Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Search
Advanced search
OR
Browse
Search
Volume 107, Issue 12
Displaying 1-14 of 14 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Editorial
  • Boron Neutron Capture Therapy (BNCT)
    Ichiro Ota, Tadashi Kitahara
    2014 Volume 107 Issue 12 Pages 937-946
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.937
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Boron Neutron Capture Therapy (BNCT) is the next generation radiotherapy approach to selectively destroy only cancer cells, which is based on the neutron capture reaction that occurs when nonradioactive boron (10B) is irradiated with neutrons of low (thermal) energy. It is possible to kill the cancer cells only, as a minimally invasive therapy, while causing less damage to the surrounding normal cells, through the selectively incorporation by cancer cells of boron compound, BPA and/or BSH, and then irradiating the cells with epithermal neutrons. BNCT is suitable for malignant brain tumors or recurrent radiation-resistant head and neck cancers. The cyclotron-based neutron source is a promising alternative to reactor-based neutron sources for treatments with BNCT.
    View full abstract
    Download PDF (2901K)
Clinical color photographs
Original articles
  • A Case of Acute Cerebellitis with Flutter-like Oscillation
    Aibi Akashi, Yasuhiro Miyamoto, Yoshimitsu Saito, Satoko Fujita, Manab ...
    2014 Volume 107 Issue 12 Pages 951-956
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.951
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We report herein on our experience in one case of cerebellitis in which the presence of flutter-like oscillation (FLO) helped in the diagnosis and treatment. A 59-year-old man underwent a medical examination for gait impairment. He presented with transient, horizontal and pendular ocular oscillation. This abnormal eye movement was diagnosed as flutter-like oscillation (FLO). The abnormal ocular motion was a characteristic finding in his neuro-otological findings, and although cell counts and protein concentration in his cerebrospinal fluid were significantly elevated, the results of his blood test and brain MRI findings (diffusion-weighted image, Gd-enhanced T1-weighted image) were unremarkable. Brain perfusion scintigraphy revealed modest increase in cerebellar blood flow. After treatment with intravenous immunoglobulin and immunoadsorption therapy, the FLO disappeared. FLO is a rapid abnormal ocular movement to the left and right of the transient lasting for a few seconds. These are important findings when making the diagnosis. FLO has been reported to be mostly due to a cerebellar deficit. Cerebellitis is a disease that is mainly associated with trunk ataxia, poor coordination of the extremities, dysarthria, and abnormal ocular movements. In many cases, cerebellitis is preceded by symptoms of infection symptoms preceding, but many cases have also been reported where such symptoms are unclear. As for the pathogenesis of cerebellitis, direct bacterial and viral infection, a post-infection-associated immunological mechanism of and activation of a subclinical virus have all been considered. We could not find any obvious signs of a preceding infection in our case and various virus antibodies were also negative. Although the findings of protein cell dissociation were recognized in the cerebrospinal fluid examination carried out as one of the assessments, the cerebellitis in this patient was identified by immunologically. Our results suggested that a diagnosis of cerebellitis could be important for the observation of ocular movement.
