Practica Oto-Rhino-Laryngologica

Regeneration of the Chorda Tympani Nerve and Fungiform Papillae after Middle Ear Surgery

Takehisa Saito

2007 Volume 100 Issue 11 Pages 867-876
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.867

JOURNAL FREE ACCESS

Show abstractHide abstract

The chorda tympani nerve is often severed during middle ear surgery. After being severed, regeneration of the nerve was observed in 46% (33/71 ears) of patients who underwent second surgery or reoperation. Since it is unclear whether these regenerated nerves have gustatory function, the threshold of electrogustometry (EGM) was measured periodically over a one-year period after surgery. In 20 (61%) of 33 cases demonstrating regenerated nerves, EGM threshold recovered completely or incompletely compared with pre-operative values. Furthermore, the morphological examination of fungiform papillae of the tongue using a digital microscope was performed. In 35 patients with recovery of gustatory function, 11 (31%) showed a similar size and distribution of fungiform papillae compared with that on the non-severed side. Based on these findings, it was concluded that the severed chorda tympani nerve can regenerate and regain gustatory function. Furthermore, it was suggested that the regenerated chorda tympani nerve fibers distribute to fungiform taste buds, although morphological study of the taste buds using a transmission electron microscope is needed.

View full abstract

Download PDF (7004K)
Imaging of Deep Neck Infection

S. Kikuchi, [in Japanese]

2007 Volume 100 Issue 11 Pages 878-879
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.878

JOURNAL FREE ACCESS

Download PDF (1993K)
Petrous Bone Cholesteatoma with Sudden Leakage of CSF: A Case Report

Atsuyoshi Asahi, Taketoshi Fujita, Ryuki Otaka, Osamu Ohshima, Yasuaki ...

2007 Volume 100 Issue 11 Pages 881-885
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.881

JOURNAL FREE ACCESS

Show abstractHide abstract

A case of petrous bone cholesteatoma with sudden leakage of cerebrospinal fluid (CSF) was encountered. An 82-year-old man complained of sudden chill and left otorrher. Computed tomography of the brain demonstrated a large area of air density in the lateral ventricles. Imaging examinations showed a tumorlike shadow, with extensive bony destruction, located in the petrous bone. Cholesteatoma was removed by a combination of lateral trans-suboccipital and trans-mastoid approaches. At surgery, the cholesteatoma was invading the pons and leakage of cerebrospinal fluid through the internal auditory canal was found. Obliteration with temporal muscle and fibrin glue was performed.

View full abstract

Download PDF (5224K)
A Case of Otogenic Brain Abscess

Hitosuke Tameno, Tatsuya Matsunami, Susumu Nakae, Yasuhiko Nishimura

2007 Volume 100 Issue 11 Pages 887-892
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.887

JOURNAL FREE ACCESS

Show abstractHide abstract

A case of otogenic brain abscess, secondary to cholesteatoma, is reported.
Early diagnosis is very important for the treatment of otogenic brain abscess, which is a life-threatening disease. Early diagnosis of this disease is often difficult, because of modification by antibiotics.
A 62-year-old male with a longstanding history of chronic left otorrhea with severe headache and fever, was admitted to our hospital. He was diagnosed as having left cholesteatoma, but prolonged headache and high fever did not improve.
Unfortunately, we could not detect otogenic brain abscess early in the diagnostic process because of the modification by antibiotics and a lack of recognition for otogenic complications. Six days after admission, brain CT demonstrated a well-encapsulated brain abscess in the left temporal lobe. Although conservative treatment was administered, the diameter of the brain abscess increased daily. There are two therapeutic approaches; one is ear surgery, followed by neurosurgical treatment; the other is intracranial surgery, followed by otogenic treatment, after the general condition of the patient has improved. We selected the latter one to treat our case. The abscess was surgically drained by a neurosurgeon because of the high possibility it would penetrate the cerebral ventricle. The shadow of the brain abscess on CT disappeared after surgical drainage, and the symptoms began to improve. After his general condition improved, removal of cholesteatoma was performed. Two months later, he continuoes to do well.
We concluded that this approach was a very useful and reasonable treatment in our case.

View full abstract

Download PDF (7705K)
Bilateral Auricular Pericondritis that Occurred by Relapsing Polychondritis: A Case Report

Hiromi Nagano, Kousuke Yoshifuku, Yuichi Kurono

2007 Volume 100 Issue 11 Pages 893-897
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.893

JOURNAL FREE ACCESS

Show abstractHide abstract

Relapsing polychondritis is a chronic inflammatory disease associated with an autoimmune disorder involving the cartilaginous tissue, eyes, and blood vessels.
This case report describes an 82-year-old man who was referred to our clinic with a chief complaint of a one-month history of bilateral perichondritis of the auricles. The patient was diagnosed as having relapsing polychondritis in the early stage, one month after onset. The diagnosis was based on bilateral perichondritis and the response to systemic predonine. Antinuclear antibodies, P-ANCA, C-NACA were negative. HLA-DR4 was positive. Intravenous predonine administration was initiated, and auricular chondritis was improved within 3 days.

