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Volume 67 (2016)
- Issue 6 Pages 379-
- Issue 5 Pages 325-
- Issue 4 Pages 249-
- Issue 3 Pages 201-
- Issue 2 Pages 47-
- Issue 1 Pages 1-
Volume 67, Issue 3
Displaying 1-7 of 7 articles from this issue
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Original
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Nozomu Wakayama, Hideto Saigusa, Satoshi Yamaguchi, Tsuyoshi Nakamura, ...2016 Volume 67 Issue 3 Pages 201-208
Published: 2016
Released on J-STAGE: June 25, 2016
JOURNAL RESTRICTED ACCESSDiagnosis of associated laryngeal paralysis conditions plays important roles in identifying the causative lesion and determining the pathological stage. However, cryptogenic cases remain even after reviewing diagnostic test results. This study was performed retrospectively on 16 patients who, over the course of the past 19 years, were examined within the first 2 weeks after onset and were followed more than a year. These cases of idiopathic associated laryngeal paralysis did not show any apparent abnormalities on MRI imaging, and also tested negative for varicella-zoster virus and fever blister. The examination items were as follows: condition of cranial nerve palsy and its convalescence, presence of prodromes, differential leukocyte count on the initial visit, and paired serum of virus antibody titers. Except for 1 case that showed intercurrent anti-side optic nerve disorder, all other cases presented with jugular foramen syndrome. Assessments of the prognosis of cranial neuropathy indicated that all cranial neuropathy was restored within 23 months from onset (average: 6.5 months). However, 8 cases with possible viral infections took a longer time to restore (average: 8.5 months). The other 7 cases which had all tested negative took an average of 1 month to restore. Notably, some of these totally negative testing cases restored all neuropathy within 11 days. The speed of neuropathy recovery was significantly faster than conventional reports of the Wallerian degeneration recovery process.View full abstractDownload PDF (508K) -
Shinji Takebayashi, Yuki Tanigami, Mai Nakahira, Yasuyuki Hayashi, Tos ...2016 Volume 67 Issue 3 Pages 209-216
Published: 2016
Released on J-STAGE: June 25, 2016
JOURNAL RESTRICTED ACCESSTracheostomy is often performed for airway control. A tracheal fistula is not always useful, and it should be promptly closed if it is unnecessary. Here, we studied 162 tracheal fistulas performed at our facility between 2010 and 2014, in order to learn how to manage a tracheal fistula properly. Eighty-seven fistulas were able to be closed. Although most of the tracheal fistulas opened for acute inflammation were able to be closed, among the tracheal fistulas unable to be closed many had been opened for tumors, long oral tube insertion, or aspiration pneumonitis. In the cases where the tracheal fistula could be closed, there was a tendency toward longer time required from decannulation to closure of the fistula, as longer time was necessary from opening of the tracheal fistula to decannulation. The larger the number of stay sutures required for tracheostomy, the longer were the operation time and period from decannulation to closure of the fistula. We recommend selecting the fenestration technique for tracheostomy in cases where it is difficult to close the tracheal fistula promptly. It seems important to decide the method of fistula closure according to the patient's status.View full abstractDownload PDF (481K) -
Keiko Ito2016 Volume 67 Issue 3 Pages 217-223
Published: 2016
Released on J-STAGE: June 25, 2016
JOURNAL RESTRICTED ACCESSWe examined the apnea-hypopnea index (AHI) readings of 67 patients who demonstrated symptoms of sleep-disordered breathing as measured by both a portable monitor and polysomnography (PSG) between April 2011 and September 2015. There was a positive correlation between the AHI readings in severe SAS cases, but no correlation in the mild or moderate SAS cases. Although there was a correlation between the respective apnea index (AI) measurements, there was no correlation with respect to hypopnea index (HI) readings. Applying the classifications of AASM, there was a more significant correlation between AHI readings by PSG than by portable monitor for type 3 as compared to type 4. Even when the AHI readings of SAS cases are low using a portable monitor, we should consider use of PSG when patients have symptoms of excessive daytime sleepiness or complications such as cardiovascular disease or apoplexy.View full abstractDownload PDF (260K)
Case Report