    View full abstract
    Download PDF (945K)
  • A Case of Extranodal Non-Hodgkin’s Lymphoma in which Otitis Media with Effusion and Combined Hearing Loss Developed as the Initial Symptoms
    Yumiko Maruyama, Yayoi Tsukada, Yoshiya Kasahara, Tomokazu Yoshizaki
    2014 Volume 107 Issue 12 Pages 957-963
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.957
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We report herein on a patient with extranodal non-Hodgkin’s lymphoma in Stage IV whose only symptoms were otitis media with effusion and combined hearing loss in the affected side. A 64-year-old female came to our hospital with right ear fullness, and the clinical examination revealed otitis media with effusion and combined hearing loss in her right ear. No tumor lesion was found in nasopharyngeal endoscopy. Since conservative treatment was not effective, a tympanostomy tube was inserted. Because her hearing did not recover well compared with her unaffected side, computed tomography (CT) of the head was performed, which showed a tumor lesion surrounding the internal carotid artery and extending to the cavernous sinus. Since malignant lymphoma was suggested from the CT findings, 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) was performed which revealed the accumulation of FDG not only from around the internal carotid artery to the cavernous sinus but also some to portions of the cranium, pelvis, lumbar vertebrae, and head of the femur. No neurologic findings and symptoms associated with osseous lesion were found except hearing loss. An excisional biopsy from the iliac bone gave the pathological diagnosis of non-Hodgkin’s lymphoma, low grade B cell lymphoma. The patient underwent eight sessions of R-CHOP chemotherapy (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone). Chemotherapy was effective and all her tumor lesion including intracranial, extracranial, and osseous lesions disappeared and her hearing ability also recovered. There has been no sign of recurrence so far. Since local symptoms of the head and neck region can sometimes indicate general disease, otorhinolaryngologists should have a wide perspective, make an accurate diagnosis and deal adequately with any disease.
    View full abstract
    Download PDF (1765K)
  • The Present Condition of Patients with Nasal Allergy Attending the Department of Otolaryngology, Kawasaki Medical School
    —Concerning the Positive Rate of Dactylis glomerata Allergen-specific IgE Antibodies Using the CAP-RAST System—
    Tomoya Fujisaki, Yukiyoshi Hyo, Masakazu Hamamoto, Katsumi Masuda, Tam ...
    2014 Volume 107 Issue 12 Pages 965-971
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.965
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Allergic rhinitis is one of the most common diseases in Japan. Various allergens can cause allergic rhinitis. Dactylis glomerata allergen have been known as one of the major causes of allergic rhinitis. The present study discusses the sensitization of D. glomerata allergen in 1927 patients treated at the Department of Otolaryngology of Kawasaki Medical School between 2000 and 2012, who were tested for serum specific IgE antibodies using the CAP-radioallergosorbent test. The sensitization by D. glomerata allergen was found in 570 patients (male 318 patients, female 252 patients). Great fluctuations were not seen in the sensitization in these thirteen years. The peak age for the positive rates for D. glomerata was between the ages of 10 and 19 years old. Single sensitization was found in the small number of 25 patients.
    View full abstract
    Download PDF (495K)
  • A Survey of Infant Chronic Rhinitis and the Onset of Perennial Allergic Rhinitis
    Shigehito Mori
    2014 Volume 107 Issue 12 Pages 973-982
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.973
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Infant chronic rhinitis (ICR) is frequently encountered in routine clinical practice in the otorhinolaryngology department, but its detailed pathology is unknown.
    In this study, 3396 children aged 6 or younger who initially visited MORI Otorhinolaryngology & Allergy Clinic were analyzed, 82.2% of whom chiefly complained of nasal symptoms. Over 70% of the children presented with a disease duration of up to 2 weeks, as determined based on their medical interviews. Among those, 75.7 to 84.2% were diagnosed as having apparent chronic nasal disease or had symptoms persisting at follow-up visits.
    Excluding 639 children diagnosed with perennial allergic rhinitis (PAR) at the initial visits among the 3396 children, we performed a prospective cohort survey in 2757 children. The results demonstrated that children with versus without ICR showed a significantly higher incidence of PAR (P<0.001). A multivariate analysis revealed that the following variables were significantly correlated with PAR onset; “previous ICR episode” (odds ratio: 7.948; P<0. 001), male (1.712; P=0.004), family history of allergy (4.858; P<0.001), previous history of allergy (10.414; P<0.001), and positive for eosinophils in the nasal discharge (7.283; P=0.005).
    In addition, 343 of the 364 children with acute otitis media (AOM) had complicating nasal diseases. The majority of these children followed the course of ICR despite a disease duration of 2 weeks or shorter based on their medical interview. Although 87.0% of the children with AOM showed immediate improvement with treatment using antibiotics such as AMPC and CDTR-PI, those complicated with ICR responded poorly to this treatment. Also in the group of children complicated with AOM, the variable “previous ICR episode” was significantly correlated with a higher incidence of PAR (odds ratio: 2.656; P=0.005).
