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Volume 58, Issue 1
Displaying 1-12 of 12 articles from this issue
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Original
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Kazuhiro Nakamura, Tomoyuki Yoshida, Ryo Sakurada, Akira Shimizu, Isak ...2007 Volume 58 Issue 1 Pages 1-7
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSVarious literature reports the effectiveness of concurrent chemoradiation therapy for laryngeal carcinoma. Here we report on 14 patients with laryngeal carcinoma treated with Docetaxel (DOC) combined with radiation therapy.
All the patients were male, with an average age of 64.1 years, and diagnosed as having T2N0M0 squamous cell carcinoma.
DOC was administered bi-weekly (Day 1, Day 15, Day 29) by 35 mg/m2 bolus intravenous injection, while radiation of 60 Gy in total was given in 30 administrations (2 Gy/day: 5 days per week).
Complete response was obtained in 13 of the 14 patients (92.8%). As an early adverse effect, grade 3 mucositis was noted in 2 patients (14.2%) and grade 1 & 2 mucositis in 10 patients (71.4%), not to an extent, however, that required any interruption of chemoradiation therapy. Hematotoxicity was mostly within the tolerance level.
Patient No. 2, who was clinically judged as partial response was treated by total laryngectomy.
Treatment was accomplished without any dropout adverse event in 13 of the patients (92.8%).View full abstractDownload PDF (382K) -
Momoka Nakai, Kiyoshi Makiyama, Takahisa Nakai, Hidetaka Yoshihashi2007 Volume 58 Issue 1 Pages 8-16
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSThe postoperative progress of laryngomicrosurgery on 57 Reinke's edema patients was examined. At the same time, the effects of smoking after the operation were considered.
Three different phonatory tests (GRBAS score, MPT and aerodynamic assessments using Nagashima PS77E) were administered before and after the operation to investigate vocal responses. The results of the tests demonstrated, phonatory function improvement. Furthermore, the results of a questionnaire clearly showed a high rate of patient satisfaction.
After the operation, it took an average of 3.2 months for the patients to discern improvement in their vocal quality. Patients who did not smoke after the operation took only 2.2 months to discern improvement whereas patients who smoked required 4.5 months. From these findings, it is obvious that patients who do not smoke after the operation take less time to recover.
There were six cases of recurrence (10.5%) after the operation. All patients who experienced a recurrence were smokers. Therefore, we strongly recommend not smoking after laryngomicrosurgery in order to prevent recurrence of disease.View full abstractDownload PDF (384K) -
Tomoyuki Yoshida, Akira Shimizu, Kazuhiro Nakamura, Shigetaka Shimizu, ...2007 Volume 58 Issue 1 Pages 17-24
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSPhotodynamic therapy (PDT) using talaporfin sodium (Laserphyrin®, Meiji Seika, Tokyo, Japan) and a diode laser (PD laser, Panasonic, Japan) was carried out in 13 patients with early laryngeal cancer and the results were compared to conventional PDT with HpD and excimer dye laser. PDT could be initiated four hours after administering the agent, and the combination of talaporfin sodium and PD laser brought primary treatment outcome equivalent to that of conventional PDT. In addition, the method proved to be excellent in that side effects, such as photosensitivity and local edema, were reduced. PDT is a significant addition to the therapeutic options, which include the standard therapies of irradiation and surgery. Although clinical experience with PDT for head and neck cancer is still limited and there are many problems to be solved, the method is a promising option and may come to be used more commonly because of the benefits of the newly developed photosensitizer, which has a high affinity for tumors, and the relatively lowcost of diode lasers. This therapy should be considered as a therapeutic option for early head and neck cancer patients in Japan, and is suitable for short stay and day surgery.View full abstractDownload PDF (756K) -
Satoru Yokobori, Meijin Nakayama, Tatsutoshi Suzuki, Masahiko Takeda, ...2007 Volume 58 Issue 1 Pages 25-29
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSWe evaluated the positional changes of the cricoid cartilage and the hyoid bone following SCL-CHEP. X-ray examination of the larynx (lateral level) was utilized for evaluation. A total of 11 cases, who underwent surgery between April 1997 and December 2004, were evaluated. All cases were male with an average age of 64.5 (53-72).
