日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
70 巻, 8 号
選択された号の論文の9件中1~9を表示しています
  • 横山 俊彦, 大迫 茂人, 杉山 正夫, 星野 健一
    1967 年 70 巻 8 号 p. 1343-1357
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    This paper was attempted to study on the temporary threshold shift (TTS) at 4000cps by a 20-min noise exposure through a earphone to each of a subdivided tone, approximately 2db step, within the range of 79 to 88 phon of white noise. The change of auditory sensitivity was observed by means of Bekesy-type audiometer. Nine subjects tested were adult men with normal hearing who had well experienced the Bekesy audiometry. These results were as follows:
    1) Although the intensities of stimuli of tones were slightly different respectively, a noise intensity which produced a remarked rise of TTS and a prolonged recovery from it was found in all the subjects.
    2) A noise intensity level producing of such an elevated threshold was significantly defferent each other:
    No. 1 and No. 7 were found at 81db; No. 2 at 82db; No. 3, No. 5, No. 6 and No. 9 at 84db; No. 4 and No. 8 at 86db.
    3) Observing the recovery process over a duration of 20 min, the following was noted, that the elevated threshold after stimuli, being recovered to normal threshold, still showed the elevation in 7-9 min after stimuli were ceased. This was classified to class IV & V. These recovery types were more frequently found on 1 grade less intensity of tone than the fatiguing tone intensity producing the remarked threshold shift and prolonged recovery of it. And these recovery pattern dissappeared on the interruped threshold tone at a frequency of 4000cps.
  • 小出 靖, 加藤 功, 山崎 久生, 椎名 睦郎, 土田 陽一, 荒井 長彦
    1967 年 70 巻 8 号 p. 1358-1366
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    Anomaly of the ossicles is frequently seen in a patient with congenital anomalies of the head or face, such as congenital obstruction of the external ear canal, Treacher Collins syndrome or cephalopathy. Congenital anomaly of the ossicles however is not a rare occurrence even in a patient without anomalies of the head or face.
    Here, we would present our own experience with six cases of congenital anomalies of the ossicles and with one case of congenital deformity of the round window. The patients with anomalies of the ossicles had non-progressive hearing impairment of purely conductive type, except for one case which had been accompanied by otosclerotic changes and had a bone conduction loss.
    Case 1. 24-year-old male.
    An exploratory operation of the left ear had revealed that there were a bony fusion of the short process of incus with the horizontal semicircular canal and a dislocation of the long process of incus, resulting in separation of the incudostapedial joint. The bony bridge was removed and the separated joint was reconstructed by means of a polyethylene tube strut. The acoustic gain was 42db.
    Case 2. 41-year-old male.
    Congenital anomaly of the left middle ear was found to be a bony fusion of the short process of incus with the horizontal semicircular canal. The bony bridge was removed, resulting in a hearing improvement. But his hearing became wor se after several months, probably due to recurrence of ankylosis.
    Case 3. 21-year-old male (left ear)
    Case 4. 24-year-old male (left ear)
    Both cases had congenital separation of the incudostapedial joints, due to maldevelopment of the long process of incus. These separated joints were reconstructed by means of a polyethylene tube strut. Hearing improvement were considerable in both cases.
    Case 5. 31-year-old male.
    Congenital absence of the head and crus of the stapes was found in his left ear. The foot-plate was movable. A polyethylene tube collumela was introduced between the long process of incus and the foot-plate. Hearing gain was about 30db.
    Case 6. 38-year-old female.
    The patient had otosclerosis in both ears. Congeaital separation of the incudostapedial joint was seen in the left ear. Following a stapes mobilization operation, the ossicular chain was reconstructed by means of a polyethylene tube strut. Hearing gain was considerable.
    Case 7. 25-year-old female (right ear).
    The round window niche was remarkably narrow.
  • 手島 温子
    1967 年 70 巻 8 号 p. 1367-1372
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    A nine years old boy had a functional disturbance of labial articulation and was not able to pronounce exactly the following tone.
