Practica Oto-Rhino-Laryngologica

Congenital External Auditory Canal Stenosis: A Serious Disease Leading to Destruction of the Mastoid Cavity

Its Diagnosis and Treatment

Hideo Yamane, Masahiro Takayama, Kishiko Sunami, Rie Tochino, Mikihito ...

2007 Volume 100 Issue 7 Pages 509-515
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.509

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Congenital external auditory canal stenosis (CAS) is usually considered one of the slight malformations related to congenital external auditory canal atresia (CAA). However, the clinical symptoms caused by the slight malformation may not be mild. Destructive external ear canal cholesteatoma commonly occurs in CAS, but is infreguent in CAA. For several reasons CAS tends to receive an inappropriately low estimate of risk compared to that for CAA. The other malformations accompanying CAS and CAA such as microtia confound the decision regarding future treatment for doctors as well as for the patients themselves. A consensus regarding the clinical entity of CAS is required among doctors not only in otorhinolaryngology but also in relevant fields such as pediatrics and plastic surgery. These two malformations, the pathological conditions and clinical treatment of CAS and CAA should be considered separately.

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Endoscopic Transnasal Resection of Olfactory Neuroblastoma Combined with Duraplasty

K. Ikeda, [in Japanese], [in Japanese], [in Japanese], [in Japanese], ...

2007 Volume 100 Issue 7 Pages 516-517
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.516

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The Use of Autologous Platelet-rich Plasma in Closing Tympanic Membrane Perforations

Kazuhide Yoshida, Nozomi Nomi, Kaori Tateyama, Masashi Suzuki

2007 Volume 100 Issue 7 Pages 519-523
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.519

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The ideal conditions for tympanic membrane perforation (TMP) closure by outpatient treatment include technical simplicity, low invasiveness, high perforation closure rate, a high safety margin and the use of economically viable materials. Platelet-rich plasma (PRP), which contains growth factors such as platelet-derived growth factor, transforming growth factor-beta and insulin-like growth factor I, induces regeneration in various tissues to promote excellent wound-healing effects. As PRP is an autohemic substance, it is non-toxic, non-immunoactivating and indicates a high safety margin in application. The present study developed a TMP closure method using autologous PRP combined with an atelocollagen membrane (CM). Of the 25 TMP ears who underwent surgical trimming of tissues around the TMP under local anesthesia, the tympanic membrane was patched with PRP-infiltrated CM preparations. In the present study, the TMP closure rate was improved to 88%. The findings in our study suggest that TMP closure with the PRP/CM patching method yields excellent rates with a high safety margin, the novel approach shows limited invasiveness, and requires simple technical skills.

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Investigation into the Safety and Certainty of Day Surgery on the Ear in our Clinic

Ken Hayashi, Maya Oishi, Atsushi Shinkawa

2007 Volume 100 Issue 7 Pages 525-531
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.525

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We performed day surgery on the ear in our clinic (2001 year; 366 cases, 2002 year; 703 cases, 2003 years; 519 cases, 2004 years; 751 cases, 2005 years; 737 cases). However, we have never encountered a case that required postoperative rehospitalization after day surgery. In addition, our all ear surgeries were completed within a short time, and the success rate was good. Our findings suggested that long-term hospitalization to ensure postoperative rest have no medical foundation because day surgery in our clinic was performed securely and surely. We think that it is most important to prevent medical accidents with reliable surgical risk management when day surgery is performed.

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Carcinoid Tumor in the Paranasal Sinus: A Case Report

Hiroshi Kajikawa, Kazuhiko Nario, Hiroshi Miyahara

2007 Volume 100 Issue 7 Pages 533-537
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.533

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We reported a 79 year old woman with a typical carcinoid tumor in the left ethmoid sinus. The patient consulted our hospital in 2002 with complaints of nasal obstruction and bleeding. On examination she was found to have a dark red mass filling the left nasal cavity. We performed a biopsy and the pathological diagnosis was a typical carcinoid tumor. We then performed lateral rhinotomy and removed the mass, while preserving the ethmoid skull base. The tumor recurred 8 months after surgery and the patient was treated with radiation therapy. The tumor seemed to disappear for a while, but recurred again after 8 months. To date, the patient has survived for six years with the carcinoid tumor.
A carcinoid tumor in the paranasal sinus is a rare neoplasm and only 5 cases have been reported previously in Japan. In such cases, relapses often occurred after surgery and the irradiation therapy. We considered that extended radical surgery is necessary to curatively resect paranasal sinus carcinoid tumor.

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A Case of Myxoma in the Zygoma

Yuki Kobayashi, Tatsuya Hayashi, Tomoki Yoshizaki, Yusuke Abe, Nobuyuk ...

