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Volume 51, Issue 5
Displaying 1-14 of 14 articles from this issue
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Naoko MATSUBARA, Mayumi INAMITSU, Shunichirou TANAKA, Hideki SHIRATSUC ...2005 Volume 51 Issue 5 Pages 319-324
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe investigated the efficacy of ventilation tube therapy in the treatment of 246 ears demonstrating otitis media with effusion (OME) in 130 children between 1990 and 1992. We used a long-term ventilation tube. We examined the age at insertion, the detention period, the combination with an adenotomy, and the presence of a tympanic membrane perforation following the removal of the ventilation tubes. After treatment, a cure was achieved in 170 ears (69.1%) and a retraction of the tympanic membrane, including a recurrence of OME, was found in 52 ears (21.1%). The average duration of tube ventilation was 18 months. The OME cure rate was significantly higher in the group intubated for 18 months or more compared with the group intubated for less than 18 months. The cases that underwent an adenotomy a showed a higher cure rate. The average age at intubation was 5. We thus concluded that a diagnosis of OME and an early commencement of treatment produced a higher cure rate. In addition, 23 ears(9.4%) demonstrated a membrane perforation following the removal of ventilation tubes. The membrane perforation correlated with neither the detention term nor the repetition of insertion.View full abstractDownload PDF (10604K) -
Mizuo ANDO, Masaki MATSUZAKI, Takashi NAKASAKI, Tatsujiro USHIJIMA, To ...2005 Volume 51 Issue 5 Pages 325-329
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA 49-year-old male smoker with a history of previously undergoing vocal fold microsurgery, presented with dyspnea, which had been worsening over the past few days. On the initial examination in the emergency room, stridor was evident and fiberoptic laryngoscopy revealed an obstructing supraglottic lesion. An urgent tracheostomy was therefore performed. Subsequent direct laryngoscopy under general anesthesia identified a valve-like laryngeal polyp attached to the upper surface of the left vocal cord. A surgical resection resulted in an uneventful recovery. This unusual lesion was considered to have been caused as a result of the previous microsurgery.View full abstractDownload PDF (9633K) -
Yasuhiro KAKAZU, Takashi NAKAGAWA, Shumei SHIBATA, Hideki SHIRATSUCHI, ...2005 Volume 51 Issue 5 Pages 330-335
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSAn extremely rare case of an inflammatory pseudotumor (IPT) in the middle ear is herein reported. A twenty-seven-year-old male was introduced to our department to be examined for a red mass that had been observed to exist near his left eardrum. Temporal bone CT revealed a soft tissue density which filled the tympanic sinus. MRI suggested it to be a neoplasm. To establish a histopathological diagnosis, surgery was performed. First, a biopsy was done during the operation and a strong permeation of inflammatory cells was merely observed with no evidence of a neoplasm. A posterior tympanotomy and the removal of the incus were then carried out to obtain a sufficient view, and then the tumor-like lesion was removed completely without damaging either the facial nerve or the oval window. The external specimen was diagnosed to be inflammatory granulation in which a dense part of the specimen consisted of fibroblasts and myofibroblasts. Based on the clinical and histopahological findings, IPT was finally diagnosed. IPTs have been reported to occur at numerous sites such as the lung, which is the most common site, as well as the liver, spleen, mediastina, and the rear peritoneum. In the head and neck area, IPTs tend to occur in eye sockets, the paranasal sinus, the large salivary gland and the thyroid. However, the occurrence of IPT in the temporal bone region is extremery unusual.View full abstractDownload PDF (10900K) -
Ryuichi MOCHIZUKI, Hiroshi MUTA, Masahiro KAWAMOTO, Keisuke YAMAMOTO, ...2005 Volume 51 Issue 5 Pages 339-343
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSThe study was performed in patients who underwent re-surgery among the 1,405 patients (1,510 cases) who underwent microlaryngoscopic surgery during the past 11 years. The percentage of the patients who underwent re-surgery within 1 year after the initial surgery was highest for patients who underwent autoglaft fat injection laryngoplasty. On the other hand, the percentage of the patients who underwent re-surgery within 4 to 8 years after the initial surgery was highest for patients who had vocal cord polyp or vocal cord nodule, followed by the percentage of the patients who under went re-surgery more than 8 years after the initial surgery. It was considered that many professional voice users who once had cure after the initial surgery underwent microlaryngoscopic re-surgery subsequently. These data indicate need for long-term voice therapy by a speech therapist specializing in voice disorder after phonetic surgery including microlaryngoscopic surgery.View full abstractDownload PDF (7497K) -
