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The primary goal of this study was to verify the incidence and degree of hearing deterioration of JBSNDUE with a prospective long-term clinical follow-up.Of 173 JBSNDUE cases, 54 were followed up untill their ages reached 25-39 (average 30.7) years. In 23 cases (42.6%) hearing deterioration was confirmed. In 16 cases, discrimination scores for nonsense syllables were as low as 0%.The criteria of the “deterioration” of pure tones were irreversible average hearing level greater than 15dB at three adjoining frequencies between 0.25 and 4kHz.Except 25 of 173 cases, either binaural or monaural amplification was used. However, the incidence of hearing deterioration showed no significant difference between aided and unaided ears.The clinical features of JBSNDUE were summerized.The communication ability of those with deteriorated hearing was discussed.

The ability to locate broad band noise (0.1-10 kHz) in the horizontal plane was measured in an anechoic room with binaural In-the-Ear Aids in normal adults. There was a definite advantage in angular localization with In-the-Ear Aids over body worn and/or Behind-the-Ear Aids. This advantage is probably lost in patients with severe high tone loss.

Since the Silverstein's first report(1966) on elevated protein concentration in the perilymph of the patients with acoustic tumor, it appears that "diagnostic labyrinthotomy" can be useful and worthwhile in certain cases of unilateral sensorineural hearing loss where acoustic neurinoma or Meniere's disease is suspected. The objective of the present clinical study is to appraise the correlation between the clinical pictures of 8 cases of acoustic tumor suspect and of 2 cases of Meniere's disease suspect and pictures of 8 cases of acoustic tumor suspect and of 2 cases of Meniere's disease suspect and the results of microchemical analysis of the inner ear fluid. Increase in perilymph protein concentration was confirmed in 5 cases of cerebellopontine angle tumor who underwent craniotomy, while one false negative case of acoustic tumor was observed. In normal subjects, the level of inner ear fluid protein was substantially less than that in acoustic tumor cases.Two cases of Meniere''s disease and one case of acoustic tumor suspects were judged as negative.However, one false positive result was obtained in the case of ac-oustic tumor suspect, in which no internal auditory cannal lesion was present on posterior fossa myelography. On the basis of the present clinical evidence, it seems likely that any condition which causes blockage of the internal auditory canal such as cerebellopontine angle tumor and/or arachnoiditis results in elevated perilymph protein concentration. High potassium concentration in the inner ear fluid was found in one patient with Meniere's disease and was considered to indicate the etiology of vertiginous episodes of this patient.The result would also suggest that "Diagnostic labyrinthotomy" is applicable for the diagnosis of Meniere's disease.

The frequency characteristics of the external ear canal in patients wearing hearing aids were measured by a probe tube microphone under several pathological conditions: stenosis of the external ear canal, central ear drum perforation, destruction of the external attic wall, open mastoid cavity after tympanoplasty. The sound pressure level was higher in small external ear cavities than in normal ears. In central perforation of the drum, a somewhat lower sound pressure level was found in some cases. In ears with destruction of the external attic wall or with an open mastoid cavity, relatively deep dips were found in the frequency range between 1KHz and 5KHz, and the peak frequency was different in each case. The necessity to take these facts into account in fitting hearing aids is emphasized.

It is well known that reverberation interferes with speech discrimination, but it is not so well recognized that hearing aid users are more affected than normal people in reverberant environments, and that monaural hearing aids and sensorineural deafness further increase the difficulties. Five hard of hearing students in middle school were tested under the following conditions. Two of them were binaural hearing aid users and all had sensorineural deafness except one with mixed deafness. Twenty recorded short sentences were presented through a loudspeaker and the subjects were required to write down words or phrases even if they could not completely follow the meaning of each sentence, first with their own aids and then with the “telescope microphone”. The tests were performed once in the gymnasium with much reverberation and once in an ordinary class room. The test results were analysed in two ways: word and phrase discrimination and sentence discrimination. Analysis of the test results showed the advantages of the “telescope microphone” in reverberant environments.

The audiometric records of 158 children covering a 5 to 22 year span (average 12 years 4 months) were analyzed statistically and the degree of average initial loss and average relative shift were correlated. The average age at the last hearing test was 19 years 7 month.It was confirmed that ears with an initial hearing level of less than 90dB (average of 3 adjacent frequencies) showed a higher rate of deterioration (average of 3 adjacent frequencies greater than 15dB) and a greater average shift than ears with an initial hearing level over 90dB. The levels of significance were 0.1% and 1%, respectively.These results must be kept in mind in the auditory training of deaf children with hearing aids.

The purpose of auditory screening test for school children is to aid in the implementation of appropriate medical and educational measures. It is disappointing that in spite of the advice of school authorities the number of children referred to otologists is very low.With our two level screening test it is possible to determine not only the grade of the hearing loss in each child but also it's nature in about 75%. Thus, it is possible theoretically to provide appropriate educational care for school children who can not consult otologists. This is especially valuable for children in rural schools where it is difficult to find an otologist.This screening method is considered to be useful in revealing sensorineural deafness of unknown origin in children.

