Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 100, Issue 8
Displaying 1-15 of 15 articles from this issue
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  • Three-dimensional Rotational Axis Analysis of Eye Movement as Clinical Applications
    Takao Imai, Noriaki Takeda
    2007 Volume 100 Issue 8 Pages 599-613
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.599
    JOURNAL FREE ACCESS
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    We developed a new video-oculography (VOG) system that can facilitate analysis of the axis angle, rotation vector or quaternions of eye movements. The axis angle, rotation vector, and quaternions measure a single rotation from a chosen reference position to the current eye position. Using the axis angle, rotation vector, or quaternions, we can calculate the axis around which the eye rotates and the angular velocity around the axis. In this review, we show how we utilize the analysis of eye rotational axis and eye velocity around the axis in clinical applications. By calculating the axis of positional nystagmus in benign paroxysmal positional vertigo (BPPV) patients, we can identify the affected lesion in the semicircular canals. Posterior semicircular canal (PSCC) type of BPPV causes positional nystagmus in which the rotational axis is perpendicular to the plane of the PSCC or pure torsional axis. Horizontal semicircular canal (HSCC) type of BPPV (H-BPPV) causes positional nystagmus in which the rotational axis is perpendicular to the plane of the HSCC. A dramatic change in the eye angular velocity and time constant of nystagmus is seen at the transitional period when cupulolithiasis changes to canalolithiasis in a patient with H-BPPV. Anterior semicircular canal (ASCC) type of BPPV causes positional nystagmus in which the eye rotational axis is perpendicular to the plane of the ASCC. BPPV due to the simultaneous involvement of both horizontal and posterior semicircular canals has two rotational axes; first, it is perpendicular to the plane of the PSCC, then, it is perpendicular to the plane of the HSCC. By calculating the eye angular velocity around the axis, we can show that the gain of the vestibulo-ocular reflex around the eye rotational axis can be calculated both when HSCCs are mainly stimulated and when vertical semicircular canals are mainly stimulated.
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  • Diagnosis and Management of Orbital Complication in Acute Sinusitis
    K. Nishimoto, [in Japanese]
    2007 Volume 100 Issue 8 Pages 614-615
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.614
    JOURNAL FREE ACCESS
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  • Brainstem Medulloblastoma Manifesting as Low-tone Sensorineural Hearing Loss
    Hitoshi Satoh, Toshiyuki Fujisaki, Tadashi Wada, Yamato Kubota, Shuji ...
    2007 Volume 100 Issue 8 Pages 617-622
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.617
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    Medulloblastoma is the most common childhood primary central nervous system tumor. In adults, most medulloblastomas occur in patients younger than 40. Common symptoms are cerebellar dysfunction and signs of CSF flow obstruction.
    This report describes the case of a 25-year-old female who presented with progressive unilateral sensorineural hearing loss (SNHL) as the first symptom of a medulloblastoma in the right inferior cerebellar peduncle and pons. She was referred to an ENT outpatient clinic, and diagnosed with right low tone-dominant SNHL. Her right SNHL progressed with an additional symptom, left moderate facial palsy, 7 months later, and she consequently visited the clinic again. She was introduced to our clinic for further examination. At that time, magnetic resonance imaging (MRI) revealed a right Brainstem lesion. The ipsilateral stapedial reflex was normal in the right ear but absent in the left. Bekesy audiometry was type III. Electronystagmography showed a spontaneous nystagmus to the left and saccade pursuit. The auditory brainstem response was absent in the right ear.
    The presented case showed that unilateral SNHL can be the first symptom of a brainstem tumor lesion. Progressive SNHL cases should be checked by MRI, in order to exclude brainstem lesions just like cerebello-pontine angle lesions.
