日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
69 巻, 2 号
選択された号の論文の9件中1~9を表示しています
  • 鈴木 達児
    1966 年 69 巻 2 号 p. 149-166
    発行日: 1966年
    公開日: 2008/07/31
    ジャーナル フリー
    "Schallsonde" test has become important for tympanoplasty because it indicates the location of lesion and predicts postoperative hearing. However the basic knowledge has not yet been accumulated enough to establish this method. Therefore, the author measured the mechanical characteristics of a nylon "Sonde" which was attached to a bone conduction receiver. It was found that this Sonde was hardly influenced by the pressure when it was pressed on the subject's ear drum, Moreover, this Sonde had no appreciabie amolitude distortion. Then the author carried out hearing test using this Sonde in 136 cases of conductive deafness. This Sonde was proved to be available in clinical use because of little pain in its application to the ear drum. Hearing loss measured by the Sonde corre- sponded with air conduction loss in cases of oto- sclerosis and pseudo-otosclerosis in which the mobi- lity of the ossicular chain was affected. On the other hand, hearing loss measured by the Sonde did not always correspond with air conduction loss in adhesive otitis, cholesteatoma otitis, and chronic suppurative otitis. This fact depended upon whe- ther the mobility of the ossicular chain was affe- cted in these cases or not. When the ossicular chain was intact in mobility, no hearing loss was detected by the Sonde and vice versa. Therefore, when hearing loss by the Sonde was more than 20 dB, it was diagnosed as the disorders of the ossi- cular chain. But when hearing loss was within 20 dB, the ossicular chain was regarded as intact or as of the type of continuity by the connective tissue. In this case liquid-conduction test and the test using the artificial ear drum should be applied to confirm the diagnosis made by Schallsonde test'
  • 立木 孝, 坂本 伸一郎, 沼倉 昌雄, 鈴木 義人, 石母 田実
    1966 年 69 巻 2 号 p. 167-175
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    Basic principles of the measurement of adaptation were studied from following three points of view; the time course, relation between adaptation and the length of the duration of comparison tones and the adaptation for the interrupted tones.
    By using the procedure which was introduced by the authors (Loudness balance between continuous and interrupted tones), the time course and theptation of the development of adaptation were measured. Test tones were 1000 cps pure tones with the intensity ranging from 10to 60 db (SL) and the comparison tones were interrupted tones with the same frequency. The comparison tone was interrupted with the repetition period of 2500ms, duty cycle of 70%o and the rise and fall decay time of 25ms. The intensity of the comparison tone was regulated by the subject with
    Bekesy type attenuator. In the result, it was concluded that the development of adaptation was very rapid, but decelerative. In the initial stage of the stimulation, it was so rapid that it could not be recorded by the Bekesy attenuation with speed of 2db/sec. Though the time required to reach the asymptote varied depending upon the intensity of the test tone, it usually ranged trom 30 to 90 seconds.
    For the second purpose, comparion tones with the length of duration ranging from 10 to 45 seconds were used in the dichotic balance procedure.
    They were given in two different fashions of tracking and descending. Two conclusions were drawn from the results. First, the longer the duration of the comparison tone, the lesser the adaptation measured were. Second, the values of the measured adaptation were strongly dependent upon the manner of the comparison stimulation, namely, about 25 db difference was observed between the values obtained by tracking and descending fashion.
    The authors supposed that the main cause of this discrepancy was the shifted loudness function due to the adaptation.
    Another two different experiments were done for the third purpose. By using the different kind of interrupted tones as the comparison stimuli in the authors' procedure, the influences of the duty cycle and the repetition period of the comparison stimulus upon the measured adaptation were studied, whereby no clear influence was observed.
    Second, the adaptation for the interrupted tone was measured by asymptotic balance procedure. Two test tones which were interupted in the following manner were adopted. (1) Repetition period of 2500 ms and the duty cycle of 70%. (2) Repetition period of 100ms and the duty cycle of 70%. In the results, no adaptation was observed.
    In conclusion, the authors stressed that the development of the perstimulatory adaptation was so rapid that the comparison stimulus with 10 seconds or more duration shold not be used in the adaptation measurement. If such a stimulus with long duration was adopted in the adaptation measurement as a comparison stimulus, the values obtained were strongly dependent upon the stimulation manner of the comparison ear. The authors recommended the use of the interrupted tone for the comparison stimulus, whereby no adaptation for the comparison ear would be expected.
  • 飯塚 俊勝
    1966 年 69 巻 2 号 p. 176-195
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    The author used 48 mature dogs in doing the above mentioned experiment. One side of the vagus, the recurrent laryngeal nerve and the superior laryngeal nerve were excised. Also the sympthetic superior cervical ganglion and the stellate ganglion were removed. The purpose of this experiment is to observe the influences of nerve interception and the histological changes of the intrinsic muscles of the laynx.