Forty patients of Tx No squamous cell carcinoma of mobile tongue were treated at Kobe University, Departments of Otolaryngology and Radiology between November 1975 and October 1980. Twenty-three patients had preventive neck irradiation prior to the local treatment. Six of these patients subsequently developed a neck nodal metastasis. The primary lesion was uncontrolled in 4 of these 23 cases.Eight of the 17 without neck irradiation subsequently developed a neck nodal metastasis within 1 year and the primary lesion was uncontrolled in 7 of these 17 cases. The rate of lymph node metastasis in T1 and T2 patients with neck irradiation was significantly lower than that in those without neck irradiation. Post-irradiation necrosis of the mandible occurred in 3 of the 23 patients with preventive irradiation. We consider that the preventive neck irradiation for the patients with T1 and T2, No tongue cancer is effective in destroying subclinical metastasis and the mandible should not be included in the irradiation field.

A case of extramedullary plasmacytoma in the oropharynx of a 41 year-old woman is reported. Histologically, the tumor was plasmacytoma consisting mainly of matured plasma cells and showing a deposit of amyloid in the interstitial structure. Immunoelectrophoretic studies of the concentrated urine specimen revealed a kappa-type Bence-Jones protein even though there was no increase in blood M-protein. Lineac electron radiation of 5,100 rad was given over a period of eight weeks but no effect was noted. After the tumor was surgically removed, follow up of the patient was made for 2 years without evidence of recurrence or metastasis.

One hundred and fifty one cases of juvenile bilateral sensorineural deafness of unknown etiology were followed up for a period from 5 to 22 years (average 12 years and 2 months) in our department. Hearing (average of 1-4KHz or 1-2KHz) was unchanged ( 15dB) in 22 cases (14.6%) and deteriorated permanently in 29 cases (monaurally in 13 cases and bilaterally in 16 cases). The degree of hearing deterioration ranged from 15 to 43dB (average 27dB).The incidence of hearing deterioration showed no significant difference (α=5%) between aided and unaided ears. The incidence to fluctuation of hearing were significantly higher in deteriorated ears.The deterioration of hearing occurred in every age groups observed: 6 ears (under10 years), 16 ears (11-15 years), 11 ears (16-19 years) and 12 ears (20-30 years). The discrimination score was high (over 80%) in 37% of the patients but low (0-35%) in 30%.

Eighty-four previously untreated patients with carcinoma of the floor of mouth were studied retrospectively. Patients with small lesions involving no regional lymphnodes were treated by radiation alone, while those with small lesions involving regional lymplinodes and those with large lesions were treated by radiation and/or surgery.In stage I, II patients treated by radiation alone, five-year survival rate was 100%, 80%, respectively. The five-year survival rate for stage III was 46% and 16.5% for stage IV. In stage III, IV patients, five year survival rate was 26.7% treated by radiation alone, 32, 7% by surgery alone, 44.7% by combined therapy.In early stage (Stage I, II), the tumor was successfully controlled by radiation alone. How-ever, in advanced stage, especially in stage IV, it was difficult to control the initial tumor. The additional therapy such as chemotherapy or immunotherapy might be required for these cases.

The authors asserted the importance of auditory screening test for school children not only in the medical, but also in the educational point of view and presented a new method of screening test.Sixty five thousand seven hundred and eighty nine primary and middle school children were tested by this method in 1979.The method are as follows:When a child fails to respond to 20dB (JIS) pure tone in 1kHz or 4kHz, he is tested immediately at 40dB level. Thus one can obtain more information as to the nature and grade of hearing impairment of the child than the usual screening test.The authors classified the hearing status into No. 0 (normal) to No. 8 types. According to this classification the hearing of both ears of the child is described in 2 numbers for example 2-5. This method may be very useful for statistical purpose as well as for individual care of the hearing impaired school children.

A statistical study was made on 741 hard-of-hearing adults who visited the rehabilitation center from 1981 to 1987.The details of the study included age distribution, nature of hearing disorder, period of hearing aiduse, type of hearing aid used and, in future, the correlation between hearing level and discrimination score.Some problems about the delivery of hearing aids in accordance with the Welfare Law and the necessity for otologists to have more interest in this field are discussed.

