Practica Oto-Rhino-Laryngologica

Application of Growth Factors for Regeneration Medicine

Juichi Ito

2007 Volume 100 Issue 1 Pages 1-5
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.1

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Recently, regeneration medicine has received considerable attention in various fields and clinical applications have been attempted. There are approaches to regeneration medicine. The first approach is to transplant cells, especially various kinds of stem cells into the organs and tissues. The other approach is to promote the self-regenerative ability of cells. In many cases, however, cellular self-regenerative ability is limited. Growth factors are thought to play an important role in cellular proliferation, differentiation and regeneration, while the loss of growth factors contritutes to various diseases. In this report, the discovery of growth factors, examples of various growth factors and the application of growth factors to regeneration medicine are discussed.

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Endoscopic Transnasal Pituitary Surgery

S. Haruna

2007 Volume 100 Issue 1 Pages 6-7
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.6

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Clinical Study on Unilateral Hearing Loss in Children

Sawako Masuda, Satoko Usui

2007 Volume 100 Issue 1 Pages 9-15
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.9

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A series of 60 children was studied (aged 0 to 10 years, 32 boys, 28 girls) with severe unilateral sensorineural hearing loss of unknown etiology.
There were two peaks, at 0 and 6 years. In 19 children, hearing loss was identified during a conservative general health checkup for school or preschool children. In 21 children aged 0 years, 16 were suspected of hearing loss by newborn hearing screening.
Temporal bone computed tomography scans were examined in 51 patients. Sixteen ears (31.4%) with hearing loss had inner ear and/or internal auditory canal abnormalities. In one patient, the anomaly was the presence of a bony wall dividing the internal auditory canal into two separate compartments associated with severe inner ear hypoplasia. Two patients had a common cavity. In one of these patients, the anomaly was revealed because of severe bacterial meningitis, and another was detected by newborn hearing screening. Six patients had a narrow internal auditory canal, 4 had a narrow internal auditory canal and hypoplastic cochlea, and 1 had a narrow internal auditory canal and cystic vestibule, and lateral semicircular canal dysplasia. Two patients had a cystic vestibule and lateral semicircular canal dysplasia.
One case showed fluctuation of the hearing level in the contralateral ear with normal hearing during the observation period at an average of 20 months.
The number of children whose unilateral hearing loss is detected early by newborn hearing screening has enormously increased. Strategies for follow-up, early intervention, and support for families are necessary for young children with unilateral hearing impairment.

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Clinical Statistics of Patients with Dizziness Consulting the Emergency Outpatient Clinic

Yasuo Ogawa, Akira Hagiwara, Naoharu Kitajima, Taro Inagaki, Masaaki S ...

2007 Volume 100 Issue 1 Pages 17-24
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.17

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Between May 2004 and April 2006, 468 emergency patients with vertigo or dizziness consulted the otorhinolarygological emergency room of Tokyo Medical University. Patients with vertigo or dizziness comprised about 9% of the whole otorhinolaryngological emergency patients. The number of female patients was larger than that of male patients. About half of the patients were brought to our hospital by ambulance. Nystagmus was observed in 219 patients (46.8%). Incidence of nystagmus was highest on positional nystagmus test. Brain CT was obtained in 185 patients (39.5%), but there were no abnormal findings in any patients. The most frequent diagnosis was inner ear disorder (22%), followed by Menière's disease (7%), vestibular neuritis (6%), BPPV (6%). Cerebral infarction was observed in 1.9%.
Eighty-four patients were admitted. Major diseases requiring admission were vestibular neuritis and inner ear disorder.
In patients with cerebral infarction, brain CT was normal. These patients were all elderly males over 60 years old. Their nystagmus in the emergency room did not suggest central disorder, or they did not have other neurological findings. Neurological signs and symptoms appeared thereafter.
In the emergency room, establishing a diagnosis by limited examination is difficult. Careful examination is necessary, since vertigo or dizzy patient with a central disorder can show sudden change.

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Power-Assisted Partial Adenoidectomy (PAPA) with Total Tonsillectomy for Pediatric Obstructive Sleep Apnea Syndrome

Masahiro Kawamoto, Ryuichi Mochizuki, Keisuke Yamamoto, Mitsutaka Tani ...

