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Volume 35, Issue 1
Displaying 1-10 of 10 articles from this issue
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Mitsuru Furukawa, Hideyo Ishiguro, Yoji Ishibashi, Ryozo Umeda1984 Volume 35 Issue 1 Pages 1-5
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSNineteen cases of bilateral recurrent laryngeal nerve paralysis were studied. The results were as follows.
1. The most frequent cause of them was due to thyroid surgery, and 9 cases out of 16 patients who received subtotal thyroidectomy and bilateral modified radical neck dissection were required tracheotomy for an adequate airway.
2. The location of paralysed vocal cord in five cases that were obviously injuried during thyroid surgery was midline position and no recovery was observed.
3. In order to allow for the possible spontaneous recovery and to close the tracheotomy, it took about 160 days.
4. Cordectomy was undertaken in one patient for treatment of vocal cord paralysis in adducted position, and no surgical treatment was performed in case of paralysis in abducted position.View full abstractDownload PDF (655K) -
Closure of Laryngotracheal TroughMasahiro Tanabe, Nobuhiko Isshiki1984 Volume 35 Issue 1 Pages 6-12
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSSeven cases of subglottic stenosis were successfully treated by the “trough method”. Four different techniques for closing the trough anteriorly were described.
1) Skin flap: The trough was closed with a hinge skin flap internally and with an advancement rotation skin flap externally in cases without deformity of the cartilagenous framework.
In cases where the trough opening had been reduced spontaneously without narrowing of the lumen during extremely long stenting, the remaining opening was closed with a bipedicle skin flap from the neck.
2) Auricular composite graft: The anterior laryngotracheal wall was reconstructed with an auricular composite graft in three infant and child cases. The skin of the graft was sutured to the mucosa, and the cartilage was sutured to that of the larynx and trachea. The exposed cartilage of the graft was covered externally with an advancement rotation flap from the adjacent area.
3) Rib cartilage (two-stage): Struts of rib cartilage were embedded beneath the skin adjacent to the laryngotracheal trough. Two months later the anterior laryngotracheal wall was reconstructed with a hinge skin graft with incorporated rib cartilage. The entire area was then covered with an advancement rotation flap.
4) Rib cartilage (one-stage): The trough was closed in one stage with a hinge skin flap internally, struts of rib cartilage intermediately and an advancement rotation flap externally. The struts of cartilage were inserted between the cut ends of the laryngotracheal cartilages, and both edges of the trough were thereby firmly supported.
Thus, there are various techniques for closing a laryngotracheal trough. The most effective method should be selected for each case, considering such factors as the severity and extent of the stenosis.View full abstractDownload PDF (9427K) -
Seiji Niimi, Kozo Furukawa, Koichi Harada, Manabu Nakahara1984 Volume 35 Issue 1 Pages 13-16
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSIn order to observe and photograph the whole area of the hypopharynx and larynx, a laryngotelescope with a variable center view angle has been developed in cooperation with Machida Endoscope Company. The range of the center view angle is variable from 70° to 110° in front and the scope provides a wide range observation field (50° to 130°). By using this newly developed device, a large objective field from the tongue base to the posterior wall of the hypopharynx can be visualised without any unfavorable movement of the scope in the subject's mouth. The nasopharyngeal region can also be visualised with the same device.View full abstractDownload PDF (5787K) -
Shinobu Iwamura, Kishiko Takeuchi1984 Volume 35 Issue 1 Pages 17-27
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSSilicone injections for unilateral recurrent laryngeal nerve (RLN) paralysis became popular in Japan over a decade because of easy and simple technique, although Teflon injections are more favoured in other countries. In contrast to more solid type which has been shown to stay longer and safer in a tissue, silicone of more fluid type is regarded as useless simply because it is believed to be finally absorbed in a tissue.
An attempt was made, therefore, to critically investigate not only biological reactions of a surrounding tissue against injected silicone of fluid type, but either long-term stay in a tissue or eventual disappearance. This project was conducted first in the animal experiments and secondly in 37 appropriately selected human cases with unilateral RLN paralysis. They were followed up from half a year to 9 years postoperatively.
Results of animal experiments delineated long-term stay of silicone covered by fibrous capsule in 38 thigh muscles out of totally 46 muscles of 23 rat to figure a success rate of as high as 83 per cent. Only 8.7 per cent was found as being absorbed.
Autopsies of these animals disclosed presence of a fibrous capsule containing silicone of fluid type therein without any other associated pathological changes.
