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Volume 62 (2011)
- Issue 6 Pages 511-
- Issue 5 Pages 433-
- Issue 4 Pages 377-
- Issue 3 Pages 315-
- Issue 2 Pages 63-
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Volume 62, Issue 6
Displaying 1-11 of 11 articles from this issue
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Original
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Kazuhiro Nakamura, Kiyoaki Tsukahara, Yusuke Watanabe, Ujimoto Konomi, ...2011 Volume 62 Issue 6 Pages 511-516
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSThe speaking fundamental frequency of men is high-pitched in childhood. At the time of the second pubescent sexual orientation, the frequency usually decreases because of the effects of androgen. However, the high-pitched voice of childhood may last if smooth transition to a low voice fails. Thus, there are rare cases of adults with a high-pitched boyish voice. This condition is referred to as mutational dysphonia. Voice therapy is usually effective in cases of mutational dysphonia but may fail in some cases. We performed type 3 thyroplasty (TP3) for cases of mutational dysphonia in which voice therapy was not effective. With TP3, the tension of the vocal folds decreases, and the voice becomes low-pitched. We report the results of treatment.
The cases consisted of three men with mutational dysphonia aged 37, 35, and 38 years old. The speaking fundamental frequency at the initial diagnosis was, respectively, 174.6 Hz, 170.2 Hz, and 180.0 Hz. In all three patients, voice therapy by the Kayser-Gutzmann method proved ineffective; therefore surgery was considered. In the anterior-posterior compression test performed preoperatively in the three patients, the voice became low-pitched. Therefore TP3 was determined as the surgery of choice. The speaking fundamental frequency decreased to 106.9 Hz, 115.4 Hz, and 87.5 Hz in the three patients postoperatively.
Thus, TP3 was effective in patients with mutational dysphonia for whom voice therapy proved unsuccessful.View full abstractDownload PDF (1065K) -
Mutsumi Sugiura, Yukio Ohmae, Yurika Kimura, Tomofumi Kato, Yoko Yamam ...2011 Volume 62 Issue 6 Pages 517-524
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSThis study quantified the relationship between pharyngeal residue and contact of the base of the tongue with the posterior pharyngeal wall during pharyngeal swallowing in elderly patients. Videofluoroscopic examinations were performed on 279 patients with globus sensation (average age : 76.8 years), and pharyngeal residue was assessed by the bolus residue on the pharyngeal wall after swallowing. The degree of pharyngeal residue was classified into 3 types :
1)Type A : pharyngeal residue observed on the entire pharyngeal wall (n=86, 30.8%)
2)Type B : pharyngeal residue observed in the valleculae and/or in the piriform sinuses (n=90, 32.3%)
3)Type C : no residue observed on the entire pharyngeal wall (n=103, 36.9%).
Contact of the base of the tongue with the posterior pharyngeal wall during swallowing (BOT-PPW contact) was detected using videofluoroscopic slow-motion images, and was classified into 3 types : normal (n=181, 64.9%), incomplete contact (n=88, 31.5%), and non-contact (n=10, 3.6%).
Pharyngeal residue of the non-contact type was revealed in all type A cases. In the incomplete contact type with BOT-PPW contact (n=88), the detection rates of pharyngeal residue were type A 58% (n=50), type B 33% (n=30), and type C 7.8% (n=8). The condition of the BOT-PPW contact significantly influenced the pharyngeal residue after swallowing.
We concluded that incomplete or non-contact of the base of the tongue with the posterior pharyngeal wall may cause decreased pharyngeal residue during oropharyngeal swallowing. Evaluation of the contact by videofluoroscopy can be useful for detecting pharyngeal residue.View full abstractDownload PDF (596K)
Case Report
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Hajime Ishinaga, Kazuya Otsu, Satoshi Nakamura, Tomotaka Miyamura, Ats ...2011 Volume 62 Issue 6 Pages 525-528
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSTwo patients suffering from severe aspiration pneumonia were treated with glottis closure procedure modified by Kano et al. In this procedure, the larynx was opened via a midline thyrotomy after removing the thyroid and cricoid cartilages. Next, glottis closure was performed with superior and inferior vocal cord flaps and a sternohyoid muscle flap. This procedure was successful in treating both patients and the postoperative course was uncomplicated.