View full abstract

Download PDF (3333K)
A Infant Case of a Chopstick as a Foreign Body in the Parapharyngeal Space

Toshiro Kawano, Junichi Ishitoya, Ryo Endou, Mamoru Tsukuda

2007 Volume 100 Issue 11 Pages 899-903
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.899

JOURNAL FREE ACCESS

Show abstractHide abstract

We sometimes experience infant cases leading to unexpected deaths due to foreign bodies. It is often difficult to identify the cause or foreign body invasion by asking questions directly to a child. We experienced an infant case of a chopstick passing through the soft palate, reaching the parapharyngeal space near the inner carotid artery circumference. At the first medical examination, we could not detect the tip of the chopstick, in the pharynx. Using 3-directional-CT images, we could locate the tip of the chopstick in the parapharyngeal space near the inner carotid artery circumference. Under general anesthesia, we could remove the tip of the chopstick from the parapharyngeal space near the inner carotid artery with an endoscope trans-orally.
It is important to investigate positional conditions between a foreign body and the vessels in the parapharyngeal space. Images such as enhancing 3-directional-CT before the operation is useful.
Furthermore, we have to be careful of the late neurosis by pencil-injury in the region and pay close attention to respiratory tract management.

View full abstract

Download PDF (6855K)
Acute Sphenoid Sinusitis Associated with Abducens Nerve Palsy

Akiko Katoh, Narihisa Ueda, Teruo Shiomori, Toyoaki Ohbuchi, Takeyuki ...

2007 Volume 100 Issue 11 Pages 905-908
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.905

JOURNAL FREE ACCESS

Show abstractHide abstract

Because the sphenoid sinus is adjacent to important structures including optic, oculomotor, trochlear, trigeminal, and abducens nerves, diseases of this sinus may cause related neurological disorders. We herein report a case of sphenoid sinusitis associated with abducens nerve palsy. A 66-year-old man with a 7-day history of diplopia was referred to our hospital. On physical examinations, he manifested left-sided abducens nerve palsy and nasal polyposis. Computed tomography and magnetic resonance imaging (MRI) demonstrated ethmoid-sphenoid sinusitis on the affected side. The patient underwent endoscopic sinus surgery on the day of examination followed by intravenous administration of hydrocortisone (200mg/day for 3 days). Postoperative MRI showed a contrast-enhanced area in the left cavernous sinus, suggesting the presence of an inflammatory change. His postoperative clinical course was uneventful, and complete neurological recovery was obtained two and a half months after surgery. It is stressed that physicians should be aware of potential diseases of the sphenoid sinus during the diagnosis and management of such patients.

View full abstract

Download PDF (4634K)
A Case of Granulocytic Sarcoma in the Tongue

Kenichiro Nomura, Kazuhiko Hokunan, Chikako Yoshida, Tatsuya Hayashi, ...

2007 Volume 100 Issue 11 Pages 909-912
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.909

JOURNAL FREE ACCESS

Show abstractHide abstract

We report a 52-year-old patient with acute myeloid leukemia who developed granulocytic sarcoma on the left side of her tongue. The tongue mass appeared very similar to squamous cell carcinoma at the first examination. However, blood test showed an extremely high level of leukocytosis. Granulocytic sarcoma was diagnosed based on histopathological findings. Although the tongue tumor disappeared after chemotherapy, the patient died of severe pneumonia without sufficient recovery from myelosuppression.

View full abstract

Download PDF (3327K)
A Case of Malignant Fibrous Histiocytoma of the Parotid Gland

Ritsuko Yoneda, Takayuki Mochizuki, Yukiko Mochizuki, Hajime Hirose, M ...

2007 Volume 100 Issue 11 Pages 913-917
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.913

JOURNAL FREE ACCESS

Show abstractHide abstract

Malignant fibrous histiocytoma (MFH) is reported to be the most common soft tissue tumor in late adult life. However, it is extremely rare in the parotid gland. A 57-year-old male with MFH in the parotid gland is reported. The patient had a 20-year history of right subauricular swelling. There was neither spontaneous pain nor tenderness. Superficial parotidectomy was performed under the tentative diagnosis of pleomorphic adenoma. The tumor was diagnosed as MFH by histological examinations including immunohistological studies. The postoperative course has been uneventful without recurrence or metastasis for six years.

View full abstract

Download PDF (3571K)
A Case of Ectopic Thyroid Papillary Carcinoma in the Lateral Cervical Region

Matsumi Tsuchiya, Atsuro Seki, Kiyoshi Misawa, Kenichi Sugiyama, Hiroy ...