2007 Volume 100 Issue 1 Pages 25-29
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.25

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Obstructive sleep apnea syndrome (OSAS) in youth causes various sequelae—life-threatening, body composition and school performance. Adenotonsillar surgery is beneficial for treating pediatric OSAS, however, the traditional methods pose some problems such as re-multiplication of adenoids. We performed total tonsillectomy and Power-Assisted Partial Adenoidectomy (PAPA) in 111 children for 3 years and 25 cases were examined Oxygen Desaturation Index 3% (ODI 3%) during sleep with a pulseoxymeter before and after the operation.
Their ODI 3% improved significantly after surgery. No long-term complications, such as relapse of OSAS and immunodeficiency, have occurred. PAPA with total tonsillectomy is very useful for the treatment of pediatric OSAS.

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Nasal Meningitis at 32 Weeks' Gestation

Ayako Furuya, Masato Morimoto, Toshikazu Shimane, Takeyuki Sanbe, Haru ...

2007 Volume 100 Issue 1 Pages 31-35
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.31

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We encountered a patient who developed meningitis subsequent to acute sinusitis at 32 weeks' gestation. Sinusitis sometimes causes intracranial complications with inflammation advancing into the skull because of its anatomical location. Its risk is high in pregnant women because the administration of antibiotics is often suspended in consideration of its effect on fetuses. Also in the present case, rhinorrhea had been noticed about one month previously, but no treatment was given, and while the clinical course was observed by oral administration of only antipyretic analgesics even after the manifestation of headache and fever, meningitis developed concurrently. There was concern about cranial nerve sequelae of the mother and child because of persistant convulsions and disturbances of consciousness; however, recovery was achieved by early diagnosis, early surgical operation and postoperative management.

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A Case of Malignant Fibrous Histiocytoma of the Right Maxillary Sinus -Associated Ovary Tumor-

Nobuo Saeki, Tomonori Terada, Kunichika Tou, Nobuhiro Uwa, Masafumi Sa ...

2007 Volume 100 Issue 1 Pages 37-41
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.37

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Malignant fibrous histiocytoma (MFH) is one of the most common soft tissue sarcomas of the extremities. MFH arising from the maxillary sinus region are extremely rare. We experienced a case of MFH of this region in a 61-year-old female. She was admitted with the chief complaints of right cheek swelling and swelling of the gingiva around the right maxillary molar area. Biopsies of the nasal cavity and maxillary gingiva indicated malignant schwannoma or MFH. Furthermore, a pelvic tumor larger than 10cm was found. We performed excision of the pelvic tumor and total maxillectomy. Histological diagnosis was fibroma of the ovary and MFH of the maxillary sinus. Postoperative radiation therapy (total dose: 50Gy) was performed. No recurrence has been observed for more than 5 years after surgery.

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Tetanus Associated with Trismus: A Case Report

Atsuko Maki, Yoshiaki Iguchi, Meijin Nakayama, Masami Nakajima, Takash ...

2007 Volume 100 Issue 1 Pages 43-46
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.43

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We report a case of tetanus with trismus. A 44-year-old man presented with difficulty in mouth opening. Progressive trismus, stiffness of cervical muscles, convulsions, and a history of trauma indicated a diagnosis of tetanus. Emergency tracheotomy was performed because of convulsions against sedatives and difficulty in endotracheal intubation. The patient was given benzylpenicillin-potassium and antitetanus serum. He had respiratory distress for 23 days, and was discharged on the 45th hospital day.

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A Clinical Study of Warthin's Tumor

Hideaki Suzuki, Tsuyoshi Udaka, Takeyuki Fujimura, Takanori Mori, Taku ...

