Practica Oto-Rhino-Laryngologica

Clinical Trial of Local Drug Application into the Inner Ear for Highly Hearing-Impaired Patients

Juichi Ito

2008 Volume 101 Issue 1 Pages 1-4
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.1

JOURNAL FREE ACCESS

Show abstractHide abstract

There is no effective treatment for sensorinenral hearing disturbance. Inner ear sensory cells have been considered very fragile and functional recovery after damage is very difficult, making sensorinenral hearing loss very difficult to treat. Recently several drugs and chemicals have been reported to protect or promote recovery of inner ear function. However, applying those drugs to the inner ear is difficult because of specific anatomical and physiological factors. However, new technology using a drug delivery system (DDS) has introduced new possibilities. Especially, application of nerve growth factor in a biodegradable hydrogel is thought to be effective for protection and recovery of the inner ear function. We have reported the effectiveness of several drugs, especially nerve growth factors to prevent inner ear hair cell damage due to noise exposure or ototoxic chemicals in animals. We have begun a clinical trial using Insulin-like growth factor 1 (IGF-1) for the treatment of sudden deafness.

View full abstract

Download PDF (587K)
Tracheal Stenosis Caused by Wegener's Granulomatosis

M. Hyodo, [in Japanese], [in Japanese]

2008 Volume 101 Issue 1 Pages 6-7
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.6

JOURNAL FREE ACCESS

Download PDF (1547K)
Catheter Drainage of Neck Abscess in Children

Kazumi Yoshino, Kan Kishibe, Tetsuji Wada, Naoki Kanai, Yasuaki Harabu ...

2008 Volume 101 Issue 1 Pages 9-13
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.9

JOURNAL FREE ACCESS

Show abstractHide abstract

Image-guided percutaneous drainage has been shown to be a safe and effective alternative to surgery in the management of neck abscess. Two patients, 7-year and 4-month-old girls, were treated with X-ray fluoroscopy and ultrasonography-guided percutaneous 7 Fr trocar-type pigtail catheter drainage and antimicrobial therapy. This method was performed without complications and open surgical drainage was avoided in both cases. One patient had a persistent abscess, but was treated successfully by repeated catheter drainages.
Percutaneous drainage may be a useful alternative to surgical drainage in a selected group of patients with localized, smaller abscess without imminent airway obstruction.

View full abstract

Download PDF (3362K)
Surgical Removal of Glomus Tympanicum Tumor with Preservation of an Intact Ossicular Chain -Case Report-

Takahiro Tsujikawa, Fumiaki Nin, Tatsuo Hasegawa, Takeshi Nishio, Masa ...

2008 Volume 101 Issue 1 Pages 15-20
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.15

JOURNAL FREE ACCESS

Show abstractHide abstract

We present a case of glomus tympanicum tumor in a 43-year-old woman complaining of left pulsatile tinnitus. Audiometry demonstrated a normal hearing level. Otoscopy demonstrated a red pulsating mass in the tympanic cavity. CT and MRI depicted a tumor in the meso-hypotympanic area without bone destruction. After preoperative angiography and embolization of a feeding artery, the patient underwent surgery through a retroauricular transcanal approach. The tumor was completely removed, and an intact ossicular chain was preserved without reconstruction. Histopathologic examination confirmed the diagnosis of glomus tumor. Postoperative audiometry confirmed the preoperative normal hearing level was maintained. There has not been any recurrence on follow-up for 1 year after surgery.

View full abstract

Download PDF (3553K)
Clinical Consideration of Fungal Paranasal Sinusitis

Tsuyoshi Okuni, Koji Asakura, Tomo Homma, Ryuichi Kawaguchi, Tadataka ...

2008 Volume 101 Issue 1 Pages 21-28
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.21

JOURNAL FREE ACCESS

Show abstractHide abstract

Fungal paranasal sinusitis is included in the differential diagnosis of unilateral paranasl lesion. Recently the incidence of fungal paranasal sinusitis has been increasing. We reviewed 24 patients (9 males and 15 females) with fungal paranasal sinusitis treated at Muroran City Hospital between January 2001 and May 2006, and clinical presentation and CT findings with those of 56 patients (36 males and 20 females) with chronic unilateral sinusitis. Fungal sinusitis patients ranged in age from 45 to 87, and the average age was 65.9 years old. In contrast, the age of chronic sinusitis patients ranged from 24 to 83, and the average age was 54.4 years old. The chief complaint of both fungal sinusitis and chronic sinusitis included rhinorrhea, nasal obstruction and post nasal discharge.
CT exam was performed in all patients. In 23 cases of paranasal fungal sinusitis and 54 cases of chronic sinusitis the findings involved the maxillary sinus. The most common observation (69.6%) was bone density within the affected sinus in fungal sinusitis. However, only 2 cases of chronic sinusitis (3.9%) showed calcification.
All cases of fungal sinusitis were diagnosed by pathological examinations. Most cases were proved to be aspergillus, while only one case was mucor. We treated all cases surgically, 18 cases underwent Caldwell-Luc's procedure and 5 cases underwent endoscopic sinus surgery under local anesthesia.