Shigeru HIRANO, Masaru YAMASHITA, Shin-ichi TAKAGITA, Morimasa KITA-MU ...2005 Volume 51 Issue 5 Pages 344-347
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSMicrovascular lesions of the vocal fold mucosa often hamper the mucosal vibration, and also cause consequent hemorrhagic polyp. The KTP laser allows photocoagulation of these lesions with minimal damage to the mucosa. The KTP laser surgery was applied to six patients with microvascular lesions accompanied with other lesions such as polyp, Reinke's edema, leukoplakia, and Tla cancer. Photocoagulation was easily and safely performed, preserving the epithelium. Postoperative phonatory functions and the mucosal vibration were improved significantly. Photocoagulation with KTP laser is considered to be easy and safe procedure in the treatment of microvascular lesions of the vocal fold.View full abstractDownload PDF (6113K) -
A case of relapsing polychondritis successfully decannulated 7 years after the emergency tracheotomyHitoshi BAMBA, Ryuichi HIROTA, Ken-ichiro TOYODA, Masato OOKA, Shinobu ...2005 Volume 51 Issue 5 Pages 348-352
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe report a case of relapsing polychondritis successfully decannulated 7 years after the emergency tracheotomy. A 14-year-old girl was admitted to the hospital with a history of cough and dyspnea worsening for a month. Flexible laryngofiberscopic examination revealed severe subglottic stenosis. Tracheotomy was performed on the admission day. Histological findings from the cricoid cartilage were compatible to relapsing polychondritis. Systemic administration of corticosteroids was performed. The subglottic stenosis improved gradually. The decannulation and surgical closure of the tracheal stoma was performed 7 years after the tracheotomy. Though relapsing polychondritis causes recurrent inflammatory reactions in the cartilaginous structures, it is not impossible to close the tracheal stoma in patients of subglottic stenosis due to this disease.View full abstractDownload PDF (9352K) -
Aki TAGUCHI, Masamitsu HYODO, Shinichi KAGEYAMA, Takahiko YAMAGATA, To ...2005 Volume 51 Issue 5 Pages 353-357
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe herein report a complicated case of post-traumatic tracheal stenosis. A 52-year-old male received an endotrachal intubation due to blunt head injury. One month later, when endotracheal tube was removed he complained of severe dyspnea. He subsequently underwent tracheostomy and consulted to our clinic. Dyspnea was caused by multifaceted factors; 1) endotracheal granulation formation enhanced by local infection of MRSA, 2) bony protrusion of the manubrium of the sternum posteriorly to compress the trachea, 3) extension of the tracheal cartilages into the trachea possibly due to previous neck injury. For these points, we performed staged surgeries in combination with an administration of antibiotics and steroids. Three years after the onset, tracheal stenosis was successfully retrieved and tracheostoma was closed. His clinical course thereafter has been well without dyspnea.View full abstractDownload PDF (8543K) -
Yasushi MESUDA, Noriko NISHIZAWA, Michiya MATSUMURA, Yasushi FURUTA, S ...2005 Volume 51 Issue 5 Pages 358-361
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSWe reported a case of gender identity disorder(GID), who was a 27 years old male to female and suffered from dysphonia after pitch-raising surgery in Southeast Asia. The vocal folds of this case were short and the fundamental frequency was 220Hz, but the voice was severely breathy. The laryngeal stroboscopy revealed the laryngeal web and the weak travelling waves of bilateral vocal folds. We began to give medicine; proton-pump-inhibitor, oral steroid, macrolides anti-biotics, etc., and then the voice was getting better slightly but the granuloma at anterior commissure was formed after catching cold. After removal of the granuloma, the anterior parts of bilateral vocal folds adhered each other and made extension of laryngeal web. We are hesitating about cutting of the laryngeal web, because that treatment may result in deterioration of pitch-raising surgery. We suppose that in the near future, with the spread of gender clinics, the cases of GID who want to change the voice will visit ENT clinic in various place of Japan.View full abstractDownload PDF (8037K) -
Tomoyuki OGAWA, Shin MASUDA, Marin MIYASATO, Hideki FUKUDA, Hiroyuki T ...2005 Volume 51 Issue 5 Pages 362-366