2007 Volume 100 Issue 11 Pages 919-922
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.919

JOURNAL FREE ACCESS

Show abstractHide abstract

The occurrence of ectopic thyroid is due to improper descent of the thyroid primordium. Most frequently, ectopic thyroid occupies the midline region, which is associated with the thyroglossal duct. Malignant transformation of an ectopic thyroid is rare and it usually arises from a thyroglossal duct cyst. Ectopic thyroid carcinomas lacking thyroglossal duct cyst and located in the lateral cervical region are extremery rare. A metastasis from primary thyroid carcinoma must be ruled out. We report a patient with an ectopic thyroid papillary carcinoma in the lateral cervical region. Pathological examination demonstrated both ectopic normal thyroid and papillary carcinoma.

View full abstract

Download PDF (5424K)
Six Cases of Cervical Mycobacterial Lymphadenitis and a Case of Non-Tuberculous Mycobacterial Infection of the Parotid Gland

Recent Trends in Mycobacterial Infection

Hiroko Monobe, Masato Nakashima, Hitoshi Tojima, Tetsuo Semba

2007 Volume 100 Issue 11 Pages 923-927
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.923

JOURNAL FREE ACCESS

Show abstractHide abstract

We encountered 6 cases of cervical mycobacterial lymphadenitis and a case of non-tuberculous mycobacterial infection of the parotid gland over a 19-month period. The incidence of mycobacterial infection is currently increasing among elderly persons and foreign workers who are socially vulnerable, and cervical mycobacterial lymphadenitis is no exception to that trend.
Six of our 7 cases were over 60 years old and the mean patient age was 75.7 years, the remaining one case was a young foreign worker. In the latter case, multiple lymphadenopathies were noted on the first examination and 6-months of oral antibiotic administration resulted in only partial improvement.
Cervical mycobacterial infection can present in many forms depending on the stage of the disease. Regarding diagnostic methods, although an accurate diagnosis was easily reached by tuberculous DNA polymerase chain reaction (PCR) in cases showing abscess formation, clinical diagnosis was delayed in atypical cases not presenting with neck abscess and excisional biopsies were needed. The clinical courses of these cases are presented along with a review of the literature.

View full abstract

Download PDF (2259K)
Rapid Preparation of Burow's Solution for the Treatment of Intractable Chronic Suppurative Disease of the External Ear Canal and Middle Ear

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

2007 Volume 100 Issue 11 Pages 929-933
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.929

JOURNAL FREE ACCESS

Show abstractHide abstract

We evaluated the effectiveness of Burow's solution prepared by the rapid preparation method for the treatment of intractable chronic suppurative disease of the external ear canal and middle ear.
We examined 34 ears of 29 patients ranging from 1 to 84 years of age. There were 19 males and 10 females with disease persisting for a range of 1 month-50 years. The disease and number of ears were as follows; chronic granulated myringitis (8 ears), chronic otorrhea caused by ventilation tubes (6 ears), chronic otitis media with perforation (6 ears), chronic otitis externa (5 ears), postoperative mastoid cavity problems (5 ears) and fungal otitis exrerna (4 ears).
Burow's solution prepared by the rapid preparation method was dripped into the ear canal for about 15 minutes or small cotton balls soaked with the solution were applied directly to the lesion.
Overall, 19 (61%) of 31 ears were cured, 7 (23%) were improved. The newly developed Burow's solution showed almost the same effectiveness in the treatment of the chronic granulated myringitis and chronic otitis externa (67-100%), but was not effective for the treatment of chronic otitis media with perforation (33%).

View full abstract

Download PDF (726K)
Clinical Usefulness of Prophylactic Treatment with Olopatadine Hydrochloride for Japanese Cedar Pollinosis in Ishikawa Prefecture

Takaki Miwa, Toshiaki Tsukatani, Naoki Uramoto, Tomokazu Yoshizaki, Ma ...

2007 Volume 100 Issue 11 Pages 935-945
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.935

JOURNAL FREE ACCESS

Show abstractHide abstract

Clinical usefulness of olopatadine hydrochloride was studied in 97 patients with cedar pollinosis in 2005. The subjects were divided into 2 groups based on the time of starting treatment before or after the onset of pollen season. Subjective symptoms, objective findings of nose and quality of life scores using Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ No 1) were compared between the two groups. Both the clinical scores and QOL scores remained normal even at the peak of pollen scattering in patients who started medication before pollen season, and showed significant differences in each index compared with those in the patient group starting treatment after the onset of pollen season. The patients who started medication after pollen dispersal were not relieved of their symptoms at the peak of pollen scattering, but they had lower scores at both the beginning and end of pollen season. There were strong correlations between the clinical symptom scores and QOL scores in both groups. In conclusion, olopatadine hydrochloride appeared to be sufficiently effective for cedar pollinosis during the season of peak pollen of scattering by starting medication before the onset of pollen season.

View full abstract

Download PDF (2205K)
The Operation in a Nose is a Form Formation Way of Nasal Cavity

M. Yamamoto

2007 Volume 100 Issue 11 Pages 946-947
Published: November 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.946

JOURNAL FREE ACCESS

Download PDF (3224K)