In 37 human cases, silicone injections showed long-term effectiveness upon voice improvement, apparent prolongation of maximum phonation time, complete glottal closure on phonation, straightness of the previously bowed vocal fold and also increased thickness of the paralyzed cord. Overall success rate was as high as 81 per cent.View full abstractDownload PDF (3546K) -
Seiichi Ryu, Kichinobu Tomita, Sohtaro Komiyama, Hiroshi Watanabe, Shu ...1984 Volume 35 Issue 1 Pages 28-33
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSThe degree of dyspnea is usually evaluated by physical findings and also by laboratory examinations such as arterial blood gas analysis.
Physical findings, however, are not necessarily responsible enough to indicate an exact situation of dyspnea, while arterial blood gas analysis shows only a point value because of clinical difficulty in frequent sampling in infant.
In order to overcome these problems, a transcutaneous blood gas sensor has recently been utilized for this purpose, and we applied this device to monitor the degree of dyspnea in four children.
In this report, several critical application are discussedView full abstractDownload PDF (2595K) -
Taketsugu Ikari, Yasushi Murakami, Shigenori Haraguchi, Koji Okada, Ta ...1984 Volume 35 Issue 1 Pages 34-39
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSIn the past three years, thirty-nine patients with hypopharyngeal cancer were treated in Keio University Hospital by total laryngopharyngectomy and primary reconstruction with pectoralis major myocutaneous flap.
These thirty-nine patients were examined on their swallowing function by esophagography and flexible fiberscopy.
In seven patients complaining various degree of dysphagia showed stenosis at mucocutaneous junctions, six at the junction to the esophagus and only one to the pharynx. Most of these stenoses were found in the patients who showed salivary fistula that were observed most likely in the patients who had a history of previous radiotherapy with more than 6000 rads.
We conclude that salivary fistula is the cause of these stenoses and some devices in operative technique should be developed in order to prevent salivary fistula.View full abstractDownload PDF (5832K) -
A Case ReportChizuko Kamori, Takuya Uemura, Sotaro Komiyama, Hiroshi Watanabe, Sada ...1984 Volume 35 Issue 1 Pages 40-47
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA rare case of supraglottic paraganglioma was reported and discussed.
A 30-year-old male visited our clinic on May, 1982, with complaints of progressive hoarseness and paroxymal hypertension. Indirect laryngoscopic examination revealed a large submucosal mass on the right supraglottic lesion. In addition to the usual examination, endocrine examination and angiography were carried out and this case was diagnosed as functional supraglottic laryngeal paraganglioma.
By an extralaryngeal approach, the tumor was excised. Hoarseness and paroxymal hypertension were both disappeared postoperatively.
The diagnostic and therapeutic value of angiography and endocrinic examination was stressed.
Its confused nomenclature and several diagnotic and therapeutic problems were discussed with special reference to the literature.View full abstractDownload PDF (4675K) -
Yuhichiro Kuratomi, Hiroshi Watanabe, Akira Kawashima1984 Volume 35 Issue 1 Pages 48-50
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSIt might be popular that most of the patients with foreign bodies in a tracheo-bronchial tree are infants and the peak age of them is a year old. In the radiolucent foreign body, most popular one is a piece of peanut, and needle in the radiopaque foreign body. We encountered an adult case with a denture incarcerated in the tracheal bifurcation for 6 months. During incarceration of the foreign body, the patient hasn't have any characteristic symptoms except for occasional episodes of coughing attack, yellowish sputum and sporadic chest pain. Using Storz's ventilation bronchoscope sized 8mm by 40cm, extripation was succeeded under general anesthesia. After taken out the denture soft granulation tissue was observed on the anterior wall of the bifurcation. Considering with the traumatic laceration of the vocal cords, tracheosto my was done postoperatively.View full abstractDownload PDF (2155K) -
Hiroshi Tanaka, Isamu Tengan1984 Volume 35 Issue 1 Pages 51-55
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSA case of left vocal cord paralysis caused by lymph node metastasis of lung cancer is reported. A 49-year-old female was admitted to the authors' hospital with hoarseness. Thoracic CT scan revealed a mass adjacent to the Botallo's ligament and another mass in the left lower lobe of the lung. The patient was diagnosed as far advanced stage of lung cancer (T3N2M1). The patient was treated by bronchial artery infusion (BAI) of mitomycin C and, additionally, bronchial artery embolization (BAE) was attempted. Metastasis to the lymph node of the Botallo's ligament should be taken as one of the causes of vocal cord paralysis. CT scan is a significant diagnostic procedure for the detection of mediastinal lymph node metastasis.View full abstractDownload PDF (4345K) -
[in Japanese]1984 Volume 35 Issue 1 Pages 56-57
Published: February 10, 1984
Released on J-STAGE: February 22, 2010
JOURNAL FREE ACCESSDownload PDF (243K)
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