tonsillar area and CT examination showed a retropharyngeal tumor. He was subsequently referred to our hospital for further examination.

Cervical enhanced CT and MRI showed a 38mm round tumor in the retropharyngeal space. We consulted with radiologists, pediatricians and plastic surgeons about the diagnosis and treatment. We decided to perform surgery via a trans-cervical approach, considering the potential for malignant tumors, such as rhabdomyosarcoma and synovial sarcoma. The pathological diagnosis was schwannoma.

Severe dysphagia due to glossopharyngeal nerve palsy and vagus nerve palsy occurred post-operatively, but recovered with rehabilitation.

Schwannoma is often seen as a cause for cervical tumor, but cases of retropharyngeal schwannoma in children are extremely rare.

Mycoplasma pneumoniae (M. pneumoniae) causes not only lower respiratory tract infections, but also various malfunction of other organs, such as the central nervous system, hematopoietic system, circulatory system, digestive system, upper respiratory tract, skin, joints, muscles, etc. In the head and neck region, M. pneumoniae causes acute laryngopharyngitis and otitis media. It is known that the pharyngeal tonsil in acute epipharyngitis caused by M. pneumoniae gets markedly swollen and turns red. This specific finding is expressed as “strawberry-like” appearance and has been reported in some children, but in few adults.

Herein, we report 2 cases of M. pneumoniae pneumonia with concurrent acute epipharyngitis in adults. Each of the patients had suffered from high fever, sore throat and cough for 10 days. We initially diagnosed these clinical conditions as acute bacterial pharyngitis and administered penicillin and cephem antibiotics. Despite these treatments, their symptoms did not improve. Chest CT scan revealed pneumonia shadows in the superior lobe of the lungs and endoscopic findings showed “strawberry-like” appearance with epipharynx in both cases. Therefore, we performed loop-mediated isothermal amplification (LAMP) assay for M. pneumoniae, which was positive in both cases. Two days after administration of macrolides, their symptoms and objective findings improved markedly.

In case that symptoms do not improve despite administration of penicillin and cephem antibiotics for acute pharyngitis, we should consider the possibility of M. pneumoniae infection and perform chest radiographic examination, endoscopic examination and LAMP assay.