2007 Volume 100 Issue 7 Pages 539-543
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.539

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We present a case of a 62-year-old woman with myxoma of the zygoma. There was no clinical sign except abnormal feeling of left buccal region. Computed tomography showed a well-defined low density lesion in the left zygoma with a deficit of cortical bone. The tumor measuring 1.3×1.0×1.0cm was surgically removed under general anesthesia, and was translucent white with a smooth surface and soft consistency.
Histopathological findings showed myxoma with no signs of malignancy. As myxoma rarely has a capsule and invades the adjacent bone, the bone surface was sufficiently shaved using a surgical burr. There has been no evidence of recurrence for 19 months postoperatively.

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Effect of Oral Moisture on Taste Sensation

Hideaki Aoki, Daisuke Mohri, Kaoru Shimazu, Akihiro Shiroyama, Toru Mi ...

2007 Volume 100 Issue 7 Pages 545-553
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.545

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Taste disorders can be caused by various factors, including zinc deficiency, adverse drug reactions, cold and xerostomia, and the number of patients seeking medical assistance for such disorders is increasing. However, because taste disorders are often difficult to treat, some medical institutions will not treat these complaints.
In the Department of Otolaryngology at Osaka Dental University Hospital, a clinic was opened on September 1, 2004, to treat patients with taste disorders.
We treated 1 outpatient who lost one side of parotid gland due to malignancy, then lost the function of the remaining salivary gland due to Sjögren's syndrome.
Subjects comprised 17 patients complaining of taste disorders with xerostomia without subjective symptoms of other otolaryngological diseases.
In the present study, 4 patients were prescribed zinc by another physician, but only 2 patients actually displayed zinc deficiency. Zinc administration did not improve symptoms in any of the patients.
According to the diagnostic criteria for xerostomia in our department, 17 patients had xerostomia, and 4 of these 17 patients were diagnosed with Sjögren's syndrome. These patients were instructed to gargle with cevimeline hydrochloride, and taste sensation improved in 12 patients.
We have examined 17 patients to data and consider this number insufficient to draw definitive conclusions but the data we have currently suggests to the following conclusions:
1. Latent Sjögren's syndrome should be suspected in patients presenting with taste disorder with xerostomia.
2. In taste disorder patients with xerostomia, gargling with cevimeline hydrochloride appears very useful.
3. One patient had lost a side of salivary gland, and Sjögren's syndrome caused loss of function of the remaining salivary gland. In this patient, favorable results were also obtained by gargling with cevimeline hydrochloride.

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Internal Carotid Artery Obstruction Due to Oropharyngeal Trauma: A Case Report

Keiko Hara, Masaaki Hata, Hiroyuki Takayanagi, Kenji Kawano, Masakazu ...

2007 Volume 100 Issue 7 Pages 555-558
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.555

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Internal carotid artery obstruction due to oropharyngeal trauma was originally reported by Caldwell in 1936. And the number of reports has been limited to seven in the Japanese literature. We report the case of a two-year-old girl who sustained oropharyngeal wall trauma from a tooth brush. After the characteristic period of several hours, hemiplegia developed on her left side. MRA revealed obstruction of the internal carotid and middle cerebral arteries on her right side. Although pediatric oropharyngeal trauma is a common injury, it is important to consider traumatic blunt carotid injury, even if there are initially no neurologic findings. Therefore, informed consent and careful observation are clinically significant in oropharyngeal trauma cases.

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A Case of a Lingual Dermoid Cyst

Yuki Komabayashi, Hayabusa Nozawa, Tetsuji Wada, Naoki Kanai, Yasuaki ...

2007 Volume 100 Issue 7 Pages 559-563
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.559

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Lingual dermoid cysts are uncommon. To date, there have been twenty reported cases. We report an additional case of lingual dermoid cyst. The patient was a sixteen-year-old girl. She was referred to our clinic for painful tongue swelling. A firm, tender lingual mass with purulent drainage from the midline of the dorsum of the tongue was noted. After treatment with antibiotics and drainage, the size of the mass reduced gradually. Eight months later, regrowth of the mass was observed. The mass was totally excised via an oral and external approach. According to histopathological examination, the mass was diagnosed as dermoid cyst.

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A Case of Subglottal Stenosis after Long-term Cannulation of Mini-Trach^® with Difficult Extubation

Takatoshi Furukawa, Teruaki Nagase

2007 Volume 100 Issue 7 Pages 565-568
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.565

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Subglottal Stenosis is always caused by endotracheal intubation or tracheostomy. Treatment of subglottal stenosis is difficult and demands a time-consuming procedure. With Mini-Trach^®, any doctor including otolaryngologists can easily perform the cricothyroidotomy, and some cases leave the hospital without extubation of the mini-trach in the cricothyroid membrane.
We report a case of subglottal stenosis after long-term cannulation with Mini-Trach^® in the cricothyroid membrane successfully treated by laser surgery, so called Ho: YAG laser vaporization. There has not been any recurrence of subglottal stenosis for 18 months postoperatively.
It is important for not only otolaryngologists but also all doctors to be aware of the difficulty removing Mini-Trach^® after long-term cannulation in the cricothyroid membrane.

