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前身誌
104 巻, 1 号
選択された号の論文の14件中1～14を表示しています
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論説
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伊藤 壽一原稿種別: 論説
2011 年 104 巻 1 号 p. 1-6
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありCochlear implant surgery is used for patients with “profound hearing loss who cannot use hearing aids.” The indications were initially limited to “adults only” but were subequently expanded to include children. In 1998, The Oto-Rhino-Laryngological Society of Japan, Inc. a published cochlear implantation adaptation guideline; the guideline was revised in 2006. Recently, the numbers of surgical patients who do not meet the Japanese Society of Otolaryngology’s criteria, such as pediatric patients below the age limit, patients requiring bilateral cochlear implants, cases of unilateral hearing loss and cases of multiple disabilities and central hearing loss cases have been increasing. In this paper, the indications for cochlear implants have been revised.
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カラー図説
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滝本 泰光, 伊東 眞人原稿種別: カラー図説
2011 年 104 巻 1 号 p. 8-9
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありPDF形式でダウンロード (701K)
臨床
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鎌倉 武史, 松代 直樹, 古川 雅史, 北村 貴裕, 梶川 泰原稿種別: 臨床
2011 年 104 巻 1 号 p. 11-16
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありIn a study of 677 patients diagnosed with idiopathic sudden sensorineural hearing loss (ISSNHL) between January 2005 and December 2008, we found 77 with diabetes mellitus. An analysis of the 77 yielded the following results:
1) No significant difference was seen in cures between diabetic (36.4%) and nondiabetic (30.0%) groups. Diabetes mellitus did not influence ISSNHL prognosis.
2) Those treated with steroids had significantly better cures than those not treated with steroids.
3) Those with lower HbA1c generally showed better cures.
4) To avoid complications due to diabetes mellitus, ISSNHL patients with diabetes mellitus should be treated under strict control in the hospital.
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―アレルギー性真菌性鼻副鼻腔炎に着目して―出島 健司, 松本 幸江, 板東 秀樹, 内田 真哉, 牛嶋 千久2011 年 104 巻 1 号 p. 17-22
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありWe studied the clinical aspects of chronic unilateral sinusitis, including allergic fungal rhinosinusitis (AFRS), newly recognized as intractable and treated by endoscopic sinus surgery (ESS) in Japan. We retrospectively analyzed 128 subjects undergoing ESS for unilateral chronic sinusitis. Subjects were divided into five groups—purulent sinusitis, mycetoma, antrochoanal polyp of the maxillary sinus, AFRS, and suspected AFRS—based on endoscopic findings. Of the 128 cases, 77 involved purulent sinusitis with a good prognosis while 28 involved mycetoma and 17 antrochoanal polyp. Most with mycetoma had a good postoperative prognosis with only endonasal approach. Antrochoanal polyp recurred without complete polyp stalk resection in maxillary sinus—6 cases with AFRS or suspected AFRS showing type 1 fungal allergy and hypereosinophilia in blood examinations. Although less common in Japan than elsewhere, AFRS must be understood as intractable in treating unilateral chronic sinusitis with type 1 fungal allergy.抄録全体を表示PDF形式でダウンロード (910K) -
伊木 健浩, 庄司 和彦, 髙橋 淳人, 児嶋 剛, 水田 匡信, 松原 真美2011 年 104 巻 1 号 p. 23-27
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありA 54-year-old man, seen for right submandibular swelling and pain, noted swelling enlargement and lymph node swelling in his right neck within a week. These were found in fine-needle aspiration biopsy to be lymph node metastases of squamous cell carcinoma.
FDG-PET showed high accumulation on the right side of the mandible bone and in the right neck. Lower gingiva showed mild mucosal inflammation with a transparent mandible bone lesion, so the right lower molar was removed by a dentist, showing a tumor in the mandible bone socket. Biopsy of the lesion showed a squamous cell carcinoma arising centrally in the mandible bone.
A diagnosis of primary intraosseous squamous cell carcinoma (PIOSCC) necessitated mandibular resection, neck dissection, and postoperative radiochemotherapy.
Within 10 months, lung metastasis was seen. He died of multiple organ metastases, despite subsequent surgery, radiotherapy, and chemotherapy.
PIOSCC generally has a dismal prognosis because symptoms are not noticed until the disease has progressed beyond treatment.
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竹野 研二, 福田 裕次郎, 長門 晋平, 竹本 洋介, 崎浜 教之, 山下 裕司2011 年 104 巻 1 号 p. 29-31
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありWe report a case of lower gingiva squamous cell carcinoma (SCC) concomitant patient with chronic oral mucosa graft-versus-host disease (GVHD) after allogenic bone marrow transplantation (BMT).
