Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 102, Issue 10
Displaying 1-17 of 17 articles from this issue
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Editorial
  • Superselective Intraarterial Infusion Therapy for Head and Neck Cancer
    Kazuo Sakurai, Hisayuki Kato, Tatsuyoshi Okada
    2009 Volume 102 Issue 10 Pages 795-803
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.795
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    It has become clear that superselective intraarterial infusion therapy has demonstrated extremely high effectiveness for advanced head and neck cancer in combination with radiation therapy. It is expected to contribute in particular to improvement of patients’ quality of life following treatment and improvement of the prognosis through organ preservation. However, some problems currently remain to be solved, such as indications or complications. We report herein on our cases and those in the literature, and discuss superselective intraarterial infusion therapy in Japan.
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Original articles
  • A Case of Perilymph Fistula with Brain Tumor
    Akemi Sugita-Kitajima, Toshiharu Shintani, Oichi Yamaguchi, Izumi Koiz ...
    2009 Volume 102 Issue 10 Pages 807-811
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.807
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    We encountered a case of perilymph fistula with brain tumor. A 14-year-old female complained of right hearing loss and dizziness after blowing her nose. An audiogram showed right deafness and we diagnosed perilymph fistula. After admission, she was confined to bed rest and treated with steroid therapy. Dizziness diminished, but deafness persisted. After one month, she returned to our hospital because of right facial palsy, ataxia and right hemiparesis. Her consciousness was drowsy. CT and MRI showed a 5 cm brain tumor. She underwent surgical removal of the tumor by neurosurgeons. The surgical specimen demonstrated medulloblastoma. Her conscious cleared but she later developed postoperative cerebrospinal fluid otorrhea and rhinorreha, in addition to dizziness. Recurrence of the perilymph fistula was diagnosed. Surgery was performed to perilymph fistula. After the second surgery, her dizziness and hearing loss were recovered.
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  • A Case of Unilateral Sudden Deafness Following Dissection of the Basilar Artery
    Masahiro Okada, Jun Hyodo, Kiyofumi Gyo, Taisuke Kobayashi
    2009 Volume 102 Issue 10 Pages 813-819
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.813
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    A 55-year-old woman suddenly noticed right hearing loss and tinnitus. Several days later, she lost consciousness, and was referred to Ehime Prefectural Central Hospital. Computed tomography (CT) showed subarachnoidal hemorrhage at the right cerebellopontine angle. However, subsequent CT-angiography and four-vessel cerebral angiography could not detect the exact cause of hemorrhage, such as aneurysm and arterial dissection. When she regained consciousness a few days later, she noticed worsening of right hearing loss and dizziness. Pure-tone audiogram showed complete deafness in the right ear. Distortion product otoacoustic emission and auditory brainstem response were not elicited in the right ear. Caloric test demonstrated canal paresis of the right ear with normal response in visual suppression. There were no neurological deficits other than right VIIIth nerve damage. Cerebral infarction and vasospasm were negative in magnetic resonance imaging (MRI) and MR-angiography performed on the 5th day. One month after onset, four-vessel angiogram demonstrated stenosis of the basilar artery near the branching site of AICA. These findings suggested that her deafness and disequilibrium were due to inner ear ischemia caused by dissection of the basilar artery, which also caused subarachnoidal hemorrhage.
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  • A Case of Benign Paroxysmal Positional Vertigo in a Child
    Kazumi Yoshino, Reiko Karasaki, Takeshi Kanaya, Kan Kishibe, Yasuaki H ...
    2009 Volume 102 Issue 10 Pages 821-823
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.821
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    Benign paroxysmal positional vertigo (BPPV) in a child is known to be very rare. There are very few papers about nystagmus during BPPV episode in a child. A nine-year-old girl who complained of severe positional vertigo was admitted to our hospital. There were no abnormal findings on physical examination and brain magnetic resonance imaging (MRI). When she was placed in a supine position, we could record characteristic positional nystagmus using video-oculography. On subsequent off-line analysis of that nystagmus recording, we diagnosed her as having BPPV in the horizontal semicircular canal. About 2 weeks earlier, she had sustained a bruise on her head and we considered that this bruise may have caused her BPPV attack. Positional vertigo decreased very quickly and she hospitalized for only 2 days for observation without any special treatment.
