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Volume 47 (1996)
- Issue 6 Pages 483-
- Issue 5 Pages 421-
- Issue 4 Pages 365-
- Issue 3 Pages 277-
- Issue 2 Pages 55-
- Issue 1 Pages 1-
Volume 47, Issue 4
Displaying 1-10 of 10 articles from this issue
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Kimihiko Hangai, Yoshifumi Kobayashi, Satoshi Nonaka, Tokuji Unno1996 Volume 47 Issue 4 Pages 365-368
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSThe purpose of this study was to analyse the postnatal development of the intrinsic laryngeal muscle fibers using the myosin ATPase stain method. We measured the ratio of type IIc fibers in all of the intrinsic laryngeal muscle fibers in postnatal-day (PND) 1, 3, 7, 14, 21 and mature Sprague-Dawley rats.
Type IIC fibers disappear at PND 14 in most intrinsic laryngeal muscle fibers. However, the decreasing rate of the fibers is different for various intrinsic laryngeal muscles. Decreases in type IIc fibers are observed most in the lateral compartment of the thyroarytenoid muscle (1-TA), and then in the posterior cricoarytenoid muscle (PCA), cricothyroid muscle (CT), lateral cricoarytenoid muscle (LCA), interarytenoid muscle (IA) and the medial compartment of the thyroarytenoid muscle (m-TA).
These results suggest that the differentiation of the intrinsic laryngeal muscle fibers in rats is nearly accomplished by the end of the second week.View full abstractDownload PDF (2722K) -
Yuko Takahashi, Toshio Yoshihara, Mikiko Takayama, Tetsuo Ishii1996 Volume 47 Issue 4 Pages 369-374
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSWhite lesions of the larynx should be diagnosed and treated carefully from the clinical and pathological point of view. Fifty-three patients with white lesions of the larynx who were not diagnosed as having carcinoma were treated surgically in our hospital between 1986 and 1993. The ratio of males to females was 7.8:1, with most patient in their fifties. About 70% of the patients were smokers and 86% were drinkers. 90% had lesions in the vocal cords, equally on both sides. All of the patients were treated by laryngomicrosurgery under general anesthesia and examined pathologically. Seventeen cases (32%) displayed dysplasia and two cases (3.8%) showed a malignant change. White lesions of the larynx should, therefore, be regularly checked and re-biopsies undertaken when necessary.View full abstractDownload PDF (2396K) -
Masatoshi Hirayama, Tetsuya Shitara, Makito Okamoto, Kazuo Yao, Kazuhi ...1996 Volume 47 Issue 4 Pages 375-380
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSA clinical study was made on 4 patients with trans-supraglottic stenosis caused by trauma who visited the authors' clinic during the period from 1971 to 1994.
In these cases, trans-supraglottic stenosis was elicited by the shortening of the antero-posterior distance between the arytenoids and the epiglottis. The following three standardized surgical methods were applied in these cases with successful results : i) Fistulization of the airway above the cricoid arch, ii) Widening of the anterior glottal space, iii) A surgical approach for supraglottic stenosis.
In addition to the above procedures, a stent was transfixed to open the supraglottic stenosis by passing a polypropylene suture through the skin for a period of 2 weeks in 3 of the 4 cases. In the single remaining case, a T-tube was also inserted for 2 weeks before successful restoration of the airway.View full abstractDownload PDF (1998K) -
Shigeu Hirano, Hisayoshi Kojima, Kazuhiko Shoji, Koichi Omori, Ken Ish ...1996 Volume 47 Issue 4 Pages 381-385
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSIn thyroplasty type I, a silicone block has usually been used as a compression plug for the thyroid cartilage. Recently, however, the employment of silicone has become limited in vivo because of its relationship to the occurrence of cancer. Thus, we have used a hydroxyapatite block in thyroplasty type I as a substitute for silicone since 1994. In the present study, we examined the post-operative results for phonation and tissue reaction in thyroplasty type I using this hydroxyapatite block. Nine patients with unilateral vocal fold paralysis underwent thyroplasty type I using hydroxyapatite. In the post-operative phonatory examination, maximum phonation time (MPT) was prolonged, the mean flow rate (MFR) decreased and the AC/DC ratio increased in almost all cases. No major complication was observed. One case needed reoperation. In the specimen of the block removed in the reoperation, bone tissue was seen growing in a pore of the block. This finding indicates that hydroxyapatite attaches well to the thyroid cartilage.View full abstractDownload PDF (2030K) -
Sinnya Takano, Hajime Aramaki, Naomi Kawachi, Mamoru Ohtake, Sei Kitaj ...1996 Volume 47 Issue 4 Pages 386-390
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSWe have recently seen 2 cases of Forestier disease.
Case 1 was a 96-year-old male who visited our hospital with dysphagia. Case 2 was a 74-year-old male who visited our hospital with hoarseness and dysphagia. The latter case was operated on and cured of left recurrent paralysis and dysphagia.
