日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
93 巻, 11 号
選択された号の論文の14件中1~14を表示しています
  • 志多 享, 吉田 みゆき
    1990 年 93 巻 11 号 p. 1823-1831
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    It has generally been agreed that the industrial deafness is characterized by the hearing loss of dip type at 4 kHz, so-called c5 dip, in the early stage of the deafness. When the hearing tests were to be made at each 1 kHz on either side of 4 kHz, however, the hearing pattern of so-called c5 dip which was shown clearly on the octave audiogram disappears so often and the accurate locations of the dip could occur at 5 kHz or 6 kHz. In short, it was reconfirmed through this observation that the early dip was found not only at 4 kHz but also frequently at 5 kHz or 6kHz, as already reported by some investigators. Then, it is indispensable to measure the hearing thresholds at 5kHz and 6kHz for the early diagnosis and control of the industrial deafness.
    Furthermore, it should be emphasized that the term "c5 dip"is replaced by the the term "high frequency dip". As the origin of inducing high frequency dip, the vaso-constriction of cochlear blood vessels which present the sympatheticotonic condition by chronic exposure to the intense sounds seems to be the most possible factor.
    At present, the vascular hypothesis has been put forward as the most reliable one, attributing the origin of the dip to the chronic blood flow disturbance at the operating area of basilar membrane which corresponds with the dip frequency. From the anatomical viewpoint, it would possibly be suggested that the blood flow disturbance is liable to occur at the anastomosing region between the cochlear proper artery and the cochlear branch of vestibulo-cochlear artery. And moreover, it has already been clarified by the physiological analysis that the controlling area of this anastomosing region for blood supply correnponds with the operating area of basilar membrane for 4 kHz, 5kHz and 6 kHz. Depending on the above-mentioned findings, it seems to be reasonable to speculate that the high frequency dip originates from the blood flow disturbance at this anastomosing area of the cochlear arterioles.
  • 湯田 厚司, 坂倉 康夫, 山田 弘之, 鵜飼 幸太郎, 斎田 哲, 増田 佐和子, 間島 雄一
    1990 年 93 巻 11 号 p. 1832-1837
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    The opacity of the maxillary sinuses on X-ray film in Waters' view in patients with nasal allergy was evaluated by a microdensitometer. The patients with nasal allergy were diagnosed with the positive results of the followings ; 1) eosinophilia in nasal secretion, 2) nasal provocation test, 3) intradermal skin test or radioallergosorbent test (RAST). The ratio of density of the maxillary sinuses and orbits was determined by a microdensitometer, and the ratio of the average degree of the opacity of the maxillary sinus to that of the ipsilateral orbit was designated as the M/O ratio. The normal range of the M/O ratio was set over the mean value - 2 standard deviations in the normal group. The results are followings.
    1) The abnormal shadows in the maxillary sinuses were found out to be 36.9% in patients with nasal allergy.
    2) Patients under 15 years-old had significantly higher incidence of abnormal shadows, especially in the bilateral sinuses compared with patients over 15 years old.
    3) Polyps in the maxillary sinus were recognized in 5.0% of all the sinuses.
    4) There were no significant differences for the incidence of abnormal shadow among the patients with nasal allergy caused by different antigens.
  • とくに原因不明のキヌタ•アブミ関節障害例について
    村嶋 龍太郎
    1990 年 93 巻 11 号 p. 1838-1846
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to elucidate the pathophysiology of an undetermined conductive deafness without perforation of the tympanic membrane, comparative study was made in several factor with conductive deafness which has normal tympanic membrane and may be due to inflammation.
    Differences and similarities in the manner of ossicular damage were discussed in these conductive deafness.
    The morbidity rate of conductive deafness without perforation of the tympanic membrane which was undetermined cause, was found in wide age group 7 to 56 years of age.
    The site of damage was found at portion of the incudostapedial joint.
    The origin of etiology was estimated may take part in inflammatory process.
    We emphasized that such as undetermined conducitve deafness may increase according to increase of otitis media with effusion.
  • ホログラフィ干渉法による実験的研究
    岡野 和美
    1990 年 93 巻 11 号 p. 1847-1855
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    The influence of middle ear liquid on the tympanic membrane (TM) vibration was studied using the holographic interferometry. The physiological saline solution was injected into the middle ear cavity of the canine temporal bone. The liquid volume in the middle ear cavity was changed into 3 grades in order to observe the difference of the vibration pattern between them.
    The vibratory patterns of a normal canine TM remained unchanged in their first mode up to a frequency of approximately 2 kHz. In this mode, there were peak displacement regions in the posterior and anterior quadrants. The TM vibrations showed sectional patterns, above 3 kHz in the posterior and above 4 kHz in the anterior.
    After liquid retention, the following were observed.
    1. The frequenecy at which sectional patterns occurred shifted to a lower frequency in the immerged portion, but showed no definite tendency in the unimmerged portion.
    2. Maximum amplitudes of the anterior and posterior quadrants of the TM and the mallar tip shifted to somewhat higher frequencies for the liquid volume below the level of the tip portion, but contrary, shifted to lower frequencies for the liquid volume thereabove.