    The results were as folios :
    1. In case of dogs, in which one side of the recurrent laryngeal nerve was excised, atrophy of the thyreoarytaenosd muscle (the vocal cord muscle) on the same side appeared most pronounced among intrinsic muscles. Atrophy of the posterior cricoarytaenoid muscle and lateral cricoarytaenoid muscle were then evident in order.
    2. In case of excision of the vagus on one side, the effects were quits equal in above mentioned cases, but the histological changes were not so pronounced.
    3. When the superior laryngeal nerve was cut off on one side, the atrophy of the cricothyreoid muscle on that side was most pronounced. Moreover, a slight atrophy of the vocal cord on the same side was seen histologically.
    4. When the superior cervical ganglion was removed, fibers of the cricothyreoid muscle slightly increased in size on the same side. These histological signs were considered as muscle dystrophy.
    5. When the stellate ganglion was removed, there appeared various wide muscle fibers in the vocal cord muscle in the transversal arytaenoid muscle and in the lateral cricoarytaenoid muscle on the same side, by turns. These histological changes were recognized as degenerative dystrophy of muscles.
    6. By excision of the recurrent laryngeal nerve on one side, nuclear numbers of the perim. ysium of the posterior cricoarytaenoid muscle and vocal cord muscle increased remarkably on the same side. These muscles seem to have the most important function of opening and closing of the glottis than the other intrinsic muscles. Consequently, these muscles react very strongly to nerve interception and have shown within themselves restorative powers.
    II) In the following experiment 17 mature dogs were used. By pulling up the exposed recurrent laryngeal nerve with a small piece of ivory on one side, the following results were obtained by repeated observations of the larynx.
    1. After three days of pulling up, the nerve fiber degeneration and the atrophy of the vocal cord muscle had partially set in.
    2. After one month, the muscle fibers were separated, cut, and collapsed and necrosis had noticeably set in. In this times, the changes are quite irreversible, function of the vocal cord muscle also.
    3. The drawing of the nerve fibers was conti-nued for three weeks and then released. Then it was found that within six months the paralyzed began to move normally.
    4. In the above mentioned experiment, two out of four cases showed the paralyzed vocal cord in paramedian position. In the other two cases the paralyzed vocal cord took the median position.
    Thus it was considered that the position of the vocal cord is changeable according to the direction or strength of the affecting power on the nerve fiber.
    In other words, when pressure or traction exerted upon the nerve fiber is slight, there may occur only incomplete paralysis of the vocal cord, and the vocal cord will take radian position. When affection is stronger, then the vocal cord will take paramedian position, as in the case of nerve interception, and this is a condition of complete
  • 喉頭癌の遺伝について
    佐藤 武男, 石井 孚, 宮崎 忠彦
    1966 年 69 巻 2 号 p. 196-205
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    Carcinoma of the larynx in two brothers was reported. Their occupation was shoemaker and the pathology of the cancer was almost identical in two cases. The clinical and pathological findings were as fallows.
    The survey of familial incidence of the can-cer was conducted on 256 patients suffering from cancer of the larynx with following results.
    1) As the family history of the cases with cancer was retrospectively traced from the patient back to a family relation of the third degree, 88 cases of 256 cases (34%) were found to be cancerinflicted and 111 cases with cancer were noticed in total.
    2) 58 cases in the first degree (parents and children), 35 cases in the second degree (brothers and grandparents) and 18 cases in the third degree (parents' siblings etc.).
    3) Among 111 cases, gastric cancer was 60 cases (54.0%), esophageal cancer, 11 cases (9.9%), cancer of uterus, 8 cases (7.2%), laryngeal cancer, 7 ca-ses (6.3%) and others were 25 cases (22.6%).
  • 石井 英男
    1966 年 69 巻 2 号 p. 199-205
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    This disease is characterized by the severe diffuse edematous swelling which involves the whole of the vocal cords but we can find few literatures on this subject.
    The author has further experienced 9 cases after the previous report and there has been a total of 13 cases. This time the genesis of this disease was examined and an inference was obtai-ned that this disease might be caused by estrogen deficiency from the following reasons :
    1) This disease is frequently found in femalethrough the climacteric.
    2) In male, edema of the vocal cord is chiefly unilateral but in female frequently bilateral.
    3) The cause of this disease is not clear up to date.
    4) The opening time of voice disturbance has a close relation with that of the suppression of menses.
    5) A patient given estrogen in the early stage of this disease had good results in hoarseness and edema of the vocal cords.
  • 鳥山 稔, 小松 崎篤
    1966 年 69 巻 2 号 p. 206-209
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    A case of palato-pharyngo-laryngeal myoclonus was reported.