    Ma Mi Mu Me Mo
    Na Ni Nu Ne No
    Ra Ri Ru Re Ro
    Wa
    In his early childhood, he had been diagnosed as a case of mentally retarded child by a doctor of a university hospital. But the result of mental test for his entrance into primary school proved that his mentality was normal, i. e, IQ=92. At present, he attends regular school. He talked the first word when be was one and half years old. Until six years old, he was not able to talk except baby-like talk and then he could barely speak short sentences.
    His parents could not remember his first word precisely. At least they were not “Mama” or “Mamma”.
    He has no difficulty in his hearing, and it is hard to find organic, neurological and psychological causes in his speech disturbance.
    In labial articulation, he seems to be able to pronounce exactly the words such as
    Pa Pi Pu Pe Po
    Ba Bi Bu Be Bo
    As his trouble was recovered by speech therapy for only fifty days, so it was sure that his trouble was caused by functional disturbance.
    There is no literatures regarding such functional disturbance without any lesion in central and peripheral nervous system.
    His motor function was not thoroughly investigated because of his other sickness (rheumatic pancarditis), but it was unlikely assumed that he had “Minimal cerebral palsy” or “Apraxie”.
    Speech Pathology of this kind of disturbances will be developed in near future.
  • 松永 喬, 佐藤 武男, 山田 康之, 川本 浩康
    1967 年 70 巻 8 号 p. 1373-1382
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    Statistical observation on the cases of foreign bodies handled in our clinic during the period from 1956 through 1965 was performed.
    The results were as follows.
    1. 1, 043 cases (approximately 1%) out of 108, 760 patients treated in our ear, nose and throat clinic during last 10 years, were recognized as the foreign bodies.
    2. The locations of the foreign bodies were as follows: 507 cases in esophagus (50% of all foreign bodies), 177 cases in pharynx (17%), 170 cases in gastrointestinal tracts (16%), 63 cases in larynx, trachea and bronchus (6%), 87 cases in ear (8%), 41 cases in nose (4%) and 2 cases in maxillary sinus.
    3, More than 50% of the foreign bodies were found in infants and were found to be coins in esophagus.
    It is important to discuss about the cases of coins in esophagus as well as beans in bronchus of the infants.
    4. 365 cases (72%) of 507 cases in esophagus were coins which were lodged at the entrance of esophagus. Fish bones, artificial dentures and pieces of meat were seen in the second strictures as much as in the first strictures.
    124 (90%) of 138 foreign bodies found in mesopharynx were fish bones and more than 50% of them were found within the palatine tonsil.
    Foreign bodies in bronchus were seen in 48 cases, which were almost lodged at the area of carina.
    Insects were most common among the foreign bodies of ear canals and often cause otitis media.
    5. The removal of foreign bodies in about 75% of total cases was performed by means of Endoscopy. Foreign bodies were removed via the external esophagotomy approach in 5 cases and via the tracheotomy approach in 13 cases.
    6. The complications of foreign bodies in esophagus were periesophageal abscess in 6 cases and in death in 2 cases. Especially in infant, there were 11 cases diagnosed as other respiratory diseases than foreign bodies by the pediatrist and 3 cases suffocated to death. The foreign bodies in these cases were found by the bronchoesopha-gologist.
    7. The authors reported the statistics of foreign bodies, treated in our clinic during the period of 1936-1965.
  • 松永 喬, 佐藤 武男, 山田 康之, 川本 浩康
    1967 年 70 巻 8 号 p. 1383-1388
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    Statistical observation on the cases of foreign bodies in infants, handled in our clinic during the period 1956 through 1965, was performed. The results were as follows.
    1. The cases of foreign bodies in infants were found to be 3% of the total number of infantile diseases and 60% of all the foreign bodies in our clinic. There were many cases of foreign bodies in infants carried into our clinic by emergency-car.
    2. About 50% of foreign bodies in infants were found in esophagus and 83% cases of them were coins. Toys and the parts of toys were found frequently next to coins.
    3. About 77% of all the foreign bodies in lower respiratory tract in our clinic were found to be beans and fish bones in infants. This should never be overlooked. It should be cautioned that there were many cases mishandled as various respiratory diseases by the pediatricians.