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  • Survey of Patients Wearing Hearing Aids Applied with and without Financial Support from the Hearing-handicapped Approval Law
    Fumiyuki Goto, Haruna Yabe, Tamotsu Ogino, Kaoru Ogawa
    2007 Volume 100 Issue 8 Pages 623-628
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.623
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    In Japan, there is a government-mandated financial support system to help hearing-handicapped patients. In this welfare law, patients with severe hearing loss are categorized into three grades according to severity of hearing disturbance. Patients in each grade have the right to obtain financial support. Obtaining financial aid is a two-step process. First, the patient must apply for a certificate or license indicating that he/she is indeed hearing handicapped. It usually takes a few weeks to receive this license. Second, the patient must complete a financial support application form, which takes about one month for government approval. A doctor must sign both of these application forms. Between January 2005 and April 2006, we surveyed patients consulting our office for hearing aid counseling to assess the current situation and satisfaction of patients who bought hearing aids using governmental financial support. The patients graded their experience on a 5-point satisfaction scale. Among the eighty-nine patients who consulted our office, 22 (24.7%) patients applied for support; all 22 of these patients qualified as having a severe hearing-handicap. The average ages of patients certified as hearing handicapped and patients not certified as hearing handicapped were 80.9±7.7 years and 75.1±23.3 years, respectively. It took, on average, another 49 days to obtain financial support. Patients receiving governmental financial support rated their satisfaction significantly higher than did patients who did not receive support. The average amount of financial support was 40, 736yen ($340). A small amount of financial support can increase patient satisfaction. To promote the government-mandated financial support system for the hearing handicapped, doctors should show more interest in this law. Doctors should also actively guide and encourage certified patients in applying for governmental financial support for hearing aids, all with long-term goal of helping these patients achieve a better quality of life.
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  • Clinical Survey of the Neurotological Clinic
    Misako Hashimoto, Toru Seo, Atsushi Miyamoto, Akiko Adachi, Akiko Yuki ...
    2007 Volume 100 Issue 8 Pages 629-635
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.629
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    We studied the recent tendency of 2295 patients with vertigo and dizziness who visited the neurotological clinic in Hyogo College of Medicine between 1994 and 2002. Also, we compared 191 patients in 1994 with 380 patients in 2002.
    A total of 60% of the patients were diagnosed with vertigo of peripheral vestibular origin, those with central or systemic origin accounted for 12%, and unknown origin for 28% in 2002. Most patients with peripheral vestibular origin were suffering from BPPV (26%), and Meniere's disease (18%). The percentage with peripheral vestibular origin increased from 36% to 60% between 1994 and 2004, and there was a significant increase in Meniere's disease. The percentage with central or systemic origin decreased from 34% to 12%.
    The age distribution of all patients showed a peak in the sixth decade in 2002 and showed an aging tendency compared to 1994. The number of women with Meniere's disease increased over widespread ages between 1994 and 2002. Most patients with Meniere's disease, BPPV, and of unknown origin were under sixty. Although only 5% of patients were diagnosed with cerebrovascular disease (including vertebro-basilar insufficiency, and cerebral infarction), 79% were over 60 years old.
    About 60% of the patients were referred from other physicians both in 1994 and 2002. The percentage of patients from other otolaryngologists increased from 5% to 22% between 1994 and 2002.
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  • Follow-up Survey of Patulous Eustachian Tube Syndrome
    Chisa Fujimoto, Akio Kondo, Masahiro Morita, Noriaki Takeda
    2007 Volume 100 Issue 8 Pages 637-641
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.637
    JOURNAL FREE ACCESS
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    In the present study, the natural course of patulous eustachian tube syndrome (PETS) was examined. Fifteen patients (3 males, 12 females, 21 to 79 years old; mean age, 61.1 years) were given the diagnosis of PETS, meeting the criteria of both aural symptoms and hyperpatent eustachian tube findings by sonotubometry and tubo-tympano-aerodynamic graphy. Their aural symptoms were assessed by questionnaire at a mean of 16.7 months after the initial diagnosis in the absence of continuous medical treatment. Based on their answers, 7 patients were subjectively cured or in remission, but the other 8 patients showed intractable aural symptoms. The function of the eustachian tube was then re-examined in 7 of the 15 patients after the questionnaire. Six patients with intractable aural symptoms still showed open tubal function, while the tubal function was improved in another patient with relief from aural symptoms.
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  • Aberrant Internal Carotid Artery in the Middle Ear: A Case Report
    Tsutomu Nagashima, Hideaki Shirasaki, Atsushi Taira, Ryoukichi Imai, E ...