We concluded that this operative method is effective and poses little risk for treatment of aspiration pneumonia in adult patients.View full abstractDownload PDF (258K) -
Naoya Nishida, Kazumi Motoyoshi, Toshihiro Mori2011 Volume 62 Issue 6 Pages 529-532
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSWe report a case of pediatric postintubation granulomas of the larynx which reguired emergency operation due to airway obstruction. An 11-year-old boy was referred to our institute with complaints of hoarseness, snoring, sleep apnea and stridor. At the initial examination, granulomatous lesions were detected in the bilateral vocal process, which together caused severe airway obstruction at the glottic level. According to his medical history, his case had been diagnosed as postintubation granulomas of the larynx. Because it was thought that discharge of the airway obstruction was necessary immediately, on the hospitalization day both granulomas were removed by laryngomicrosurgery under general anesthesia. In cases with intubation history, one should be alert to laryngeal granulomas as a late complication of intubation.View full abstractDownload PDF (892K) -
Maki Inoue, Noboru Ogahara, Teruhiko Tanabe, Kiminao Ooishi, Mamoru Ts ...2011 Volume 62 Issue 6 Pages 533-537
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSWe studied 4 cases diagnosed with juvenile laryngeal papilloma at our institutions since 1985. All cases exhibited hoarseness and multiple papillomatosis around the larynx. We treated by CO2 laser surgeries, but all cases had recurrent papillomatosis. After several CO2 laser surgeries, 2 cases could be cured, 1 case was not followed because of the patient moving abroad, and 1 case has not revealed any subsequent recurrence. The cause of juvenile laryngeal papilloma is suspected to be human papilloma virus (HPV) transmission at birth. Vaginal delivery and first birth are the risk factors. All 4 of our cases had been delivered vaginally, while only 1 case was firstborn. Juvenile laryngeal papilloma is very difficult to cure because it tends to have multiple papillomatosis and repeated recurrences. However, CO2 laser surgery is suspected to be effective.View full abstractDownload PDF (591K) -
Keisuke Yamamoto, Hiroyuki Ito, Ryuichi Mochizuki2011 Volume 62 Issue 6 Pages 538-544
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSThis report presents a case of dysphagia after treatment of descending necrotizing mediastinitis (DNM) resulting from dental abscess. The patient was a 56-year-old male who had been a high-rise construction worker. He had undergone debridement, surgical drainage and tracheotomy for DNM at another hospital. He was gastrostomized because of dysphagia. At first consultation with us 6 months after the onset of treatment for dysphagia, he had a severe neck scar and a tracheal stoma. The esophagopharyngeal junction was endoscopically and radiologically found to be open when he moved the mandible to the anterior. On pharyngo-esophagogram, movements of the hyoid bone and larynx were restricted and small amounts of contrast media were aspirated. The cause of dysphagia was diagnosed as the severe neck scar. Physical therapy was performed to relax the neck and improve the hyoid bone and larynx movements. Four months after physical therapy the patient came to take liquids and solids orally. The tracheal and gastric stoma were closed ; however the severe neck scar prevented him from looking upward, which impeded his vocational return.
After escharectomy by plastic surgeons at another hospital, he had dysphagia and obstructive sleep apnea. The hyoid bone and the larynx were radiologically proved lower after the escharectomy than before. Physical therapy enabled him to take liquids and solids orally. Nasal CPAP was induced to obstruct the sleep apnea.
