日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
81 巻, 12 号
選択された号の論文の8件中1~8を表示しています
  • 友野 時雄
    1978 年 81 巻 12 号 p. 1517-1530
    発行日: 1978/12/20
    公開日: 2008/07/08
    ジャーナル フリー
    Direct adenoidectomy is a method of removing hypertrophied tonsillar tissue in the epipharynx under a direct view for restoring conductive hearing loss due to tubal stenosis. The method was originally evolved by Guggenheim in 1941, but recently it was almost forgotten and paid little attention. The author performed a modified method of Guggenheim's direct adenoidectomy in 76 children (51 males and 25 females) with conductive hearing loss mostly ranged between 15 and 40dB. In all cases, the surgery was performed under general anesthesia and hypertrophied pharyngeal tonsil was removed. After complete hemostasis, exessive adenoid tissue lying on the posterior lip of the tubal ostium (torus tubarius) was carefully removed using Hartmann's cutting forceps.
    Postoperative hearing improvement was satisfactory. Average gain of hearing reached 15 to 17dB in a period of 4 weeks after the operation. A follow-up study one year after the operation revealed that the improved hearing was maintained in more than 72% of the cases tested. No scar tissue formation which would interfere with the tubal function was observed one year after the operation.
  • 第3報 家兎のアルサス型扁桃炎における血中線溶動態
    小杉 忠誠
    1978 年 81 巻 12 号 p. 1531-1539
    発行日: 1978/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to clarify the relationship between inflammatory process and fibrinolytic system, Arthus-type hypersensitivity was experimentally designed in rabbit tonsil. At the beginning of this study, we discussed if Arthus tonsillitis of rabbit was useful or not as the model of human acute tonsillitis. Furthermore, macroscopic, histopathological findings were obtained and fibrinolytic activity of blood was estimated in parallel with the process of the Arthus tonsillitis.
    These results obtained from this experiment were as follows:
    1) In the first day after Arthus phenomenon was provoked at the tonsil of rabbit, the swelling and bleeding were macroscopically observed. In the 7th day, however, these findings subsided.
    2) The tonsil was divided into six portions, which were lacunal epithelium, interstitial portion of parenchyma, follicle, blood vessels, capsule and connective tissue surrounding the tonsil, and they were histopathologically observed. In the first day, the remarkable cell infiltrations and bleeding were observed at interstitial portion of parenchyma and connective tissue surrounding the tonsil.
    3) As the parameters of fibrinolytic system in blood, the content of fibrinogen, content of plasminogen, inhibitor activity and whole plasmin (euglobulin+streptokinase) were estimated. In comparison with the control group, the increase of fibrinogen content, slight decrease of plasminogen content and remarkable decrease of whole plasmin were observed from first to third day.
    4) To summarize these findings, in the first day after Arthus tonsillitis, strong inflammatory reactions were observed at the local site. In accordance with these local inflammatory reactions, fibrinolytic activity of blood increased. From these results, fibrinolytic activity of blood was correlated to the inflammatory process of Arthus tonsillitis, furthermore it may modify the clinical process of the tonsillitis.
  • 佐藤 意生, 山口 良二
    1978 年 81 巻 12 号 p. 1540-1546
    発行日: 1978/12/20
    公開日: 2008/12/15
    ジャーナル フリー
    This study was intended to know to what extent of the peripheral nerve injury does completely recover and whether the nerve fibers which once degenerated and afterwards regenerated have normal neuro-muscular function or not in the peripheral facial nerve of the rabbit.
    In the experiment, the state of the recovery from facial paly and the state of the regeneration of the nerve fibers were investigated by observing the movement of M. orbicularis oris at the time of food intake, as well as by measuring the evoked wave and the degree of muscle contraction induced by nerve or muscle stimulation.
    The conclusions obtained were as follows:
    1) The peripheral facial nerve palsy recovers completely in a short period following a nerve impairment if over a half of nerve fibers maintain intact without degeneration.
    2) After sectioning and suturing the nerve fibers, they regenerate to some extent, but the neuro-muscular system of these regenerated nerves has no normal function.
    3) When the nerve is crushed, over a half of nerve fibers do not degenerate, and consequently the nerve palsy recovers shortly.
  • 黄川田 啓子, 安部 治彦, 船坂 宗太郎
    1978 年 81 巻 12 号 p. 1547-1552
    発行日: 1978/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    Two cases of the tuberculous otitis media were reported. The first case (8-year-old female) visited Branch Hospital, University of Tokyo with a chief complaint of otalgia and otorrhea. Otoscopic examination revealed a central perforation and mucopurulent discharge. The infection was resistent to the usual antibiotic therapy and a dirty whitish yellow mass appeared. Thus, tuberculous otitis was strongly suspected and debridement of the involved part of the ear was performed with a satisfactory result. The diagnosis was established by histological examination.
    The second case (30-year-old female) had a past history of otitis media since childhood. She underwent operation because of the repetitive inflammation. However, discharge reappeared 2 months after the operation. Enlarging of the perforation and the production of a dirty mass was observed, and the facial paresis appeared 7 months after the operation. Then, tuberculous otitis media was suspected and the involved tissue was removed surgically. Tuberculous infection was verified histologically. She showed a satisfactory wound healing 8 months after the second operation and facial paresis was recovered with antituberculous drugs.
    Summarizing these two cases, no specific features were noted on the otoscopic examination in the out-patient clinic. However, these two cases showed enlargement of the perforation and the dirty whitish mass in the tympanic cavity resistent to the usual therapy. These findings seemed to be indicative of tuberculous otitis media.
