巻号一覧
前身誌
102 巻, 3 号
選択された号の論文の15件中1～15を表示しています
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論説
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―病態と診断―小川 郁, 井上 泰宏, 齊藤 秀行, 神崎 晶, 岡本 康秀, 水足 邦雄, 鈴木 隆史, 大石 直樹2009 年 102 巻 3 号 p. 169-175
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありOtosclerosis is an otological disease that typicaly causes conductive hearing loss. This disease is an important clinical entity since hearing impairment in these case can be dramatically improved by surgery. In this review paper, we review recent research into the pathophysiology of otosclerosis and summarize clinical features, audiometry and diagnostic imaging examinations in 160 ears with otosclerosis that we treated surgically in our department.
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カラー図説
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岩崎 朱見, 角田 篤信, 倉田 奈都子, 岸本 誠司2009 年 102 巻 3 号 p. 176-177
発行日: 2009年
公開日: 2010/12/03
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臨床
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福嶋 宗久, 宮口 衛, 佐々木 崇博, 神原 留美2009 年 102 巻 3 号 p. 179-183
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありA 25-year-old female suffered an attack of vertigo and noticed hearing impairment, so this case was initially treated as sudden deafness. Subsequently, she presented with facial nerve paresis and the diagnosis was found to be cerebellopontine angle meningioma after examination at another facility. Of tumors that occur in the cerebello-pontine angle, acoustic tumors have the highest frequency. Meningiomas occur in this part secondarily, and it is reported that they account for about ten percent of all tumors in this area. Cerebellopontine angle meningiomas cause vertigo and disequilibrium, but are rarely accompanied with sudden sensorineural hearing loss. When they develop as sudden deafness, it might be difficult to clinically differentiate meningioma and non-classic acoustic tumor. Meningiomas might therefore follow a rapid clinical course.
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永井 賀子, 萩原 晃, 河野 淳, 西山 信宏, 古瀬 寛子, 鈴木 衞2009 年 102 巻 3 号 p. 185-190
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありCochlear implantation is a well-established treatment for total deafness. According to the increased number of cochlear implantation cases and the postoperative period, we have encountered various problems and complications. We describe a patient with cochlear destruction from repeated otitis media several years after cochlear implantation. She underwent cochlear implantation in the opposite ear. We assume that the uncontrolled infection led to a chronic state, thus causing cochlear destruction. We sometimes experience fungus-induced otitis media after cochlear implantation which is difficult to control. It is therefore important to control otitis media before cochlear implantation.
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澤井 尚樹, 羽藤 直人, 寺岡 正人, 菰渕 勇人, 高橋 宏尚, 暁 清文2009 年 102 巻 3 号 p. 191-195
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありSome facial palsy patients develop bilateral and/or recurrent facial palsy. To clarify the characteristic of bilateral and recurrent facial palsy, we retrospectively investigated 193 patients with bilateral and recurrent facial palsy in the 3385 patients who were treated for facial palsy during the past 3 decades. Among the 193 cases, 62 patients had ipsilateral recurrent palsy, 25 patients had bilateral simultaneous palsy, 88 patients had bilateral alternative palsy, and 18 patients had bilateral recurrent palsy. The major cause of palsy was Bell's palsy, and it accounted for 84.5% (163/193). Traumatic palsy, Guillain-Barré syndrome and facial schwannoma were rare, with rates below 3%. Therefore, the 163 patients with Bell's palsy were further investigated, and the following characteristic were found. (1) Patients with bilateral alternative palsy were more frequently associated with diabetes mellitus and hypertension, and patients with bilateral recurrent palsy were more frequently associated with diabetes mellitus than patients who had a single ipsilateral palsy. (2) The age at the first episode in patients with bilateral recurrent palsy and ipsilateral recurrent palsy was significantly younger than that in those without recurrent palsy.
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吉福 孝介, 馬越 瑞夫, 黒野 祐一2009 年 102 巻 3 号 p. 197-200
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありAuricular hematoma is considered to occur between the perichondrium and cartilage, or within the cartilage. This disease results from trauma producing a soft, smooth, doughy, rounded swelling of the auricule that is tender and shows size changes, often obliterating the anatomic contours of the auricle.