The cricoid cartilage shifted 3.3cm superiorly and 0.9cm posteriorly (average rate). The neoglottis after the surgery was therefore elevated, and this contributed to the effective closure of the glottis. The hyoid bone shifted 2.1cm inferiorly and 0.7cm posteriorly (average rate). Because of the pexis between the hyoid bone and the cricoid cartilage, positional change of the hyoid bone can be understood. Since the supracricoid musculatures were all preserved, descending of the hyoid bone may not have much negative impact on the swallowing function. Our evaluation confirmed that morphological changes induced by the CHEP procedure positively support swallowing function.View full abstractDownload PDF (331K) -
Ryuichi Mochizuki, Hiroshi Muta, Yusuke Watanabe, Masahiro Kawamoto, K ...2007 Volume 58 Issue 1 Pages 30-37
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSSurgical removal of laryngeal granulomas is usually undertaken as a last resort because recurrence is common. Surgery is normally indicated when granulomas continue to grow and cause severe dysphonia or aphonia despite first-line treatments such as voice therapy and/or gastric reflux management. Some laryngeal granulomas are said to be complicated by incomplete membranous vocal fold approximation from bowing, associated with loss of tissue volume caused by atrophy, which may induce additional contact force on the vocal processes during glottal closure.
We supplement resection of the laryngeal granuloma with autologous fat injection into the membranous part of the vocal folds. This makes the bilateral vocal fold bulky and reduces the contact force on the vocal processes after surgery.
We performed microlaryngoscopic autologous fat injection immediately after granuloma resection in 14 patients of intractable laryngeal granuloma with vocal fold bowing, from May 1999. We found complete disappearance of complaints of aphonia or severe dysphonia in all 14 cases, and no single case of recurrence was noted.
Vocal fold granulomas should be treated comprehensively by removing the underlying causes, such as forceful contact of vocal folds and/or acid reflux. Vocal fold bowing may be a compounding condition, which should sometimes be treated surgically.
Our method of surgical resection of laryngeal granulomas followed by vocal fold injection with autologous fat has achieved a high cure rate of 100% for intractable laryngeal granulomas that had repeatedly recurred after various treatments including repetitive operations. Vocal fold injection with autologous fat following resection of laryngeal granulomas associated with bowing, which aims at reduction of mechanical contact force to the wound and satisfactory epithelization after surgery, thus appears to be a very effective technique.View full abstractDownload PDF (434K) -
Taro Komachi, Hideto Saigusa, Iichiro Aino, Chiharu Matsuoka, Takayuki ...2007 Volume 58 Issue 1 Pages 38-50
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSRecently, it has been recognized that gastroesophageal or laryngopharyngeal reflux can contribute to the pathophysiology of some recalcitrant laryngeal conditions. Subglottic stenosis also is considered to be in a relationship with laryngopharyngeal reflux. We report nine cases of subglottic stenosis and examined whether or not laryngopharyngeal reflux can contribute to the conditions of their subglottic stenosis, based on interviews for typical symptoms of gastroesophageal reflux disease and findings of laryngeal fiberscopy, lateral cervical X-ray and VTR esophagography. Previous histories included prolonged intubation (4 cases), high tracheotomy (2 cases) and cricothyrotomy (1 case), and 2 cases were idiopathic. There were only three cases with typical symptoms (regurgitation, belching and hiccups); however, there was found to be swelling of the arytenoid and inter-arytenoid mucosa in eight cases, abnormal X-ray findings (swelling of cervical esophagus) in 7 cases, and abnormal findings of VTR esophagography (abnormal peristalsis, hiatal hernia and reflux) in eight cases. The conditions of subglottic stenosis were found to be granulous or edematous changes for cases within two months after previous history and scar formation with inter-arytenoid bar for cases more than six months after previous history.