    These results suggest that ICR is essential for the growth-related onset of PAR and constitutes the pathology of PAR.
    View full abstract
    Download PDF (822K)
  • A Case of Traumatic Hemorrhagic Pseudoaneurysm of the Maxillary Sinus
    Misako Kaneda, Sayaka Nakanishi, Tomokazu Yoshizaki
    2014 Volume 107 Issue 12 Pages 983-986
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.983
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We describe herein a rare case of a traumatic pseudoaneurysm affecting the maxillary sinus. An 83-year-old man presented with intractable epistaxis was admitted to our hospital. He had fallen down, hitting his face on the ground three days before hospitalization. He presented with epistaxis that could be controlled with anterior nasal packing, however, his blood tests revealed anemia which became worse in 24 hr. Paranasal sinus CT imaging showed a mild bone fracture of the maxillary sinus and a hematoma in the maxillary sinus, so we performed contrast-enhanced CT (CECT) to verify the active bleeding site. The CECT showed that there was a pseudoaneurysm affecting the maxillary sinus. To confirm the bleeding site, angiography was performed. Angiograms showed a pseudoaneurysm arising from the right posterior superior alveolar artery. The patient successfully underwent transarterial embolization therapy to control the bleeding.
    View full abstract
    Download PDF (615K)
  • Categorization of Benign Parotid Gland Tumors Based on Dynamic Contrast-enhanced MRI
    Mariko Ishida, Yuma Yoshioka, Nozomu Wakayama, Kuwon Sekine, Satoshi Y ...
    2014 Volume 107 Issue 12 Pages 987-991
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.987
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    To predict the histological type of parotid salivary gland tumors, dynamic-enhanced MRI could be useful. Eight patients with parotid salivary gland tumors were examined preoperatively using gadolinium-enhanced dynamic MRI. The time of peak enhancement (T peak) and washout ratio (WR) were determined from time-signal intensity curves (TSI-curves). According to previous reports, we categorized our 8 patients into four main patterns based on the T peak and WR. Type A (T peak>120 sec) was the pleomorphic type, type B (T peak≦120 sec, WR≧30%) was the Warthin tumor type, type C (T peak≦120 sec, WR<30%) was the malignant tumor type, and type D (flat) was not enhanced. According to the pathological diagnosis, the tumors of patients study comprised four cases of pleomorphic adenomas, two cases of Warthin tumors, one case of sebaceous lymphadenoma and one case of salivary duct cysts. While all four cases of pleomorphic adenoma were categorized into type A, one sebaceous lymphadenoma case, a rare benign salivary gland tumor, was categorized into type B (pattern of Warthin tumors). We obtained basically the same result as previous reports on categorization. On that basis, we were able to examine the histological type of sebaceous lymphadenomas using dynamic contrast-enhanced MRI.
    View full abstract
    Download PDF (496K)
  • A Study on Peritonsillar Abscesses
    —Severity of Peritonsillar Abscess and Ambulatory Care—
    Natsuko Kurata, Akiko Ishihara, Megumi Sakamoto, Fuminori Nomura, Ken ...
    2014 Volume 107 Issue 12 Pages 993-1001
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.993
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    In Japan, patients with peritonsillar abscess are usually hospitalized. In contrast, ambulatory management has been performed in other countries. Patients seek safe, inexpensive, convenient, and shorter periods of treatment. We compared the therapeutic effects between ambulatory and hospitalized care in patients with peritonsillar abscess of a moderate degree.
