Chiefly due to the human papilloma virus (HPV), the number of tonsillar carcinoma cases in the U S and Europe has increased significantly. Features associated with HPV carcinoma include younger adults, no alcohol use, and sensitivity to radiation and chemotherapy. Many primary unknown neck metastases have been reported to be involved in tonsil carcinoma. Of 11 patients with primary unknown neck metastases undergoing tonsillectomy with neck dissection, primary carcinoma of the tonsil was revealed in 7. When neck metastasis was diagnosed as originating from tonsil carcinoma, radiation was omitted or the irradiation field was reduced. Complications in radiotherapy were fewer in tonsillar carcinoma than in primary unknown neck metastases.
Transoral resection for 27 tonsillar carcinomas were T1, T2, and T3. When primary resection was connected with neck dissection, we also conducted transneck resection. It should be noted that it is imperative that there is no damage to the internal carotid artery (ICA) and cranial nerves. We place a piece of green cloth around the ICA to prevent ICA injury and other surgical complications. Five-year overall survival for untreated cases and previously treated cases was 79% and 15% respectively.

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We conducted two studies to evaluate the clinical effect of tonsillectomy in patients with pustulosis palmaris et plantaris (PPP).
1. Retrospective study
Objectives: We evaluated the clinical effect of tonsillectomy on PPP treatment.
Subjects: Subjects numbered 80 patients (23 in the tonsillectomy group and 57 in the control group) diagnosed with PPP.
Methods: Patients were followed up for 1.5 years or longer and skin lesions were evaluated by dermatologists based on 5-grade scales.
Results: The tonsillectomy group showed significantly more improvement than the control group (p<0.01), with 60.8% of patients showing “improvement” or a better outcome.
2. Prospective study
Objectives: We prospectively evaluated the clinical effect of tonsillectomy on PPP treatment.
Subjects: Subjects numbered 63 patients (26 in the tonsillectomy group, and 37 in the control group) diagnosed with PPP and treated for 1.5 years or longer.
Methods: After definitive diagnosis based on skin biopsy, we explained treatments to patients, who then selected a treatment and were prospectively followed up. Clinical effect was evaluated using the same methods as in the retrospective study.
Results: The tonsillectomy group showed significantly more improvement than the control group (p<0.01), with 86.2% of patients showing “improvement” or a better outcome.
Conclusion: We concluded that tonsillectomy is effective and reliable for treating PPP.

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I disintegrated about method of tonsillectomy and reaffirmed it about surgical technique. Especially I thought that traditional dissection with ligation of lower pole decreased postoperative bleeding rate. In addition, Coblation method could perform an incision, hemostasis, irrigation, and suction with only a kind of Wand and thought to be a unique method as compared to the conventional method.
As the surgical treatment for snoring, LAUP or radiofrequency ablation had been performed to the soft palate, however these techniques were not widely used in Europe and America. In addition the existence of nasal obstruction causes snoring, so that otolarygologist should make attention to this and examine the several deseases causing snoring.

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