    4. The foreign bodies of ear and nose were mostly found in infants, and spherical shaped foreign bodies were seen to have lodged during play.
    5. The removal of foreign bodies in infants should be perfomed steadily and quickly. It is good to apply the TV-camera or biplane radiological illumination.
    6. As the campaign for the social development in regard to infantile diseases, the authors wish to emphasize the parents the following criteria.
    (1) Do not have infant eat the solid food and confections (e.g. peanut or chocolate-cake, including peanut etc.).
    (2) Cease to produce the unsatisfactory and incomplete toys. Put radioopaque materials to plastic products.
    (3) Keep the baby powder cans away from babies.
  • 野々山 純
    1967 年 70 巻 8 号 p. 1389-1419
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    Lymphography of the cervical lymphatic system was performed experimentally and clinically for the diagnostic purposes in the head and neck surgery.
    The results were as follows:
    1) Observations of the cervical lymphograms at different.
    Stages after injection of a contrast medium in dogs. The visualization of the cervical lymphatic vessels was of the most clear at 2 hours after injection and gradual disappearance was up to 24 hours thereafter. The lymph nodes were demonstrated most finely at 24 hours showing the typical homogeneous reticular patterns.
    2) The histopathological investigation of the cervical nodes in dogs.
    Upto 6 months after injection, mild nonspecific inflammatory changes occurred in the nodes due to the foreign body reaction of the contrast medium and lymphocytes were hoted to be decreasing grodually in the nodes.
    But after 6 months, the fatty droplets phagocytized by giant cells were eliminated, lymphocytes increased in number. At 9-12 months stage after injection, the tissues of the nodes showed normal histology.
    3) The fat embolism following the cervical lymphography in dogs.
    Although the fat embolism following the cervical lymphography in dogs may not be prevented completely, there is no risk of mentioned above following the cervical lymphography if the injection is performed with the greatest care of the volume and the speed.
    4) Clinical investigation of cervical lymphography.
    Cervical lymphography was performed in 24 patients exclusively via the single retroauricular approach.
    The visualizations of the normal cervical lymphatic system were made by the lymphography.
    In the cases sofar experienced, abnormal changes were the following:
    A) The passage disorder or blockage of lymphatic vessels
    a) Increase of Lynphatic capillaries in number and reticular changes of lymphatic vessels
    b) The changes of lymphatic vessels (rupture, dilatation, blockage, tortuosity and collateral formation)
    B) Abnormal changes of lymph nodes
    a) Moth-eaten appearance
    b) Gohst-like appearance
    c) Homogeneous filling or non-structure
    C) Normal but apparently abnormal lymph nodes
    a) Pseudo-moth-eaten appearance
    b) Central filling defect
    Cervical lymphography is a valuable procedure for the diagnosis of malignant tumors in regions of head and neck, although it has a limited value for detecting an early small lesion of the lymphatic system.
  • 横山 俊彦, 大迫 茂人, 永江 温
    1967 年 70 巻 8 号 p. 1420-1429
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    An attempt was made in this paper to study the reliability of the retest of NI-TTS and to reaffirm that an abrupt and marked rise of the hearing threshold even following by slight difference of stimulous noise intensity can occur. That is, the amount and recovery process of a rise of hearing threshold induced by a 20-min exposure of intensities between 81 and 86 phon of white noise were measured using Bekesy audiometry at tone of 4000cps over a duration of 20min after noise stimulation.
    All of the six subjects employed had normal hearing and were well trained with this testing method. They were repeatedly tested in the same way and conditions, above 3 times at intervals of 1 or 2 weeks.
    The conculusions obtained from the present study were as follows:
    1) The significant differences in a value of the hearing threshold shift obtained from retests were found in two of all subjects. The amount of one of three- to four-time measurements in them was decreased a half to a third as others.
    2) The variations about recovery time from NI-TTS were relatively low.
    But, at times, it was found to happen a remarkedly prolonged recovery.