The origins of tinnitus are not confined to diseases of the auditory system, but this symptom is also seen in patients with other somatic and/or psychological disturbances. It is sometimes a danger signal of hidden serious diseases.It is, therefore, important to know how often and in what disease this symptom is found. Questionnaires were filled by doctors during history taking in the outpatient clinic. The number of patients with tinnitus were;1. Orthopedic clinicdiseases of cervical vertebrae 11.3% (18/160)thoracic and lumbar vertebrae 0.6% (2/340)2. Neurosurgery clinicinfratentorial tumors 44.4% (16/36)supratentorial tumors 3.3% (2/61)3. Gynecology clinicclimacteric 37.5% (30/80)4. Internal medicine clinici) diabetes mellitus 16.0% (23/144)ii) chronic nephritis (under dialysis) 40.5% (47/116)5. Ophthalmology clinichypertensive and diabetic retinopathy 38.5% (37/96)

1. 口蓋扁桃悪性リンパ腫の放射線単独治療群の1年から4年までの生存率は, 64%, 47%, 36%, 34%であったが, 放射線化学療法併用群では82%, 66%, 60%, 49%と生存曲線は有意に上昇が認められた.2. 実測生存率による0～1年, 2～3年で放化群の生存率が有意に高かった.3. Stage I では放単群と放化群の生存率に有意差を認めなかった.4. Stage II では0～1年, 2～3年の観察期間で放化群の生存率は放単群に比較して, 有意に高かった.5. Stae III, IVでも放化群の生存期間の延長が認められた.6. Lucus-Collins の分類では Non-T Non-B の生存率が最も良く B-cell lymphoma, T-cell lymphoma でも他領域の悪性リンパ腫に比較して予後は良好であった.

The two-level screening audiometry has been performed every year since 1980 in Kobe City. The method is as follows. When a child fails to respond to 30 dB at 1 kHz or 25 dB at 4 kHz, he is tested at a level 20 dB higher. Thus one can obtain more information as to the grade and type of the hearing impairment of a child than by the usual one-level screening method. According to the two-level test the hearing status of each child was classified into 9 types, i.e. , 0 (normal) to 8. Thus the hearing types of both ears of each child are described in two digits, for example 3–6. This method may be useful for statistical purposes as well as for individual care of hearing impaired school children, especially for children who need educational care but cannot consult the otological clinics for some reason. From the otological point of view, our method offers valuable information about the unawared * sensorineural deafness in children of school age. ( * The children themselves, school teachers, and parents do not aware of its presence.)

Two hundred and forty-two patients with squamous cell carcinoma of the mobile tongue were reviewed. Most of them were initially treated by irradiation and then treated surgically for salvage. Cervical node metastases were frequently developed during or after the initial therapy. The patients in the advanced stage showed poor prognosis due to uncontrolled cervical node metastases and/or local recurrence. In the patients with no initial cervical node involvement, better local control and less frequent incidence of subsequently developed cervical node metastases were observed in the group treated by surgery than in those treated by irradiation. In the patients with initial cervical node involvement, no significant difference was noted in the survival yielded by either treatment modality. In advanced carcinoma, combined treatment with radiotherapy and surgical therapy seemed to give better results than with either radiotherapy or surgical therapy alone in this study.

This study was made to test the clinical significance and the prognostic value of the T-B immunological classification of non-Hodgkin's lymphomas. Thirty-four patients with adult diffuse lymphomas were studied. Nine patients with T-cell lymphomas and three patients with non-T and non-B lymphomas had poor immunity and poor prognosis. Fifteen patients with B-cell lymphomas have been found to be associated with a prognosis of intermediate range between that of T-cell lymphomas and undetermined lymphomas. Seven patients with undertermined lymphomas, which were considered to have lost surface markers of B-cells, had the best prognosis. Thus the T-B immunological classification of this disorder appears to be essential for clinicians, and provides a basis for proper differentiation of treatment for different groups.

Forty nine patients less than 40 years old with carcinoma of the oral cavity and oropharynx treated primarily at the Kobe University Hospital and/or Hyogo Medical Center for Adults from 1966 to 1985, were retrospectively analyzed. During this period a total of 616 of carcinomas of the oral cavity and oropharynx were treated in the department giving this age group an incidence of 8.0 %. Females predominated over males (27/49) and 39 out of 49 patients (80%) had squamous cell carcinoma of the mobile tongue. The 3 and 5-year survival rate for all patients in all stages was 74% and 69% respectively. The prognosis was better as for older patients and a surgical procedure in combination with pre- and/or postoperative irradiation is recommended without compromise as to the cosmetic results. Their clinical appearance, stage, histologic state, treatment, and survival rate are reported and discussed.

Evoked responses to pure-tone pulses in normal cats under pentobarbital anesthesia were averaged by an electronic computer. One recording point which represents most effectively the auditory responses of a cat was determined on the middle ectosylvian gyrus. The typical averaged response consists of a diphasic wave (P 1 N 1 -complex). Mean thresholds and standard deviations of averaged cortical responses in 122 normal cats (128 ears) were determined at each frequency from 500 hertz to 8,000 Hz. Some examples of the audiograms of experimentally deafened cats obtained by this computer audiometry were shown. This averaged cortical response technique might serve as the most practical and useful method of measuring the auditory responses of animals.