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  • Cochlear Reimplantation due to Electrode Problems
    Shinya Hori, Yasushi Naito, Shogo Shinohara, Keizo Fujiwara, Masahiro ...
    2009 Volume 102 Issue 10 Pages 825-829
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.825
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    We report two cases of cochlear reimplantation due to electrode problems. Case 1: A 76-year-old woman, complaining right-ear tinnitus in the 8 years following CI22 cochlear implantation in the right ear, was found in an X-ray examination to have the electrode array bending near the cochlear stoma. In cochlear reimplantation using a CI22 device upgraded to CI24RCS, fibrous tissue around the stoma and in the cochlear basal turn was removed and the electrode was replaced. Her speech perception score improved thereafter and tinnitus was reduced. Case 2: A 6-year-old boy with bilateral inner ear malformation presented with right facial spasm and decreased speech recognition 2 years and 4 months after right-ear cochlear implantation. An X-ray examination showed slight electrode slipout, so we inserted a CI24M device upgraded to CI24RCS, after which his speech perception score improved. Cochlear reimplantation was thus proved to be safe and effective in cases of electrode problems.
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  • The Study on the Change of Symptoms in Allergic Rhinitis during Asian Sand Dust Phenomenon
    Tatsuaki Sato
    2009 Volume 102 Issue 10 Pages 831-839
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.831
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    Allergic rhinitis, especially Japanese cedar pollinosis, is a major problem in Japan. On the other hand, recently Asian sand dust (ASD) phenomenon originating in the deserts of Mongolia and China has also been reported to affect human health. The ASD concentrations measured by laser radar beginning in 2007 made it possible to detect atmospheric ASD particles even when ASD phenomenon is not observed.
    Objective: As ASD phenomenon occurs concomitantly with pollen season in Japan, the aim of this study is to investigate the effects of ASD on allergic rhinitis in periods when ASD phenomenon is observed and is not observed. Patients of allergic rhinitis were retrospectively investigated between April 1st and May 31st, 2007.
    Results: Although the floating pollen counts were low during this study, 53 of 77 patients (68.8%) with allergic rhinitis complained of aggravated nasal symptoms, and developed respiratory symptoms such as sore throat, abnormal sensation in the pharyngolarynx and cough. This trend was noted in those with seasonal allergic rhinitis such as Japanese cedar pollinosis both when ASD phenomenon was observed and non-observed.
    Conclusion: The results suggest that ASD may adversely affect allergic rhinitis symptoms regardless ASD levels. Although further investigation is required, it is important to pay more attention to ASD to maintain good quality of life of the patients with allergic rhinitis.
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  • Experience with Mohs’ Paste for Giant Parotoid Carcinoma
    Kenji Fukutsuji, Takema Sakoda, Akira Shibano, Hiroki Ikeda, Kei Nakah ...
    2009 Volume 102 Issue 10 Pages 841-845
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.841
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    A 60-year-old man with carcinoma of the right parotid gland judged to be inoperable was treated using the escharotic agent Mohs’ paste to improve quality of life (QOL). The tumor surface had become fixed where Mohs’ paste was applied by the next day and dried, reducing the offensive odor and stopping the bleeding. After approximately 40 days, the patient was able to be discharged. Mohs’ paste is effective for improving QOL for parotid carcinoma patients with local advanced, inoperable skin lesions.
