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Volume 109, Issue 2
Displaying 1-8 of 8 articles from this issue
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[in Japanese]2006 Volume 109 Issue 2 Pages 75-83
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESS -
Hidenori Kanebayashi, Ryoji Tokashiki, Hiroyuki Hiramatsu, Mamoru Suzu ...2006 Volume 109 Issue 2 Pages 84-87
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSTechniques and the outcome of our approach that combined two operations, a direct pull of the lateral cricoarytenoid muscle (LCA-Pull) and Isshiki's thyroplasty type I are reported. LCA-Pull is very simple and allows natural adduction of arytenoid by pulling LCA. The subjects were five patients whose maximal phonation time (MPT) were under 5 seconds. All patients achieved MPT over 13 seconds. Mean flow rates (MFR) varied from 340ml/s to over 1000ml/s before the operation. In all patients, the post operative MFR improved to under 150ml/s. Sometimes severe unilateral vocal cord paralysis requires both arytenoid adduction and medialization thyroplasty to obtain good voice. Combination of LCA-Pull and thyroplasty type I is very effective for severe case, and could be done in the same operating field by creating an additional window in the thyroid ala.View full abstractDownload PDF (1048K) -
Toshiki Tomita, Kaoru Ogawa, Takamasa Tagawa, Masato Fujii, Hideo Name ...2006 Volume 109 Issue 2 Pages 88-95
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSDespite its rarity, information on the diagnosis of parapharyngeal space tumors such as through imaging and aspiration biopsy cytology, is slowly accumulating. Little detailed examination has been conducted, however, on surgical approach, complications, and sequelae. We report the results of a retrospective review of 27 patients with primary parapharyngeal space tumors-25 with benign disease and 2 with malignant lesions-treated surgically. Surgical approach, postoperative complications, sequelae, and operative indications of parapharyngeal space tumors were examined in 28 operations on the 27 patients.
Tumors found in the prestyloid region in CT or MRI are treated as salivary gland or malignant tumors. Those found in the poststyloid region are treated as shwannoma or paraganglioma. The transcervical approach is often used in patients with shwannoma, while a variety of approaches are selected for patients with salivary gland tumors. Complications occur in 50% of patients, however, bias based on pathological diagnosis has not been examined to the degree needed. Sequelae in our series occurred in 46.4% of our patients. Sequela in the patients with shwannoma, however, is 81.8%, compared to 9.1%, in patients with salivary gland tumors.
Prestyloid parapharyngeal space tumors seem to be "automatically" indicated for surgery, because the surgical risk is lower than the risk of inaction. In poststyloid parapharyngeal space tumors, however, it appears necessary to judge indication for surgery more carefully while considering the social background, age, and occupation of prospective surgical candidates.View full abstractDownload PDF (1367K) -
Toyoaki Ohbuchi, Tsuyoshi Udaka, Naokimi Tokui, Hidenaga Yamamoto, Ter ...2006 Volume 109 Issue 2 Pages 96-102
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSInternuclear ophthalmoplegia (INO) is a distinctive ocular motor disorder resulting from dysfunction of the medial longitudinal fasciculus, which lies in the pontine tegmentum. We retrospectively analyzed clinical and magnetic resonance imaging (MRI) findings for four consecutive patients with internuclear ophthalmoplegia who were treated in our hospital. The causes of the disease were cerebral infarction in three cases and multiple sclerosis in one case. Vertigo and facial nerve palsy were associated in three cases and one case, respectively. MRI studies visualized an ischemic lesion in the responsible portion of the brainstem in one patient but failed to reveal responsible lesions in the other three patients. All the patients completely recovered in 1 to 22 days, with an average recovery period of 9.3 days. The etiology, diagnosis and management of INO were bibliographically reviewed.View full abstractDownload PDF (2742K) -
Kikuo Sakamoto, Hideki Chijiwa, Yoshimi Miyajima, Hirohito Umeno, Tada ...2006 Volume 109 Issue 2 Pages 103-111
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSThe clinical features of 74 patients (39 men, 35 women; mean age, 62 years) with malignant parotid tumors were retrospectively investigated. According to the TNM Classification, 4 patients were classified as T1, 9 as T2, 6 as T3, and 55 as T4. Fifty cases were staged as N0, 9 as N1, 14 as N2 and 1 as N3. Tumors located in both lobes of the parotid gland were the most frequent type of tumor (49%). Twenty-four percent of the 74 patients exhibited facial nerve palsy before treatment. Facial palsy was found predominantly in cases with a higher T classification or with deep lobe occupation. Histopathologically, sixteen tumor types were observed; mucoepidermoid carcinoma was the most common.
The overall five-year and ten-year survival rates determined using the Kaplan-Meier method were 65% and 61%. The factors influencing a poor outcome were T4 classification (p=0.0189), an N+stage (p<0.0001), and facial palsy (p<0.0001). As for the major histopathologic types, the five-year survival rates were 69% for mucoepidermoid carcinoma, 48% for adenocarcinoma, 71% for adenoid cystic carcinoma, and 100% for acinic cell carcinoma and malignant mixed tumor.
With respect to the treatment modality, patients who were classified as T1 or T2 and whose tumors were located in the superficial lobe without facial nerve invasion could be satisfactorily treated with only a superficial lobectomy conserving the facial nerve. A total parotidectomy with total removal of the facial nerve seemed necessary for T3 and T4 cases, especially those with adenocarcinoma or mucoepidermoid carcinoma. Modified neck dissection may be necessary for N0 cases, especially those with adenocarcinoma, adenoid cystic carcinoma or undifferentiated carcinoma. Nerve grafting after total nerve resection is recommended for a better quality of life.View full abstractDownload PDF (701K) -
[in Japanese]2006 Volume 109 Issue 2 Pages 124-127
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
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[in Japanese]2006 Volume 109 Issue 2 Pages 128-129
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSDownload PDF (189K) -
[in Japanese]2006 Volume 109 Issue 2 Pages 129-131
Published: February 20, 2006
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSDownload PDF (248K)
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