It has been reported that the most common complaint in Forestier disease is dysphagia and among the reported cases in Japan only 2 cases (6.45%) revealed the recurrence of the disease after operation. From this study, it can be suggested that surgery is the most preferable way to treat cases of Forestier disease with hoarseness and dysphagia.View full abstractDownload PDF (2556K) -
Extra-pharyngeal and Extra-esophagealHiroki Kimura, Yutaka Takeyama, Takashi Yokoyama, Toshio Fukui, Akihik ...1996 Volume 47 Issue 4 Pages 391-397
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSTwo cases of fish-bone foreign body were reported. Case 1 was a 75-year-old female who suffered from cervical pains after eating bonito. No foreign bodies were found by indirect laryngoscopical nor esophagoscopical examination. The foreign body was found embedded in the posterior wall of the pharyx on X-ray and CT scan. Case 2 was a 77-year-old female who had pains after eating bonito. Neither indirect laryngoscopical nor esophagoscopical examination revealed any foreign bodies in the pharyngoesophageal space. X-ray and CT scan revealed an extra-esophageal foreign body with a surrounding periesophageal abscess and cervical subcutaneous emphysema. By an extra cervical incision, the foreign body was found penetrating the esophagus and reaching carotid artery. These two cases suggest the importance of conducting X-rays and CT scans even if no foreign bodies are found under laryngo-esophagoscopical examination.View full abstractDownload PDF (2520K) -
An Application in a Patient with Motor Neuron DiseaseKazuo Watanabe, Ryuichi Osanai, Masanobu Kinoshita, Isuzu Kawabata1996 Volume 47 Issue 4 Pages 398-401
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSA new system that enables both speech and artificially aided ventilation is reported. The system consists of 1) BiPAP® (Respitronics Inc., USA), an extracorporeal artificial ventilator of the flow-triggered type, small size and light weight ; 2) a nasal pressure mask ; and 3) a fenestrated tracheotomy tube (FEN type, Shiley Inc.). These instruments were applied to a 42-year-old female patient with progressive spinal muscular atrophy. She had been suffering from chronic respiratory failure, but showed no bulbar palsy. She was artificially ventilated by the BiPAP® which was connected to the inner tube of the tracheotomy tube when she was at rest. When she wished to speak, the pressure mask was firmly fixed on her nose with a rubber belt and connected to the BiPAP®, the inner tracheotomy tube was extracted and the outer tracheotomy tube was inserted.
After these procedures, she could speak with a very good voice and articulation using passively expirated air through the fenestration of the tracheotomy tube.View full abstractDownload PDF (1113K) -
Kousei Takeda, Akira Ogawa, Tomoaki Kai, Hideyuki Ohnuma, Nobuo Usui1996 Volume 47 Issue 4 Pages 402-406
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSWe present a patient with sleep apnea syndrome, in whom disturbance of consciousness (stupor), and bilateral abducens palsy developed concurrently along with acute sinusitis. The sleep apnea was of the palatine tonsil type. All of the symptoms cleared markedly after uvulopalatopharyngoplasty (UPPP).
A 34-year-old male was admitted to our hospital in the department of otolaryngology for an evaluation of his sleep apnea and disturbance of consciousness, which was described as an E3V4M5 score of 12 on the Glasgow coma scale. His other neurological disorders included bilateral abducens palsy and right pyramidal signs. The results of an extensive investigation indicated a persistent hypoxemia affecting the brain as the possible cause of his neurological disorders. The patient, therefore, underwent UPPP in the hope that the hypoxemia could be corrected.
All the symptoms cleared shortly after surgery. Sleep studies of the patient had shown an apnea index of 47.4 and the lowest SaO2 of 64% prior to UPPP. Postoperatively, the results of these figures were 1.3 and 89%, respectively.
It cannot be overemphasized, based on the case presented, that a successful outcome depends upon an accurate diagnosis made early in the course of disease and its appropriate treatment.View full abstractDownload PDF (1557K) -
Fumihisa Hiraide, Shinya Ohashi, Kazuo Watanabe1996 Volume 47 Issue 4 Pages 407-410
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSIn order to avoid direct damage to the teeth by a laryngoscope a prosthesis was devised. The prosthesis was made from polyester resin with thermo-plasticity following a model of the dental arch in each patient. Thus, the prosthesis perfectly fitted the dental arch of each patient and did not disturb the scopic view during laryngomicrosurgery.View full abstractDownload PDF (913K) -
Hiroya Yamaguchi, Hitoshi Inoue, Hajime Hirose1996 Volume 47 Issue 4 Pages 411-414
Published: August 10, 1996
Released on J-STAGE: October 20, 2010
JOURNAL FREE ACCESSAfter its introduction, Hirano's method, which preserves the free margin of the vocal fold, has become the most common surgical method for the treatment of Reinke's edema. A total of 11 cases with Reinke's edema were treated in our clinic with a laser by excising the superior surface of the vocal fold in a spindle-shaped manner followed by the sucking or sqeezing method to remove the contents of Reinke's space. Comparative evaluation of the laser method to Hirano's revealed the following :
LASER ADVANTAGES : 1. Decrease in bleeding ; 2. Easier manipulation or handling of the mucosal edge ; 3. Trimming of the mucosa was unnecessary ; 4. Minimum scar tissue formation.
POSSIBLE DISADVANTAGES : 1. Increase in surgical time.View full abstractDownload PDF (1375K)
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