日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
84 巻, 5 号
選択された号の論文の8件中1~8を表示しています
  • 上松 敦子, 畔柳 久志, 鈴木 昭男, 高須 昭彦, 西村 忠郎, 岩田 重信
    1981 年 84 巻 5 号 p. 465-469
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    A 53-year-old woman complained of hoarseness and felt the egg-sized tumor at anterior cervical region for 3 years. These symptoms were progressively emphasized, and dyspnoeic feeling had also appeared gradually. Clinical findings observed were as follows; left laryngeal paralysis on intermediate position of paralyzed vocal cord, thyroid tumor infiltrated into the larynx and trachea on X-ray films and CT scanning, and a high value of respiratory resistance such as 16cm H2O/L/sec. Total thyroidectomy and laryngectomy were performed. Fresh wound in the neck was contaminated by regurgitated inhalts from the stomach during operation. The histopathological diagnosis was determined the papillary adenocarcinoma originated from thyroid. Postoperatively, temperature elevated to 39-40°C, and clinical symptoms suggested the serious infection. Serratia marcescens was isolated from blood in pure culture during treatment. The haemorrhagic tendency, decreasing of platelet, and increasing of FDP were indicated the presence of DIC with septicemic infection. It was estimated that the Gram-negative rod septicemia as this case was induced by the wide and deep operative invasion, following to the lowered preoperative vital resistance of this patient.
  • 田中 幹夫
    1981 年 84 巻 5 号 p. 470-482
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Forty four cases (forty six ears) of chronic otitis media excluding cholesteatoma were studied using Polytome. The middle ear cleft and external areas of the temporal bone were measured at sections using AP plane (cochlear, vestibular and antral planes) and lateral plane (antral, a plane 2mm medial to the antral, and tympanum planes). The values obtained by measurements of chronic otitis media were compared to the values obtained by normal subjects. Majority of the values of chronic otitis media was smaller than those of normal subjects with statistically significant differences.
    Two factors contribute to the smaller values obtained by chronic otitis media. First factor is the hereditary one which gives rise to the underdevelopment of the temporal bone as a whole and to either hypo- or a-cellularity. Second factor is the environmental one which is actually the chronic inflammation producing thickening of mucosa and periosteum and proliferative osteitis.
  • 野村 公寿
    1981 年 84 巻 5 号 p. 483-489
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    In the past eight years and eight months 1, 502 cases were examined by electronystagmography (ENG). Among them 36 cases (2.4%) were vertiginous or dizzy children between six to fourteen of age. Twenty-three cases were boys and 13 cases were girls. Vertigo was chief complaint in 16 cases and dizziness or dysequilibration was complained in 20 cases.
    Eleven cases were peripheral vestibular dysfunction and 18 cases were central vestibular disorder. Most important disease is infratentorial brain tumor: two medulloblastoma, two ependymoma, one astrocytoma, one pontine glioma. These tumors show many symptoms even under fundamental vestibular function tests such as detection of gaze nystagmus and righting reflex test.
    In ENG examination moderately or remarkably abnormal eye tracking test, decreased optokinetic fusion limit(<60°/sec.)in optokinetic nystagmus and dysrhythmia in damped pendular rotation test indicate disorders of central vestibular system.
    It is necessary for otolaryngologist never to miss brain tumor of posterior fossa complaing to dysequilibration or vertigo. These tumors are suspected by routine vestibular tests.
  • 後藤 重雄
    1981 年 84 巻 5 号 p. 490-505
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Forty four cases, Forty seven ears, of cholesteatoma in adult were studied using polytomo-graphy by AP (cochlear, vestibular and antral planes) and lateral (antral, 2mm medial to antral and tympanal planes) projections. The structures related to the middle ear cleft and to the surgical and developmental landmarks of the temporal bone were measured, and the results were compared to those of the normal adult ears. Measures related to the middle ear cleft were larger in cholesteatomatous ear than in normal, and those related to the developmental land marks of the temporal bone were smaller in cholesteatomatous ear. These differences were statistically significant in the majority of cases. As the conclusion, cholesteatoma is essentially an expansive lesion causing bone destruction, and the poorly developed temporal bone is valuable to cholesteatoma.
    Cholesteatoma cases were classified to type 1 (confined to the attic), type 2 (extending from attic to aditus) and type 3 (from attic to antrum), and measures were compared between three types. Type 3 showed large measures not only in the antrum but also in the aditus and attic. Type 3 shows extensive distribution and bone destruction. Bibliographical discussions were also included.
  • CTスキャンの応用
    石田 稔, 真銅 昌二郎, 白石 孝之, 吉田 淳一, 吉野 邦俊, 玉置 弘光, 松永 亨, 藤野 保定
    1981 年 84 巻 5 号 p. 506-512
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Tumors arising in the epipharyngeal space and skull base were satisfactorily located by a combination of routine clinical examinations and CT scanning in 10 patients who were seen at the ENT clinic of Osaka University Hospital during the period from January 1979 to June 1980.