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSIn medialization laryngoplasty such as thyroplasty type I and arytenoid adduction etc, for intraoperative assessment of vacal cord medialization and voice quality, it is required patient to phonate and surgeon to observe glottis with fiberscope at the appropriate time during the procedure. We performed medialization laryngoplasty under general anesthesia with propofol by target controlled infusion (TCI). Patients were allowed to breath spontaneously. We performed difficult parts and painful parts of surgical procedure under hypnosis. When we discontinued anaesthetizing prior to medialization of the vocal cord, the patient could awake and phonate promptly. We compered laryngeal mask with nasal airway for maintenance of airway. When we observed glottis with fiberscope, in the laryngeal mask cases, a positional adjustment was necessary and mask pushed arytenoid to the median so that there was a possibility that the glottis was not suitable for assessment in those cases. In nasal airway cases, a positional adjustment was unnecessary and the observation of the glottis was easy.View full abstractDownload PDF (8626K) -
Hiroyuki YAMASHITA, Chie TOKITSU2005 Volume 51 Issue 5 Pages 367-369
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSThe poor results of the abduction of vocal cord by Ejnell operation in two patients were reported. Case 1: 74 years of age, woman, larynx palsy on both sides, thyroid cancer post-operative state and cardiac failure. The patient visited our office on September 9th in 1999. She underwent total thyroidectomy and tracheotomy in 1989. The abduction of vocal cord by Ejnell operation were performed to close the tracheotomy on October 26th. However, we could not close the tracheotomy due to dyspnea. Case 2: 64 years of age, man, larynx palsy on both sides, acute myocardial infarction, diabetes melitus. The patients visited our office on February 10th. He had trachyotomy due to dyspnea. We observed larynx palsy on both sides. The abduction of vocal cord by Ejnell operation were performed on October 28th. The taracheal canulae was pulled out post-operatively. However, the canulae was inserted due to dyspnea. The laryngomicrosurgery was perfomed to remove subglottic granulation on August 29th in 2003. The closure of tracheotomy was failed duo to cardiac failure in case 1. The subglottic granulation was made due to diabetes melitus in case 2.View full abstractDownload PDF (5158K) -
Shinzo TANAKA, Ryo ASATO, Masaru YAMASHITA, Haruto IKEDA2005 Volume 51 Issue 5 Pages 370-373
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSA relatively large granuloma in the subglottis was successfully removed with transnasal laryngeal surgery, in which the lesion was repeatedly snatched off with a flexible forceps inserted through a transnasal flexible tube while the larynx was monitored with an endolaryngoscopy through another nasal way. Immediately after surgery, a respiratory distress disappeared and her voice was normalized. Four months after surgery, the granuloma perfectly disappeared. Tracheotomy was not necessary and the patient was satisfied with these results. Our method of transnasal laryngeal surgery is useful as a minimally-invasive surgery for resection of a laryngeal lesion.View full abstractDownload PDF (6947K) -
Tetsuji SANUKI, Nobuhiko ISSHIKI2005 Volume 51 Issue 5 Pages 374-380
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSDiagnosis of adductor spasmodic dysphonia (abbreviated as ADSD hereafter) is primarily based on the patient's complaint i. e. difficulty of phonation and on auditory perception of the voice characteristics of the ADSD. It has been said that the voice of ADSD may roughly be classified into three types ; stress-strangulated, and tremulous, interruption type, and they are frequently mixed in type. Relying on such complaints and data solely, the diagnosis inevitably ends to be subjective, creating discrepancy among the specialists. Over a 7-year period, from 1997 through 2004, 64 patients with ADSD were treated at Isshiki Clinic, Kyoto Voice Surgery Center. In an attempt to improve diagnostic criteria for ADSD, clinical assessment was made on their complaints, symptoms, and laryngeal, perceptual as well as acoustic findings.View full abstractDownload PDF (12776K) -
Tetsuji SANUKI, Nobuhiko ISSHIKI2005 Volume 51 Issue 5 Pages 381-386
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSType 2 thyroplasty or midline lateralization thyroplasty was performed under local anesthesia on 64 patients with adductor spasmodic dysphonia. In sixty of them, the surgery has been successful in relieving vocal stress-strain. Because they had greatly varied symptoms and laryngeal findings, the surgery had to be individually tailored. The most delicate aspect of the technique is how to maintain the localization of the glottis. Successful clinical experiences with the surgery for spasmodic dysphonia support the rationale for surgical treatment.View full abstractDownload PDF (10167K) -
2005 Volume 51 Issue 5 Pages 387-390
Published: September 20, 2005
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSDownload PDF (5569K)
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