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Clinical Analysis of Fine Needle Aspiration Biopsy for Lymph Nodes of Malignant Lymphoma

Naoki Ashimori, Minako Tsurita, Rieko Yamamoto, Satoru Takebayashi, Hi ...

2007 Volume 100 Issue 7 Pages 569-574
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.569

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We retrospectively reviewed fine-needle aspiration biopsy diagnosis of malignant lymphoma to evaluate the diagnostic accuracy and pitfalls. Sixty-eight cases of malignant lymphoma and fifty-two cases of non malignant lymphoma evaluated by FNAB were identified between 1997 and 2004. Based on the original diagnosis, 41 (60%) cases had a positive diagnosis of malignant lymphoma, 21 (31%) had a suspicious diagnosis, and 6 (9%) had a false negative diagnosis. On histological examinations DLBCLs yielded a high positive diagnosis, whereas FL and HD had less positive diagnosis and there were also false negative cases. Fourteen (39%) lymphadenitis cases had a suspicious diagnosis and some cases were difficult to differentiate from malignant lymphoma. FNAB is considered a useful and efficient method of estimating malignant lymphoma but we should remain aware of the existence of false negative cases.

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A Case of Tonsillar Carcinoma Presenting as a Pendular Tonsil

Fusako Iikuni, Sohei Endo, Minoru Ikeda, Akinori Kida

2007 Volume 100 Issue 7 Pages 575-578
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.575

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In most cases, pendular tonsils are benign. We report a 75-year-old man who presented with a pendular tonsil which was finally diagnosed as a squamous cell carcinoma of the tonsil. The patient was seen with the chief complaint of a foreign body in his throat. On his first visit, a smooth-surfaced pedunculated mass protruding from the lower pole of the right palatine tonsil was observed. Biopsy of the pendular lesion revealed a squamous cell carcinoma. Extended right tonsillectomy was performed. Pathological examination of the lesion revealed squamous cell carcinomas in the pendular tonsil as well as in the palatine tonsil. At present, no recurrence has been observed and his clinical course is favorable. It is necessary to perform a histological examination for every case of pendular tonsil.

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A Case Report of Cicatrical Pemphigoid with Acute Onset

Takeo Nonoda, Keiichi Izuhara, Toshimitsu Ohhashi, Masami Ohnishi, Nan ...

2007 Volume 100 Issue 7 Pages 579-585
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.579

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We report a rare case of cicatrical pemphigoid with acute onset. A 54-year-old man had complained of sore throat and swallowing pain six days before he was admitted our hospital. He demonstrated blisters of the oral cavity, lips, gingiva and epiglottis which showed multiple aphta and erosions. As antibiotics (penicillin and cephem) were not effective, we speculated that this was a viral infection or Bechet disease. Since there was no improvement after admittion, we consulted dermatologists regarding the possibility lichen planus, pemphggus or pemphigoid. A diagnosis of cicatrical pemphigoid was established by immunopathological examination of lip biopsy.
Cicatrical pemphigoid is a chronic subepithelial blistering disorders of the mucous membranes. This chronic blistering disorder is characterized by tense bullae on an erythematous base which healed with scarring. The oral mucosa and conjunctiva are common sites of involvement. The esophagus, trachea, nose, and genitalia are sometimes affected. Generally, cicatrical pemphigoid is a chronic progressive disease, but this rare case demonstrated acute onset.

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A Clinical Study on Deep Neck Abscess

Yumi Ota, Toru Sawada, Yoshiko Ogawa, Teiji Takemura

2007 Volume 100 Issue 7 Pages 587-592
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.587

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Although various effective antibiotics have been synthesized, deep neck abscess is still a serious and life-threatening infection. It is important to diagnose promptly and treat adequately, and contrast-enhanced CT is useful and indispensable for diagnosis. We reviewed our patients with deep neck abscess, and analyzed the location by reviewing CT images, and discussed the treatment. Surgical drainage is a fundamental treatment for abscess but if it exists in only one area such as the parotid gland space, it can be cured with needle aspiration and suitable antibiotics.

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Treatment of Pollinosis -True or Not?-

Y. Ohashi

2007 Volume 100 Issue 7 Pages 594-595
Published: July 01, 2007
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.100.594

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