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Volume 50, Issue 3
Displaying 1-12 of 12 articles from this issue
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Hidekazu YAMAMOTO, Masashi KAKIUCHI2004 Volume 50 Issue 3 Pages 217-220
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe herein report a case who demonstrated an abscess of the neck after a traffic accident. The patient was a 23-year-old woman who suffered an injury to the maxillary central incisor due to the accident. In addition, her lower lip also demonstrated a lacerated wound. On the third day after the accident, the swelling of the neck with pain increased, and thus the administration of antibiotics was started, however, the pain and swelling did not improve. In the initial diagnosis in our hospital, the right side of the neck was swollen and the neck was also tilted toward the left, and the entire neck showed considerable tenderness. In addition, she also had extremely bad smelling breath. In a blood examination, an inflammatory reaction was strongly positive. As a result, urgent drainage was performed since the MRI findings indicated the possible presence of an abscess. Two antibiotics were administered, namely clindamycin and piperacillin. In a bacterial culture analysis, an anaerobe, fusobacterium, was detected. Many anaerobes exist in the oral cavity and pharynx of humanswhich may cause bad breath when the oral hygiene is bad. An abscess can form in some cases when the anaerobe invades the inside of the mucosa due to a deep injury. Therefore, when a patient who had suffered a deep mouth injury demonstrates strong bad breath, an anaerobe infection should be suspected and treated appropriately.View full abstractDownload PDF (8288K) -
Takeharu ONO, Hideki CHIJIWA, Kiyoshi HASHIMOTO, Tadashi NAKASHIMA2004 Volume 50 Issue 3 Pages 221-225
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSAlthough the number of deep neck infections has dramatically decreased owing to advancements in antibiotics, it is still a life-threatening infection disease which can lead to complications such as mediastinitis. We reviewed 93 cases with a deep neck abscess who were treated in a Kurume University hospital between 1986 and 2002. Anatomically, they were classified into 31 submandibular space abscesses, 35 parapharyngeal space abscesses and 27 retropharyngeal space abscesses. Only 4 patients with a submandibular space infection were treated by antibiotics alone. All other cases required surgical therapy to open and drain the abscess. Two patients died because of extensive infection to the mediastinum and one patient died of sepsis which occurred as a complication of diabetes melltus. These results indicate that a deep neck abscess can still be a fatal disease and both prompt and appropriate surgical treatment is urgently required in such cases.View full abstractDownload PDF (8551K) -
Hideaki KATORI, Mamoru TSUKUDA, Junichi ISHITOYA, Yoichi IKEDA, Machik ...2004 Volume 50 Issue 3 Pages 226-229
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe reviewed 35 patients who were diagnosed to have acute epiglottitis in our hospital between January 2000 and December 2003. 33 (94%) patients were adults while only two were children. No seasonal variation in the incidence of acute epiglottitis was encountered. The average duration of the symptoms before hospital admission was 24.2 hours and 28 patients (80%) were admitted between 0 to 48 hours after the commencement of symptoms. 30 patients (86%) received intravenous antibiotics and 28 patients (80%) were also treated with steroids. Three patients underwent an emergency tracheotomy, however, no endotracheal intubation was performed.View full abstractDownload PDF (4779K) -
Hiroyuki YAMASHITA2004 Volume 50 Issue 3 Pages 230-235
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSThe initial effects of olopatadine hydrochloride treatment were evaluated in 17 patients with cedar pollinosis. The administration of olopatadine hydrochloride (5mg) twice daily before cedar pollen begins to disperse in earnest was found to help prevent any aggravation of the patient symptoms. Such an aggravation of the symptoms tended to be suppressed in the initial treatment group in comparison to the non-initial treatment group. This tendency was also especially strongly observed regarding the symptom medication score. There was also no incidence of any discontinuation of the drug administration due to any adverse effects. The results of our study therefore demonstrated the safety and effectiveness of this agent.View full abstractDownload PDF (8301K) -
Hiroyuki YAMASHITA, Takafumi SUGA2004 Volume 50 Issue 3 Pages 239-243
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe performed cricopharyngeal myotomy and arytenoid adduction in patients with skull base injury. Case 1: 58 years of age, male. He fell from the ladder and admitted to the nearby hospital on February 9th in 2000. He suffered from dysphagia and hoarseness six days after the accident. He was diagnosed as traumatic lower cranial nerves paralysis by the neurologist at Kyushu University. He was admitted to the department of neurosurgery at our hospital on February 21st in 2000. He came to our office on February 28th. We observed paralysis of soft palate and vocal cords on both sides and restricted tongue movement on both sides. He was admitted to our department on May 22nd and underwent cricopharyngeal myotomy and arytenoid adduction on the left side under general anesthesia on May 26th. He was discharged free from dysphagia and hoarseness on June 9th. Case 2: 52 years of age, female. She fell from the pickup and admitted to the nearby hospital. She suffered from dysphagia and hoarseness right after the accident. She came to our office on March 12th in 2003. We heard rhinolalia aperta and breathy hoarseness and observed soft palate and vocal cord paralysis on the left side. She was admitted to our department on March 27th on 2003 and underwent cricopharyngeal myotomy on both sides and arytenoid adduction on the left side on April 4th. She was discharged free from dysphagia and hoarseness on May 6th.View full abstractDownload PDF (10267K) -