    2007 Volume 100 Issue 8 Pages 643-648
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.643
    JOURNAL FREE ACCESS
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    We report a rare case of aberrant internal carotid artery in the middle ear. The patient was a 71-year-old woman with pulsatile tinnitus and hearing loss. A CT scan demonstrated an aberrant course of the internal carotid artery in the middle ear.
    MR images and 3DCT were useful in distinguishing this anomaly from other possible diseases.
    Here we discuss the clinical presentation, relevant radiographic investigations and further managemaent of these patients.
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  • Examination of the Effects of Burow's Solution on Intractable Chronic Suppurative Ear Disease
    Suetaka Nishiike, Takeshi Akisada, Teruhito Aihara, Masako Uno, Dai Sh ...
    2007 Volume 100 Issue 8 Pages 649-653
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.649
    JOURNAL FREE ACCESS
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    We examined the effects of Burow's solution on intractable chronic suppurative ear disease. Cotton balls soaked with the solution were applied to the canal wall and/or the tympanic membrane for more than 10min once or twice a week in each patient. Subjects were 19 ears of 13 patients with a mean age of 60 years old treated at the Otolaryngological unit of Kawasaki Medical School between September 2005 and December 2006. Ten ears had chronic otitis externa, 8 ears had fungal otitis externa, 4 ears had chronic granulated myringitis, 3 ears had chronic otitis media with perforation and 2 ears had postoperative mastoid cavity problems. Six ears (31.6%) were cured, 10 ears (52.6%) were improved, 1 ear (5.3%) was unchanged and 2 ears (10.5%) deteriorated. There was no subjective hearing impairment observed after treatment. The two ears that deteriorated were in one patient with bilateral chronic otitis media due to MRSA and Candida albicans infection with a history of radiotherapy for nasopharyngeal carcinoma. Generally Burow's solution is extremely effective for intractable chronic suppurative ear disease, but physicians should remain aware that Burow's solution may rarely cause deterioration of ear disease symptoms in some cases.
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  • Day Surgery on the Septal and Turbinate Regions under Local Anesthesia
    Shigeki Kawamura
    2007 Volume 100 Issue 8 Pages 655-661
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.655
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    Recently, Septal surgery has been identified in other countries as suitable for day-case surgery but is not widely performed as such in Japan. In this study, the charts of 66 patients who underwent septal and turbinate day surgery under local anesthesia were analyzed retrospectively and a questionnaire survey regarding the operation was conducted. The bleeding rate and unexpected admission rate were 1.5 and 0 per cents respectively. Among 42 patients who responded to the questionnaires, 97% of cases showed good improvement, the majority of the patients (90%) felt that the procedure was suitable for day surgery under local anesthesia. Our results show that septal and turbinate surgery can be performed with satisfactory quality and good safety and with patient satisfaction as a day procedure.
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  • Maxillary Hematocele
    Tsuyoshi Inaba, Takeyuki Fujimura, Tsuyoshi Udaka, Teruo Shiomori, Yoh ...
    2007 Volume 100 Issue 8 Pages 663-668
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.663
    JOURNAL FREE ACCESS
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    Hematocele is a benign hemorrhagic pseudotumor that preferably arises in the sinonasal tract, particularly in the maxillary sinus. The occurrence of maxillary hematocele has sporadically been documented, but its nature is not clearly understood. We herein report four cases of maxillary hematocele. The patients were 3 men and one woman, 30-62 years of age with an average of 49.8 years. Major symptoms were nasal obstruction (2 cases), nasal bleeding (2 cases), and toothache (1 case). Computed tomography demonstrated well-defined expansive soft tissue shadows with bone erosion. The lesions showed intermingled high/intermediate/low intensity in both T1- and T2-weighted magnetic resonance imaging. Endoscopic sinus surgery was performed in 3 cases, and the other patient underwent Caldwell-Luc procedure. Surgical specimens microscopically exhibited inflammatory changes with hematoma and fibrin deposition. The postoperative clinical course was uneventful in all cases, and all the patients are currently free from disease 4-25 months after surgery. Clinical, histopathological and radiological characteristics of maxillary hematocele are reviewed.