    The survey of literature also lead us to the conclusion that otitis media resistent to the usual therapy and the production of whitish mass strongly suggest the tuberculous otitis.
    The pathology of tuberculous infection was discussed referring to its clinical features.
  • 富山 紘彦
    1978 年 81 巻 12 号 p. 1553-1560
    発行日: 1978/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    The whole thickness of the epithelium of the human circumvallate papillae was dividedtentatively into three portions from its superior surface; upper (UP), middle (MP), and lower portions (LP). The photos of three transverse sections of circumvallate taste bud in one portion, totally nine sections in three portions, were taken with an electron microscope. After making a photomontage connecting nine photos at each level, the number and the area of nerve fibers were observed morphometrically.
    The results are as follows:
    1. The numbers of nerve fibers observed were 535 at LP, 272 at MP and 239 at UP. The average numbers in sections were 178.3 at LP, 90.7 at MP and 79.7 at UP. The packing densities were 0.47/μ2 at LP, 0.12/μ2 at MP and 0.10/μ2 at UP.
    2. The mean values of the area were 0.30μ2 at LP, 0.92μ2 at MP and 1.05μ2 at UP. The size distribution of the area did not distribute even at each portion ranging from 0.01μ2 to 8.23μ2. The areal distribution was not significant under the level of 1 percent by the triserial correlation among LP-MP-UP, but significant under the level of 1 percent by the biserial correlation and critical ratio alnong LP-MP, LP-UP and LP-(MP+UP). Sixty-six percent of the nerve fibers at LP, 29.4 percent at MP and 40.3percent at UP were small than o.20μ2, which indicates characteristic distribution. The result on the significance of the independence of the areal division by χ2-test, when areas were divided into two categories at 0.20μ2 and into four categories at 0.40μ2, 1.80μ2 and 4.00μ2, was the same as that of the areal distribution mentioned above.
    The nerve process and nerve courses presumed from the results of the present observation are characteristic and support quantitatively the reports previously published by other authors.
  • 斎藤 久樹, 朴沢 二郎, 鎌田 重輝, 平岡 真理子, 笠原 正明
    1978 年 81 巻 12 号 p. 1561-1568
    発行日: 1978/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    Two cases with chronic severe laryngo-tracheal stenosis due to rheumatic diseases were treated in our clinic during 8 years from 1970 to 1977. The first case, 48-year-old female, died in 1971, after one and a half year treatment. The second case, a 33-year-old female, is under treatment. When we performed tracheotomy, disappearance of the upper tracheal cartilages was observed and, in microscopic study of the residual tracheal cartilages, many collagen fibers were found by H.E. staining together with degeneration or absorption of hyaline cartilage in both cases. Laryngeal examination showed ankylosis of the cricoarytenoid joint in both cases. In the first case, abnormal findings were obtained in X-ray examination of the breast suggesting Tietze's syndrome and, at autopsy, marked wrinkle formation and stenosis of the trachea and main bronchus were observed the appearance of which resembled the esophageal lumen. In microscopic observation, columnar tracheal epithelium was found to change to the squamous epithelium with keratinization. The first case had a history of RA and the second was diagnosed to be a typical case of RA, based on the ARA's classification.
  • 第2報 難聴耳における検討
    平井 靖人
    1978 年 81 巻 12 号 p. 1569-1578
    発行日: 1978/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    The auditory brain stem response (BSR) and the middle latency response (MLR) were recorded in 44 hearing-impaired adult subjects, and the relation between the subjective threshold to the stimuli and the response threshold was studied.
    Tone pips at 500, 1000, 2000 and 4000Hz with 2-cycle rise-decay time and one-cycle peak were delivered with the intensity of 10, 20 and 30dB above the subjective threshold.
    No significant difference was found between the normal-hearing and the hearing-impaired subjects in Po, Na and Pa to each stimulus intensity, and the thresholds for these components were 10 to 20dB above the subjective threshold. It should be noted that hearing-impaired subjects could evoke the response for the same stimulus intensity above the subjective threshold as normal subjects.
    The mean latency of the BSR (Po) from subjects with conductive hearing losses was equal to those from normal subjects. The latency-intensity curves (L-I curves) in these subjects sifted to the right side, of the normal L-I curves with same wiveture. With regard to subjects with sensori-neural hearing losses, the latency was shortened in all tone pips except 4000Hz.
    These results suggested that the BSR (Po) and the MLR (Na, Pa) are reliable in threshold audiometry of adults with hearing losses.
  • メニエール病とめまいを伴う突発性難聴について
    井元 俊夫, 田中 耕一, 岡本 了, 中井 義明, 北畠 暁
    1978 年 81 巻 12 号 p. 1579-1587
    発行日: 1978/12/20
    公開日: 2008/03/19
    ジャーナル フリー
    There are many epidemiological studies on Meniere's disease and sudden deafness. Little investigations are done on interactive analysis of each factor in these diseases, though many factors interact on each other in a complexed manner. So it is not enough to analyse one test by another test. We thought that the interactive analysis is essential after giving equilibrium tests.
    We performed multivariate analysis of 1282 patients who had recieved equilibrium tests diagnosed as A) Meniere's disease and other vertiginous diseases, B) sudden deafness with vertigo and other vertiginous diseases, C) Meniere's disease and sudden deafness. The equilibrium tests were classified into 19 items and further into 51 categories. We noted many differences among interactions of each disease on the basis of the above-mentioned categories. We got approximately 70 percent of correct diagnostic rate.
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