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Volume 108, Issue 5
Displaying 1-6 of 6 articles from this issue
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Yutaka Hanamure, Norimitsu Tanaka, Takayuki Kawabata, Fujihiko Kasano, ...2005 Volume 108 Issue 5 Pages 513-521
Published: May 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSJuvenile nasopharyngeal angiofibromas (JNAs) are benign tumors that occasionally invade the pterygopalatine fossa, infratemporal fossa, or middle cranial fossa. Several surgical approaches have been used based on the location of the tumor, including transpalatal, transmaxillary, and lateral rhinotomy, midfacial degloving, and Le Fort type I osteotomy. We reviewed 4 cases of JNA that had been treated by resection in the Department of Otolaryngology of Kagoshima City Hospital and 31 cases of JNA reported in the Japanese literature between 1990 and 2003. We analyzed the outcome of the surgical treatment of JNA in these cases to identify the surgical approaches that were most effective in removing tumors at several different stages. Radkowski staging showed that 17 (48.6%), 2 (5.7%), 4 (11.4%), 9 (25.7%) and 3 (8.6%) patients had stage IA, IB, IIA, IIC, and IIIA tumors, respectively. A transpalatal approach was employed in 11 cases (31.4%), a transmaxillary approach in 9 cases (25.7%), a transnasal approach in 6 cases (17. 1%), and other approaches, including midfacial degloving, Le Fort type I osteotomy, lateral rhinotomy, and the craniofacial approach in 9 cases (25.7%). The recurrence rate was 5% in the stage I cases, 38% in the stage II cases, and 33% in the stage III cases. The transpalatal approach was followed by a high recurrence rate in the cases of stage II and higher stage. Several factors are critical when choosing the surgical approach to JNA: adequate exposure of the tumor, ability to control bleeding, prevention of postoperative facial deformity, and avoidance of interference with growth of the face.View full abstractDownload PDF (2497K) -
Carcinoma Study of Patients, It's Feasibility, and ProblemsYoshihiro Ohno, Naoyuki Kohno, Takeo Kanaya, Kazutaka Nakamura, Tetsuy ...2005 Volume 108 Issue 5 Pages 522-527
Published: May 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSWe assessd the feasibility and problems associated with sentinel lymph node (SLN) study in 13 cases of oral and pharyngeal squamous cell carcinoma (SCC) that were neck-node-negative clinically. The primary sites were the tongue (n=10), other sites in the oral cavity (n=2), and the mesopharynx (n=1). The day before surgery, tracer was injected into the submucosa around the tumor, and scintigraphic images were acquired 2 hours later. The SLN was identified intraoperatively with a handheld gamma probe, and neck dissection, including the SLNs, was performed. Radioactivity within the nodes was confirmed with a well-type scintillation counter, and all resected lymph nodes were histologically examined for metastasis. The SLN was identified in every case. There were regional lymphnode metastases in 4 cases, and metastasis to the SLNs was present in all of 4 cases. Thus, the SLN concept was valid for head and neck SCC, sentinel node navigation surgery (SNNS) was thought to be applied in stage NO SCC of the head and neck. If SNNS is performed, about 70% of patients do not require neck dissection. SNNS is feasible and cost-effective in these cases. We used two different tracers: phytate and tin colloid, and found that phytate was more useful. To avoid the effects of the shine-through phenomenon, it was thought that some directions of lymphoscintigram should be taken. For intraoperative identification of the SLNs, care should be taken to the angle of gamma probe. SLN study leads to clarify each patient's lymphoid flow mapping, and it is also useful to determine the dissection area of selective neck dissection.View full abstractDownload PDF (3150K) -
Nobuko Makino, Yasushi Ohta, Toshio Ishikawa, Keiichi Ichimura2005 Volume 108 Issue 5 Pages 528-532
Published: May 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSPurpose: To evaluate the systemic effects of intranasal steroid drops in patients with dysosmia.
Cases and Methods: Intranasal steroid drops were administered for 12 weeks to 23 patients with dysosmia, and their plasma cortisol and adrenocorticotropic hormone (ACTH) values were measured before and after treatment. Improvement in dysosmia was judged based on the standerd olfactory test and the patients' symptoms.
Results: The post-treatment plasma cortisol levels ranged from 0.1 to 25.0μg/dl (5.4±5.9μg/dl), and the posttreatment plasma ACTH levels ranged from 5.0 to 55.0pg/ml (13.8±11.7pg/ml). After treatment, the 23 cases were divided into two groups: 14 cases (60.9%) with a decline in cortisol and/or ACTH level, and 9 patients (39.1%) with normal plasma cortisol and ACTH levels. Improvement in dysosmia was found in 4 patients (28.6%) in the former group and 4 patients (44.4%) in the latter group. The difference in percentage of patients who improved was not significant between the groups.
Conclusions: We conclude that the direct topical effect of intranasal steroid drops on the olfactory mucosa may have been the principal reason for the improvement in the patients' dysosmia.View full abstractDownload PDF (481K) -
Hiroaki Katano, Yukiko Iino, [in Japanese], Kazuoki Kodera, Yoshihiko ...2005 Volume 108 Issue 5 Pages 533-536
Published: May 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSWe report the histopathological findings in the temporal bone of a 30-year-old female who died of cervical esophageal carcinoma. The temporal bone sections revealed severe bilateral suppurative labyrinthitis and otitis media that presumably occurred immediately before her death. Many inflammatory cells were present in the middle ear, particularly around the stapes and the round window niche. They had also infiltrated the inner ear via the annular ligament of the stapes and the round window membrane. Inflammatory cell accumulation was also observed in the peri-and endolymphatic spaces, and it was most severe in the basal turn. Most of the inner and outer hair cells were preserved, but some had degenerated or were missing. Numerous round cells were observed in the modiolus, and some of the spiral ganglion cells had degenerated. On the basis of these findings, we concluded that bacterial otitis media had extended in to the inner ear via the oval window and round window membrane and had resulted in suppurative labyrinthitis. These findings are consistent with those of stage II suppurative labyrinthitis according to the classification of Schuknecht.View full abstractDownload PDF (2500K) -
[in Japanese]2005 Volume 108 Issue 5 Pages 538-541
Published: May 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSDownload PDF (349K) -
[in Japanese]2005 Volume 108 Issue 5 Pages 542-543
Published: May 20, 2005
Released on J-STAGE: October 22, 2010
JOURNAL FREE ACCESSDownload PDF (212K)
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