In conclusion, we should pay much attention to swallowing and respiratory function in cases of performing escharectomy of the neck. Physical therapy is useful for improvement of disorders of hyoid bone and larynx from scars, to enable good swallowing.View full abstractDownload PDF (1122K) -
Takehiro Matsuda, Masatsugu Masuda, Takehiro Karaho, Naoyuki Kohno2011 Volume 62 Issue 6 Pages 545-550
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSAmyloidosis is a group of diseases in which pathological fibrous protein named amyloid accumulates in almost every type of tissue and impairs organ function. It is classified as systemic or localized amyloidosis according to the degree of spread of disease. In the present paper, we reported a case of localized pharyngeal AA amyloidosis with bibliographic considerations. The case is a 51-year-old female. She visited a local otolaryngological clinic with complaint of left ear fullness. She was found to have exudative otitis media and an epipharyngeal tumor, and was referred to our hospital. Fiberscopic examination revealed a red and partially yellowish smooth mass from the epipharynx to the mesopharynx. MRI revealed a tumor of iso-intensity with T1-weighted MRI (T1-MRI) and low intensity with T2-MRI. Histopathological examination revealed AA amyloidosis. Systemic amyloidosis was excluded by several examinations, and a diagnosis of localized pharyngeal amyloidosis was made. Most AA amyloidosis is secondary to chronic inflammatory disease and is systemic with poor prognosis in general. In addition, the rate of transformation from localized to systemic amyloidosis is reported to be 2.1%. Therefore, we must follow the patient closely.View full abstractDownload PDF (2627K) -
Kenji Okami, Ryousuke Sugimoto, Akihiro Sakai, Kouji Ebisumoto, Takahi ...2011 Volume 62 Issue 6 Pages 551-555
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSWe reported a case of a tracheal burn and stenosis caused by a surgical fire due to electrocautery during tracheostomy. A 63-year-old male with oropharyngeal cancer underwent a tracheostomy under general anesthesia. During the tracheostomy under hyperoxygenation the endotracheal tube was inflamed by the use of electrocautery. The trachea and skin suffered the second- to third-degree burns which led to tracheal stenosis. The stenosis was repaired by the scar resection and dome-tipped T-tube 7 months after the injury. During tracheostomy, electrocautery should be not used under hyperoxygenated conditions. We attempted to call surgeons' attention to the risk of surgical fire during tracheostomy.View full abstractDownload PDF (1673K) -
Takehito Kishino, Hiroshi Hoshikawa, Nozomu Mori2011 Volume 62 Issue 6 Pages 556-561
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSAcute respiratory distress syndrome (ARDS) is recognized as lung edema caused by vascular endothelial and alveolar epithelial damage due to hypercytokinemia and activated neutrophils. The mortality rate exceeds 30%. We report a case developing ARDS during recovery from G-CSF-induced neutropenia, due to pneumonia during the neutropenic period.
The patient was a 70-year-old male. He had been administered 83 mg (60 mg/m2) of docetaxel to treat cT4aN2cM1 (Stage IVC) oropharyngeal carcinoma. His neutrophil count dropped to 61/μl by day 8. In response, 100 μg of lenograstim was administered from days 8 to 10. The neutrophil count reached 8275/μl on day 11. From day 10, dyspnea and elevation of CRP were observed and treatments for pneumonia were started, but respiratory deterioration had progressed by day 13. We diagnosed severe pneumonia and disseminated intravascular coagulation and treated the patient accordingly. Respiratory deterioration progressed, however, necessitating mechanical ventilation. He was diagnosed with ARDS, and was administered 200 mg/day of both Sivelestat sodium and hydrocortisone, after which his respiratory function recovered. Pneumonia during a neutropenic period is a risk factor for ARDS development during recovery from G-CSF-induced neutropenia.View full abstractDownload PDF (1383K)
Glossary
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[in Japanese]2011 Volume 62 Issue 6 Pages 562-563
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSDownload PDF (1063K) -
[in Japanese]2011 Volume 62 Issue 6 Pages 564-565
Published: December 10, 2011
Released on J-STAGE: December 25, 2011
JOURNAL RESTRICTED ACCESSDownload PDF (503K)
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