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Shigetaka MORIAI, Reiko KARASAKI, Takeshi KANAYA, Yasuaki HARABUCHI
2001 Volume 47 Issue 6 Pages
431-434
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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We report a case of a sudden onset of a hearing disturbance during interferon therapy for type C chronic hepatitis. The patient was a 48-year-old man who developed bilateral hearing loss at six weeks after the start of interferon therapy. He was admitted to our hospital for treatment. We administered high-dose steroids and loop diuretics-vitamin therapy. This treatment regimen proved to be effective and his hearing ability returned to the same level as that before the interferon therapy was started. Interferon is widely used for the treatment of chronic hepatitis, gastric cancer and multiple myeloma, but side effects to the inner ear are not ordinarily reported. We therefore think that otorhinolaryngologists must thus be aware of potential inner ear disturbances of patients treated with interferon.
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Hitoshi HIRAKAWA, Masaharu URA, Tatuhito OOWA, Yukio NAKAMURA, Akira G ...
2001 Volume 47 Issue 6 Pages
435-438
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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Children frequently present with acute otitis media and postoperative treatment is difficult. As a result, the indications for tympanoplasty in children remain controversial. We experienced 109 ears inpatients under 18 years of age who all underwent tympanoplasty from 1989 to 1998. The results were satisfactory with a success rate of 82% regarding hearing and of 90% regarding the tympanic membrane. The above successful findings suggest that surgeons should not make age restrictions regarding the indications for tympanoplasty.
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Taketo KUROKI, Kiyoshi HASHIMOTO, Yoichi MATSUDA, Yoshihisa UEDA, Shin ...
2001 Volume 47 Issue 6 Pages
439-443
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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This is an analysis of 53 primary cases who underwent surgery for cholesteatoma in children under 15 years of age from 1989 to 1998. The observation period ranged from 1 year to 10 years and 9 months. The rate of recurrence was 20.8% in 53 cases. The success rate in hearing was 78.3% in 46 cases (reoperation cases included). The success rate was calculated based on the following criteria: 1) A-B gap: 15dB, 2) Hearing gain: 15dB, and 3) Hearing level: 30dB The results were considered to be satisfactory if one of the 3 criteria were successfully achieved.(Otology Japan 2000) Staged tympanoplasty was performed for progressive cases. In cases that were selected to undergo staged tympanoplasty, the rate of recurrence was 25.0%, and the success rate for hearing was 75.0%. In addition, in cases that were selected to undergo a one stage operation, the rate of recurrence was 25.0%, and the success rate for hearing was 72.0%. Staged tympanoplasty was thus found to be an effective treatment for progressive cases of cholesteatoma in children.
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Yukio OYAMADA, Sumihito KINOSITA, Tomoaki SADANAGA, Touhiko MIYAYAMA, ...
2001 Volume 47 Issue 6 Pages
444-449
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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Deep neck infections continue to be seen despite the widespread use of antibiotics. These infections course along the facial planes to create deep neck space abscesses. The clinical presentation often points to the space involved. Understanding the regional anatomy gives surgeons the ability to treat these serious infections. Two cases of deep neck infections are herein presented. Case 1 was a 37-year-old male who complained of a high fever and a sore throat. A peritonsillar abscess was considered to be the cause of the deep neck infection in this patient. Case 2 was a 59-year-old male who complained of frontal neck swelling and dysphagia. Either an odontongenic infection or a peritonsillar abscess were considered to be the cause of the deep neck infection in this patient. Both patients received drainage and antibiotic treatment. Case 1 recovered in about 1 month while Case 2 died of sepsis. We therefore consider that we should have performed drainage of the mediastinum abscesses in case 2.
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The role of a CT examination in combination with a barium swallow
Tetsuya NAKAMOTO, Masatake OISO, Hirotaka MATSUMOTO, Norihisa OGATA, K ...
2001 Volume 47 Issue 6 Pages
450-455
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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Pyriform sinus fistula is one of the known congenital deformities consisting of a third or fourth branchial anomaly. It is often detected in association with symptoms of acute suppurative thyroiditis. After treating the initial inflammation, CT, US and barium hypopharyngography can be used to make a final diagnosis by recognizing the presence of a fistula. We report two cases of pyriform sinus fistula. In one case, a CT taken just after a barium swallow was useful for detecting the fistula and locating it between the pyriform sinus and the upper pole of the thyroid gland.
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Kyo YASUDA, Shigetoshi FUJITA, Youhei YAMAMOTO, Atsushi NANBA, Akira S ...
2001 Volume 47 Issue 6 Pages
456-460
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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We report a case of maxillary hematoma. The patient, a 70-year-old man, presented with the chief complaint of a right nasal obstruction and nasal bleeding. A CT scan showed an isodensity mass, which occupied the right maxillary sinus with a destruction of the posterior and superior bony wall. Although a malignant tumor was suspected from these findings, we found a hematoma in the maxillary sinus and extirpated it. A histopathological examination confirmed the diagnosis. Endoscopic sinus surgery was performed to establish a communication between the maxillary sinus and the nasal cavity. We could not preoperatively distinguish the hematoma in the maxillary sinus from a malignant tumor. However, if surgeons notice a well-preserved mucous membrane in the maxillary sinus on the MRI findings, then it may be possible to differentiate a hematoma from a malignant lesion through careful examination.
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Kazumi KOSAKA, Manabu NONAKA, Kenichi WATANABE, Eriko KAMURA, Hideharu ...
2001 Volume 47 Issue 6 Pages
461-464
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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Meningoencephalocele is a very rare disease. The case of a 67-year-old man with transshenoidal meningoencephalocele is presented. The patient did not have any anomalies or any episode of trauma. The patient often demonstrated cerebrospinal fluid rhinorrhea, in addition to meningitis with headache and high fever. The coronal and sagittal MRI findings were very useful in making a diagnosis of meningoencephalocele. A transcranial approach was used to remove the meningoencephalocele. The postoperative course was uneventful.
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Kaoruko NUKUMI, Atsushi OBATA, Kouji NAKANO, Eiji YUMOTO
2001 Volume 47 Issue 6 Pages
465-469
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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A 70-year-old woman presented with the chief complaint of right abducent nerve palsy and a bilateral defect of the lateral visual field without any nasal symptoms. A computed tomographic examination revealed a soft density mass which occupied both sphenoid sinuses with partial calcification while also showing the skull base bone in the sinuses to be extensively defective. The patient underwent endoscopic sinus surgery to remove the diseased tissue endonasally. The sphenoid sinuses were marsupialized and irrigated with saline solution. The optic chiasm, dura mater and bilateral carotid arteries were observed during the operation. The patient's symptoms began to improve the day after operation. Her postoperative course has been uneventful for two years since then. A clear differentiation of non-invasive type mycosis from an invasive type is therefore essential in order to select the optimal treatment strategy. Our experience suggests that non-invasive type mycosis does not require a total removal of the involved structures.
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Akiko BABA, Toshihiko KIKUCHI, Naotaro AKIYAMA, Keiichi KASE, Jun TAKA ...
2001 Volume 47 Issue 6 Pages
470-475
Published: November 20, 2001
Released on J-STAGE: May 10, 2013
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CT and MRI images were evaluated in the 4 cases of hematocele in the maxillary sinus. A CT scan demonstrated a soft tissue density in the unilateral maxillary sinus and nasal cavity. MRI images showed a heterogeneous mass lesion and a thickened mucosa in the maxillary sinus. An MRI scan proved to be very useful for the preoperative diagnosis of a hematocele in the paranasal sinuses.
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