View full abstract

Download PDF (2321K)
Case Report on HIV Infection Diagnosed from Intractable Pharyngeal Ulceration

Toshiharu Hirota, Takehiro Karaho, Yuuichiro Maruyama, Akihiro Shiotan ...

2008 Volume 101 Issue 1 Pages 29-32
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.29

JOURNAL FREE ACCESS

Show abstractHide abstract

Human immunodeficiency virus (HIV) infection induces acquired immunodeficiency syndrome (AIDS) as a consequence of collapsed immunity ten or more years after infection. At present, the number of HIV-infected patients is supposed to be about 39, 400, 000 worldwide. In Japan, the total number of HIV and AIDS patients may be over 10, 000 and the most frequent cause is homosexual intercourse. We report on a patient with intractable pharyngeal ulceration who consulted our clinic for pharyngeal and swallowing pain and was finally diagnosed as HIV-positive.
Case A: 36-year-old man. His complaint started at the beginning of June 2006. He was treated for pharyngitis at a local clinic of internal medicine, but there was no response. Therefore, he was referred to our clinic on July 24th. An oro-pharyngeal examination demonstrated an ulcer and white furred region at the right oropharynx and left aryepiglottic fold. A cuture of hemanalysis demonstrated panhematopenia and the white furred region showed indigenous bacterial flora. Swallowing pain increased and he was admitted to our hospital on August 24th. Since he was noncompliant with antiseptic medication at the outpatient clinic, we suspected the possibility of a sexually transmitted infection at admission. It was determined that he was homosexual and HIV-positive. As a result of conservative therapy pharyngeal pain has diminished and the treatment of AIDS was started after referred to the general clinical department. We report the characteristics of HIV-positive induced oro-pharyngeal symptoms with a review of the literature.

View full abstract

Download PDF (2104K)
A Case of Quadruple Primary Cancers

Misako Hashimoto, Jun Watanabe, Hironori Takebayashi, Hidenori Boku, O ...

2008 Volume 101 Issue 1 Pages 33-37
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.33

JOURNAL FREE ACCESS

Show abstractHide abstract

The frequency of multiple primary cancers in the head and neck area is higher than that in other areas, and has increased in recent years.
We report a case of synchronous quadruple primary cancers in a 68-year-old man. He consulted our department with hypopharyngeal cancer and during systemic work-up, three other cancers were detected: esophagus, lung and stomach. Initially, we chose irradiation therapy for hypopharyngeal and esophageal cancer, and then performed simultaneous resection of lung and stomach cancer. To date, the patient has survived for 44 months without recurrence.
When we determine the appropriate treatment, for multiple cancers it is very important to evaluate the location, stage, and prognosis of each cancer and develop good cooperation with other departments involved in patient care.
We must detect second cancer as soon as possible by systemic work-up and must never forget the possibility of another cancer origins after treatment.
Early detection of additional cancer legions and good cooperation with other departments can improve the survival prognosis and quality of life even in patients with synchronous multiple cancers.

View full abstract

Download PDF (4271K)
Thyroplasty Type III for Treatment of Voice Problem in GID of Female-to-Male Type

Tsuyoshi Kojima, Kazuhiko Shoji, Nobuhiko Isshiki, Kazuhiro Nakamura

2008 Volume 101 Issue 1 Pages 39-43
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.39

JOURNAL FREE ACCESS

Show abstractHide abstract

We report a case of GID (gender identity disorder) of the female-to-male type, where her vocal pitch was lowered to her satisfaction by Thyroplasty type 3. The distress of GID patients derives from the contradiction between their sexual physical features and gender self-consciousness. As to the levels of distress and the means patients select to resolve the problems they face, individual variations are great. The present patient did not want either transsexual surgery or hormonal treatment, but merely her vocal pitch lowered. Thyroplasty type 3 successfully lowered her vocal pitch as desired without any complication. Surgical details and key points were described.

View full abstract

Download PDF (4015K)
A Case of Obstructive Sleep Apnea Syndrome due to a Parapharyngeal Space Tumor

Masato Miyoshi, Kazumasa Maehara, Hirokazu Tanaka, Shuntaro Inagawa, H ...

2008 Volume 101 Issue 1 Pages 45-49
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.45

JOURNAL FREE ACCESS

Show abstractHide abstract

A 63-year-old man with a complaint of snoring and apnea was diagnosed as having severe obstructive sleep apnea syndrome. His apnea-hypopnea index was 68.3. His soft palate was swollen and the uvula was deviated to the left. A tumor covered by normal epithelium occupied and obstructed the choana and epipharynx. Computed tomography and magnetic resonance imaging demonstrated a mass measuring 55×55×45mm in this area.
A biopsy was performed and the pathological diagnosis was schwanoma (neurilemmoma).
Nasal continuous positive airway pressure was introduced but was ineffective for apnea.
Due to the slow growing tendency of the tumor, transoral resection was planned under general anesthesia and the entire tumor was removed. The postoperative course was uneventful and apnea improved after this procedure.

