Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
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Volume 117, Issue 11
Displaying 1-19 of 19 articles from this issue
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Review article
Original article
  • Subjective Evaluation of Cochlear Implants through a Questionnaire Survey in 100 Long Term Adult Cochlear Implant Users
    Kyoko Shirai, Atsushi Kawano, Nobuhiro Nishiyama, Akira Hagiwara, Sach ...
    2014 Volume 117 Issue 11 Pages 1329-1338
    Published: November 20, 2014
    Released on J-STAGE: December 19, 2014
    DOIhttps://doi.org/10.3950/jibiinkoka.117.1329
    JOURNAL FREE ACCESS
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    　The satisfaction level is one of the important parameters to evaluate the effectiveness of cochlear implant (CI) in adult CI users. The purpose of this study is to investigate what factor improves the satisfaction level in adult CI users. Questionnaires were used to evaluate the items concerning the satisfaction level. One hundred patients who underwent cochlear implant placement at or over the age of 20 years were enrolled in this study. All patients had an experience of at least 5 years of CI use. To evaluate the effect of CI, questionnaire items were answered about the common communicative methods, listening under various situations, points of dissatisfaction, useful level, anxiety level without CI, satisfaction level, and the duration of CI usage. Sixty two percent of the patients were satisfied with the effect of CI and 80% felt that their CI was useful. Their listening results tended to be better in quieter environments or conversation in small groups. Furthermore, listening was related to the useful and satisfaction levels. Therefore, the better they could hear, the more they were satisfied with their CI, and appreciated its usefulness. The frequency of using CI as a communicative method (application level of CI) was statistically related to useful level, but no statistical relationship was seen between the application level of CI and anxiety level or satisfaction levels. These results suggest that other factors such as psychological status might affect the satisfaction level in addition to the CI application level. We concluded that it was necessary for us to understand the listening level before CI surgery in order to predict the postoperative course and to give an appropriate explanation to the patients.
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  • What Is the Role of Otolaryngologists in Deglutition Practice?
    ―A Survey for Medical Practitioners in Different Fields―
    Yurika Kimura, Tomofumi Kato, Midori Nagaoka, Keiko Ono, Koichiro Nish ...
    2014 Volume 117 Issue 11 Pages 1339-1348
    Published: November 20, 2014
    Released on J-STAGE: December 19, 2014
    DOIhttps://doi.org/10.3950/jibiinkoka.117.1339
    JOURNAL FREE ACCESS
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    　The advent of a super aging society is causing a rapid increase in the number of patients with dysphagia, and, in response, the use of percutaneous endoscopic gastrostomy (PEG) has become markedly widespread over the past decade. As the result of its rapid spread, PEG is controversial both ethically and economically, and, in the revision of medical treatment fees for 2014, the preoperative deglutition usability test of all cases is fixed for the full amount request requirements of gastrostomy. Thus, the demands on dysphagia practice are rising. Therefore, we conducted a survey of the dysphagia practice of otolaryngologists, doctors, and speech therapists in charge of dysphagia practice in hospitals, home medical care clinics, and dental offices in Itabashi-ku, Tokyo, and we considered the role of otolaryngologists in dysphagia practice. According to the survey, the roles that are expected of otolaryngologists in dysphagia practice are the evaluation of swallowing function using videoendoscopic examination of swallowing in over 50% of home medical care clinics and dental offices. On the other hand, surgical treatment is expected of otolaryngologists in over half in the hospital group. A total of 64% of the home care clinic group and 47% of the dental group did not coordinate with otolaryngologists in dysphagia practice because there are no otolaryngologists to consult. The home care clinic group indicated a demand of the swallowing function test in short-term admission or home practice. In the survey of departments of otolaryngology in hospitals or otolaryngology clinics, 40% of these institutions evaluate deglutition, while the other institutions did not perform evaluations because of the lack of human resources or deficient facilities.
    　The otolaryngologist specializes in the laryngopharynx where aspiration occurs, and not only diagnoses local organic disease, but also directs the patient to a doctor in an appropriate department on the basis of understanding the patient's background diseases. We conclude that organized participation and leadership in this region are urgent tasks of otolaryngologist.
