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Volume 108, Issue 11
Displaying 1-8 of 8 articles from this issue
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[in Japanese]2005 Volume 108 Issue 11 Pages 1067-1070_1
Published: November 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESS -
[in Japanese], [in Japanese], [in Japanese]2005 Volume 108 Issue 11 Pages 1071-1076_2
Published: November 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESS -
Akinori Kashio, Mitsuya Suzuki, Hidetoshi Watanabe2005 Volume 108 Issue 11 Pages 1077-1082
Published: November 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSHardy's operation using a microscope has long been the standard for treating pituitary adenoma. A new endonasal approach to the sella using an endoscope combined with a navigation system has been reported, which we used to conduct endocopic endonasal hypophysectomy from October 2000 to June 2003 in 11 patients with pituitary lesions. We introduced an angle-dependent navigation system, Neuro Navigator III. We approached the sphenoid sinus mainly via the hemilateral common meatus. The deviation of the nasal septum and sphenoidal septum was carefully evaluated to determine the optimal operating side. We concluded that the hemilateral common meatus route is useful because it is least invasive in endocopic endonasal hypophysectomy. Another route should be taken, however, if hemorrhaging is uncontrollable or the tumor is quite large. Navigation systems are quite effective in executing this operation safely. Angle-dependent navigation system is a good choice for this operation, considering its cost performance.View full abstractDownload PDF (4997K) -
Kei Ijichi, Yasuhisa Hasegawa, Tetsuya Ogawa, Akihiro Terada, Ikuo Hyo ...2005 Volume 108 Issue 11 Pages 1083-1090
Published: November 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSIn patients with cervical adenopathy, especially, those of cervical lymph node metastasis with no detectable primary tumor, diagnosis and treatment planning can become confused.
We evaluated 36 patients with cervical lymph node metastasis of unknown origin between 1985 and 2002.
Primary sites were detected in 20 before treatment. The other 36 patients clearly had no primary lesions when treatment started. Primary sites were 5 cases of oropharynx, 2 of the parotid gland, and 1 each of larynx, nasopharynx, hypopharynx, and malignant lymphoma detected in 11 after treatment for cervical lymph nodes. No primary lesion was found in 28 patients.
The neck LN stage was N1 in 11 patients, N2 in 29, N3 in 11, and unknown in 8.
To detect the primary site, we conducted “random” biopsy, panendoscopy, and radiographic evaluation including FOG-PET Biopsy sites were the nasopharynx, palatine and lingual tonsil, and piriform sinus. Some 35 patients (59.3%) underwent random biopsy, and primary sites were found this way in 5 patients (14.3%).
The 36 who had no primary lesion were treated for cervical lymph nodes, of whom 24 underwent neck dissection. Chemotherapy and radiotherapy were the treatment of choice in many cases.
We analyzed 31 patients for 5-year survival. Overall survival was 63.7%, disease-specific survival 69.2%, and diseasefree survival 46.8%. In another analysis a statistically significant difference was seen in survival among patients who had neck surgery or not (85.7% vs. 38.9%, p=0.029; log rank test).
Analysis suggested that primary sites should be studied by CT. MRI, FDG-PET, and panendoscopy, including random biopsy. The primary site cannot be detected, treatment should initially involve cervical adenopathy with combined surgery, chemotherapy, and radiotherapy. After treatment, the patient should be followed up carefully to find the primary lesion.View full abstractDownload PDF (2391K) -
Hiroyoshi Yoshinami, Hideki Takegoshi, Shigeru Kikuchi, Toshitaka Iinu ...2005 Volume 108 Issue 11 Pages 1091-1100
Published: November 20, 2005
Released on J-STAGE: February 18, 2011
JOURNAL FREE ACCESSThe external nasal dilator Breathe Right® is a nonprescription disposable mechanical device worn over the bridge of the nose that supports the outer walls of the nasal vestibule to increase cross-sectional nasal valve area and enhance air flow through the nose. When worn, the device applies a gentle outward pull to the outside walls of the nasal vestibule that helps prevent collapse of the lateral walls of the nasal vestibule. The device appears similar to an adhesive bandage with two polyester springs attached lengthwise to the nonadhesive side of the hacking material. The form of the external nose varies significantly between racial groups and some comment is possible about the form of the nasal valve, i.e., Caucasian noses are leptorrhine, Negroid noses platyrrhine, and Oriental noses intermediate. A question exists about whether Breathe Right® is as effective in Japanese as in Caucasians against nasal obstruction. We measured the effect by acoustic rhinometry in 35 healthy subjects. We measured 2 cross sectional areas the I-notch and C-notch-and 3 nasal volumes-V (0-1), from 0 to 1 cm corresponding to the I-notch, V (1-3). from 1 to 3cm corresponding to the C-notch, and V (3-6), from 3 to 6cm.
