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Cineradiography enables the second stage of swallowing to be analyzed visually in hyoid and laryngeal movements during swallowing, but cost and preparation time have limited its clinical dissemination. To overcome this, we computerized quantitative video fluorographic imaging using commercially available DIPP-Motion Pro 2D® software. This has the advantages of 1) DV images are fed to the computer as animation and analyzed directly; 2) numerous points can be marked and tracked automatically, 3) with coordinate setting and scale correction, movement distance and velocity are measured automatically, and 4) functions synchronizing graphs with cineradiography video facilitate visual understanding. We quantitatively studied swallowing in 6 subjects without dysphagia. Median hyoid bone movement is 10.5 mm on the abscissa and 16.2 mm on the ordinate. Median laryngeal movement is 9.3 mm on the abscissa and 25.1 mm on the ordinate. Maximum bolus is 1011.3 mm/sec. We analyzed swallowing conveniently and effectively, displaying data with visual information. This makes it a handy tool for analyzing swallowing quantitatively in clinical practice. It also enables us to exchange information effectively with other medical personnel and gain informed consent.

A case of transitional cell carcinoma (TCC) of the frontal sinus is reported. An 83-year-old man complained of left exophthalmos and nasal obstruction. On examination, the nasal cavity was blocked with a polypoid swelling. Computed tomography and magnetic resonance imaging demonstrated tumor in the frontal sinus and mucocele in the paranasal sinus. The mass in the left frontal sinus was excised and diagnosed as TCC. The treatment was performed by a linear accelerator. The prescribed dose was 70Gy. Irradiation was performed without effect, and the patient died 1 year later. Previous reports of TCC in the paranasal sinus are reviewed and discussed.

Innominate artery fistulas require a surgical procedure, although the prognosis is usually very poor because of complications such as re-bleeding and infection. A 50-year-old man presented with laryngeal carcinosarcoma (T1a, N0, M0). Partial laryngectomy was performed but there was a recurrence; therefore, total laryngectomy, total thyroidectomy, right radical neck dissection, left functional neck dissection, skin-combined resection and D-P flap were performed. On postoperative day 6, after intense coughing, copious hemorrhage from the tracheostoma was demonstrated. Immediately, bleeding was arrested by pressing the tracheostoma. Fistula of the innominate artery was then repaired using left great saphenous vein, but recurrent perforation of the innominate artery developed. Therefore, innominate artery transection and omentopexy were performed. These results demonstrate that in cases of trachea-innominate artery fistula, innominate artery transection should be performed first.

We reported a rare case of perforation of the piriform sinus caused by gastroenterological endoscopy examination, leding to deep cervical abscess. The patient was a 56-year-old man who complained of dyspnea, high-grade fever and neck pain after gastroenterological endoscopy examination. Computed tomography revealed a deep cervical abscess and obstruction of the airway. We immediately, performed drain-age under general anesthesia, and found a perforation at the piriform sinus. He was treated with frequent wound washing and the daily intravenously instillation of antibiotics for anaerobic bacteria, and was discharged 31 days after the operation. Early diagnosis and operation are important for the management of deep cervical abscess.

From January 1990 to December 1999, we treated twelve patients with cervical lymph node tuberculosis. The diagnosis was confirmed by histopathological findings of biopsy, 10 cases by resection of lymph node, 1 case by fine needle aspiration biopsy and 1 case was diagnosed following resection of lymph node at another hospital. After diagnosis, all patients received antituberculous chemotherapy and one patient with pocket formation underwent total resection of neck masses with infectious skin. Four cases were lost to follow-up, but the others showed good response and had no recurrence.Tuberculosis is an important infectious disease demanding constant attention because of the possibility of herd infection. We should consider tuberculosis when cervical lymph node swelling is seen, and early diagnosis and treatment are needed to prevent the spread of infection to others. Antituberculous chemotherapy is effective, however, when pocket and abscess formation occur, combination therapy of chemotherapy and operation such as neck dissection are needed in early course.

Hearing loss is a rare complication of mumps infection, however improvement of mumps-related deafness is difficult. In Japan, immunization against mumps is not required and mumps-related deafness is thought to have increased.We encountered three cases of unilateral sensorineural hearing loss due to mumps infection. The diagnosis was based on criteria determined by the Acute Profound Deafness Committee in Japan. All cases were treated for sudden deafness with routine steroid therapy.Case 1 was a 5-year-old boy. He was diagnosed as having mumps-associated hearing loss and his hearing improved. Case 2 was a 27-year-old woman, diagnosed as having mumps-related deafness and her hearing was not improved by therapy. Case 3 was a 43-year-old man, diagnosed as having mumps-associated deafness, but his hearing was not improved with therapy.Sensorineural hearing loss due to mumps infection is considered difficult to recover. However, some cases showing improvement have been reported such as our case 1. Early diagnosis and therapy are thought to be needed. Immunization against mumps should be required from the perspective of preserving hearing.