Auricular hematoma is not a rare disease, and its prognosis has been considered good. However, the recurrence of hematoma frequently occurs through the use of simple aspiration or incision, and a pressure dressing. In this paper, we report a case of continuous portable vacuum drainage for auricular hematoma.
A 15-year-old male was admitted to our hospital complaining of swelling and slight pain in his left auricle. Based on ENT examination, he was diagnosed with auricular hematoma. After obtaining informed consent, we applied continuous portable vacuum drainage for the treatment of auricular hematoma. Repeated drainage resolved the symptoms as well as clinical findings, and no reccurrence has been observed to the present.
Various techniques have been applied to treat auricular hematoma, such as fine needle aspiration, incision and drainage, pressure dressing with a splinting mold, mattress suture, or injection of OK-432. This report confirmed the usefulness of continuous portable vacuum drainage for the treatment of auricular hematoma.
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窪島 史子, 中川 隆之, 坂本 達則, 伊藤 壽一2009 年 102 巻 3 号 p. 201-205
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありArachnoid cysts are commom intracranial lesions; however, their extension to the paranasal sinus is rare. Here we report a case of arachnoid cyst extending to the sphenoid sinus. Imaging examinations indicated an epidermoid cyst. We then performed endoscopic transsphenoidal surgery for partial resection of the cyst or formation of a drainage route. Opening the cyst wall resulted in a massive CSF leak, indicating an arachnoid cyst. Management of CSF leakage requires complete closure of the defect in the skull base using a fat graft and a pedicle mucosal flap elevated from the nasal septum. An arachnoid cyst should be included in the differential diagnosis of intracranial cystic lesions extending to the paranasal sinuses.
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平木 信明, 宇高 毅, 塩盛 輝夫, 小泉 弘樹, 門川 洋平, 小野 頌子, 鈴木 秀明2009 年 102 巻 3 号 p. 207-212
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありEikenella corrodens (E. corrodens) is a Gram-negative facultative anaerobic bacillus that originally was thought to be an attenuated and indigenous bacterium. In this study, we investigated the clinical and bacteriological characteristics of E. corrodens infections of the tonsil.
Seventeen consecutive patients treated in our department for E. corrodens infections of the tonsils were retrospectively analyzed. Microbial specimens were subjected to light microscopic examination, aerobic culture using chocolate and sheep blood agar media, and anaerobic culture using Brucella HK agar medium. Cultured bacteria were subjected to antimicrobial susceptibility tests using the broth microdilution method.
The patients were 11 males and 6 females, ranging in age from 4 to 53 years with an average of 22.8 years. One patient had liver cirrhosis, while the other patients had no particular risk factors or underlying diseases. E. corrodens was detected from the surface of the tonsil in 4 cases, from the resected tonsillar tissue in 11 cases, and from pus in the abscesses in 2 cases. Twelve patients demonstrated polymicrobial infections. Streptococcus was the most frequently detected pathogen coexisting with E. corrodens. Isolated E. corrodens was susceptible to third-generation cephems, carbapenems, and new quinolones; and moderately susceptible to benzylpenicillin, ampicillin, cefotiam, and minocycline; but resistant to first-generation cephems, oxacillin, erythromycin, and clindamycin.
In conclusion, E. corrodens infections of the tonsils are not rare even in hosts with normal immunity. We should be aware of this bacteria in tonsillar infections.
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大久保 圭子, 上田 祥久, 小野 剛治, 中島 格2009 年 102 巻 3 号 p. 213-218
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありWe reviewed the clinical effect of tonsillectomy against IgA nephropathy in 34 patients who had received tonsillectomies (group A) and compared the results with 58 patients who were treated without surgery (group B). For analysis, we used the IgA score for renal pathology, and examined the clinical remission rate, stable renal function rate and the renal survival rate. The clinical remission rate was 35% in group A and 16% in group B, but there was no significant difference between the two groups (p=0.03). The stable renal function rate was 85% in group A and 67% in group B, but there was no significant difference between the two groups (p=0.06). Our results showed that tonsillectomy is a clinically effective treatment for IgA nephropathy, however, it is necessary to perform long-term follow-up.