    3) The recovery pattern over a duration of 20 min after exposure termination, in general, tended to differ even in retest under the same condition. That the variation of the recovery pattern is high or low depends upon how to take a criteria of the characteristics.
    Therefore, the estimate of this result should be more prudent, and further study will be demanded.
    4) A diphasic recovery pattern (II type) like sensitization or bounce were not always appeared in the retests. The II type pattern was never found when tinnitus appeared not.
    5) Concerning existence of small excursion of Bekesy tracings and tinnitus after noise exposure, it was found little significant difference in the remeasurements respectively. The change of tone colour of tinnitus was low, and, otherwise, duration of tinnitus seemed to vary easily in each retest.
  • 第1編 Proteus Vulgaris のアレルギー効果 (卵白アルブミンにて感作した場合)
    関 六郎
    1967 年 70 巻 8 号 p. 1430-1446
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    The author carried out an experiment on allergy affecting hearing organ of guinea pigs to study the relationship between allergy and chronic otitis media.
    A solvtion containing proteus vulgaris was injected into the bulla of the middle ear of 24 normal animals which had been previously sensitized with egg albumin.
    The animals were divided into 8 groups of 3 animals each, and were sacrificed at intervals of 4 hours, 1-, 3-, 5-, 7-, 10-, 15-, and 30 days for histo-pathological examination of the bulla and and the labyrinth.
    In the 4-hour -and 1-day-specimens, there were accumulation of secretion and falling of cilia out of the ciliary epithelium; there were remarkable edema, bleeding, and eosinophiles (the so-called allergic findings) in the submucous tissue.
    The 3-day-specimens showed less edema, bleeding, and eosinophiles; however, proliferation of connective tissue and inflitration of round cells (the so-called infectious findings) were found.
    In the 5-, 7-, and 10-day-specimens, there were signs of remarkable inflammation and osteogenesis in the submucous tissue.
    In the 15- and 30-day-specimens, the ciliary epithelium returned to normal, and the inflammatory process was subsided in the submucous tissue.
    Dilalation of the stria vascularis was noticed in the labyrinth all specimens of 4-hour, 1-, 3-, 5-, 7-, 10-day.
    During the course of 15 and 30 days, a tendency of healing to the normal state was detectable.
    Each cell was mildly swollen in the organ of Corti. In some cases there were swelling or looseness of Reissner's membrance, most of which, however, showed a normal histology.
    In the 3-, 5-, 7-, 10-day speciemns, a secretion of fibrinoid substance was noticed in the scala vestibuli.
  • 第2編 Proteus Morgani の菌体成分による影響 (菌体成分で感作注入したもの)
    関 六郎
    1967 年 70 巻 8 号 p. 1447-1464
    発行日: 1967年
    公開日: 2007/06/29
    ジャーナル フリー
    The bacterial components A and B were extrated from Proteus morgani by a special method. The bacterial component A was weak in effect of protein and strong in effect of lipopolysaccharoid and the bacterial component B was strong in effect of protein and weak in effect of lipopolysaccharoid. The bacterial component A was regarded as carbohyderate fraction and the bacterial component B was regarded as protein fraction. The bacterial component of proteus morgani was separately injected into the bulla of the middle ear of the nonsensitized adult guinea pigs.
    After single injection and also after two to six multiple injections with an interval of 10days, those animals were sacrificed and histological examination temporal bones of the were carried out.
    In the animals receiving single injection, there were slight allergic findings but no significant differences among the animals received different experimental procedures.
    In the animals receiving two to six multiple injections of bacterial component A or B.
    There found goblet cell formation and flattening of the ciliary cells in the epithelial cells of the bullar mucosa.
    In the submucous tissue, inflammatory finding was prominent and the degree of increase in plasma cells was paralleled to the number of injection.
    In the labyrinth of all specimens receiving multiple injections, dilatation of the stria vascularis and vesicle formation in the epithelial cells were noticed.
    Cells were mostly swollen in the organ of Corti, but Reissner's membrane was almost normal. Conclusively, the allergenic effect of bacterial components A and B was detectable by our experimental study, and the effect of B was more prominent than that of A.
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