We studied the influence of the nasal cycle on the effect of Breathe Right® in the nasal cavity.
We evaluated subjects in a stable sitting position before applying Breathe Right®, after using 5 minutes, and in a free interval of 25 minutes following. The experiment was repeated 10 times. We found that Breathe Right® increases the nasal volume especially in V (1-3) and the cross-sectional area especially in the C-notch. Interestingly, the change in the C-notch decreased gradually with time. One possible mechanism may be the change in compliance between the skin under the Breathe Right® and the nasal mucous membrane. The nasal cycle did not significantly influence the effect of Breathe Right®.View full abstractDownload PDF (2228K) -
Satoshi Seno, Mikio Suzuki, Hironori Sakurai, Tsuyoshi Kitanishi, Dais ...2005 Volume 108 Issue 11 Pages 1101-1109
Published: November 20, 2005
Released on J-STAGE: December 22, 2010
JOURNAL FREE ACCESSWe evaluated the effectiveness of two navigation systems with optical tracking in endoscopic sinus surgery (ESS). The Signa SP/i Intraoperative navigation system (General Electric Co., Intraoperative NS) is advantageous in acquiring both real-time and high-resolution images during surgery, compared to conventional image-guided navigation (Stealth Station TREON® Medtronic Inc., IGNS) that rely entirely on preoperative three-dimensional images. We studied the following in 14 patients treated with intraoperative NS and 19 treated with IGNS: 1) additional time for navigation system implementation, 2) available instrumentations in ESS, and 3) navigation system accuracy.
Navigation systems required additional time to prepare ESS. The time lapse from admittance to the operating room to ESS onset was measured in patients under both systems and controls undergoing ESS without any image guidance. Preparation of the intraoperative NS required an additional 52 min and IGNS required 17 min compared to the control group. Based on operative instruments, the intraoperative NS has some limitations arising from the application of a high magnetic field. Surgical instruments must not be attracted by the magnetic field in the operating room. So those used in our study were thoroughly examined and some remanufactured using MR-safe materials. All instruments in ESS could be used in surgical guidance during surgery in the IGNS. Anatomic landmarks were accurately visualized using intraoperative NS and IGNS. Intraoperative NS renews the image during surgery, so surgeons could confirm the surgical outcome during ESS. Since the average distant error in both systems was between 1 mm and 2.5 mm, we confirmed that accuracy obtained with both navigation system was suitable for ESS completion. The intraoperative NS renewed the image during navigation.
In conclusion, both navigation systems are sufficient for accurate image navigation in ESS, but navigation systems must be selected based on the individual case.View full abstractDownload PDF (7239K) -
Satoshi Iwasaki, Yasuyuki Hashimoto, Mituyoshi Nagura, Satoru Takebaya ...2005 Volume 108 Issue 11 Pages 1110-1113
Published: November 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSThe bone-anchored hearing aid (BAHA) is an implantable bone-conduction device that vibrates the skull directly via a surgically implanted titanium screw behind the ear. The BAHA has advantages for patients with aural atresia or chronic ear drainage, who cannot wear air-conduction hearing aids. We compared the function of BAHA to conventional bone and air-conduction hearing aids based on functional gain and speech discrimination tests in quiet and noisy environments in 2 patients with chronic ear problems.
All expressed a clear preference for the BAHA over conventional bone-conduction hearing aids. The BAHA and air-conduction hearing aid provided similar audiological performance when the functional gain of each hearing aid coincided. As the air-bone gap widens, however, audiological performance with the BAHA showed an evident preference, indicating that the width of the air-bone gap is of some help in BAHA preference compared to air-conduction hearing aids.View full abstractDownload PDF (478K) -
[in Japanese]2005 Volume 108 Issue 11 Pages 1114-1117
Published: November 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSDownload PDF (2034K)
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