Practica Oto-Rhino-Laryngologica

The Characteristics of Strial Capillaries

Permeability of HRP

Kensuke Watanabe

2007 Volume 100 Issue 2 Pages 73-82
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.73

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When the cochleas of guinea pigs were fixed after decapitation, HRP leakage from the strial capillaries was observed with blood sludge. HRP was transported to the extracapillary space by many pinocytotic vesicles and marginal folds. However, when the cochleas were fixed before decapitation, blood sludge was not observed in the strial capillaries and leakage of HRP from the capillaries was not observed 10 minutes after HRP injection. Thereafter, the level of HRP leakage increased with time. It was noted that capillary permeability to HRP at the basal turn was lower than that of the upper three turns. HRP leakage was not observed in the capillaries of the spiral ligament even beyond one hour after injection.
As a result of severe hemorrhagic shock in guinea pigs, blood sludge appeared in strial capillaries and capillary permeability to HRP increased. However, in moderate hemorrhagic shock, both blood sludge and accentuation of capillary permeability did not occur.
After the inoculation of endotoxin in the middle ear, a large amount of HRP leaked out of the capillaries through the opened endothelial cell junctions.
After vibration administered to auditory ossicle is by a drill, the permeability of the strial capillaries to HRP also increased. High permeability was thought to be caused by damage to the strial endothelial cells. HRP leakage initially took place through the tubules in the endothelial cytoplasm, and HRP leaked in to the extracapillary space when the cell membranes were damaged by vibration. Administration of the steroid inhibited HRP leakage from the strial capillaries.
The stria vascularis became markedly edematous after the administration of furosemide, while capillary permeability to HRP was decreased.
From the above, the route of HRP leakage is different depending on the type of stimulation, even if it occurs alongside increased capillary permeability.

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A Case of Neurilemmoma of the Base of Tongue

Y. Kogashiwa, [in Japanese], [in Japanese]

2007 Volume 100 Issue 2 Pages 84-85
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.84

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To Cope with Acute Low-Tone Sensorineural Hearing Loss at a Private Clinic

Harunori Goto

2007 Volume 100 Issue 2 Pages 87-96
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.87

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This study was performed on 73 patients (58 females and 15 males) with acute low-tone sensorineural hearing loss (ALHL) without vertigo, who visited my clinic from 2002 to 2004.
These patients were investigated and under long-term observation for more than 2 years to study their condition, prognosis, treatment, and background.
The increase in ALHL patients (especially female) in the last 3 years was remarkable. This increase maybe caused by stress, depression, or autonomic disorder.
Outpatients with ALHL were administered 15mg of predonisolone per day for 5 days in my clinic, and then the dose was gradually reduced. Eighty-six percent of patients responded well to the treatment.
However, a recurrence of hearing loss occurred in 20 patients (27.4%), with 5 of these patients (5.5%) later developing Meniere's disease.
Recently, the ALHL patients were sent questionnaires with SRQ-D by post. Our results (69.1% response rate) shed light on the problems concerning the level of satisfaction after treatment and the quality of life (QOL).
These findings suggested that long-term follow up and assertive psychosomatic approaches are necessary in the future to evaluate the clinical progress and prognosis of patients with ALHL.

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A Case of Neuro-Behçet with Dizziness

Osamu Shibasaki

2007 Volume 100 Issue 2 Pages 97-100
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.97

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A 51-year-old woman complained of nausea, headache and dizziness with nystagmus. She had presented with recurrent oral aphthous ulcers, genital ulcers and erythematous lesion, except for eye lesion, and was diagnosed as incomplete Behçet's disease in another hospital. Headache and dizziness were first suspected as cerebellum infarction, but MRI of the brain and cerebrospinal fluid analysis revealed Neuro-Behçet. When patients with Behçet's disease visit otolaryngology clinics for oral lesions, we should be sensitive to minor symptoms of Behçet's disease.

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Meningocele of the Temporal Bone

Koji Miyata, Hideyuki Fukushima, Nobuya Fujiki, Nobumitsu Honda, Akiko ...