Therapies for subglottic stenosis combined with acid-suppression therapy using proton pump inhibitor were performed for all patients. In eight cases, anterior cricoid split and insertion of the T-tube were performed, and for one case, intravenous administration of steroid. The results were that all patients saw improvement in the conditions of their subglottic stenosis. Two cases saw recurrences due to terminated administrations of the proton pump inhibitor; they recovered with readministration of the inhibitor. From these results, we considered that laryngopharyngeal reflux can contribute to the condition of subglottic stenosis directly or as an aggravation factor, and combining therapies with acid-suppression therapy using a proton pump inhibitor is useful for treatment of subglottic stenosis.View full abstractDownload PDF (604K) -
Kikuo Sakamoto, Hideki Chijiwa, Kiminori Sato, Hidetaka Shirouzu, Hiro ...2007 Volume 58 Issue 1 Pages 51-58
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSThe purpose of this study was to clearly define any correlations between cancer invasion into the laryngeal space and neck lymphnode or distant metastasis.
Analysis was performed in 80 patients (77 males, 3 females; mean age of 67) who underwent total laryngectomy against previously untreated supraglottic carcinoma at Kurume University Hospital between 1991 and 2003. In the histopathologic analysis, clinicopathological evidence of invasion into the surrounding laryngeal space was examined.
Preepiglottic space invasion was observed in 43 patients (54%). Paraglottic space invasion was observed in 47 (59%). Cricoid area invasion was observed in 13 (16%). Pathologically, neck lymphnode metastasis was observed in 39 (43%) of 80 patients. Distant metastasis was observed in 9 (12%) of 74.
Neck lymphnode metastasis was observed in 28 of the 43 patients whose cancer invaded into the preepiglottic space. Neck lymphnode metastasis was not observed in 26 of the 37 patients whose cancer did not invade into the preepiglottic space. Preepiglottic space invasion thus strongly correlated with cervical lymphnode metastasis (p<0.01). Distant metastasis was observed in 8 of the 43 patients whose cancer invaded into the paraglottic space. Distant metastasis was not observed in 30 of the 31 patients whose cancer did not invade into the paraglottic space. Paraglottic space invasion thus correlated with distant metastasis (p<0.05). Paraglottic space and cricoid area invasion strongly correlated with distant metastasis (p<0.01). In addition, extracapsular spread correlated with distant metastasis (p<0.05).
These results indicate that neck dissection is necessary in cases of tumor invasion into the preepiglottic space. Adjuvant chemotherapy is necessary in cases of tumor invasion into the paraglottic space or extracapsular spread. These findings suggest that invasion into the surrounding laryngeal space is useful for estimating the prognosis of patients with advanced supraglottic-type laryngeal cancer.View full abstractDownload PDF (456K) -
Toshifumi Hasegawa, Kazuo Kumoi2007 Volume 58 Issue 1 Pages 59-63
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSOne hundred and sixty-four cases (109 males and 55 females) with recurrent laryngeal nerve paralysis examined at Himeji Medical Center between April 2001 and March 2005 were reviewed. Patient ages ranged from 19 to 89 years with an average of 65.5 years. The left vocal cord was affected in 109 cases (66.5%), the right one in 42 cases (25.6%) and the bilateral cords in 13 cases (7.9%). The causes of paralysis could be identified by examination in 41 (61.2%) of 67 cause-unknown cases and could not be identified in 26 (15.9%) of all 164 cases. Eighty-seven cases (53.0%) were related to malignant diseases. The most frequent cause was lung cancer in 57 cases (45 males and 12 females). The number of left, right and bilateral paralysis cases were 44 (77.2%), 12 (21.1%) and one (1.8%), respectively. Lung cancer was predominant among men with left-side paralysis. Among 