A fenestration-based approach simplified the combination of AA and type I thyroplasty because the two treatments could be performed in the same operating field and provided good voice improvement. Pulling the AA braid in the contractile direction of the LCA and endoscopic vocal cord observation during surgery may have contributed to the positive results.

Laryngeal framework surgery is usually performed under local anesthesia. However, some patients are unable to tolerate extended surgery. A case of an 82-year-old woman who underwent medialization thyroplasty and arytenoid adduction of direct lateral cricoarytenoid (LCA) muscle pulling at the same time under general anesthesia using a laryngeal mask is reported. Endoscopic observation through the laryngeal mask allows direct visual control of the vocal cord. The LCA pulling method does not touch the posterior border of the thyroid cartilage so that the laryngeal mask does not disturb the arytenoid adducts.

Fifteen cases of ossicular anomalies without external ear malformation were studied. The anomaly of the incus-stapes complex was the most frequent. There were two cases of fused incudostapedial (IS) joint, which is an extremely rare occurrence. Case 1 was a 33-year-old man, in whom otosclerosis was suspected and exploratory tympanotomy was performed. The IS joint was fused, and the stapes was immobile. Small fenestra stapedectomy was performed. In case 2, a 52-year-old woman, otosclerosis was also suspected and exploratory tympanotomy was performed. The IS joint was fused and the incus was fixed. After the long process of the incus was cut, the stapes became mobile. However, since the incus remained immobile, it was removed and was placed on the stapes. In both cases, the hearing improved after surgery. The averaged hearing gain of 15 cases was 28.8 dB.

No abstract

Three dimensional analysis of the plane that includes each semicircular canal is essential for understanding the vestibule-ocular reflex evoked in each plane. The fact that the semicircular canals do not lie in single planes has been reported. We measured the helical angle of the plane where each semicircular canal existed using a simulated 3 D model of the inner ear and a software-based three-dimensional computed tomographic (3 D-CT) imaging program. The diameter of each semicircular canal was also measured. The helical angle was the greatest in the anterior semicircular canal both in measurement of the models and the software-based images. The diameter was the greatest in the anterior semicircular canal when measured in the models. It is suggested that the helical angle of the semicircular canal potentially influences the sensitivity of the vestibulo-ocular reflex (VOR) that the semicircular canal evokes in each plane. A sufficient VOR may be evoked in the plane less strictly determined.