View full abstract

Download PDF (5765K)
A Case of Schwannoma Arising from Great Auricular Nerve in Neck

Masahiko Fukasawa, Daisuke Oyake, Hideo Tomisawa, Tomoyuki Okada, Izum ...

2008 Volume 101 Issue 1 Pages 51-54
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.51

JOURNAL FREE ACCESS

Show abstractHide abstract

Schwannoma occasionally arises in the head and neck region and it is reported that pre-operative diagnosis of this lesion is usually difficult. We encountered a case of schwannoma in the submandibular region which needed to be differentiated from parotid tumor. A 66-year-old man with schwannoma in the left upper neck region was reported. He had noticed swelling of the left upper neck in 2000 but did not consult a hospital for treatment because the swelling was painless. The patient was referred to our department for swelling on March 27, 2006. Based on enhanced CT (contrast study) and magnetic resonance imaging (MRI) findings, the lesion was diagnosed as a neurogenic tumor. Since the surgery, patient has not developed any recurrence.

View full abstract

Download PDF (6584K)
A Case of Tetanus with Facial Nerve Palsy

Kousuke Yoshifuku, Hiromi Nagano, Yuichi Kurono

2008 Volume 101 Issue 1 Pages 55-60
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.55

JOURNAL FREE ACCESS

Show abstractHide abstract

Tetanus is a well acknowledged infectious disease designated in the law on infectious disease. Due to a progress of protective inoculation and public health, the incidence of this disease has been decreasing recently. In Japan, we seldom encounter patients with tetanus at present; however, it is important to consider this disease, because of its extremely poor prognosis. If early diagnosis and suitable treatment are not perfomed, prognoses of tetanus is frequently miserable. A sixty-four-year old woman consulted our hospital complaining of trismus and severe dysphagia, with facial nerve palsy 10 days after a head injury. Physical examination showed trismus, and a 5cm wound was seen on her left forehead. Blood examinations showed an increased level of C-reactive protein. The patient was suspected of having tetanus based on the clinical symptoms and was admitted to our hospital immediately. She received 3000 units of antitetanus human immunogloblin on the first day, and daily intravenous infusion of Benzylpenicillin was administered for 10 days. After the treatment was initiated, trismus showed daily improvement, and she recovered without developing any complications such as airway obstruction or circulatory disturbance. Despite progress in protective inoculation and public health, tetanus has not been eradicated, since bacillus tetani widely exists in the soil and intestines.
Altough tetanus is rare in Japan, it is important to consider this disease as part of the the differential diagnosis when we encounter patients with Stage 1 or Stage 2 symptoms of tetanus such as dysphonia, dysphagia, and trismus after an injury.

View full abstract

Download PDF (3939K)
PET as a Possible Indicator of the Prognosis of Head and Neck Squamous Cell Carcinoma

Comparative Analysis of FDG-PET and Choline-PET

Hiroshi Ninomiya, Noboru Oriuchi, Hideo Kamada, Motoaki Miyashita, Kat ...

2008 Volume 101 Issue 1 Pages 61-66
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.61

JOURNAL FREE ACCESS

Show abstractHide abstract

Positron emission tomography (PET) using ¹⁸F-fluoro-2-deoxy-D-glucose (FDG), which reflects glucose metabolism, has been reported to be useful for staging head and neck cancers and for investigating the primary lesion of unknown origin, double cancer, recurrence and residual cancer after treatment. It has also been reported that the degree of accumulation before treatment may be utilized as a prognostic factor. The usefulness of PET using ¹¹C-choline, which reflects cell membrane phospholipid metabolism, for cancer diagnosis has been reported as well.
In this study, we investigated differences in the prognosis based on the degree of ¹¹C-choline-PET and FDG-PET accumulation. ¹¹C-choline-PET and FDG-PET were taken before treatment in patients with squamous cell carcinoma of the head and neck. To indicate the degree of accumulation, the standard uptake value (SUV) was used. Choline and FDG were accumulated in the primary lesion in all patients. The SUVs in both choline and FDG were higher in patients who responded poorly to primary treatment than in those who responded well. The cumulative survival rate of patients with a high SUV of choline was significantly lower than that of patients with a low SUV of choline.
SUV of choline-PET before treatment may be utilized as a prognostic factor.

View full abstract

Download PDF (648K)
Transoral Surgery for Laryngeal and Hypopharyngeal Cancer

A. Shiotani

2008 Volume 101 Issue 1 Pages 68-69
Published: January 01, 2008
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.101.68

JOURNAL FREE ACCESS

Download PDF (2294K)

Register with J-STAGE for free!