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  • Intraparotid Gland Toxoplasmosis Lymphadenitis: A Case Report
    Takayuki Imai, Ryoko Watanabe, Kiyoshi Hiruma
    2009 Volume 102 Issue 10 Pages 847-851
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.847
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    Toxoplasmosis, a usually asymptomatic protozoan infection caused by the coccidian Toxoplasma gondii, is mainly acquired by ingesting cat-shed oocysts or by eating raw meat containing tissue cysts. Infection may cause cervical lymphadenitis. Toxoplasmosis manifesting as a parotid mass is very rare. We report a case of intraparotid gland toxoplasmosis lymphadenitis mimicking a parotid gland tumor. A 30-year-old man seen for a rapidly growing parotid gland mass underwent superficial parotidectomy, for suspected parotid gland carcinoma. Histopathological results indicated toxoplasmosis lymphadenitis, and serological findings showed elevated toxoplasma IgM and IgG antibodies, yielding a definitive diagnosis of intraparotid gland toxoplasmosis lymphadenitis. Localized toxoplasmosis disease usually requires no treatment. The man remained asymptomatic at 5-month follow-up. He had a history of eating raw meat before the event, so, we assume that the infection was transmitted via raw meat containing tissue cysts.
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  • Efficancy of Concurrent Chemoradiotherapy in Advanced Hypopharyngeal Carcinoma
    Tsutomu Ueda, Haruo Hirakawa, Hiromi Furuie
    2009 Volume 102 Issue 10 Pages 853-856
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.853
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    Concurrent chemoradiotherapy is effective in preserving the hypopharynx in a high percentage of patients, but neck control after concurrent chemoradiotherapy is poor.
    We treated 21 patients—18 men and 3 women with a mean age of 60.8 years—for advanced hypopharyngeal carcinoma from 1996 to 2006 using concurrent chemoradiotherapy.
    Primary tumor sites included the pyriform sinus in 13, the posterior pharyngeal wall in 3, and postcricoid in 5. Six were stage III and 15 stage IV.
    Seventeen had complete response (CR) and 4 partial response (PR). Disease—specific 3-year survival was 60.2%—stage III: 83.3%, stage IV: 62.5%—. Disease—specific 5-year survival was 46.8%—stage III: 62.5%, stage IV: 39.6%—.
    Eighteen of the 21 (85.7%) showed CR at primary, and 14 of 18 node—positive patients (77.8%) showed CR in neck lymph nodes. Recurrence rate at the primary site was 16.7%—3 of 18 CR patients—and 57.1%—8 of 14 CR patients—at neck lymph nodes.
    We are now considering planned neck dissection after concurrent chemoradiotherapy to improve neck lymph nodes control.
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  • Clinical Study of 122 Cases of Acute Epiglottitis with Hospital Treatment
    Shuichi Matsumoto, Tadahiko Saiki, Masaru Sakaki, Futoshi Watanabe
    2009 Volume 102 Issue 10 Pages 857-864
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.857
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    In a retrospective study of clinical acute epiglottitis findings, we reviewed cases of 122 subjects-85 men and 37 wemen from 17 to 90 years old (mean: 49.1)-hospitalized and treated between January 2003 and December 2008. Chief symptoms (individual cases had multiple symptoms) were sore throat in 121 (99.2%), dysphagia in 32 (26.2%), elevated fever in 30 (24.6%), and dyspnea in 17 (13.9%). Prior to hospitalization, 70.5% of patients had been to otorhinolaryngological clinics and 27.0% to internal medicine clinics. Laryngeal inspection using a flexible fiberscope was important for diagnosis. Based on epiglottis swelling, arytenoid and aryepiglottic fold, and the dyspnea grade, we divided patients into stage I, slight, stage II, moderate, and stage III, severe. Stage I epiglottitis cases number 61 (50.0%), stage II 43 (35.2%), and stage III 18 (14.8%). Time from symptom onset to hospital visit averaged 3.7 days in stages I and II and 2.6 days in stage III. Local complications were peritonsillitis or peritonsilar abscess in 9 (7.4%), whitish wound of the epiglottis in 9 (7.4%), and epiglottic cyst in 8 (6.6%). We administered antibiotics in 121 cases (99.2%), mainly flomoxef sodium (FMOX) and clindamycin (CLDM) and steroid in 110 cases (90.2%). Six stage III cases (4.9%) required emergency airway management, 5 tracheostomy, and 1 endotracheal intubation. Hospitalization was from 3 to 33 days, or an average of 6.9 days, specifically 6.0 days for stage I, 6.3 days for stage II, and 11.6 days for stage III. Recurrence was seen in 5 (4.1%) and prognosis was good with no deaths.
