Practica Oto-Rhino-Laryngologica

Recent Treatment Modalities for Advanced Head and Neck Carcinoma

Mamoru Tsukuda

2007 Volume 100 Issue 12 Pages 949-961
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.949

JOURNAL FREE ACCESS

Show abstractHide abstract

Conventional treatments with surgery and/or radiotherapy have significantly improved the poor outcome of advanced head and neck squamous cell carcinoma (HNSCC). After the clinical application of cisplatin (CDDP), chemotherapy including CDDP has been administered for the initial treatment of advanced HNSCC, e. g., neoadjuvant chemotherapy (NAC) and concurrent chemoradiotherapy (CCR). Using the standard chemotherapy with CDDP and 5-fluorouracil (5-FU), i. e., the PF regimen, a treatment modality with NAC has been examined, however NAC with the PF regimen has not improved the poor prognosis of advanced HNSCC in comparison with CCR. Recently, NAC with taxane in addition to the PF regimen, i. e., TPF regimen, has been shown to be more efficacious than PF alone, providing survival benefits. However, CCR has also contributed to improved survival of advanced HNSCC. Patients, to define the limitations of CCR, the optimal regimen should be studied and evaluated in order to augment the anti-tumor effect of CCR. Multidisciplinary treatments including molecular targeted agents are being developed, since conventional treatment combined with a certain molecular targeted agent is more effective than the conventional treatment alone. In the future, our adequate treatment scheme including molecular targeted agents should be developed for advanced HNSCC.

View full abstract

Download PDF (1571K)
Superior and Posterior Canal Dehiscence Syndrome

K. Ishijima

2007 Volume 100 Issue 12 Pages 962-963
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.962

JOURNAL FREE ACCESS

Download PDF (2496K)
Conservative Treatment of Eosinophilic Otitis Media

Toshiro Kawano, Junichi Ishitoya, Ryo Endo, Mamoru Tsukuda

2007 Volume 100 Issue 12 Pages 965-971
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.965

JOURNAL FREE ACCESS

Show abstractHide abstract

Objective: The eosinophilic-otitis-media have characteristic pooling of viscous liquids and granulation tissues in the tympanic cavity. The basic treatment is removal of granulation tissue allowed by an eardrum incision, steroid injection into the tympanic cavity. Therefore, we made eardrum incisions and removed the fluid accumulation and granulation tissues. However, this treatment may induce postoperative eardrum perforation. Therefore, to avoid eardrum perforation after treatment, we injected steroid liquids into tympanic cavity using a 23G fine needle without making an eardrum incision or inserting a tube into the tympanic cavity. Then, we examined the treatment outcomes.
Materials and Methods: We diagnosed 17 cases, 33 ears (male: 2 cases 4 ears, female: 15 cases, 29 ears) (average age: 51.4 years old) as having eosinophilic-otitis-media without perforations based on standard diagnostic criteria. Then, we retrospectively investigated the hearing levels and eardrum perforation after treatment by dividing two groups. One group was treated without making eardrum incisions using a 23G fine needle to inject steroid solution, into the tympanic cavity along with oral steroid administration. The other group was treated by making an eardrum incision or inserting a tube, then, injecting steroid solution into the tympanic cavity along with oral steroid administration.
Result: The group undergoing eardrum incisions had an eardrum perforation rate of 76.4% (13/17 ears) after treatment. However, the group without eardrum incisions had an eardrum perforation rate of 25.0% (4/16 ears) after treatment. Regarding hearing improvement, there was not a meaningful hearing improvement after treatment in the group receiving eardrum incisions. However, there was a meaningful postoperative hearing improvement of 500-4000Hz in the group without eardrum incisions.
Conclusion: We found that treating eosinophilic-otitis-media without eardrum incisions by using a fine needle to inject steroid solution into the tympanic cavity along with oral steroid administration significantly diminished the rate of postoperative perforations.

View full abstract

Download PDF (2525K)
Two Cases of Invasive Aspergillosis of the Sphenoid Sinus treated with Voriconazole

Daisuke Kawakita, Masayuki Kondo, Noriko Sahara, Masaru Hatano, Shinic ...

2007 Volume 100 Issue 12 Pages 973-978
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.973

JOURNAL FREE ACCESS

Show abstractHide abstract

Invasive aspergillosisis of the sphenoid sinus easily causes severe complications due to the anatomical position of the sinus. Thus, invasive aspergillosis of the sphenoid sinus is known to have a poor prognosis. We report two cases showing good results following endoscopic sinus surgery and voriconazole treatment.
Case 1 was a 78-year-old male, and the chief complaint was ache in the left eye, decrease in the left eyesight with field of vision stricture. We performed endoscopic sphenoidectomy and administered Micafungin sodium, but the symptoms recurred. After changing to voriconazole, a good result was obtained.
Case 2 was an 80-year-old male, and the chief complaint was descensus of both eyelids and obstruction of ocular movement. We performed endoscopic sphenoidectomy and the voriconazole dosage. The patient have not been recurred yet.
With an early diagnosis, invasive aspergillosis of the sphenoid sinus can be treated by endoscopic sinus surgery and voriconazole therapy. Voriconazole may be to the first choice of anti-fungul drugs for invasive aspergillosis of sphenoid sinus.