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  • A Case Report of a Solitary Fibrous Tumor Occurring in the Paranasal Sinus
    Masaki Kawabata, Shoji Matsune, Yuichi Kurono
    2007 Volume 100 Issue 8 Pages 669-674
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.669
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    Solitary fibrous tumor (SFT) is a relatively rare mesenchymal neoplasm that usually arises in the pleura. Recently, SFT has been reported to occur in various extrapleural sites such as the liver, thyroid, sublingual gland, nasopharynx, and parapharyngeal space without any relation to serosal surfaces. SFT occurring in the nasal cavity and paranasal sinus is extremely rare, with only 3 cases being previously reported in the Japanese literature. We report here a case of SFT occurring in the paranasal sinus of a 46-year-old female. CT scan demonstrated an enhanced solid tumor occupying the left nasal cavity with extension posteriorly to the nasopharynx. MRI showed a hypointense mass on T1-weighted images and a heterogenous isointense mass on T2-weighted images. The tumor showed a prominent and inhomogenous enhancement with gadolinium. The tumor was removed by an endoscopic transnasal approach under general anesthesia. Since the tumor was too large and hard to remove en-block, the lesion was resected in a few fragments. Immunohistochemical study revealed that the tumor cells were positive for CD34, Bcl-2, and vimentin, and the tumor was pathologically diagnosed as SFT.
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  • A Case of Subperiosteal Hematoma
    Diagnosed as Extracranial Extension of Frontal Sinus Mucocele
    Yasuhiro Inayoshi, Atsunobu Tsunoda, Ken Kitamura
    2007 Volume 100 Issue 8 Pages 675-679
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.675
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    We report a rare case of frontal sinus mucocele with a subcutaneous forehead mass. A 62-year-old woman presented with a soft forehead mass. Computed tomography and magnetic resonance imaging revealed a subcutaneous forehead lesion and frontal sinus mucocele, but no communication existed between these lesions. We diagnosed frontal sinus mucocele extending outside the skull through existing defects. After surgery, this subcutaneous lesion was proved to be a subperiosteal hematoma.
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  • Long-term Results of Tonsillectomy in Children
    Tomoki Yoshizaki, Nobuyuki Bandoh, Miki Takahara, Takashi Goto, Yasuak ...
    2007 Volume 100 Issue 8 Pages 681-686
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.681
    JOURNAL FREE ACCESS
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    We retrospectively analyzed 289 children who underwent tonsillectomy for recurrent tonsillitis and/or obstructive sleep apnea syndrome (OSAS). The analysis revealed that the number of times of postoperative pharyngitis and exothermic degree were markedly improved in patients with recurrent tonsillitis, and as a result, the number of days absent from school decreased. In patients with OSAS, snoring and sleep apnea symptoms were improved markedly and immediately after tonsillectomy. Patient satisfaction was extremely high in both recurrent tonsillitis and OSAS, and we found postoperative bleeding, as a postoperative complication, only in 6 cases (2%).
    Tonsillectomy for recurrent tonsillitis and OSAS in children was extremely effective and safely.
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  • A Case of Reversible Posterior Leukoencephalopathy Syndrome which Developed during Chemoradiotherapy for Head and Neck Cancer
    the Involvement of Bacterial Translocation was Considered
    Shinya Tachibana, Hajime Terao, Masahiro Katsuno, Hideki Takemura, Tak ...
    2007 Volume 100 Issue 8 Pages 687-693
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.687
    JOURNAL FREE ACCESS
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    Combination therapy such as chemotherapy and radiotherapy is often chosen, depending on the case, for head and neck cancer in view of the preservation of potency. However, on the other hand, it is necessary to note the onset of therapeutic side effects.
    The patient was a 35-year-old woman. During chemoradiotherapy for mesopharyngeal carcinoma, she suddenly developed shock and multiple organ failure, requiring intensive treatment. She also developed reversible central nerve symptoms during the course.
    The involvement of bacterial translocation was thought to be the cause of shock, and the reversible central nerve symptoms were considered to be a pathological condition, known as reversible posterior leukoencephalopathy syndrome. We discuss these conditions on the basis of the clinical features, and the process that led to diagnosis in this case.
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  • Therapy of Changing Acute Otitis Media in Children
    How to Apply the Clinical Practice Guideline for Diagnosis and Management of Acute Otitis Media in Children
    F. Kudou
    2007 Volume 100 Issue 8 Pages 694-695
    Published: August 01, 2007
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.100.694
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