    The subjects, recruited between January 2009 and October 2012, comprised 125 patients with peritonsillar abscess (95 men and 30 women) consisting of 70 hospitalized patients and 55 ambulatory care patients with ages varying from 17 to 89 years old. Of the 125 patients, 74 were affected on the right side and 51 on the left. The ratio of smokers was 63% in men and 20% in women. All patients were treated with antibiotics and aspiration for drainage of abscess. Both SBT/ABPC and CLDM were most frequently administered. The average number of aspiration treatments was 3.04. Peritonsillar abscess recurred in 19 cases (19%), while 14 cases (14%) had recurrence within one month after discharge.
    The therapeutic effect was compared regarding the recovery period, inflammatory parameters, and the number of aspiration treatments. The clinical outcome showed no statistically significant difference between the ambulatory and hospitalized care groups. We concluded that ambulatory therapy is as effective as and less expensive than hospitalized care in moderate and mild cases of peritonsillar abscesses.
    View full abstract
    Download PDF (855K)
  • A Case of IgG4-related Disease with Pseudotumor of the Larynx
    Mami Morita, Morimasa Kitamura, Shigeru Hirano, Ichiro Tateya, Yo Kish ...
    2014 Volume 107 Issue 12 Pages 1003-1010
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.1003
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    IgG4-related disease (IgG4-RD) is a novel clinical disease entity characterized by elevated serum IgG4 concentrations, tissue infiltration by IgG4-positive plasma cells and formation of pseudotumor with fibrosis. Occuurence of IgG4-RD has been described in multiple sites, from salivary glands, thyroid gland, pancreas and bile duct retroperitoneum. IgG4-RD with pseudotumor of the larynx is extremely rare, with only 5 cases reported in the literarure until date.
    A 62-year-old female patient was admitted to our hospital with a submucosal tumor in the right supraglottic area. Biopsy was performed under general anesthesia twice. The histological findings showed only fibrosis and chronic inflammatory plasma cells. However, the serum IgG4 level was clearly elevated to 1460 mg/dl. In addition, immunohistological staining of the larynx, parotid gland and lymph node confirmed the diagnosis of IgG4-RD. Treatment was started with a high dose of prednisolone (0.6 mg/kg/day) for 2–4 weeks, with tapering of the dose subsequently tapered to 8 mg/day. About 3 days after the initiation of treatment, the pseudotumor of the larynx disappeared completely.
    This case is only the sixth report of the association of IgG4-RD with pseudotumor of the larynx. The initial symptom in all patients was hoarseness, and only one gave a history of dyspnea. All the case had been treated with prednisolone and showed improvement of the laryngeal symptoms, except in one case which developed persistent vocal cord immobility.
    There is an urgent need for prompt treatment when the larynx is involved, considering the potential for irreversible damage. Long term follow-up and careful check up of whole body are required
    View full abstract
    Download PDF (875K)
  • Two Cases of Thyroid Carcinoma Diagnosed from Neck Lymph Node Specimens Following Surgery for Head and Neck Cancers
    Kunihiko Tokashiki, Kiyoaki Tsukahara, Kazuhiro Nakamura, Ray Motohash ...
    2014 Volume 107 Issue 12 Pages 1011-1016
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.1011
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We report 2 cases of thyroid cancer diagnosed in lymph node specimens obtained following surgery for head and neck carcinoma. Case 1 was a 60-year-old male who was diagnosed as having stage II carcinoma of the tongue; the patient was treated by partial resection of the tongue, left neck dissection, reconstruction with forearm free flap and tracheotomy. Preoperatively, 10-mm nodules in the CT and SUV3.3 accumulation in PET-CT were observed in the left thyroid lobe and adenomatous goiter was diagnosed. However, post-operative histopathology specimens revealed the diagnosis of metastatic papillary carcinoma in the left Level III area. Ultrasonography revealed 8×10×12 mm nodules with calcification in the left thyroid lobe. Left thyroid lobectomy and central zone dissection were performed and the final diagnosis was pT1N1b0 stage III papillary thyroid carcinoma. Case 2 was a 60-year-old male. For the stage III mesopharyngeal carcinoma, resection of the carcinoma, right neck dissection, reconstruction with a forearm free flap and tracheotomy were performed. Pre-operative CT and PET-CT, revealed no abnormality of the thyroid. In the post-operative histopathology specimens, however, metastatic papillary carcinoma was diagnosed in the left Level II region. Ultrasonography revealed 5×6×11 mm nodular lesions of irregular shape with internal calcification in the superior aspect of the right thyroid lobe. Right thyroid lobectomy and central zone dissection were performed and the final diagnosis was pT1N1b0 stage III papillary thyroid carcinoma. These cases reconfirmed the usefulness of ultrasonography for the diagnosis of thyroid carcinoma. In head and neck carcinoma patients, it is important to devise an examination plan bearing in mind the possibility of thyroid cancer.
