Kenji Suzuki

The human palatine tonsil germinates at about the 4th fetal month. Although the size of the tonsil is small, the tonsil histologically demonstrates the first primary follicles and epithelial crypts; these remain insufficient until 6 months after birth. At the tonsil starts to participate in immunity, to actively produce immune-globulin, and that time to show a development of epithelial crypts and germinal centers. The palatine tonsil reaches the maximal size at 7-8 years of age, then the immune-function starts to decline at puberty and begins to show increasing atrophy and connective tissue with aging. The degeneration of tonsil lymphatic tissue and the thickness of the connective tissue were investigated in subjects over 50 years old, and degenerated lymphatic tissue was replaced by fatty tissue, the connective tissue showing partial chondrification and ossification.<BR>The incidence of tonsillar infection is thought to decrease with aging because of age-related anatomical and tological changes in the tonsil and decreases in the bacterial receptors on the surface of tonsil. We investigated the change in adherence of Streptococcus pyogenes by the aging, one of the main causative organisms of acute tonsilitis, against tonsillar epithelial cells, and the change in the amount of fibronectin, the receptor of S. pyogenes. We found that the adherence of S. pyogenes and the amount of fibronectin were decreased by aging.

It is well known that the inner ear and stapes function are remained normal and the hearing improvement can be expected by meatoplasty, myringoplasty and ossiculoplasty in the patients with congenital atresia or stenosis of the ear canal. The patients who underwent meatotympanoplasty are expected for having good influence on daily life because of the patients being youths.<BR>Recently, we have operated on 13 ears of 11 patients (two bilateral patients), aged from 5 to 21, 10 atresia, 2 stenosis, and one post-operative sequelae. Two dimensional target computed tomography was useful for surgical approach. We drilled the temporal bone at the external auditory meatus with the one tunnel method upto sufficient width for making the tympanic cavity and the external auditory canal.<BR>Meatotympanoplasty for congenital auditory canal atresia or stenosis is good news for the patients suffering from this disease.

A juvenile angiofibroma initially arises from the nasopharynx with high blood flow. The treatment method for the tumor should be examined carefull aynd decide bdyu sing enhance CdT, MRI and X?ray examination. Recently, we treated a 13?year-old boy with tumor recurrence. We selected Weber's incision to complete the total resection of the recurrent tumor. The patient has been tumor-free since surgery for 1.8 years. Multi-directional enhanced CT and MRI are useful for decidings urgica ml ethod asnd the limits of incision a, nd will contribut teo the preventio onf head and neck tumor recurrence.

It is well known that the inner ear and stapes function retain their normal condition and hearing improvement is achieved by carrying out meatoplasty, myringoplasty and ossiculoplasty in patients with congenital ear canal atresia or stenosis. Patients who undergo meatotympanoplasty are expected to have improved daily life because of their young age.<BR>Recently, we operated on 8 ears of 6 patients (two bilateral patients), aged from 5 to 16 years,7 with atresia and one with stenosis.<BR>Meatotympanoplasty for congenital microtia and auditory canal atresia or stenosis is good news for children suffering from this disease.

In patients with recurrent tonsillitis, the detection rates for Bacteroides spp. as well as for Prevotella spp. and Porphyromonas spp. (which are included among the genus Bacteroides spp. in the old classification) were significantly higher in patients aged 13 years or older than in the patients aged 12 years or younger (P<0.01).<BR>Bacteroides spp. and Porphyromonas gingivalis were only detected in patients with recurrent tonsillitis. In addition, the detection rate of Peptostreptococcus spp. was significantly higher in patients with recurrent tonsillitis.