    3. The ossicular chain tended not to make normal function for the TM vibration with an increase of liquid volume.
  • 竹内 義夫
    1990 年 93 巻 11 号 p. 1856-1863
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    In order to overcome defects of dictation method, a new 5-choice method introduced into Japanese mono syllables discrimination test. A new 20-items mono syllables list was developed on the principle of equal probability of the Japanese consonant phonemics, instead of the present mono syllable frequencies among the 100 Japanese mono syllables. The choice items for the each stimulus syllables were selected on the analysis of perceptual confusions data among hard of hearing persons. Comparison of discrimination scores and consonat confusions of the dectation method speech test and 5-choice method revealed that the two tests were parallel with some advantages of easiness of test procedure, and easiness and objectivity of scoring on the side of 5-choice method.
  • 原田 克也, 小松崎 篤, 高橋 博文, 野村 俊之, 谷野 徹, 山本 昌彦, 小田 恂
    1990 年 93 巻 11 号 p. 1864-1868
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    Two patients suffered from acute hearing loss of the contralateral side after acoustic tumor surgery were reported.
    The first patient was a 42-year-old-male. He had had a right progressive hearing loss over two years and CT scan revealed a mass of 20mm in diameter in the right cerebellopontine angle. The patient noticed the contralateral hearing loss on next morning after the total removal of tumor by translabyrinthine approach. However he had no complaint of vertigo or facial palsy. An audiogram of the contralateral side just after the onset showed flat type audiogram of sensorineural hearing loss with positive recruitment. With steroid therapy for two weeks, hearing and ABR findings improved and returned to nearly normal.
    The second case was a 47-year-old male. The patient had chronic renal failure treated by hemodialysis. His hearing loss in the right ear had gradually decreased over two years and an acoustic tumor of 2.5cm in diameter was demonstrated by CT scan. The tumor was removed by translabyrinthine approach. Nine day after the operation, he noted total deafness in contralateral ear and vertigo. He was given steroid hormone and his hearing improved up to 68 dB.
    Four cases have been reported in the literature. The mechanisms of acute sensorineural hearing loss observed in these cases were discussed. The cause remained unknown, however there were some hypothesis such as the compression to the opposite brainstem, peripheral nerve or feeding vessels by tumor or brain edema after operation, and local vasospasms might be also the cause of hearing impairment. In the first case IgE was elevated in the serum level as reported previously. It was speculated that the pathogensis of acute sensorineural hearing loss in the second case might be due to hemodialysis.
  • 梁 耀, 原渕 保明, 形浦 昭克
    1990 年 93 巻 11 号 p. 1869-1873
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    Distribution of various T-cell subsets in the palatine tonsil was investigated by two-color flow cytometry and double immunoenzymatic stain. Tonsillar lymphocytes contained many (about 20%) helper T (CD4+Leu8-) cells and few (only 1%) suppressor T (CD8+CDllb+) cells. In interfollicular area, each T-cell subset, i, e., helper, helper-inducer (CD4+CD29+), suppressor-inducer (CD4+CD45RA+), cytotoxic (CD8+CDllb-), and suppressor, was identified by double immunoenzymatic labeling technique using alkaline phosphatase and peroxidase. On the other hand, only two T-cell subsets, helper, and cytotoxic T-cell subpopulations, were recognized in germial center. These results indicate that double immunoenzymatic stain as well as two-color flow cytometry gives us useful informations in terms of tonsillar T-cell subsets.
  • 原田 勇彦, 山岨 達也, 八木 真人
    1990 年 93 巻 11 号 p. 1874-1881
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    It is pointed out that sensorineural hearing loss sometimes accompanies otitis media with effusion. In order to clarify the incidence and clinical features of sensorineural hearing loss associated with otitis media with effusion, the cases over the past ten years were reviewed. During the period from January 1979 through December 1988, 1338 patients were diagnosed to have otitis media with effusion and showed reliable audiograms in our clinic. Among these patients, 237 patients (17.7%) showed sensorineural hearing loss, defined as a bone conduction loss of 25 dB or more at any one of the frequencies of 500 through 4 kHz. The incidence of sensorineural hearing loss increased as the age of the patients increased. By analyzing their clinical course, these 237 patients were classified into 3 groups according to the etiological relationship of sensorineural hearing loss and otitis media with effusion. In Group A which comprises 14 patients (1.0%), a strong causal relationship was suspected. This group was further divided into 2 subgroups. In one subgroup of 4 patients, sensorineural hearing loss developed rather rapidly during the course of otitis media with effusion and recovered gradually. In the other subgroup of 10 patients, sensorineural hearing loss progressed and did not recover. The clinical features of these 2 subgroups were quite different. In Group B which comprises 50 patients (3.7%), causal relationship was suspected but was not confirmed. Many of the patients in this group showed unilateral otitis media with effusion and the sensorineural hearing loss in the same ear, which was characteristically demonstrated as bone conduction loss at 2 and 4 kHz. In Group C which comprises the rest of the patients (173; 12.9%), the cause of the sensorineural hearing loss was considered to be unrelated with otitis media with effusion.