    1) Routine physical examinations alone for neurological damage provides a certain amount of information on the extension of the tumors.
    2) Axial projection has inherent shortcomings in that it gives no well-defined image of involvement within the maxillary sinus, due to the overlapping mandible and maxilla, and that it forces the patient to assume an uncomfortable position.
    3) CT scanning surpasses conventional radiological examination in that it gives lower irradiation does and that the use of contrast enhancement gives better images.
  • 服部 浩, 藤谷 哲造, 岡田 聡
    1981 年 84 巻 5 号 p. 513-519
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    The stages of patients with oral cancer visiting our clinic are sometimes so advanced that the cure is very difficult to obtain and that the functional damage after treatment is serious. The relation between oral cancer and denture has been discussed long time. According to a statistical study including about 500 oral cancers at an oral surgery clinic, about 70% of them visited dental doctors at first, and often incorrect diagnosis and inadequate management were done by dentists. Many patients with decubital ulcer caused by a decayed tooth or leukoplakia of unknown origin visit our clinic with anxiety for oral cancer.
    According to our 15 years experiences, follow up study of these partients are necessary even when the first biopsy was negative, because sometimes squqmous cell carcinomas developed from those ulcer or leukoplakias 1 to 3 years later.
    The authors wish to emphasize the necessity of health education of the people and good cooperation between otolaryngologists and dentists for the purpose of prevention and early detection of oral cancer.
  • 橘 正芳, 斎藤 等, 佐藤 文彦, 貴田 秀樹, 水越 治
    1981 年 84 巻 5 号 p. 520-530
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    Fifty patients of the nasopharyngeal carcinoma and 27 patients of the nasopharyngeal sarcoma who visited our hospital from 1955 to 1979 were statistically examined.
    Histologically the carcinoma was mainly squamous cell carcinoma (27 cases) followed by epidermoid carcinoma (10 cases) and undifferentiated carcinoma (8 cases). One case each of the basal cell carcinoma, papillary adenocarcinoma and cystic carcinoma was also found. The sex ratio was 1.35 in favour of males. The age distribution was from 18 to 77 and the incidence showed one peak in the 60-70 age range. The most frequent first signwas a lump in the neck followed by nasal obstruction, nasal bleeding, hearing impairment, double vision and others along this line. The period from the first awareness of the symptomsto visiting the doctors was 8 months on an average, being significantly longer than that for the sarcoma patient (3.9 months on an average). This is perhaps because of the invasive tendency of the cancer when growing. In the past, in some cases, we had treated cancer patient surgically. However, knowing the discouraging results of this treatment, at the moment we treat them primarily by tele-60Co irradiation with the combination of chemotherapy (5FU+Vitamin A). Adjuvantive immunotherapy is also applied. Thus the net five-year survival rate over these last ten years has improved to 29% (4/14).
    The histology of the sarcoma was mainly the malignant lymphoma (21 cases) followed by the reticulum cell sarcoma (4 cases). One case each of Hodgkin's disease and fibrosarcoma was also found. The sex ratio was 1.45 in favour of male. The age distribution was from 8 to 84 and the incidence showed two peaks at 10 years and 50 years. The most frequent first sign was nasal obstruction followed by a lump in the neck, pharyngeal symptoms, blocked ear and other symptoms along this line. The percent distribution of these first signs was significantly different from that of the cancer by χ2-test. This difference may be explained by the difference in the way of growth of the two kinds of tumors. The carcinoma grows invasively and the sarcoma grows exophitically. In the past, the sarcoma was also treated surgically. However, around ten years ago this method was abandanded because of its discouraging results. At the moment the sarcoma is primarily treated with tele-60Co irradiation or chemotherapy, depending on its clinical stage of An Arbor Classification; the first stage patients are treated by the irradiation, only the second stage patients are treated by the irradiation followed by VEP (combination of vincristine, endoxan and predonisolone) chemotherapy, while the over third stage patients are treated only by VEMP (VEP + mitomycin C). Thus the net five year survival over on these last ten years has improved to 57.1% (4/7).
    Since the survival rate of the nasopharyngeal tumors in our hospital, especially in the carcinoma, is not satisfactory, further improvement of treatment methods including adjuvantive immunotherapy or the use of interferon is necessary, as well as early diagnosis and treatment.
  • (Panoratomの臨床応用)
    新川 敦, 坂井 真, 三宅 浩郷, 岩井 宏方
    1981 年 84 巻 5 号 p. 531-540
    発行日: 1981/05/20
    公開日: 2008/03/19
    ジャーナル フリー
    The value of maxillo-temporal panoramic tomographic machine which has recently been commercialized as Panoratom is discussed. The Panoratom film may show the internal acoustic meatus, pyramidal bone, mastoid process, mastoid air cells, and the inferior meatus, inferior turbinate, middle meatus, middle turbinate, the maxillary, ethmoidal and sphenoidal sinuses and the superior and inferior orbital fissures on one projection. This suggests that the Panoratom radiograph is suitable for diagnostic screening of the ear and nose diseases.
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