A 57-year-old man seen in March 2009 for lower gingiva and tongue SCC. He had had chronic myelocytic leukemia (CML) in 1989, chronic GVHD arising in allogenic BMT in 1898 and tongue SCC in 2005. He underwent surgical resection, neck dissection, and mandible reconstruction in April 2009. He remains free of cancer but suffers from chronic oral mucosa GVHD. Chronic GVHD has been reported associated with secondary malignancy risk following allogeneic BMT, indicating the careful oral cavity observation needed in those with chronic oral mucosa GVHD.
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谷口 善知, 井口 福一郎, 髙橋 由佳, 村井 紀彦2011 年 104 巻 1 号 p. 33-38
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありSalivary duct carcinoma (SDC), a rare aggressive salivary gland tumor with poor prognosis first described by Kleinsasser et al. in 1968, histologically resembles invasive mammary ductal carcinoma.
A 68-year-old man with painful left parotid swelling and left facial nerve paralysis underwent extended total parotidectomy, ipsilateral modified neck dissection, and postoperative radiotherapy of 50 Gy.
Histopathological examination showed cribriform and papillary intraductal growth and comedonecrosis, yielding a diagnosis of parotid gland SDC. Immunohistochemistry showed strong complete membrane staining for human epidermal growth factor receptor 2 (HER-2).
HER-2 protein overexpression is reported to be associated with early distant breast cancer metastasis causing its dismal prognosis. Given studies correlating HER-2 protein expression with poor SDC prognosis, further studies are expected to produce biological therapy for SDC targeting this molecule.
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平野 隆, 児玉 悟, 鈴木 正志2011 年 104 巻 1 号 p. 39-45
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありDonor site morbidity must be considered when harvesting conventional flaps. Perforator flaps such from the anterolateral or anteromedial thigh minimize donor morbidity and let the flap be harvested simultaneously in head and neck reconstruction. We reconstructed defects using anterolateral and anteromedial thigh flaps in 7 oropharyngeal cancer cases between January 2008 and March 2010. Using color Doppler ultrasonography to detect anterolateral and anteromedial thigh flap perforators, we completed reconstruction after oropharyngeal cancer ablation without complications. Preoperative color Doppler ultrasonography has thus aided in detecting the perforator in such organ harvesting.
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細川 誠二, 岡村 純, 瀧澤 義徳, 高橋 吾郎, 大和谷 崇, 峯田 周幸2011 年 104 巻 1 号 p. 47-53
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありMucosa-associated lymphoid tissue (MALT) lymphomas of the head and neck occurs with chronic inflammation in extranodal organs such as the salivary gland, thyroid gland, and Waldeyer’s ring.
In the 20-years from 1990 to 2009, we treated 15 patients with head and neck MALT lymphoma. None undergoing fine-needle aspiration biopsy was diagnosed with MALT lymphoma before surgery or open biopsy. Four had tumors, resected and remainder open biopsy on, head and neck masses for final pathological diagnosis. Three were treated using general R-CHOP chemotherapy, i.e. standard CHOP with rituximab. Three had radiotherapy alone with 30-40 Gy, and three chemoradiotherapy, resulting in complete response for all. Low-grade or indolent malignant lymphoma such as MALT lymphoma is often observed long-term, necessitating frequent biopsy or resection of the mass for diagnosis.
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藤村 真太郎, 平野 滋, 楯谷 一郎, 北村 守正, 嘉田 真平, 石川 征司, 庄司 和彦, 伊藤 壽一2011 年 104 巻 1 号 p. 55-59
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありAs concurrent chemoradiotherapy becomes increasingly common in organ preservation even in advanced head and neck cancer, postchemoradiotherapy has raised many difficult problems in salvage surgery.
We report the case of a 61-year-old man developing severe facial edema and sternum osteonecrosis following treatment for hypopharyngeal cancer with bilateral cervical lymphnode metastasis (T2N2cM0).
Following induction chemotherapy with cisplatin and 5-fluorouracil, then concurrent chemoradiotherapy with a total dose of 70 Gy with cisplatin (80 mg/m2 every three weeks), computed tomography (CT) showed bilateral residual lymph node metastasis. Salvage surgery involved level II and III right radical and selective left neck dissection. Some 40 days post operatively, the man developed severe facial, pharyngeal, and laryngeal edema difficult to control despite intensive antibiotics, hydrocortisone, and glycerin administration. CT subsequently detected cellulitis around the tracheal stoma wound and sternum osteonecrosis necessitating emergency surgery totally removing necrotic tissue. Final wound healing and resolution of the facial edema took few months.
