Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
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Volume 119, Issue 2
Displaying 1-13 of 13 articles from this issue
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Review article
Original article
  • Otologic Manifestations in Patients with ANCA Associated Vasculitis-Comparative Analysis among Microscopic Polyangiitis, Granulomatosis with Polyangiitis and Eosinophilic Granulomatosis with Polyangiitis
    Yoshiyuki Kawashima, Yoshihiro Noguchi, Taku Ito, Kota Mizushima, Masa ...
    2016 Volume 119 Issue 2 Pages 110-117
    Published: February 20, 2016
    Released on J-STAGE: March 10, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.110
    JOURNAL FREE ACCESS
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    　Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) include microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA), the incidences of which are reported to be increasing in Japan. We reviewed the clinical records of 20 cases with systemic AAVs (five cases with MPA, nine cases with GPA, and six cases with EGPA), who visited our otolaryngology department with otological symptoms from 2004 to 2014, and compared the otological characteristics among the diseases. Otologic symptoms appeared as an initial symptom(s) in 40% of MPA cases, 56% of GPA cases, and 83% of EGPA cases. GPA and EGPA cases showed a variety of symptoms such as otalgia, otorrhea, hearing loss, ear fullness, tinnitus and dizziness, while MPA cases showed only hearing loss and ear fullness, but otalgia or otorrhea. AAVs and otitis media associated with ANCA vasculitis (OMAAV) are usually diagnosed shortly after the appearance of otological symptoms in GPA cases, while the final diagnosis is delayed in EGPA cases. Furthermore, the diagnosis of OMAAV was made after the diagnosis of AAV in most cases of EGPA. More than half of MPA cases did not meet the diagnostic criteria for OMAAV. It is noteworthy that in a significant number of AAV patients with ear disease, otological symptoms are supposed to appear as an initial symptom(s). Therefore, otolaryngologists have a major role to achieve early diagnosis of AAV. The patients with adult-onset inflammation of the middle ear, inner ear or both should undergo careful examinations, and they should be closely followed even if the diagnosis is uncertain.
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  • A Case of Cystic Cervical Lymph Node Metastasis of HPV-positive Tonsil Cancer, Being Discriminated as the Branchiogenic Carcinoma
    Rumi Kambara, Masamitsu Tamai, Arata Horii
    2016 Volume 119 Issue 2 Pages 118-124
    Published: February 20, 2016
    Released on J-STAGE: March 10, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.118
    JOURNAL FREE ACCESS
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    　In recent years, human papillomavirus (HPV)-positive oropharyngeal carcinomas have been increasing. The first manifestation of these tumors is frequently as cystic metastasis to cervical lymph nodes that may precede recognition of the primary tumor, so, they often result in misdiagnosis as branchial cleft cysts. We report a case of cystic cervical lymph node metastasis of HPV-positive tonsil cancer. The patient was a 70-years-old man who noticed a mass on his left neck. The tumor was large and soft, and it was diagnosed as benign in fine-needle aspiration cytology. We diagnosed the tumor as a branchial cleft cyst and undertook surgery. The histopathological diagnosis was squamous cell carcinoma arising from a branchiogenic cyst. However, because it did not satisfy the diagnostic criteria, we diagnosed the tumor as an unknown primary tumor. One year later, left tonsil cancer was suspected based on PET-CT imaging and a left tonsillectomy was undertaken, whereafter tonsil cancer was found. In p16 immunostaining, it was positive in both cystic mass and tonsil. The cervical mass was cystic lymph node metastasis of HPV-positive tonsil cancer. It is important to investigate the oropharynx, when we found cystic cervical mass, because HPV-positive oropharyngeal carcinoma frequently results in cystic neck metastasis.
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  • Assessment of Cachexia in Head and Neck Cancer Patients Based on a Modified Glasgow Prognostic Score
    Takashi Matsuzuka, Masahiro Suzuki, Satoshi Saijoh, Masakazu Ikeda, Mi ...
    2016 Volume 119 Issue 2 Pages 125-128
    Published: February 20, 2016
    Released on J-STAGE: March 10, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.125
    JOURNAL FREE ACCESS
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    　We retrospectively analyzed 54 patients who died of head and neck squamous cell caricinoma regarding the process and duration of cachexia using the modified Glasgow Prognostic Score (mGPS). The patients were classified as having cachexia when the serum albumin level was less than 3.5mg/dL and the C-reactive protein (CRP) level was more than 0.5mg/dL. The number of patients with cachexia was eight (8%) at the first visit and 50 (93%) at the time of death. In the 50 patients, the median and average time of having cachexia was 59 and 95 days, respectively. Thirty-two of the 50 patients (64%) died within three months after the presence of cachexia was confirmed. In this study, the time of having cachexia was so short, then the policy of care should be converted from aggressive into supportive in patients classified as having cachexia. mGPS would be an accurate assessment tool for cachexia and ascertain the end stage of head and neck cancer patients.
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  • Trial of Micro CT Scanner SKYSCAN1176 for the Imaging of the Guinea Pig Cochlea in vivo
    Takafumi Yamano, Hitomi Higuchi, Tetsuko Ueno, Takashi Nakagawa, Tetsu ...
    2016 Volume 119 Issue 2 Pages 129-133
    Published: February 20, 2016
    Released on J-STAGE: March 10, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.129
    JOURNAL FREE ACCESS
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    　The usefulness of the micro CT scanner system SKYSCAN1176 was evaluated for the study of the guinea pig cochlea. Each slice of the section was 9 μm and we were able to identify each ossicles, modiolus, upper, middle, and basal turn of the cochlea. This scanner enables us to observe inner ear structure repeatedly in vivo.
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Skill up lecture
Lifelong learning for Board Certified Otorhinolaryngologist
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