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Volume 66 (2015)
- Issue 6 Pages 365-
- Issue 5 Pages 299-
- Issue 4 Pages 245-
- Issue 3 Pages 191-
- Issue 2 Pages 57-
- Issue 1 Pages 1-
Volume 66, Issue 3
Displaying 1-8 of 8 articles from this issue
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Original
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Akiko Tani, Choichiro Tase, Yasuhiro Tada, Takashi Matsuzuka, Takamich ...2015 Volume 66 Issue 3 Pages 191-197
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSCricothyrotomy is a surgery often performed under emergency circumstances necessitating airway management or sputum discharge. The surgery is typically carried out by a surgeon, emergency physician, or otolaryngologist. In this report, we surveyed 99 patients who had undergone cricothyrotomy surgery at our hospital over an eight-year period. Emergency physicians were most likely to perform the surgery, handling 37.4% of patients. Next were cardiovascular surgeons, gastroenterological surgeons, and otolaryngologists, with the latter handling 12.1% of patients. In all, 87.9% of patients underwent the cricothyrotomy for sputum discharge. Intubation was maintained for 5 days or less in 45.5% of patients, whereas 18.2% continued intubation for 16 days or more, and 2.0% for 41 days or more. All cases that were intubated for 16 days or more had undergone the cricothyrotomy for sputum discharge. Complications occurred in 2.0% of cases during surgery and in 3.0% of cases postsurgery. Permanent vocal cord paralysis occurred in 1.0%. Complications from cricothyrotomy can be prevented by inserting the tube in the correct place and avoiding long-term intubation. If long-term intubation is required, evaluation of laryngeal function will be necessary.View full abstractDownload PDF (737K) -
Ray Motohashi, Kiyoaki Tsukahara, Hiroki Sato, Minoru Endo, Kazuhiro N ...2015 Volume 66 Issue 3 Pages 198-202
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSA diagnosis of cervical lymph metastasis is important for determination of treatment methods for hypopharyngeal carcinoma. Recently the usefulness of 18F-2-fluoro-2-deoxy-D-glucose-positron emission tomography combined with computed tomography (FDG-PET/CT) has been reported. We retrospectively compared postoperative histopathological findings with preoperative FDG-PET/CT findings for hypopharyngeal carcinoma patients with cN0. Fourteen patients were studied who had been diagnosed as hypopharyngeal carcinoma at the Otolaryngology/Head and Neck Surgery Department of Tokyo Medical University Hachioji Medical Center between 2009 and 2011, treated with total pharyngolaryngectomy and bilateral neck dissection, and diagnosed by FDG-PET/CT as cN0M0. Twelve patients were male and 2 were female. Ages ranged from 62 to 84, with a mean of 72. One patient was diagnosed as stage II, 7 as stage III, and 6 as stage IVA. Six of the 14 patients, i.e. 42.9%, were diagnosed as histopathologically positive for carcinoma in the cervical lymph nodes. The accuracy of the preoperative FDG-PET/CT findings was 57.1%. There were 14 lymph node metastases in 6 patients. In the lymph node metastases, the mean of the major axis was 9.1 mm, the mean of the minor axis was 6.2 mm, and the mean occupation rate of carcinoma was 59.8%. Eleven of the 14 lymph node metastases, i.e. 78.6%, were in the ipsilateral neck. We should recognize a near 40% possibility of occult neck lymph node metastasis even when hypopharyngeal carcinoma patients are diagnosed by FDG-PET/CT as cN0.View full abstractDownload PDF (245K) -
Seri Nagai, Yuki Hamajima, Motohiko Suzuki, Toshio Kimura2015 Volume 66 Issue 3 Pages 203-207
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSSmoke inhalation divides into two types: thermal injury to the upper airway and chemical injury to the lung parenchyma. In thermal injuries, within two days laryngeal edema can become a problem and intubation is needed to prevent dyspnea. In chemical injuries, ventilation failure due to gas exchange can become a problem within two to three days. For thermal injuries, no criteria exist concerning intubation, and there have been few reports about the relationship between upper airway findings and laryngeal edema. Here, we discuss the relationship between the soot site and laryngeal edema, and factors affecting the progress of laryngeal edema in thermal injuries. Between April 2008 and March 2014, 47 patients were admitted to Nagoya Red Cross Hospital due to burn and inhalation injury. All patients underwent laryngeal fiberscopy within 24 hours after injury. Based on upper airway findings (site of soot), we divided the patients into four groups: Group 1 (n=9) : no soot in upper airway and no laryngeal edema; Group 2 (n=7) : soot in the naso-oropharynx and no laryngeal edema; Group 3 (n=14) : soot in the larynx and trachea and no laryngeal edema; Group 4 (n=17) : laryngeal edema. The results revealed no relationship between the soot site and laryngeal edema progression. The burn index and burn area are significantly important to progressive laryngeal edema. Conclusion: In case of thermal injury, preventive intubation will be recommended due to burn index and burn area and prognostic hypoprotein plasma, even if there is no laryngeal edema. Conclusion: In case of thermal injury, preventive intubation will be recommended due to burn index and burn area and prognostic hypoprotein plasma, even if there is no laryngeal edema.View full abstractDownload PDF (1231K) -