    Clinicians should keep each other mutually informed about clinical features of acute epiglottitis, especially those involving severe sore throat and/or dysphagia without severe local pharyngeal findings.
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  • A Case of Primary Tuberculosis of Thyroid Gland
    Kenichiro Nomura, Nobuyuki Bando, Osamu Ohshima, Taketoshi Fujita, Yas ...
    2009 Volume 102 Issue 10 Pages 865-868
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.865
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    We report a 57-year old man with primary tuberculosis of the thyroid gland. He visited our hospital with a chief complaint of hoarseness caused by right recurrent nerve paralysis. CT findings revealed a right thyroid mass with calcification and paratracheal lymph node swelling. This mass was thought to be malignant thyroid tumor and we performed right hemi-thyroidectomy and paratracheal lymph node dissection. The unexpected diagnosis of tuberculosis based on pathological examination was made postoperatively. No tuberculosis lesion was found elsewhere. Primary tuberculosis of the thyroid gland is very rare. The preoperative findings are similar to papillary carcinoma and it is difficult to make a diagnosis preoperatively.
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  • Chondrosarcoma of the Hyoid Bone
    Keiichiro Okuno, Taketoshi Nogaki
    2009 Volume 102 Issue 10 Pages 869-873
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.869
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    Chondrosarcoma is a malignant tumor of cartilaginous origin, and the second most common primary malignant bone tumor, however, chondrosarcoma of the head and neck is relatively rare. Only 10% of chondrosarcomas occur in the head and neck region, such as the skull base, maxilla mandible, and larynx. Chondrosarcoma of the hyoid bone is a very rare site of involvement. In the English literature to date, only 14 cases of chondrosarcoma of the hyoid bone have been reported.
    We present a case of chondrosarcoma of the hyoid bone. The patient was a 69-year-old man who underwent surgical excision of the tumor via a transcervical approach. The resected tumor originating from the hyoid bone was a 4×4 cm encapsulated lesion. Histological examination demonstrated grade II chondrosarcoma. Five years after surgery, there is no any evidence of recurrence. Long-term follow-up is essential.
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  • A Case of Parathyroid Adenoma and Cyst Associated with Primary Hyperthyroidism
    Masanobu Mizuta, Kazuhiko Shoji, Atsuhito Takahashi, Takehiro Iki, Mam ...
    2009 Volume 102 Issue 10 Pages 875-879
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.875
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    We report a rare case of parathyroid adenoma and cyst associated with primary hyperparathyroidism. A 51-year-old woman seen for elevated serum alkaline phosphatase and serum parathyroid hormone was found in ultrasonography to have a solid mass near the lower right thyroid pole and a cystic mass near the lower left pole. 99mTc-MIBI scintigraphy in the delayed phase showed uptake only in the right mass, diagnosed as parathyroid adenoma elevating parathyroid horomone. We diagnosed the left mass as a nonfunctioning parathyroid cyst. Following surgery to remove the masses, serum parathyroid hormone returned to normal levels. Histological examination confirmed our diagnosis.
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  • A Case of Lemierre Syndrome due to Fusobacterium necrophorum
    Yoshiki Watanabe, Eriko Hoshi, Satoshi Sonoda, Juichi Ito
    2009 Volume 102 Issue 10 Pages 881-884
    Published: 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.102.881
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    We encountered a rare case of Lemierre syndrome. A 38-year-old man visited us due to his severe sore throat, general fatigue, high fever and poor intake of meals. He had slightly red swollen tonsils. Neck computed tomography (CT) showed no parapharyngeal abcess then. So we diagnosed him as peritonsillitis first, and started drip infusion of antibacterials and hydrocortisone to reverse his disease. He evidenced some disturbance in consciousness when seen that continued despite improvement in objective findings. So we put some tests including enhanced CT, magnetic resonance imagind (MRI), bacterial culture and blood studies yielded a diagnosis of Lemiere syndrome as defined by tonsillitis or peritonsillitis/peritonsillar abcess with thrombophlebitis of the jugular vein potentially causing disseminated intravascular coagulation (DIC) and critical damage.
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