    The patient was 42 year old male with chief complaints of hoarseness and slight speech distur- bance.He was diagnosed as mitral stenoinsuffi- ciency and had been treated for 2 years.Sudden attack of motor disturbance of the left upper and lower extremities without loss of consciousness appeared after one year treatment of heart disease.
    No myoclonus was pointed out at the time of that attack.Onset of the myoclonus was not clear in this case.Some discussions were made on eti. ology and pathology of palato-pharyngo-laryngeal myoclonus.
  • 徳丸 徹
    1966 年 69 巻 2 号 p. 210-221
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    We, otorhinolaryngologists, often met with shock condition in surgical procedure of the pha- ryngical area, especially after local anesthesia in this area.
    A large number of studies have been carried on to get some informations on the factors of these shock conditions.Recently the hyperactivity of the autonomic nervous systems has been regarded as the important factor.On the other hand, we always use epinephrine for local anesthetics, which is a well-known stimulating drug of the sympathe- tic nervous system.
    The purpose of this experiments is to study the influence of epinephrine which injected into palate.Guinea pigs were used in these experi- ments.
    1) 0.3cc of epinephrine was injected into the palate of guinea pigs.41.9% of them died within 30 minutes.
    2) Same amount of epinephrine was injected subcutaneously.None of them died.This result indicates local speciality of the palate.
    3) Same amount of epinephrine was injected intravenously(into, V.femoralis).About 80% of them died.
    4) Same amount of epinephrine was injected into the palate of animals which were previously administered with chlorpromazine(1mg/kg).None of them died.This shows that the death due to epinephrine injection was completely prevented by chlorpromazine.
    5) After Opium-Scopolamine(Inj.Alkaloid. Opii et Scopol.Ice) was administered, epinephrine was injected in the same way.The mortality of this group was 35.5%, and about a half of died injection of epinephrine.
    6) On these experiments, histological findings of the lungs, livers, kidneys, and the adrenal glands were compared pathologically, and the peri- pheral circulatory failures induced by epinephrine were observed.
  • 佐竹 虔介
    1966 年 69 巻 2 号 p. 222-233
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    The tracheotomy, which has been used for long time is yet considered as one of the important therapeutic methods today, but it has some problems in itself to be studied from the standpoint of progressed medicine.
    Therefore three such problems were selected and studied.
    1.As to the indication of tracheotomy, it should be performed not only in the cases of dyspnea due to the stenosis of the upper respiratory tract, but also in the cases of pulmonary insufficiency due to the disorder of the central nervous system or of the lower respiratory tract.
    2.As the usefulness of tracheotomy for surgical operation of the upper respiratory tract is considered, it was proved that in some serious operations, tracheotomy gave better results.
    3.Animal experiments of the intratracheal microdrop method through the tracheostoma showed that this method was effective as postoperative care.
  • 田中 博之
    1966 年 69 巻 2 号 p. 234-253
    発行日: 1966年
    公開日: 2008/03/19
    ジャーナル フリー
    In connection with stapes surgery, several studies have been carried out.The results are as follows:
    1.Our three years clinical experiences on stapes surgery have shown that at the operation of stapedovestibulo interposition, the veingraft was a little more effective than any other tissues, which were equal value to each other, and for the prost- hesis, the stapes itself was the best of all, if it were not so much damaged, and the better one was the incus meanwhile the malleus was out of value.
    The results of surgery were the best on the cases of otosclerosis, while they were not so much on chronic otitis media. Furthermore, stapes surgery showed some effe- cts on some cases of vertigo.
    2.As for the X ray photographing of the stapes, the normal and enlarging transillumination was performed by using a method similar to Guil- lens.Adding to it, the tomograph photographing was also tried.Furthermore, the auditory ossicles embedded in resin, or a cadaver temporal bone was irradiated to take photograph.And it was concluded, some image would be able to be expo- sed to some extent, although it would not be eno- ugh to be used for diagnosis. 3.A condenser pick up was applied to the foot plate of the stapes from the inner ear side to measure its vibration, and the following characta- ristics were decided. (1)As for the longitudinal direction, the anterior pole vibrated 1.6 times stronger than the posterior pole for 80db of sounds.The motion was the combination of a piston movement and a hinge movement.The ratio did not change corre- sponding to the frequency of sound, but to the pressure of sound decreasing in a straight line. (2)As for the tranSversal direction, the lower part vibrated stronger than the upper part, and its relation was constant to the frequency and pressure of sounds.
    (3)There was no rotatory axsis that passed through the foot plate.
    (4)The amplitude was some microns above 10 the maximum.And the relationship between the at pressure and the frequency showed a curve like aparavola.
    (5)On aged persons, the amplitude of vib- ration was small and the strain was apt to agpear. And this made some imagination, that senile hardness of hearing of aged persons would confuse some conductive hardness of hearing.
    4.Summarising the clinical and experimental results, it was presumed that the hinge movement of the stapes would play an important role in the sound conducting mechanisms.
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