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岡田 昌浩, 小林 泰輔, 中村 光士郎2009 年 102 巻 3 号 p. 219-223
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありHemorrhage following tonsillectomy is still a major complication despite the development of new hot knives. In this study, a retrospective review of 242 adult patients who underwent tonsillectomy in the Department of Otolaryngology, Ehime Prefectual Central Hospital between January 2000 and March 2007 was conducted. Post-tonsillectomy hemorrhage occurring in 56 patients (23.1%); four of these patients experienced hemorrhage during the first 24 hours postoperatively, and the remaining 52 had delayed bleeding. Nine of 56 patients (3.7%) required a procedure to control their bleeding under general anesthesia. The hemorrhage rate in males was significantly higher than in females. There was no statistically significant difference in hemorrhage rates based on age, body mass index (BMI), duration of surgery and smoking. Patients who received antibiotics postoperatively experienced less secondary hemorrhage than those without antibiotics. In 99 patients who were administered antibiotics, patients who used cephalosporins experienced less secondary hemorrhage than those who received penicillins. These results indicate that antibiotics after tonsillectomy are effective to reduce post-tonsillectomy hemorrhage rates.
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山口 浩志, 土師 知行, 佐藤 進一, 田村 哲也, 本吉 和美, 小澤 一之, 辻村 隆司, 山田 光一郎, 本多 啓吾2009 年 102 巻 3 号 p. 225-228
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありMycosis localized in the larynx is relatively rarely observed, and only a small number of cases have been reported. We encountered a 69-year-old male with laryngeal mycosis due to Aspergillus. He visited our department due to hoarseness/abnormal laryngeal sensation. At the first consultation, electronic laryngoscopy showed a white lesion anterior to the membranous portions of the bilateral vocal folds. Based on the results of biopsy, a diagnosis of laryngeal aspergillosis was made. He was treated with the oral administration of an antifungal drug on an outpatient basis, and showed a tendency toward improvement, however, the fungus partly remained, and additional resection was performed using a laser by laryngo-microsurgery. He has since remained under follow-up observation.
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水田 匡信, 庄司 和彦, 髙橋 淳人, 伊木 健浩, 松原 真美2009 年 102 巻 3 号 p. 229-232
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありFine-needle aspiration cytology (FNAC) of thyroid nodules is an excellent diagnostic test to distinguish between malignant and benign nodules. However no experienced cytologist can make a diagnosis based on insufficient materials. We examined the ratio and characteristics of cases in which insufficient materials are obtained.
We performed FNAC on 588 patients with thyroid nodules in our hospital from February 2006 to June 2007. In 107 (18.2%), insufficient materials were obtained.
We failed to obtain sufficient materials in 31 (35.2%) of 88 nodules of less than 10 mm in diameter, and in 76 (15.2%) of 500 nodules of more than 10 mm in diameter. In addition, we were unable to obtain sufficient materials in 64 (27.2%) of 235 nodules located under the surface of the trachea, whereas this was the case in 43 (12.2%) of 353 nodules located over it.
The smaller the size of a nodule and the deeper its location, the more frequently insufficient materials are obtained.
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上田 征吾, 安部 裕介, 大髙 隆輝, 片山 昭公, 高原 幹, 片田 彰博, 坂東 伸幸, 林 達哉, 原渕 保明2009 年 102 巻 3 号 p. 233-237
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありWe report a case of inflammatory myofibroblastic tumor in the neck. A 14-year-old male was brought to our department complaining of right cervical swelling and slight fever. CT and MRI showed a 21×20×10 mm mass and swelling of the surrounding lymph nodes in the posterior cervical space. A biopsy was performed. The tumor was histopathologically and immunohistochemically diagnosed as inflammatory myofibroblastic tumor and was treated with selective neck dissection. The patient is currently alive with no signs of recurrence.
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研修ノート
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小川 徹也, 稲福 繁2009 年 102 巻 3 号 p. 238-239
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありPDF形式でダウンロード (760K)
耳鼻咽喉科処置の有用性
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高原 幹, 原渕 保明2009 年 102 巻 3 号 p. 240-241
発行日: 2009年
公開日: 2010/12/03
ジャーナル 認証ありPDF形式でダウンロード (513K)
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