Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
Volume 110, Issue 6
Displaying 1-6 of 6 articles from this issue
Original article
  • Gunji Nagatani, Takanori Mori, Tsuyoshi Udaka, Teruo Shiomori, Toyoaki ...
    2007 Volume 110 Issue 6 Pages 447-452
    Published: June 20, 2007
    Released on J-STAGE: December 25, 2008
    JOURNAL FREE ACCESS
    We retrospectively analyzed 71 consecutive cases of early laryngeal cancer (stage I or II) that had undergone primary treatment in our department between 1999 and 2004. There were 68 males and 3 females, and their ages ranged from 40 to 85 years of age (average ; 67.7 years). Eight patients had the supraglottic type, 61 had the glottic type, and 2 had the subglottic type. Chemoradiotherapy was performed as the primary treatment except in the patients with glottic T1a cancer, who received radiotherapy alone.
    The 5-year survival rates was 91.1% for glottic cancer (T1a : 100%, T1b : 92.3%, T2 : 85.8%) and 75.0% for supraglottic cancer. The local control rate of glottic cancer was 79.6% (T1a : 80.0%, T1b : 74.0%, T2 : 85.2%), and significantly higher than that of supraglottic cancer (56.2%, p<0.05). The laryngeal preservation rate was 84.4% in glottic cancer (T1a : 100%, T1b : 76.9%, T2 : 77.5%) and 58.3% in supraglottic cancer, and the difference between T1a and T2 glottic cancer was significant (p<0.05). Local recurrence and cervical lymph node metastasis were seen in 9 patients and 6 patients, respectively. Distant metastasis occurred in 4 patients, all of whom had the glottic type. Four patients died of their disease, and distant metastasis was the major cause of death in 3 of them.
    These results indicate that additional treatment should be performed in cases in which radiotherapy/chemoradiotherapy is ineffective and that both in the early stages glottic and supraglottic cancers can be successfully treated by radiotherapy/chemoradiotherapy.
    The results also suggested that the survival of patients with early laryngeal cancer depends on whether they develop distant metastasis. Introduction of adjuvant chemotherapy to improve their prognosis remains to be assessed.
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  • Masaru Tateda, Takayuki Kudo, Jun Hasegawa, Shun Sagai, Makiko Miyazak ...
    2007 Volume 110 Issue 6 Pages 453-460
    Published: June 20, 2007
    Released on J-STAGE: December 25, 2008
    JOURNAL FREE ACCESS
    Unlike other advanced nations, secondary spread of tuberculosis still occurs in Japan. Cervical tuberculous lymphadenitis is still an important disease of the neck, and between 2001 to 2005, we treated 6 patients with cervical tuberculous lymphadenitis. All 6 patients were females, and their ages ranged from 28 to 77 years old (average : 62 years). One patient had received antitubercular chemotherapy for pulmonary tuberculosis 40 years earlier. Two patients had a family history of pulmonary tuberculosis. One patient was an immigrant from Thailand. Three patients underwent open biopsy of the cervical lymph node, and were diagnosed with tuberculosis histologically. The remaining three patients had an abscess, and fine-needle aspiration (FNA) biopsy was performed. The diagnosis of tuberculosis was made by detection of acid-fast bacilli, MTD (Mycobacterium tuberculosis direct test), PCR (polymerase chain reaction), and culture. All six patients were treated with antitubercular chemotherapy for 6-9 months and recovered. MTD and PCR of the FNA sample seemed to enable early treatment. Attention needs to be paid to countries around Japan where tuberculosis is spreading. We suggest that treatment should be performed while at the same time making an effort to grasp the trend of spread in other countries as well as Japan.
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  • Masahiro Suzuki, Akihiro Terada, Tetsuya Ogawa, Hidenori Suzuki, Yasuh ...
    2007 Volume 110 Issue 6 Pages 461-465
    Published: June 20, 2007
    Released on J-STAGE: December 25, 2008
    JOURNAL FREE ACCESS
    Few reports have covered salvage surgery after radiotherapy, especially with chemotherapy for oral, oropharyngeal, and hypopharyngeal squamous cell carcinoma. The feasibility of salvage surgery is unclear. We analyzed postoperative complications and prognosis after salvage surgery for local recurrence after definitive radiotherapy. Subjects were 37 patients with oral, oropharyngeal, and hypopharyngeal squamous cell carcinoma treated from 1994 to 2003. Of these, 14 (37.8%) had postoperative complications. The complication rate was significantly high in the reconstructive operation group (p=0.031) and the chemotherapy group (p=0.049).
    The 5-year overall survival rate after salvage surgery was 70.7%. Although there was no significant improvement, the prognosis was good in early-stage groups with primary tumors.
    We found that salvage surgery after definitive radiotherapy was effective for recurrent oral, oropharyngeal, and hypopharyngeal squamous cell carcinoma. We stress the need to pay attention to postoperative complications in reconstructive operation and chemotherapy groups.
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  • Toshihito Suda, Ayako Ishii, Keizou Hukuda, Hiroya Utahashi, Masanori ...
    2007 Volume 110 Issue 6 Pages 466-469
    Published: June 20, 2007
    Released on J-STAGE: December 25, 2008
    JOURNAL FREE ACCESS
    The patient was a 63-year-old Japanese male who came to the hospital with a chief complaint of a sore throat. Hypopharyngeal carcinoma (T4N2bM0, stage IVA) was diagnosed, and at the strong request of the patient he was treated by chemoradiotherapy. The tumor markedly decreased in size, but atrial fibrillation was detected when an ECG was performed in preparation for planned a scheduled re-biopsy of the hypopharynx. The echocardiography findings and result of a myocardial biopsy led to a diagnosis of cardiac metastasis by the hypopharyngeal carcinoma. Metastasis by head and neck malignancies is rare, and it is extremely rare for a confirmed diagnosis to be made while the patient is still alive. The case is described together with some discussion of the published literature.
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  • —Comparison of Prosthesis Fixation to the Malleus vs. the Incus—
    Hisayo Nagamine, Miho Arai, Miki Manabe, Kazuoki Kodera
    2007 Volume 110 Issue 6 Pages 470-476
    Published: June 20, 2007
    Released on J-STAGE: December 25, 2008
    JOURNAL FREE ACCESS
    We report the surgical results of stapes surgery using the Schukneht-type wire piston prosthesis performed on 30 ears with fixation of the stapes footplate and absence of the long process of the incus. The prosthesis was reformed to avoid dislocation and fixed to the handle of the malleus. The surgical results in another 49 ears, the comparator group, in which the prosthesis was fixed to the long process of the incus because the anomaly was restricted to fixation of the footplate without other associated anomalies, were also analyzed for comparison.
    The mean postoperative air conduction hearing levels were 28.6dB in the subjects and 21.6dB in the comparator group, and the mean hearing improvements were 35.7dB and 29.7dB, respectively. The success rate of the operation, based on the criteria established by the Japan Otological Society, was 90% in the subjects and 98% in the comparator group.
    The mean postoperative air-bone gap in the subjects was 15.8dB, which was 4.3dB higher than that in the comparator group. The difference between the two groups was considered to be due to the difference in the effectiveness of the conduction mechanism after the surgery. We therefore concluded that the surgical procedure using the Schukneht-type wire piston prosthesis to fix the malleus handle is a useful surgical method that yields satisfactory results.
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