    View full abstract
    Download PDF (1056K)
  • A Case of Papillary Carcinoma Arising from Thyroid Tissue around the Thyroglossal Duct
    Tsuyoshi Morisaki, Takahiro Fukuhara, Yukari Endo, Eiji Takeuchi, Hiro ...
    2014 Volume 107 Issue 12 Pages 1017-1020
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.1017
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Surgical resection is generally recommended as treatment for thyroglossal duct remnant carcinoma. On the other hand, no definite agreement exists concerning the extent of the resections. We present herein on a case of papillary carcinoma arising from the thyroglossal duct remnant of a 68-year-old woman with a swelling of about 25 mm, located at the middle region of the neck under the hyoid bone. The blood chemistry showed normal thyroid function and high serum levels of thyroglobulin. An MRI scan demonstrated a homogeneously enhanced solid mass in the anterior neck and ultrasonography showed a heterogeneous isoechoic lesion at the same site. Fine needle aspiration cytology of the mass at the middle of the neck showed specific findings of papillary thyroid carcinoma. We performed resection of the mass with the Sistrunk procedure: based on the pathological findings, the diagnosis was papillary carcinoma arising from the thyroglossal duct remnant. The postoperative histopathological examination revealed thyroid tissue was adjacent to the thyroglossal duct. We thought it was better to remove this thyroid tissue to prevent recurrence of the carcinoma. Based on the findings of this case report, the Sistrunk procedure may be recommended for cases of papillary carcinoma arising from the thyroglossal duct remnants.
    View full abstract
    Download PDF (626K)
  • Two Cases of Calcific Tendinitis of the Longus Colli Muscle Initially Suspected as being a Retropharyngeal Abscess
    Ayumi Agata, Sachie Kawaguchi, Yasuo Ogawa, Hiroyuki Ito, Masaaki Shim ...
    2014 Volume 107 Issue 12 Pages 1021-1027
    Published: 2014
    Released on J-STAGE: December 01, 2014
    DOIhttps://doi.org/10.5631/jibirin.107.1021
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Head and neck infections include various etiologies that cause acute neck pain and swallowing pain. Calcific tendinitis of the longus colli tendon with rapid development of symptoms requires strict differential diagnosis. The physical burden on vulnerable parts of the neck tendon causes a buildup of calcium deposits in the tendon, thus inducing neck pain. It is characterized on CT findings by the deposition of calcified particles in the anterior aspect of the spine. When swelling of the soft tissue of the throat develops, the image finding mimics that of a retropharyngeal abscess, and hence, careful differentiation is important to determine the appropriate treatment.
    We encountered two cases of calcific tendinitis of the longus colli tendon the suspected diagnosis of which was a retropharyngeal abscess. The first patient was a 41-year-old man complaining of neck pain. The second was a 25-year-old woman complaining of neck pain and limitation in the range of motion of her neck. Both patients were initially suspected as having a retropharyngeal abscess based on the symptoms and the imaging findings, and were urgently hospitalized. They were started on a course of intravenous antibiotics and analgesic medications. A close review of the images, the local findings, symptoms, and laboratory data gave a final diagnosis of calcific tendinitis of the longus colli tendon. Both patients were treated conservatively without having to undergo surgery.
    View full abstract
    Download PDF (734K)
Technical notes
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top