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Volume 55 (2004)
- Issue 6 Pages 433-
- Issue 5 Pages 367-
- Issue 4 Pages 305-
- Issue 3 Pages 229-
- Issue 2 Pages 55-
- Issue 1 Pages 1-
Volume 55, Issue 3
Displaying 1-10 of 10 articles from this issue
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Original
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Koichiro Saito, Akihiro Shiotani, Keisuke Okubo, Kazuhisa Moro, Koji A ...2004 Volume 55 Issue 3 Pages 229-234
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSClinical investigation was conducted on 11 cases of laryngo-tracheal stenosis who had been referred to our clinic during the past 11 years (1989-2000).
These cases were all difficult to treat and all experienced many operations (14.1 times, on average). The most frequent cause of the stenoses was intra-laryngeal surgery. Silicone T-tubes were successfully used to treat 8 cases. We designed a silicone T-tube with a solid upper half and a tubular lower half (hereafter we will refer to this tube as a “solid T-tube” and the usual tube as a “tubular T-tube”). To treat patients with glottic stenosis, the solid T-tube can be safely applied without causing mis-swallowing. The solid T-tube is also useful in treating patients with subglottic stenosis if they suffer from subglottic granulation caused by contact with the tubular T-tube. We believe that any T-tube should be kept in place for at least 6 months to acquire a firm lumen. We should select the solid T-tube or tubular T-tube according to the location and severity of the stenosis.View full abstractDownload PDF (758K) -
Miwako Hanamoto, Tomoyuki Haji, Atsushi Suehiro, Shinji Takebayashi, S ...2004 Volume 55 Issue 3 Pages 235-238
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSWe report our experience using a microdebrider system with a laryngeal blade for surgery of Reinke's edema in six patients. The microdebrider made it possible to do sucking, squeezing and pinching procedures at the same time and thus to shorten the total operation time. The postoperative data of PPQ and APQ improved and all patients was satisfied with their vocal outcome. The laryngeal blade we used was still large at its end and the degree was fixed, so we had to be careful to control the position of the end of blade, the power of the vacuum and the number of rotations. We found the microdebrider system to be very useful for Reinke's edema surgery, especially for cases with advanced lesions.View full abstractDownload PDF (683K) -
Kosuke Ishii, Hideo Adachi, Keiju Tsubaki, Yasushi Ota, Takeshi Shinoz ...2004 Volume 55 Issue 3 Pages 239-244
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSOf the patients treated at the Department of Otorhinolaryngology, Omiya Medical Center, Jichi Medical School, between April 1999 and March 2002, 14 patients who had undergone artificial vessel replacement for a thoracic aortic aneurysm and developed recurrent nerve paralysis postoperatively (surgical paralysis) were evaluated. Surgical paralysis was observed in 9% of those who had undergone surgery of the thoracic aorta. The mobility of the vocal cords recovered in 4 of the 11 patients with surgical paralysis who could be followed up. Their symptoms were alleviated by rehabilitation, which was the case also in many patients who did not recover full mobility of the vocal cords. The positions of the two ends of the replaced artificial vessel are considered to be closely related to the outcome of paralysis. Recurrent nerve paralysis not only reduces the patient's QOL but also his survival by leading to disorders which include aspiration pneumonia. Therefore, early rehabilitation is a priority, and surgical treatment should be considered, if necessary, for patients with recurrent nerve paralysis.View full abstractDownload PDF (521K) -
Daimon Hashimoto, Kazuo Yao, Koichiro Nishiyama, Yoshiaki Iguchi, Taka ...2004 Volume 55 Issue 3 Pages 245-252
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSA retrospective survey was conducted on 237 cases of epiglottitis (152 males and 85 females) admitted to Kitasato University Hospital during the period from 1971 to 2003. Twenty-one cases of the 237 underwent aggressive procedures on admission to maintain an open airway. A comparison was made between the airway-maintained group and the conservatively treated group, with reference to clinical findings. The findings suggested that orthopnea on admission, severe epiglottis swelling under laryngeal examination, and progressive aggravation of symptoms within 24 hours from the onset of symptoms are risk factors indicating the necessity of urgent aggressive preservation of the airway.View full abstractDownload PDF (1093K) -
Toshiro Nishimura, Kazuhiro Yamada, Takaki Miwa, Mitsuru Furukawa2004 Volume 55 Issue 3 Pages 253-257
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSTo analyze the outcome of radical surgery with a free jejunal graft performed on previously untreated advanced hypopharyngeal cancers (Stages III and IV) patients at our institution were studied to identify factors beneficial for survival. A retrospective chart review was done. The charts from January 1, 1988, through December 31, 2000 for 35 consecutive patients with previously untreated squamous cell carcinoma of the hypopharynx were reviewed. All had been treated with circumferential total laryngopharyngectomy, combined with a free jejunal graft. Survival curves calculated with the Kaplan-Meier method were compared by means of log-rank tests for specific subsets of the patient population. Factors associated with survival were further analyzed with Cox's proportional hazards model. The overall 5-year survival rate was 32.9%, and the disease-specific 5-year survival rate was 36.2%. Early (T2) primary disease was associated with a significantly better survival rate than advanced (T3 and 4) primary disease (p=0.025).