View full abstract

Download PDF (6865K)
A Study of Pediatric Allergic Rhinitis

Investigation of the Number of Cytological Examinations

Takashi Hiramatsu

2007 Volume 100 Issue 12 Pages 979-985
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.979

JOURNAL FREE ACCESS

Show abstractHide abstract

Clinical features and diagnosis of pediatric allergic rhinitis need to be clarified. In our clinic, children suspected of having allergic rhinitis often undergo cytological examination of nasal smear (CENS) because the detection of eosinophils in nasal smear has a significant diagnostic value for allergic rhinitis in children, especially infants. To clarify the features of pediatric allergic rhinitis, the number of CENS conducted at our clinic during 2005 was investigated.
1. when a microscope was skillfully used for observation of nasal cavity, the positive quantification of eosinophilia in nasal smears from children was compared with that from adults.
2. The total number of CENS conducted for patients aged between one and 10 years old was higher than that of patients aged above 14 years old.
3. Two peaks were found in the monthly numbers of CENS and they corresponded to the two turning points of atmospheric pressure, humidity, and temperature each year. Moreover the main peak for infants appeared around November, while that of adults peaked around March.
These findings suggest that particular managements may be necessary for pediatric allergic rhinitis, differing from those for adults.

View full abstract

Download PDF (1066K)
A Case of Ossifying Fibroma of the Maxillary Bone

Mutsukazu Kitano, Hiroko Monobe, Asayo Endo, Masayuki Kabeya, Masato N ...

2007 Volume 100 Issue 12 Pages 987-991
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.987

JOURNAL FREE ACCESS

Show abstractHide abstract

We report a rare case of ossifying fibroma of the maxillary bone. This patient was a 48-year-old female with pain and swelling on the left root of the nose. CT scan demonstrated a broken appearance of the anterior wall of the maxillary sinus and a ground-glass appearance of the maxillary bone. We performed Caldwell-Luc procedure under general anesthesia to rule out malignant neoplasm. The pathological diagnosis was ossifying fibroma of the maxillary bone. Ossifying fibroma is a benign neoplasm, but classification of this tumor is under discussion. We describe the diagnosis and classification of this tumor with reference to the literature.

View full abstract

Download PDF (5435K)
Light-guided Endoscopic Dacryocystorhinostomy

Satoshi Ohno, Makoto Miura, Kazuyuki Ichimaru, Kiyohiro Fujino

2007 Volume 100 Issue 12 Pages 993-996
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.993

JOURNAL FREE ACCESS

Show abstractHide abstract

We performed endoscopic dacryocystorhinostomy to treat idiopathic naso-lacrimal duct obstruction in 14 cases. The light guide facilitated adequate fenestration of the lacrimal sac safely and easily. All patients had successful outcomes without hyperlacrimation. For the treatment of idiopathic naso-lacrimal duct obstruction, light-guided endoscopic dacryocystorhinostomy is considered more useful than external dacryocystorhinostomy.

View full abstract

Download PDF (2818K)
Tonsillar Sarcoidosis: A Case Report

Atsuvoshi Asahi, Mitsuru Asanome, Tatsuya Hayashi, Yasuaki Harabuchi

2007 Volume 100 Issue 12 Pages 997-1000
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.997

JOURNAL FREE ACCESS

Show abstractHide abstract

We report a patient with bilateral tonsillar sarcoidosis. A 23-year-old female patient complained of sore throat and low grade fever with bilateral cervical lymph node swellings. At the first examination, the bilateral tonsils appeared to be swollen and reddish. Bilateral cervical lymph node swellings could also be palpated.
We conducted bilateral tonsillectomy and lymph node biopsy to confirm the exact diagnosis. Sarcoidosis was diagnosed in all specimens.
Clinical symptoms subsided with in one month after the bilateral tonsillectomy.

View full abstract

Download PDF (6991K)
An Adult Case of Obstructive Sleep Apnea Syndrome Associated with Nocturnal Enuresis

Hiyoshi Tsurumoto, Takeshi Minami, Teiso Kiyama

2007 Volume 100 Issue 12 Pages 1001-1007
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.1001

JOURNAL FREE ACCESS

Show abstractHide abstract

We report an adult case of obstructive sleep apnea syndrome (OSAS) associated with nocturnal enuresis. A 33-year-old man consulted our department complaining of nocturnal apnea and bed-wetting. Tonsillectomy and uvulopharyngoplasty was performed. The patient's apnea and bed-wetting disappeared after surgery. It is suggested that the nocturnal breathing state was improved post operatively, which resulted in an improvement in the hormonal and autonomic balance of the body and led to recovery from nocturnal enuresis. Additionally, there is a possibility that the rise in the intra-vesical pressure resulting from the unusual breathing movements in OSAS disappeared following surgery, and this contributed to the improvement in symptoms.

