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Volume 103, Issue 1
Displaying 1-5 of 5 articles from this issue
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Nobuyoshi Otori, Shinichi Haruna, Mamoru Yoshiyuki, Hiroshi Moriyama2000 Volume 103 Issue 1 Pages 1-6
Published: January 20, 2000
Released on J-STAGE: December 15, 2008
JOURNAL FREE ACCESSWe evaluated the advantages and disadvantages of image-guided endoscopic endonasal surgery for various diseases. Thirty-threc patients, including 8 with chronic sinusitis, 14 with paranasal cysts, 1 with paranasal tumor (biopsy), 1 with sellaturcial cyst (Rathke's cleft cyst) and 9 with pituitary tumors were endonasally operated on from September 1998 to May 1999, with an electromagnetic navigation system, The Insta TrakTM (Visualization Technology Inc. USA). The Insta TrakTM system is composed of a computer, a metal probe with a nonmetallic suction tube attachment, and a soft-type headset with an electromagnetic sensor. This freehand, armless system compensates well for patient's head movement during surgery, and precludes the need for head fixation. Either straight or curved suction tube (probe) can be used to access almost of all pathological sites in the sinus cavity. Location of the metal probe is displayed on the computer moniter as an intersection point on the axial, coronal and sagital CT images. In all cases, Insta TrakTM showed the surgeon the appropriate location and direction of each lesion. The Insta TrakTM also indicated the location of the orbit, optic canal, nasolacrimal duct and/or skull base, thus, preventing intraoperative complications. When the anatomy was distorted by previous surgery and/or when there was uncontrollable bleeding from a severe lesion so that the surgeon had difficulty finding the proper orientation, the usefulness of image-guided surgery was sufficiently recognized, However, the following disadvantages were also pointed out. An additional 15 to 20 minutes is needed for equipment set up and operation, unless the surgeon and the operation room staff are familiar with the machine. The patient's CT image used for navigation relies on data obtained preoperatively, that is to say. it can not reflect morphological changes produced during surgery. Moreover, the surgeon must consider possible errors of the navigational point that may result in the headset during surgery, as well as, errors the machine may originally possess. The image-guided system success. fully integrated the most up to date computer technology with a surgeon's anatomical knowledge for improved treatment of endoscopic endonasal surgery. However, we also concluded that the system should be used as a surgical supporting device for safer and more adequate procedures.View full abstractDownload PDF (2216K) -
Tadashi Kitahara, Kazumasa Kondoh, Junko Murata, Shin-ichi Okumura, Ya ...2000 Volume 103 Issue 1 Pages 7-12
Published: January 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSBecause profound bilateral hearing impairment is a catastrophic event, the management and care of an individual with an 8th nerve lesion in an only/better hearing ear remains a significant challenge for both patient and physician. Current options regarding the treatment of the acoustic tumor in an only better hearing ear include: observation, attempted hearing preservation surgery and stereotactically guided radiation therapy. In this article, we present 3 cases of acoustic tumor within the internal auditory canal in an only/better hearing ear diagnosed by gadolinium enhanced MRI and discuss the recommendations, especially observation, available in the care of these cases. In one patient, hearing disturbance caused by the tumor in a better hearing ear made the patient quite depressive and desperate. One of the most important consideration is for the physician to provide the patient with adequate informed consent regarding the possibility of profound bilateral hearing loss caused by either the natural growth or surgical removal of the tumor in the future, and alternative methods of communication with others such as: hearing aid and lip reading, cochlear implant and brainstem implant.View full abstractDownload PDF (2177K) -
Hiroyuki Yamada, Akihiko Katoh, Hajime Ishinaga2000 Volume 103 Issue 1 Pages 13-18
Published: January 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSIn our hospital, ultrasonography is performed for patients who come for thyroid cancer screening. Seventyeight patients with thyroid cancer which was found by such screening were operated on from 1989 to 1998, while 287 patients with thyroid cancer found by other methodd were operated on during the same period in our department The age of the patients at surgery in the screening group was younger than that of the contrast group. In the screening group, 41 (52.6%) patients had small thyroid cancer, a higher rate that in the contrast group Invasion of surrounding organs by the primary cancer was observed in only one patient (1.3%) in the screening group, a rate of invasion that was statistically lower than that in the contrast group.
Twenty-six patients with benign thyroid disease detected in our screening were operated on during the same period.
Careful selection of patients who need fine-needle aspiration cytology is demanded of head and neck surgeons, and careful evaluation of indicators is necessary to avoid surgery in the case of benign thyroid disease.View full abstractDownload PDF (684K) -
Mitsuko Suetake, Mihoko Irimada, Shin Takahashi, Kenji Ohyama, Kimiko ...2000 Volume 103 Issue 1 Pages 19-23
Published: January 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThis study was undertaken to investigate whether each episode of recurrent acute otitis media (rAOM) is caused by the same strain of bacteria or different strains at each episode.
Seventy infants less than 3 years of age having experienced rAOM for a period shorter than 8 weeks, were selected and included in the present study. The total number of AOM episodes experienced by this group was 282.
At each subsequent episode of AOM otorrhea and nasopharyngeal swabs were taken for bacterial culture and determination of the MIC for antibioties When S. pneumoniae was identified, its serotype, and its pbp, ermAM, and mdE genes were also investigated to determine the bacterial species and strains.
S.pneumoniae was the most frequently cultured bacteria with 26 penicillin-sensitive S. pneumoniae (PSSP), 65 penicillin insensitive S. pneumoniae (PISP). and 50 penicillin resistant S. pneumoniae (PRSP). H. influenzae was the next most frequently cultured bacteria of which 65 were sensitive to penicillin, 27 were found to be β-bactamase-negative ampicillin-resistant (BLNAR) and 17 were found to be β bactamase positive.
Bacteria cultured from each pair of two successiv episodes of AOM were compared as to the identity of the bacteria during the two episodes. In 150 out 202 pairs (74%), the cultured pathogen was different. In 22 cases in which either PISP or PRSP was the pathogen detected in two consecutive AOM episodes, 15 cases (68%) were found in which the involved strain differed between the two episodes. This study indicates that the pathogen involved in rAOM is likely to differ at each episode of A0M, not only in cases caused by PSSP, but also in those caused by PRSP.View full abstractDownload PDF (1014K) -
Tomoko Tsukuda, Fumiyo Kudo2000 Volume 103 Issue 1 Pages 24-27
Published: January 20, 2000
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSIn general, patients who suffer from pharyngeal foreign bodies can explain the time and nature of the object which had been swallowed, resulting in easy diagnosis. However, in infants, difficulty in communication makes diagnosis troublesome. Two cases of long standing pharyngeal foreign bodies were treated at our hospital. Case I was a 16 month old girl complaining of stridor and fever. She had fallen with a toothbrush in her mouth two months before, and was hospitalized in the pediatrics department for one week with upper airway inflammation and dehydration, A toothbrush head was embedded in the back wall of the mesopharynx and hypopharynx. Case 2 was a 10 month old boy complaining of dysphagia and failure in weight gain, He was hospitalized in the pediatrics department with pneumonia two months before. A PTP (press through pack for medicine) was embedded in the back wall of the hypopharynx. We removed both foreign bodies under general anesthesia.View full abstractDownload PDF (1460K)
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