2007 Volume 100 Issue 1 Pages 47-50
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.47

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Warthin's tumor is the second most common benign neoplasm arising in the salivary glands. We retrospectively analyzed 60 consecutive patients with Warthin's tumor who were treated in our Department from 1991 to 2006. The patients were 52 men and 8 women, 33-82 years of age with an average of 62.3 years. The site of occurrence was the parotid gland in all cases; bilateral and multiple occurrence was seen in 27% and 50% of cases, respectively. The diameter of the tumor was 10-80mm with an average of 33.9mm, and showed a tendency to increase with age. Preoperative facial nerve palsy was observed in one patient who manifested signs and symptoms of acute inflammation of the affected parotid gland. A positive finding of ^99mTc-pertechnetate scintigram was obtained in 45 out of 47 patients (sensitivity: 96%). The number of patients increased, and their age and the diameter of the tumor decreased in the latter period (1999-2006) compared with in the first period (1991-1998). Clinical and epidemiologic characteristics of Warthin's tumor were bibliographically reviewed.

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Two Cases of Metastatic Renal Cell Carcinoma to the Submandibular Gland

Atsushi Kondo, Takayuki Kozawa, Tadataka Ishikawa, Junichi Wakashima

2007 Volume 100 Issue 1 Pages 51-55
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.51

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Renal cell carcinoma can metastasize to any part of the body. We encountered two cases of renal cell carcinoma that metastasized to the submandibular gland.
The first case was a 74-year-old man and the second case was a 78-year-old man. Each patient complained of a painless swelling of the right submandibular gland after nepfrectomy for renal cell carcinoma. In both cases, we performed resection of the submandibular gland. Pathological examination demonstrated metastatic renal cell carcinoma to the submandibular gland. Metastatic renal cell carcinoma as a submandibular gland tumor is rare, and we discussed metastasis of renal cell carcinoma especially to the submandibular gland.

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Large Vocal Cord Polyp Causing Dyspnea: A Case Report

Shinya Hori, Kenichi Kaneko, Rie Kanai, Seita Kubo

2007 Volume 100 Issue 1 Pages 57-60
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.57

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A rare case of large vocal cord polyp causing dyspnea is reported. A 55-year-old man with thrombocytopenia visited our department complaining of dyspnea and hoarseness. Laryngeal endoscopy showed a large mass located between the vocal cords, which moved up and down in accordance with breathing. The upper airway was very narrow because of the mass. Tracheostomy was performed under local anesthesia and then the mass was resected under general anesthesia using a laryngomicrosurgery technique. The patient's dyspnea and hoarseness disappeared after surgery. The histopathological findings indicated a diagnosis of vocal cord polyp. We consider that tracheostomy is the safest and most useful procedure to guarantee the upper airway in cases of large vocal cord polyp showing dyspnea.

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Experience with Laryngotracheal Separation at Hiroshima Prefectural Hospital

Tomohisa Hirai, Noriyuki Fukushima, Kunihiko Ono, Keishin Go, Masaaki ...

2007 Volume 100 Issue 1 Pages 61-64
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.61

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We report the outcome of laryngotracheal separation for the treatment of intractable aspiration in eight patients; six children and two adults. The surgical procedures should be adopted depending on whether the patient is a child or adult because of differences in the anatomical stiffness of the trachea. Postoperative pharyngeal-tracheal leakage in one case was treated conservatively for three months and the fistula was closed. As a result, recurrent aspiration subsided in all of the patients. In addition, in some cases of tracheal granulations caused by the canula, the granulations disappeared.

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Giant Cell Tumor of 1st Thoracic Vertebra Resected by a Lower Cervical Approach

Keigo Honda, Ryo Asato, Shigeru Hirano, Shinzo Tanaka, Juichi Ito, Mas ...

2007 Volume 100 Issue 1 Pages 65-69
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.65

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We report a rare case of giant cell tumor of bone arising in the 1^st thoracic vertebra, which was successfully resected by a lower cervical approach. The patient was a 16-year-old female who presented with a cervical mass and dyspnea. Imaging study revealed a mediastinal mass arising in the 1st thoracic vertebra, extending upward into the lower neck. After repeated open biopsies, a diagnosis of giant cell tumor of bone was made. Curative surgery was performed by orthopedic and head and neck surgeons. Surgical exposure of the tumor was performed mainly by head and neck surgeons using a lower surgical approach without a median sternotomy. The postoperative course was uneventful and the patient is doing well without recurrence.

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The Hearing Aid Allowance System (The Law for Supporting Independence of Persons with Disabilities)

T. Sanbe

2007 Volume 100 Issue 1 Pages 70-71
Published: January 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.70

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