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Kahori Hirose, Kaori Nishikubo, Masahiro Komori, Masamitsu Hyodo2016 Volume 67 Issue 3 Pages 224-229
Published: 2016
Released on J-STAGE: June 25, 2016
JOURNAL RESTRICTED ACCESSTraumatic neuroma is a benign lesion which originates at the cut end of a peripheral nerve. Its pathogenesis is considered to be a disorder of the regeneration process of the damaged nerve. We herein report a rare case of infantile traumatic neuroma in the subglottis and cervical trachea. With long-term airway management and staged operations, the patient was treated successfully. A 4-year-old boy presented stridor at birth that gradually worsened. He was diagnosed as having subglottic stenosis and treated by tracheal intubation and tracheostomy. He presented with extubation difficulty thereafter. A submucosal mass lesion in the cervical trachea was diagnosed at 4 years of age. We planned continuation of airway management and staged operations. The submucosal hard mass lesion was resected by tracheal fissure approach at 11 years of age. Traumatic neuroma was confirmed histopathologically. Three additional operations were performed against regrowth of the submucosal lesion. After confirming the patient was free from respiratory distress, the tracheostoma was closed at age 15. He has been uneventful during the two years thereafter.View full abstractDownload PDF (3269K) -
Rieko Goto, Kanako Indo, Terushige Mori, Hiroshi Hoshikawa2016 Volume 67 Issue 3 Pages 230-236
Published: 2016
Released on J-STAGE: June 25, 2016
JOURNAL RESTRICTED ACCESSEpithelial hyperplasia of the larynx is histopathologically comprised of simple hyperplasia and dysplasia of various degrees, and it is widely recognized as a precancerous lesion. We reported a 77-year-old male who, over the course of six years, repeatedly underwent resection by laryngomicrosurgery but still suffered recurrence of his lesions. Ultimately the lesions became malignant, and a total laryngectomy was performed. We resected the leukoplakia lesions present in both vocal cords and the area between the arytenoids. On each occasion, the pathology results were dysplasia and severe hyperkeratosis. Bilateral vocal cord paralysis was found one year and two months after the last surgery, CT and PET-CT revealed a shadow with bone destruction around the rear of the larynx, and malignancy was strongly suspected. A total laryngectomy was performed and the pathology result was squamous cell carcinoma. Long-term follow-up is necessary for larynx epithelium hyperplasia regardless of degree of cellular atypia that follows laryngeal cancer. Also, when lesions invade and multiply under the mucosa, this may lead to delay in diagnosis, and therefore close attention is required.View full abstractDownload PDF (1355K) -
Miho Nitta, Hideo Shimada, Takayuki Nishi, Soji Ozawa, Hiroyasu Makuuc ...2016 Volume 67 Issue 3 Pages 237-241
Published: 2016
Released on J-STAGE: June 25, 2016
JOURNAL RESTRICTED ACCESSThe residual cervical esophagus after operation for thoracic esophageal squamous cell carcinoma (TESCC) has a high risk for metachronous squamous cell carcinoma. We report a case of cervical esophageal squamous cell carcinoma (CESCC) that was treated by endoscopy after operation for TESCC. A 71-year-old male underwent an esophagectomy for TESCC. Pathological diagnosis was moderately differentiated squamous cell carcinoma, pT1a-LPM, ly0, v0, pN0. Four years and eight months later, endoscopic examination revealed a 0-IIb lesion, involving four-fifths of the esophageal circumference, located from the pharyngoesophageal junction to the cervical esophagus. By biopsy the patient was diagnosed with squamous cell carcinoma. The lesion was located at the cervical esophagus, a challenging location for performing endoscopic procedures. Thus, argon plasma coagulation (APC) was performed eight times over five years, and local control was achieved. The cervical esophagus, which is the physical esophageal narrowing, is difficult to observe by endoscopy, and operation or chemoradiotherapy for advanced CESCC is invasive. Because metachronous squamous cell carcinoma, or field cancerization, is commonly observed, it is important to perform endoscopy for the cervical esophagus after TESCC operation for diagnosis and treatment at the early stages.View full abstractDownload PDF (1729K)
Glossary
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[in Japanese]2016 Volume 67 Issue 3 Pages 242-244
Published: 2016
Released on J-STAGE: June 25, 2016
JOURNAL RESTRICTED ACCESSDownload PDF (222K)
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