Kazuhiro Hirasawa, Kiyoaki Tsukahara, Ray Motohashi, Minoru Endo, Hiro ...2015 Volume 66 Issue 3 Pages 208-213
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSAlthough various antibiotics have been synthesized, deep neck infection is still a life-threatening disease. An incision and drainage should be performed if an abscess has already formed. However, in some cases no abscess is formed and treatment is administered with antibiotics. In these cases abscesses will form later, at which time surgical drainage should be undertaken. In this study, 19 patients with deep neck infection who were treated conservatively are investigated retrospectively. We divided them into two groups : those who recovered by conservative treatment, and those who did not recover and on whom surgical drainage was performed. Latter-stage elderly seem to be in need of careful follow-up. For patients with diabetes mellitus, it is necessary to control blood sugar levels strictly. Especially when the infected region exists in multiple areas, the probability of abscess formation should always be kept in mind.View full abstractDownload PDF (504K)
Case Report
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Yasushi Samukawa, Rieko Goto, Masafumi Yonezaki2015 Volume 66 Issue 3 Pages 214-219
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSThyroglossal duct cyst is usually discovered as a mass-related lesion of the midline of the anterior neck. Progression of a thyroglossal duct cyst to the larynx is rare, but when it occurs it may cause airway obstruction and therefore requires appropriate treatment. We report a 70-year-old male with a thyroglossal duct cyst progressing in the larynx which was discovered accidentally. When the subject underwent upper gastrointestinal endoscopy to check for a cause of anemia, the attending physician found a mass-related lesion around the larynx. As an abnormal shadow was seen around the larynx in CT, the patient was introduced to our department. We found a cystic lesion which had progressed to the larynx. A colectomy had been planned for transverse colon cancer, and cyst resection was also performed at the same time under general anesthesia. We made a diagnosis of a thyroglossal duct cyst from operation views and pathological examination. We were able to resect the cyst without damaging the laryngopharynx mucous membrane. We were able to extubate after the operation with no problem. The form of the larynx was almost back to normal in the endoscope views after the operation.View full abstractDownload PDF (2767K) -
Takaaki Inui, Masaya Uchida, Rei Yamamichi, Shigeyuki Mukudai, Kenji D ...2015 Volume 66 Issue 3 Pages 220-225
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSMucoepidermoid carcinomas generally occur in the major and minor salivary glands ; mucoepidermoid carcinomas in the laryngeal area are rare. We report a case of mucoepidermoid carcinoma of the subglottic region. A 56-year-old female was referred to our institute complaining of hoarseness, and fiberscopic examination revealed significant subglottic stenosis. Low-grade mucoepidermoid carcinoma was pathologically suspected from the biopsy specimen taken in a tracheotomy. A total laryngectomy was performed with the negative surgical margin, and the conclusive pathological diagnosis was low-grade mucoepidermoid carcinoma. Although the postoperative course is still short, the course has been favorable without local recurrence or distant metastasis.View full abstractDownload PDF (1432K) -
Kenzo Ohara, Yasuaki Harabuchi2015 Volume 66 Issue 3 Pages 226-231
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSRecently, along with advances in endoscopic devices, endoscopic removal of esophageal foreign bodies is increasing. Here we report an 80-year-old woman who suffered from sore throat and fever due to an unshelled shrimp foreign body in the esophagus. Endoscopic management removed half of the foreign body, but the remainder required a surgical approach via cervical incision. We have found no reports of cases similar to this one.View full abstractDownload PDF (4809K)
Glossary
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[in Japanese]2015 Volume 66 Issue 3 Pages 232-233
Published: June 10, 2015
Released on J-STAGE: June 25, 2015
JOURNAL RESTRICTED ACCESSDownload PDF (383K)
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