Salvage surgery following concurrent chemoradiotherapy may cause severe complications, meaning that dissection damage to tissue should be minimized, making it also important to consider about minimallyinvasive surgery to preserve remnant tissue function.
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増田 佐和子, 臼井 智子2011 年 104 巻 1 号 p. 61-66
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありCoughing, one of the most common pediatric symptoms seen in the ear, nose, and throat (ENT) clinic is caused by a variety of conditions. We studied the prevalence, cause, and characteristics of coughing in 367 children 11 years old or younger via questionnaires filled out by their parents. All children had been examined by otorhinolaryngologists. According to the questionnaire, 41.1% had coughs when seen at clinic, especially if they had asthma or sinusitis. Coughing was significantly more prevalent in infants under 6 years old than in school-age children. The ratio of respiratory infection was higher and that of sinusitis was lower in infants under 3 years old than in older children. Asthma was more prevalent in school-age children than in infants under 3 years old. In children with coughs, 78.3% of coughing lasted less than two weeks and most cases involved upper respiratory infection. Those with coughs lasting over four weeks accounted for 7.9% of children with coughs and they were caused by asthma, sinusitis, primary ciliary dyskinesia, lower respiratory infection, and psychogenic reasons. In conclusion, 41.1% of children seen at the ENT clinic had coughs mostly due to respiratory infection, including sinusitis. Prolonged coughing, while not prevalent, requires an interdisciplinary approach due to diverse pathogenic problems.
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薬物
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―広域抗菌剤や多剤併用は必要なのか？―竹中 幸則, 武田 和也, 喜井 正士, 橋本 典子, 猪原 秀典原稿種別: 薬物
2011 年 104 巻 1 号 p. 67-73
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありPeritonsillar abscess, although common in Japan, as yet has no treatment guidelines. Current treatment consists of abscess drainage and antibiotic administration. Despite guidelines in other countries recommending clindamycin or augmented penicillins, Japanese practice still often uses beta lactum drugs with or without clindamycin. We evaluated inpatient peritonsillar abscess management by intravenous clindamycin injection following needle aspiration. Of 54 such subjects treated between 2006 and 2009, 46 underwent intravenous aintibiotic administration following needle aspiration. Antibiotics used were clindamycin, sulbactam/cefoperazon, cefepime, and carbapenems. We compared clinical drug efficacy to hospitalization length, posttherapeutic pain duration and days until normal meal resumption. Clinical outcome showed no statistically significant difference among the four drug groups. We concluded that post needle aspitaion clindamycin treatment is as effective as and cheaper than alternatives. Narrow-spectrum antibiotics, such as clindamycin, also help prevent pathogen resistance.
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総説
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岩崎 聡原稿種別: 総説
2011 年 104 巻 1 号 p. 75-80
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありCytomegalovirus (CMV) infection, the most common congenital infection cause, occurs in 0.2-2.5% of all liveborns and causes 20-30% of congenital sensorineural hearing loss.
We evaluated long-term audiometric follow-up for a mean average of 37 months in 18 infants with congenital cytomegalovirus (CMV) infection determined in serological and neonatal urine CMV DNA tests, i.e. congenital CMV infection identified in PCR urine analysis. Of these, only 2 were symptomatic. Hearing loss was detected in 1 of these (50%) symptomatic cases and 4 (25%) asymptomatic in the first audiometric evaluation. The symptomatic infant suffered profound unilateral hearing loss. Two of the asymptomatic 4 had mild hearing loss and 1 profound. Longitudinal audiometric evaluation in asymptomatic infants showed 2 passing newborn screening to have delayed-onset hearing loss, 2 progressive hearing loss, and 2 hearing loss improvement. The 2 rendered deaf with delayed-onset and progressive loss underwent cochlear implantation.
Combining neonatal CMV screening and audiometric follow-up for 3 years should be considered in congenital CMV infection. Clinical trials evaluating ganciclovir and valganciclovir in treating CMV-based hearing loss have reported effective hearing loss reduction, although research and development remains vital for further improving such outcomes.
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研修ノート
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花澤 豊行原稿種別: 研修ノート
2011 年 104 巻 1 号 p. 82-83
発行日: 2011年
公開日: 2011/01/01
ジャーナル 認証ありPDF形式でダウンロード (555K)
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