57 lung cancer cases, lesions involving the recurrent laryngeal nerve were the primary pulmonary tumor in 17 cases (29.3%), subaortic lymph node in 11 cases (19.0%), mediasinal lymph node without subaortic lymph node in 27 cases (46.6%), and brain metastatic lesion in 3 cases (5.2%). It is important for the etiology of vocal cord paralysis to examine mediastinal lymph nodes as lung cancer metastasis. Twelve cases of esophageal cancer consisted of 4 cases (33.3%) with right paralysis, 5 cases (41.7%) with left paralysis and 3 cases (25.0%) with bilateral paralyses. The primary esophageal tumor was the lesion involving the recurrent laryngeal nerve in 3 left cases and 3 bilateral cases. Lymph node along the recurrent laryngeal nerve involved the nerve in 4 right cases and 2 left cases.View full abstractDownload PDF (326K) -
Masatsugu Asai, Yuichi Adachi, Hajime Nakagawa, Hiroshi Kimura, Toshik ...2007 Volume 58 Issue 1 Pages 64-70
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSTwenty-three children with tracheobronchial foreign bodies were statistically studied. The number of cases under 3 years of age was 16 (70%). The male-female ratio was 1.9:1. In 19 cases, the foreign bodies were radiolucent. Within these 19 cases, 12 cases involved peanuts. In 4 cases, the foreign bodies were radiopaque. Eight patients underwent extirpation more than 1 week after inhalation because of diagnostic delay. Some of these cases showed granulation in the bronchus and other complications. For early diagnosis, education is necessary not only for parents but also for general physicians. Foreign bodies were lodged in the right bronchus in 11 cases, left bronchus in 11 cases, and trachea in 1 case. Chest X-ray was performed in all patients. Auxiliary examinations performed were lung perfusion scintigraphy (n=9), CT scan (n=8) and MR imaging (n=4). Lung perfusion scintigraphy and CT scan are easy to perform and seemed to be effective for diagnosis. Observation of the trachea and bronchus using a flexible fiberoptic bronchoscope before insertion of rigid ventilation bronchoscopy (VBS) is useful for avoiding subglottic swelling. Furthermore, it is helpful for suctioning sputum and for collecting useful information on the airway before using VBS. For extirpation, we used VBS in 20 cases and a flexible fiberoptic bronchoscope in 3 cases. Sometimes, after extirpation patients suffer respiratory disturbance from complications such as pneumonia. Cooperation of otolaryngologists and pediatricians as a team is necessary for treatment of tracheobronchial foreign bodies.View full abstractDownload PDF (497K)
Case Report
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Satoru Kodama, Kanako Oribe, Masashi Suzuki2007 Volume 58 Issue 1 Pages 71-75
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSForestier's disease is a relatively rare condition characterized by calcification and ossification of the anterior longitudinal ligament of the spine. We report a case of Forestier's disease presenting pharyngeal discomfort in a 65-year-old male. Fiberscopy of the pharynx disclosed protrusion of the posterior pharyngeal wall, and a cervical radiograph showed ossifications of the anterior longitudinal ligament along the anterior cervical spine. In addition, 3-D reconstructed CT showed a massive ossification anterior to the cervical spine. The case was diagnosed as Forestier's disease. Considering the patient's mild symptoms, follow-up treatment was performed. Although pharyngeal discomfort is common, it can be caused by cervical spine disorders. 3-D CT is useful for evaluation of spinal ossifications.View full abstractDownload PDF (420K)
Glossary
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[in Japanese]2007 Volume 58 Issue 1 Pages 76-77
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSDownload PDF (253K) -
[in Japanese]2007 Volume 58 Issue 1 Pages 78
Published: 2007
Released on J-STAGE: February 24, 2007
JOURNAL RESTRICTED ACCESSDownload PDF (98K)
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