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  • An Endoscopic Transnasal Transsphenoidal Biopsy for Pituitary Gland Langerhans Cell Histiocytosis in a Child: a Case Report
    Hisao Amatsu, Tsunemasa Aiba, Tomoaki Nakano, Naomi Koshimo, Ayako Kin ...
    2014 Volume 117 Issue 11 Pages 1349-1355
    Published: November 20, 2014
    Released on J-STAGE: December 19, 2014
    DOIhttps://doi.org/10.3950/jibiinkoka.117.1349
    JOURNAL FREE ACCESS
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    　Endoscopic transnasal transsphenoidal surgery is gaining wide acceptance as the first-line treatment of pituitary tumors in adults, as this procedure is minimally invasive and associated with good outcomes. On the other hand, conventional transcranial and sublabial approaches are chosen for infants as their small anatomical structures pose some difficulty.
    　This study reports on the case of a 5-year-old boy who had a Langerhans cell histiocytosis appearing in the sella. The biopsy was performed using the endoscopic transnasal transsphenoidal approach, and the patient has not exhibited any post-operative complications. Although the patient was a fairly young child, the endoscopic transnasal transsphenoidal approach resulted in fewer complications as compared to the transcranial and translabial approaches. Otolaryngologists, therefore, should view this approach more positively. The indication for pediatric skull base diseases can be expected to expand to include endoscopic transnasal surgery.
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  • Four Cases of Extracranial Trigeminal Benign Neurogenic Tumors
    Yusuke Mada, Yuji Ueki, Akiyoshi Konno
    2014 Volume 117 Issue 11 Pages 1356-1361
    Published: November 20, 2014
    Released on J-STAGE: December 19, 2014
    DOIhttps://doi.org/10.3950/jibiinkoka.117.1356
    JOURNAL FREE ACCESS
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    　Extracranial trigeminal schwannomas are rare tumors accounting for about 10% of all trigeminal schwannomas. We report herein on four cases of extracranial trigeminal benign neurogenic tumors. The patients were aged between 39 and 75 years; they consisted of one male and three females. The origins of the schwannomas consisted of the maxillary nerve in two cases and the mandibular nerve in two cases. All cases were surgically treated using a transmaxillary approach in three cases, and a combination of the transcervical-parotid approach with a midline mandibulotomy in one case. In two cases, the schwannomas located in the pterygopalatine fossa were removed using a transmaxillary approach with the endoscope and the surgical microscope. Two patients underwent selective intravascular embolization of the feeding artery to reduce intraoperative bleeding, and they were less invasively treated via the transmaxillary approach.
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  • Parotidectomy for Parotid Gland Tumor Using a Retrograde Approach from the Peripheral Branches of the Facial Nerve
    Ryusuke Hori, Kazuhiko Shoji, Kiyomi Hamaguchi, Tsuyoshi Kojima, Yusuk ...
    2014 Volume 117 Issue 11 Pages 1362-1366
    Published: November 20, 2014
    Released on J-STAGE: December 19, 2014
    DOIhttps://doi.org/10.3950/jibiinkoka.117.1362
    JOURNAL FREE ACCESS
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    　There are two techniques for excising a parotid gland tumor. The first technique is the anterograde approach, and the second is the retrograde approach. Although the anterograde approach has generally been adopted, the retrograde approach may be useful depending on the identification and dissection of the facial nerve and the localization of the tumor. We reviewed 35 patients who were surgically treated with a parotidectomy using the retrograde approach between 2002 and 2012 at Tenri Hospital. We also reviewed the clinical records for evidence of temporary or definitive injury to the facial nerve. In cases where the identification of the main nerve trunk was expected to be difficult, the parotidectomy was performed using the retrograde approach guided by the mandibular branch. In cases where a tumor was located in the marginal region of the parotid gland, the retrograde approach was guided by the mandibular branch or the zygomatic branch. Of the 35 patients, 17 underwent the retrograde approach guided by the mandibular branch and 18 underwent this approach guided by the zygomatic branch. The mean surgical time and amount of bleeding using the retrograde approach were 70.7 minutes and 33.9 g, respectively. Two of the 35 patients in the retrograde group exhibited a temporary facial deficit.
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Final Lecture
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Lifelong learning for Board Certified Otorhinolaryngologist
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