Although tonsil-related diseases are seen frequently by both otolaryngologistasnd pediatricians, there are some differences in recognition between otolaryngologists and pediatricians about tonsillectomy. One of the reasons is that there are no guidelineso btained from consensusa bout adaptation of tonsillectomyw idely by both pediatricians and otolaryngologists. To produce guidelines, the long-term results of each disease should be reviemed and discussed. In this study, we investigated the availability of tonsillectomyf or children based on the data of questionarys urvey for patients and both otolaryngologistsa nd pediatricians, and discussed the approach of otolaryngologistst otonsillectomy.

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Our clinic for children with hearing impairment was visited by 1993 cases during the period from 1981 to 2005. The number of patients has increased gradually in spite of a decrease in the infant population. The number of children diagnosed as having severe hearing loss (>70 dBHL) has decreased in proportion to the number of births. Due to the spread of newborn hearing screening from the year 2000, the number of 0-year-old infant patients referred from obstetric clinicsa nd the diagnosis of moderate hearing loss (40-70 dBHL) at the age of 0 year were increased, but the age of diagnosis of severe hearing loss has not changed. Systematic introduction of universal newborn hearing screening appears to be required.

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Various outcomes of language development have been reported among children with prelingual hearing impairment and successful hearing intervention may not always ensure appropriate language development in their future. Learning disability is the symptom that is most frequently combined with hearing impairment, accounting for nearly 10% of these children. The combination of developmental dyslexia, which is the main symptom of learning disabilities, may hamper their language development by affecting their reading/writing ability. However, the detection of developmental dyslexia during their preschool period is highly difficult regardless of the presence of hearing loss. Before evaluating hearing impaired children,37 normal-hearing children in preschool education were examined in terms of the cognitive abilities that are required for reading/writing abilities. The evaluations included Raben's colored progressive matrix test (RCPM), language developmental tests (S-S), Benton's visual memory tests, Phonological awareness tests and the Single Kana-moji writing test. S-S test and RCPM are useful for the exclusion of the cases with apparent developmental delays and reading comprehension did not correlate with their calendar age. However, drastic development of Kana-writing was observed after 60 moths of age.

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We treated a case of ameloblastoma arising from the maxillary sinus and nasal cavity of a 4-yearold boy. The patient underwent an operation on the right maxillary sinus based on the diagnosis of a dentigerous cyst made six months before visiting our hospital.
As the tumor had a tendency to bleed, we performed angiography and embolization of the right maxillary artery before the operation. The tumor was extirpated using the Caldwell-Luc approach. There has been no recurrence four years postoperatively. The pathological diagnosis was ameloblastoma, which is extremely rare in infants, especially in the maxillary sinus.

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Objective: To investigate the occurrence of occult bacteremia associated with acute otitis media with fever.
Methods: Pediatric patients treated between January 2005 and June 2006 and satisfying the following four conditions were enrolled in this study: (1) age 3 to 36 months without immunodeficiency; (2)max temperature≥39°C during the clinical course; (3)no apparent toxicity; and(4) fever without an dentifiable source. In all cases, the diagnosis of acute otitis media was made with otoscopy or a fiberscope, and leukocyte counts were determined by sampling a small amount of blood from the fingertip. Leukocyte counts≥15,000/μl and neutrophil counts≥10,000/μl were used as criteria for a high risk of occult bacteremia and blood cultures were obtained for all patients in the high risk group.
Results: Of 466 children included in the study,74 were diagnosed as having acute otitis media. Blood cultures were obtained from 20 patients with otitis media (20/74; 27.0%) and pathogenic bacteria were found in 3 cases (3/74; 4.1%). Among the 392 children without acute otitis media, blood cultures were obtained from 51 patients (51/392; 13.0%) and pathogenic bacteria were also detected in 5 cases (5/392; 1.3%). These cases were diagnosed as occult bacteremia. Occult bacteremia detection rate tended to be higher in cases with acute otitis media, although there was no significant difference between the two groups (P= 0.09 odds ratio 3.27; 95% confidence interval 0.83-12.9).
Conclusions: Occult bacteremia must be considered in patients with acute otitis media when a high fever is present.

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Embryological anomalies of the first branchial apparatus result in rare forms of developmental abnormality of the head and neck. We described two cases of first branchial cleft cyst. The swelling and otorrhea disappeared after drainage in both cases. The definitive therapy of this cyst is complete surgical resection. However, when this procedure is performed, in most cases parotidectomy and exposure of the facial nerve are required. Accordingly, facial nerve injury is a complication. We thought that if the swelling was not seen after drainage, the first choice of therapy was not only surgical resection.

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False positive results were frequently observed in the responses to a questionnaire administered to parents about allergic rhinitis of their elementary school children. Examination of the antigen specific IgE was indispensable to improve the specificity of the study. In addition, nasal inspection and nasal cytology were very helpful in the accurate diagnosis of pediatric allergic rhinitis.

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We divided 53 cases of pediatric pychogenic deafness who were 6-12 years of age into a consultation group (CG) and a school hearing screening group (SG). Boy to girl ratios of both groups were 1: 3. The average age was 9.4 years in CG, and 8.9 years in SG. As for the diseased side of CG the bilateral to the unilateral ratio was 1: 1, in SG, all cases were bilateral. Type V in Bekesy audiometory was 67% in CG, and 63% in SG. The hearing level at six months recovered in 71% of cases in CG and 67% of cases in SG.

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We studied bacteria isolated from the middle ear fluid in 135 children under 6 years of age with acute otitis media (AOM) between April 2004 and March 2005. Approximately 42% of samples were culture-negative. Eighty-nine bacterial pathogens were identified from those samples:Streptococcus pneumoniaein 35 (39.3%),Haemophilus influenzaein 14 (28.6%), and Branhamella catarrhalis in 3 (3.4%). ForS. pneumoniae, the rate of non-susceptibility to penicillin G was 77.1%(PISP + PRSP). For H. influenzae, the rate of ampicillin-resistant strains was 28.6%. Among all isolates of our hospital, recently there has been a marked increase in→-lactamase non-producing ampicillin-resistant H. influenzae(BLNAR). The rate of BLNAR was 0.8%,1.4%, and 15.8% for the years of 2003,2004, and 2005, respectively. Among the AOM isolates obtained in this study,78.2% were resistant to ampicillin. In contrast, the rate of resistance to amoxicillin-clavulanate among the AOM isolates was 13.6%. For selecting a first-line antibiotic in the treatment of AOM, an increase in drug-resistant organisms should be taken into consideration.

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