Although circumferential laryngopharyngectomy for hypopharyngeal cancer with a free jejunal graft is considered one of the most radical procedures, this procedure is not always successful for advanced primary (T3 and 4) disease. Because concomitant chemo-radiation therapy has been becoming the treatment of choice for advanced head and neck cancer in current clinical practice, a comparative randomized control study is needed of the surgical procedure and the chemo-radiation therapy.View full abstractDownload PDF (382K)
Case Report
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Hiroyuki Yamada, Ryuichi Aibara2004 Volume 55 Issue 3 Pages 258-264
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSRetropharyngeal hematoma, the major cause of which is trauma, is comparatively rare. This article reports an extremely rare case of retropharyngeal hematoma in a hemophiliac.
An 18-year-old male with type A hemophilia complained of right neck swelling and dyspnea following an upper respiratory infection. Physical examination revealed pharyngeal erythema and swelling. Laryngeal fiberscopic examination showed that a hematoma surrounding the epiglottis was reducing the airway space. Laboratory tests revealed a low level of factor VIII under 3%. The patient underwent an emergent tracheotomy after receiving a factor VIII concentrate. After a diagnosis of retropharyngeal hematoma treatment with the factor VIII concentrate continued, and his hematoma disappeared in about 22 days.
This patient is the fifth case of retropharyngeal hematoma in hemophiliacs reported in the world, and the first case in Japan. He was also the first of these cases to undergo a tracheotomy.View full abstractDownload PDF (1737K) -
Taketoshi Shimada, Youichiro Sugiyama, Tatsuya Matsunami, Shigeru Naka ...2004 Volume 55 Issue 3 Pages 265-269
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSWe report two cases of foreign body in the extrapharyngeal space. The first case involved a 71-year-old woman who experienced pharyngealgia after eating fried rice. No foreign body was found under laryngoscopic examination, but a CT scan and X-ray film revealed a metallic foreign body in the extrapharyngeal space. An extracervical incision was required to prevent a piece of wire from piercing the common carotid artery. The second case was an 86-year old woman who complained of pharyngealgia. A retropharyngeal abscess was not observed, but a CT scan and X-ray film revealed a fish-bone in the posterior pharyngeal wall at the lowest level of the palatine tonsil. The bone was removed orally.View full abstractDownload PDF (1517K) -
Katsuro Sato, Yuichiro Sato, Hideyuki Hanazawa, Jun Watanabe, Sugata T ...2004 Volume 55 Issue 3 Pages 270-275
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSTuberculosis, recently recognized as a re-emerging infectious disease, sometimes involves the trachea and bronchi and causes subsequent airway stenosis. We herein present a case with tracheobronchial stenosis after prolonged tracheal intubation for the treatment of bronchial tuberculosis. A 33 year-old female, who had been treated and intubated for 11 months with a diagnosis of bronchial tuberculosis, developed a slowly progressive dyspnea, and a severe tracheobronchial stenosis was observed. As an initial treatment, tracheostomy and vaporization of the stenosis using KTP-LASER under percutaneous cardiopulmonary support was performed, but further surgery using LASER and T-tube placement was required due to the reappearance of the stenosis. One year after the removal of the T-tube (six months after the second surgery), T-tube replacement, combined with LASER surgery was needed because of repeated stenosis. Finally, 1 year after the third surgery, the T-tube was removed due to a deterioration in the tube, and the patient has been followedup with a patent tracheostoma, which has been used for direct observation of her airway, while wearing a Retainer. The bronchial lesion in this case was was probably due to direct involvement of bronchial tuberculosis, but the repeated tracheal stenosis, which required several surgeries, might have affected the stenting instruments inserted into the airway. Because the morphology of the air way in cases with this disease differ, careful treatment strategies are required in order to reduce the irritation caused by instruments to the airway. Although direct observation of airway through a patent tracheostoma is useful, the timing of the closure of the tracheostoma also needs careful planning.View full abstractDownload PDF (1564K) -
Michiro Kawakami, Kanako Ito, Katsuhiro Yoshimura, Hitoshi Tanaka2004 Volume 55 Issue 3 Pages 276-282
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSWe reported a case of thyroid cancer recurring 25 years after a first operation. A 56-year-old woman with a 15 cm-diameter hemorrhagic tumor in the left neck visited Saiseikai Suita hospital. She had been operated on for thyroid cancer and undergone a subtotal thyroidectomy about 25 years earlier. On CT and MRI, a huge tumor in the left neck and a right thyroid tumor were recognized. Total thyroidectomy and tumor resection with neck dissection were performed. The postoperative clinical course was good and no regional recurrence was detected for eight months. In cases of papillary adenocarcinoma of the thyroid, careful and long clinical observation are especially important.View full abstractDownload PDF (3070K)
Short Communication
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Mitsuhiko Nakahira, Shuji Matsumoto, Hiroyuki Ikenaga, Kasumi Higashiy ...2004 Volume 55 Issue 3 Pages 283-287
Published: 2004
Released on J-STAGE: August 24, 2007
JOURNAL RESTRICTED ACCESSWe reported two advanced techniques in the surgical treatment of dysphagia. First, an overtube with a large volume cuff was utilized in the cricopharyngeal myotomy to expose and stretch the muscle. It enabled us to cut the muscle fibers extensively and to reduce the risk of recurrent laryngeal nerve injury. In addition, endoscopic examination through the tube offered some valuable information.
Second, suture anchors were used in the laryngeal suspension for the fixation of the thyroid cartilage to the mandible. Their advantage was an easy and rigid fixation with less invasiveness in terms of the mandible.View full abstractDownload PDF (1452K)
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