  • 鼻腔側壁より原発した悪性多形腺腫の一症例
    金子 まどか, 古川 政樹, 久保田 彰, 持松 いづみ, 大石 公直, 澤木 修二
    1990 年 93 巻 11 号 p. 1882-1889
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    Nineteen cases with malignant tumors in the nasal cavities have been treated at the department of otolaryngology, Yokoharma City University, during the 10 years from 1978 to 1987.
    1. Cases were 8 males and 11 females, and their ages ranged from 27 to 84 years (Mean age: 64.6).
    2. In the histological classification, 9 cases were the epithelial malignant tumors (squamous cell carcinoma 5 ; adenoid cystic carcinoma 2 ; transitional cell carcinoma 1 ; malignant pleomorphic abenoma 1), 9 cases were non-epithelial malignant tumors (malignant melanoma 6 ; malignant lymphoma 2 ; olfactory neuroblastoma 1), and one case was unclassified malignant tumor.
    3. Cases with epithelial malignant tumors showed better prognose after treatment of surgical and radiation therapy. But those of non-epithelial malignant tumor were worse.
    4. A very rare case with malignant pleomorphic adenoma, originated at the lateral nasal wall was reported and its clinical features and treatment were discussed. This tumor has not been reported up to the present in Japan.
  • 阿部 隆, 立木 孝, 伊藤 俊也, 遠藤 芳彦, 鈴木 健策
    1990 年 93 巻 11 号 p. 1890-1897
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    The effects of contralateral noise exposure on evoked otoacoustic emission (e-OAE) were investigated in 10 normal hearing subjects and 3 cases with unilateral deafness. The e-OAE was recorded by IL088 and weighting noise was given to the contralateral ear (impaired side in unilateral deafness cases.). The air conducted noise exposure showed suppressive effect on e-OAE along with the increase of noise stimulus intensity in normal hearing subjects, but did not in unilateral deafness cases. The degree of suppression in e-OAE was most remarkable in highest peak power between 1 kHz and 2 kHz in FFT picture and the mean value of maximal suppression in 10 normal hearing subjects was 2.2 dB.
    The bone conducted noise exposure showed no effects on e-OAE in either normal hearing subjects or unilateral deafness cases.
    It was suggested that the contralateral noise exposure could suppress the function of cochlear micromechanics probably via crossed olivocochlear bundle.
  • 免疫組織化学的研究
    紀平 晋也
    1990 年 93 巻 11 号 p. 1898-1907
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    The distribution and fine structure of calcitonin gene-related peptide-like immunoreactive (CGRP-LI) cells and fibers in the vestibular nuclei of the rat were investigated by light and electoron microscopic immunocytochemistries.
    In addition to the previous report that CGRP-LI cells were found in the lateral vestibular nucleus, the present study clarified that they are found also in the inferior vestibular nucleus, medial vestibular nucleus and nucleus X. The lateral vestibular nucleus contains a high density of CGRP-LI cells. They are medium in size and multipolar in shape. CGRP-LI cells in the inferior vestibular nucleus are small to medium in size and triangular or pea shaped. CGRP-LI cells in the medial vestibular nucleus and nucleus X are both few in number and small in size. Possible colocalization of CGRP with acetylcholine, γ-aminobutyric acid or substance P in the single neuron of the vestibular nuclei might be suggested.
    CGRP-LI fibers are more extensively distributed in various areas throughout the vestibular nuclei, though previous studies reported that they were found in the lateral vestivular nucleus and inferior vestibular nucleus. A number of CGRP-LI fibers are clearly observed in the inferior vestibular nucleus.
    Under electron microscopic analysis, CGRP-LI endoproducts are diffusely localized throughout the cytoplasm and some of CGRP-LI dendrites are identified to receive synaptic inputs form non-immunoreactive axon terminals with small spherical vesicles.
    It seems likely that CGRP is participated both in the intrinsic neurons in the vestibular nuclei or in the reciprocal innevations between the vestibular nuclei and the reticular formation or the cerebellum.
  • 田口 清男
    1990 年 93 巻 11 号 p. 1908-1912
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
    The vision of 35 subjects with normal oculomotor function was artificially reduced with the use of convex and concave lenses and neutral density filters. The effects of blurred vision on the oculomotor function test were subsequently studied. In using neutral density filters, abnormal findings tended to be confirmed in the eye tracking test (ETT) and optokinetic nystagmus test (OKNT) for vision of O.5 or less. However, the ratio of abnormal findings to the ETT markedly decreased as the intensity of the target luminance increased.
    Blurred vision dueto refractive abnormality using lenses, had hardly any effect was detected on either test even in the cases of severe blurred vision.
    In conclusion, the effects on the oculomotor function test varied according to causes of blurred vision.
  • 形浦 昭克
    1990 年 93 巻 11 号 p. 1944-1945
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
  • 田中 敬明
    1990 年 93 巻 11 号 p. 1946-1947
    発行日: 1990/07/20
    公開日: 2008/03/19
    ジャーナル フリー
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