2007 Volume 100 Issue 2 Pages 101-106
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.101

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We report a case of meningocele of the temporal bone. A 22-year-old female consulted our hospital complaining of high grade fever and vomitting. Meningitis was detected and treated with antibiotics. About one month after the initial hospitalization, meningitis recurred. CT examination demonstrated bone defect at the skull base of mastoid cavity. We diagnosed this patient as having cholesteatoma or meningocele.
Surgery was performed by the trans-mastoid approach. After mastoidectomy, a round mass was found and the mass decreased after leakage of liquor. Meningocele of the temporal bone was confirmed. Reduction of meningocele was performed using bone fragment and temporal muscle. Postoperatively, there has not been any recurrence of meningitis to date.

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Clinical Evaluation of Sphenoid Sinus Carcinomas: Six Cases

Shinsuke Ohbuchi, Kikuo Sakamoto, Tadashi Nakashima

2007 Volume 100 Issue 2 Pages 107-111
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.107

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Primary sphenoidal carcinoma is very rare. In this report, we have reviewed the clinical characteristics as well as the treatment results of six patients with primary sphenoid sinus carcinoma admitted to Kurume University Hospital between 1986 to 2005. They were 4 males and 2 females, with age ranging between 28 and 70 (average: 52).
The chief complaint was headache in all cases. Histopathologically, the most common type was squamous cell carcinoma (n=4). As the treatment, combined operation and chemo-radiotherapy (n=3) or chemotherapy and radiotherapy (n=3) was performed. Three of the six cases died. In the analysis of tumor extension into the surrounding space by CT and MRI, there was one skull base invasion, two cavernous sinus invasions, two clivus invasions, three nasopharynx invasions, and four nasal and paranasal sinus invasions. In the analysis of the three surviving, it became evident that they were free from invasion to the skull base or cavernous sinus, and received combined operation and chemo-radiotherapy. These results indicate that post-operative chemo-radiotherapy is necessary for the treatment of carcinomas of the sphenoid sinus. Invasion into the skull base and cavernous sinus seemed to be a high risk factor for a poor prognosis in patients with advanced sphenoid sinus carcinoma.

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A Foreign Body in the Maxillary Sinus

Yo Kishimoto, Kazuhiko Shoji, Atsuhito Takahashi, Takehiro Iki, Tsuyos ...

2007 Volume 100 Issue 2 Pages 113-116
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.113

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We report a foreign body in the maxillary sinus. A 46-year-old man was referred to our hospital because of misplacement of his implant fixture. X-ray and CT examinations revealed a misplaced implant fixture in the left maxillary sinus, and thickening of mucosa of the sinus.
Under local anesthesia, Caldwell-luc procedure was performed and the implant fixture was removed from the sinus without any complications.
We should be aware that foreign bodies can be inserted into the maxillary sinus by dental treatment.

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Submandibular Salivary Calculus of Three Children under 10 years old

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

2007 Volume 100 Issue 2 Pages 117-120
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.117

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Sialolithiasis is rare in children. In this paper, 3 pediatric cases (8, 9 and 10 years-old, respectively) of sialolithiasis observed in the submandibular gland are reported. In each case, a single calculus of less than 5mm in diameter was removed through an intraoral incision. Sialolithiasis in children is easily diagnosed because it is usually found in the duct, even though X-ray examination fails to indicate it.

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Two Cases of Soft Tissue Tumor Arising in the Deep Neck

Hideki Chijiwa, Yoshihisa Ueda, Yoshimi Miyajima, Tadashi Nakashima

2007 Volume 100 Issue 2 Pages 121-125
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.121

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We encountered two rare cases of soft tissue tumor arising in the deep neck. The first case was a 29-year-old woman diagnosed as having pseudomalignant osseous tumor. At surgery, a circumscribed, hard mass was found in the deep portion and adhered to the cervical vertebra. The mass was extirpated together with a layer of the surrounding macroscopically intact tissue. The post-operative course was uneventful. The second case was a 59-year-old man diagnosed as having epithelioid sarcoma. At surgery, a circumscribed, invasive mass was found in the deep portion and adhered to the cervical vertebra. The mass was excised together with adjacent muscle tissue and fat tissue. The post-operative course was uneventful. Immunohistochemical evidence in these cases are also presented.