Masamitsu HYODO, Takahiko YAMAGATA, Akira SUGIMOTO, Masato TERAOKA2004 Volume 50 Issue 3 Pages 244-247
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA case of dermatomyositis presenting with severe dysphagia in a 77-year-old male was reported. Endoscopic examination revealed impaired pharyngeal contraction and nasopharyngeal insufficiency in swallowing. Manometric study also supported these findings. Videofluorography showed severe cricopharyngeal obstruction resulting in aspiration into the trachea. Conservative treatment including administration of corticosteroid improved general symptom and serum level of muscle enzymes, however, it did not restore oral food intake. He underwent cricopharyngeal myotomy providing with little improvement of swallowing function. Mechanism and therapeutic manner of swallowing disorder in patients with dermatomyositis were briefly discussed.View full abstractDownload PDF (7803K) -
Kazuo ADACHI, Toshiro UMEZAKI, Katsuya MATUYAMA, Testuya KOYAMA, Soh-t ...2004 Volume 50 Issue 3 Pages 248-254
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA 65 year old woman came to our hospital. She suffered from aspiration pneumonia so, we did video fluorogram (VF). The VF revealed limited elevation of larynx, dysfunction of pharyngeal constrictor muscle and poor clearance of barium. A neurological examination revealed right V, VII, VIII, IX, X and XII cranial nerve palsy. Serum examination was not done and head MRI revealed no abnormal findings. But from neurological examination we thought that poly neuropathy was caused by infection. On the basis of those examination we operated. We elevated larynx, cut cricopharyngeal muscle, tuckrt pharyngeal mucosa, and adducted arytenoid caritlage. After the operation, she could take food orally and didn't suffer from aspiration pneumonia. We think that it is important to analyze the swallowing function of the patients. and compensate for the lack point of swallowing funcion with operation.View full abstractDownload PDF (10827K) -
Miwako KIMURA, Masato NAKASHIMA, Niro TAYAMA2004 Volume 50 Issue 3 Pages 255-259
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSCase study of a 58 year-old male who suffered from a hemorrhage of the right pons. He complained of dysphagia. After the hemorrhage the patient complained of dysphagia. The patient underwent 8 months of rehabilitative therapy however his symptom did not improve. A laryngoscopy revealed poolings of secretions in the vallecula and hypopharynx. A video fluoroscopy showed that the larynx wasn't elevated enough, and when the patient tried to swallow the upper esophageal sphincter didn't relax so aspiration of the secretions in the larynx occurred. The VF and the laryngoscopy were useful for evaluating the patient's swallowing process. Eventually it was decided to perform a laryngeal elevation and tracheostoma plasty. Though laryngeal elevation is usually combined with cricopharyngeal myotomy, and though cricopharyngeal myotomy might have shortened the required time for rehabilitation, the laryngeal elevation was only performed in this case, because a tracheostoma plasty was needed for the patient's rehabilitation after the operation. The laryngeal elevation improved the patient's dysphagia. Approximately one year's retraining was necessary for the patient to learn to swallow again.View full abstractDownload PDF (9406K) -
Shuji MATSUMOTO, Mitsuhiko NAKAHIRA, Hiroaki NAKATANI, Taizo TAKEDA2004 Volume 50 Issue 3 Pages 260-263
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe treated 8 patients with dysphagia using laryngeal suspension at Kochi Medical School from 1999 to 2003. Of the 8 patients, 5 had developed dysphagia following the resection of the head and neck tumor and 3 were cerebrovascular disease. All patients had strengthened the ability of the swallowing function postoperatively. Six of these 8 patients (5 head and neck tumor patients and 1 cerebrovascular disease patient) were able to eat by mouth, while 2 patients (2 cerebrovascular disease patients) still required enteral feeding. However, even in the two patients, postoperative aspiration and pulmonary infection remarkably decreased. The results showed that laryngeal suspension offered certain advantages in the management of patients with dysphagia.View full abstractDownload PDF (6396K) -
Junko SUGIURA, Yasushi FUJIMOTO, Seiichi NAKATA, Tsutomu NAKASHIMA2004 Volume 50 Issue 3 Pages 264-267
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSDysphagia and laryngeal paralysis are the burdensome complications of some types of head and neck surgery. The purpose of this study was to appraise the usefulness of early stage conservative therapy in these cases. Swallowing rehabilitation consisted of indirect therapy and head rotation was performed on four cases whose dysphagia associated with laryngeal paralysis after head or neck surgery. The rehabilitation started in the early stage of recovery. Distinct improvement was observed in three cases in spite of unchanged cerebral nerve paralysis. The therapy had little effect in one case whose physical conditions not ameliorated. From these data, the efficiency of swallowing rehabilitation was reaffirmed and the physical state after surgery seemed to be important for remedy.View full abstractDownload PDF (8394K) -
[in Japanese]2004 Volume 50 Issue 3 Pages 268-270
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESS -
2004 Volume 50 Issue 3 Pages 271-278
Published: May 20, 2004
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSDownload PDF (11945K)
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