View full abstract

Download PDF (6611K)
A Case Report of Extrapharyngeal Foreign Body

Sei-ichi Nakano, Hitomi Kawata, Takanori Sato, Katsushi Miyazaki, Shin ...

2007 Volume 100 Issue 12 Pages 1009-1013
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.1009

JOURNAL FREE ACCESS

Show abstractHide abstract

We report a sixty-four-year-old woman with an extrapharyngeal foreign body due to swallowing a fish bone. The patient complained of a sore throat after she swallowed fried cutlass fish. However, there was no foreign body detected under pharyngolaryngoscopy or on the cervical X-ray film. Although the sore throat disappeared, cervical CT was carried out, because fish bone as a foreign body was strongly suspected based on the case history. Accordingly, it was demonstrated that the fish bone had extruded from the pharyngeal lumen and penetrated the thyroid. The extrapharyngeal foreign body was successfully removed by lateral neck incision under general anesthesia.

View full abstract

Download PDF (5426K)
A Case of Dysphagia Secondary to Pharyngo-laryngeal Trauma

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

2007 Volume 100 Issue 12 Pages 1015-1019
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.1015

JOURNAL FREE ACCESS

Show abstractHide abstract

Trauma to the pharynx and larynx often leads to dysfunctions of phonation and deglutition. In the case of an old injury, the treatment is always particularly difficult due to the subsequent formation of scar or granulation tissues. We recently encountered a case of trauma to the pharynx associated with open injury of the neck by a power shovel. The patient was referred to our clinic more than 2 months after the initial wound closure for reconstruction of air and food passages. Through a careful revision of the pharyngeal stenosis due to scar formations, we succeeded in reestablishing his vocal and swallowing functions.

View full abstract

Download PDF (7288K)
Treatment of Laryngeal Radionecrosis with Hyperbaric Oxygen Therapy: A Case Report

Akiko T. Nishida, Nobumitsu Honda, Yoshiharu Kitani, Mika Tsujimura, T ...

2007 Volume 100 Issue 12 Pages 1021-1026
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.1021

JOURNAL FREE ACCESS

Show abstractHide abstract

Laryngeal necrosis is a rare complication of radiotherapy for early-staged laryngeal or hypopharyngeal cancer. However, when it occurs, there is no definitive treatment and laryngectomy is frequently required. Here we present a case of advanced laryngeal necrosis (grade 4, Chandler classification) treated with hyperbaric oxygen (HBO) therapy.
A 60-year-old woman received radiotherapy with 64.8Gy for early-staged hypopharyngeal cancer in combination with three courses of cisplatin (40mg/body/week). She developed pharyngeal pain and progressive dyspnea because of laryngeal edema 3 months after the completion of radiotherapy, and received an emergent tracheostomy. In order to differentiate radiation injury from cancer recurrence, biopsies were obtained under direct laryngoscopy and showed intense necrosis without malignancy. Since laryngeal radionecrosis was presumed, the patient received HBO therapy at 2 atmospheres absolute (ATA) with 100% O₂ for 2 hours per session. After 20 HBO treatments, laryngeal edema improved and her clinical symptoms including pharyngeal pain, swallowing pain and dysphagia, were ameliorated significantly. However, decannulation has not been achieved because of bilateral vocal cord fixation. We considered that HBO therapy was effective in the present case and that HBO therapy should be recommended as a therapeutic option whenever laryngeal necrosis occurs and there is a chance to save the larynx.

View full abstract

Download PDF (6131K)
Vertebral Artery Dissection after Direct Laryngoscopy

Kuniyuki Takahashi, Yutaka Yamamoto, Sugata Takahashi, Yoshio Sekihara ...

2007 Volume 100 Issue 12 Pages 1027-1031
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.1027

JOURNAL FREE ACCESS

Show abstractHide abstract

A case of subarachnoid hemorrhage due to vertebral artery dissection after direct laryngoscopy is reported. The patient, a healthy 61-year-old man with hoarseness, was treated for vocal cord polyp with laryngomicrosurgery. After surgery, he complained of nape pain without neurological symptoms. Six days after the onset of nape pain, he suddenly lost consciousness. CT showed subarachnoid hemorrhage and CT angiography demonstrated enlargement of the right vertebral artery which was suspected to be dissecting aneurysm. The right vertebral artery was occluded proximal to the aneurysmal dilation using detachable coils. Most vertebral artery dissections have been described as showing spontaneous onset. Recently, some cases were associated with minor neck trauma like extension and/or rotation. Direct laryngoscopy is a widely used technique in otolaryngological surgery, but it requires that the patient's neck be placed in hyperextension. This is the first report of vertebral artery dissection as a complication of otolaryngological surgery. Physicians should recognize that a hyperextended neck position during surgery may induce vertebral artery injury.

View full abstract

Download PDF (6004K)
Diagnosis for Benign Paroxysmal Positional Vertigo (BPPV)

M. Iida

2007 Volume 100 Issue 12 Pages 1032-1033
Published: December 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.1032

JOURNAL FREE ACCESS

Download PDF (2324K)

Register with J-STAGE for free!