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Effects of the Herbal Medicine “Juzen-taiho-to” on Otitis-Prone Children

Yumiko Maruyama, Shigeru Hoshida, Makoto Ito, Mitsuru Furukawa

2007 Volume 100 Issue 2 Pages 127-135
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.127

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Juzen-taiho-to (JTT) is known as a herbal medicine that improves immune function. We evaluated whether JTT has a beneficial effect in otitis-prone children. Twenty otitis-prone infants took JTT at 0.1-0.14mg/kg/day twice a day for three months. The medication compliance rate was 85%. The frequency of otitis media purulenta significantly decreased (t-test, p=.000, Wilcoxon signed rank test, p=.000) by the oral administration of JTT. The number of days of fever (t, p=.000, Wilcoxon, p=.000), antibiotic administration (t, p=.002, Wilcoxon, p=.001), hospital visits (t, p=.014, Wilcoxon, p=.005), and emergency hospital visits (t, p=.000, Wilcoxon, p=.000) also showed significant decreases after taking JTT as compared with before.
The onset and progression of infection depends on the balance between the reproductive power of microbes and host defense. The effects of JTT on otitis-prone individuals have not been investigated before. JTT is thought to be one of the effective treatments for otitis-prone cases, and avoiding the overuse of antibiotics would prevent the increase of drug-resistant bacteria both in terms of their number and level of resistance.

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Utility of Olopatadine Hydrochloride as Prophylactic Treatment against Japanese Cedar Pollinosis

Katsumi Masuda, Tamotsu Harada, Tsuyoshi Yoshihiro, Yukiyoshi Hyo, Ken ...

2007 Volume 100 Issue 2 Pages 137-144
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.137

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It is a common knowledge that the number of Japanese Cedar Pollinosis patients is increasing. Prophylactic treatment is recommended as one of the pollinosis treatments.
In 2005, Japanese cedar pollens were extensively scattered. We used the Japan Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ) to examine the utility of prophylactic treatment using olopatadine hydrochloride in 2005.
As a result, symptoms in the prophylactic treatment group were milder than those in the untreated group. Furthermore, the prophylactic group could maintain a good Quality of Life.
In years with extensive scattering of Japanese cedar pollen, prophylactic treatment with olopatadine hydrochloride is effective, and should be considered when choosing a strongly effective drug for prophylactic treatment.

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Treatment of Human Dry Mouth Using Various Medicines

Masanori Umemoto, Tomomi Nin, Shinya Miuchi, Atsushi Negoro, Masafumi ...

2007 Volume 100 Issue 2 Pages 145-152
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.145

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There is no effective therapy for dry mouth, although the number of patients with this condition has been increasing in recent years. In the past, Chinese medicine was commonly used in human dry mouth. Recent studies reported that cevimeline hydrochloride hydrate and nizatidine, histamine H₂ receptor antagonists, enhanced salivary secretion. Therefore, this study was designed to evaluate whether Chinese medicine, cevimeline and nizatidine can enhance salivary secretion in patients with dry mouth.
Basal/stimulated salivary secretions and subjective symptoms were measured before and after the administration of Chinese medicine (9.0g/day), cevimeline (90mg/day) and nizatidine (300mg/day) over 90 days period in 100 patients with dry mouth, 13 men and 87 women (mean age: 69.0), who consulted our clinic.
Both the basal and stimulated salivary secretions were significantly increased in both the cevimerine and nizatidine treated groups. However, the Chinese medicine group did not show salivary secretion. Both the basal and stimulated salivary secretions after administration of nizatidine for 90 days were significantly different from those in the cevimeline and Chinese medicine groups on paired t-test. In addition, over 70% of dry mouth patients reported subjective improvement of oral dryness after administration of cevimeline and nizatidine. These findings suggest that cevimeline and nizatidine increased salivary secretion and nizatidine is most useful for the treatment of patients with dry mouth.

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Clinical Manifestations of Temporal Bone Tumor

T. Nakagawa

2007 Volume 100 Issue 2 Pages 154-155
Published: February 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.154

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