Practica Oto-Rhino-Laryngologica

Treatments for Carcinoma of the Tongue

Minoru Hirano, Shigejiro Kurita, Shigenobu Mihashi, Yoko Watanabe, Cho ...

1979 Volume 72 Issue 3 Pages 333-343
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.333

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The five-year survival rate for carcinoma of the tongue usually ranges from 40 to 60 percent. Recently, it was reported that an excellent result was obtained with intra-tissue radium needle therapy, as conducted at the National Cancer Center in Tokyo. With this therapy the five-year survival rate was 60 percent. Because of the minimum disturbance in function, this therapeutic approach is probably the best available. It requires, however, special facilities which many hospitals do not have. The present paper is a discussion of treatments for carcinoma of the tongue in the absence of the facility for intra-tissue radium needle therapy.
For the 34 patients treated at our hospital between 1960 and 1970, different approaches were applied on a patient to patient basis. The five year survival rate was 44 percent. The cause of death in 19 was local recurrence in 11 and cervical metastasis in 6. Thus, there was a necessity for improvement in managing the primary lesion and the cervical lymph nodes.
Since 1971 we have been using a program which includes preoperative radiation and local infusion chemotherapy followed by extensive removal of the primary lesion and radical neck dissection. In some patients, the basic program was modified according to their condition. The five-year survival rate for 40 patients was 65 percent. Only one patient died of local recurrence and three died of cervical metastasis.
A retrospective study and histological examination of the neck specimens appears to justify the following conclusion:
(1) For T1 and T2 lesions limited within one half side of the tongue body, radiation and local infusion chemotherapy without surgical removal is frequently successful. Neck dissection in an attempt at prevention is not required.
(2) For a T2 lesion extending beyond one half side of the tongue body, and the T3 lesion, treatments should include preoperative radiation and local chemotherapy followed by extensive surgical removal and radical neck dissection. Reconstructive procedures are required to minimize functional disorders.

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Process of Compensation of Eye Deviation after Unilateral Labyrinth Loss

Taizo Takeda

1979 Volume 72 Issue 3 Pages 345-353
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.345

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Eye deviation with eyes closed and open in total darkness was followed up after labyrinthectomy in order to elucidate the process of compensation of eye deviation after unilateral labyrinth loss. The results were as follows:
1) The degree of eye deviation decreased to the 90% tolerance limits of normal subjects in about one month, with a close correlation between eye deviation with eyes closed and that with eyes open in total darkness.
2) The direction of eye deviation with both eyes closed and open in total darkness was consistently to the affected side, except for cases of minute eye deviation, and the process of compensation of eye deviation did not show repeated compensation and over-compensation, in contrast to that of vestibular spinal reflexes.
3) The pattern of eye deviation stabilized from an unstable pattern, i. e. types II and III to a stable pattern, and type I with a decrease in eye deviation.
4) The process of compensation of eye deviation did not coincide with that of nystagmus.

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Statistical Observations on Patients with Vertigo and Dizziness

Koichi Tanaka, Toshio Imoto, Ritsuko Matsubara

1979 Volume 72 Issue 3 Pages 355-365
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.355

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Statistical observations were made of outpatients with vertigo and dizziness seen in the Dept. of Otorhinolaryngology, Osaka City University from 1972 to June 1977. The results are reported herein:
1) Those with vertigo and dizziness included 4-6% of the total number of outpatients. However, the number of Equilibrium function tests carried out in our patients was extremely large, as many more outpatients were seen in our clinic as compared with the number in other universities.
2) There was almost no difference in the number of males and females with vertigo and dizziness. Occurrences were in the descending order of 40>30>50>20.
3) About 70% of the patients were introduced by other physicians. They were mainly otorhinolaryngologists outside the hospital or physicians in the Depts. of Orthopedics, Internal Medicine and Neurosurgery in our hospital.
4) When we investigated statistics of diseases, we found that Meniere's disease acounted for about 10% and an extremely large number of patients with “cerebral vascular insufficiency” (our term) and patients with trauma at the head and neck were encountered.
5) Fifty percent of all patients revealed abnormalities in blood pressure, and 60% belonged to III and IV field as to CMI.

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Comparative Studies in Bell's Palsy and Ramsay-Hunt's Syndrome in Relation to Virus Infection

So Called “Zoster Sine Herpete”

Hiromu Mori, Kazuaki Kitahara, Michiyuki Kita, Haruo Takahashi, Yoshih ...

1979 Volume 72 Issue 3 Pages 367-377
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.367

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Viral titer was investigated in 159 cases of 296 Bell's palsy and in 44 cases of 66 Ramsay-Hunt's syndrome. Diagnostic titer of viruses was observed in 55 cases of 159 Bells palsy (35%) including 21 cases of herpes zoster virus (13%). These 21 cases are regarded as ‘Zoster sine herpete (ZSH)’ because they have peripheral facial paralysis with a diagnostic titer of herpes zoster virus but without herpes oticus.
Cases of ZSH generally had a lower titer of herpes zoster virus than cases of Ramsay-Hunt's syndrome. Those with ZSH showed a more severe degree of facial paralysis than did those with Bell's palsy and a negative titer of viruses. Furthermore, those with ZSH showed a negative stapedial reflex in 3 cases out of 4 and suggested a more likely possibility of supra-stapedial lesion in ZSH. As for the clinical course, those with ZSH showed a tendency toward a longer period for complete recovery than did any of the others with Bell's palsy, but no definite statistical differences among Ramsay-Hunt's syndrome, ZSH, and Bell's palsy with negative titer of viruses were noted. In addition, those with ZSH revealed intermediate features between those with Ramsay-Hunt's syndrome and Bell's palsy with regard to distribution. There were no particular findings concerning vestibular involvement.

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Anaerobic Bacteria in Otitis Media Chronica

Rinya Sugita, Ginichiro Ichikawa, Shigeo Goto

1979 Volume 72 Issue 3 Pages 379-385
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.379

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Anaerobic bacteria of purulent aural discharge from 760 patients with chronic otitis media were studied. Middle ear discharge was collected with a sterile cotton stick. The steel wool method was used for anaerobic culture. The anaerobic cultures were carried out at 37°C and the results were determined after 48 hours.
1) Nine species and 81 strains of anaerobic bacteria were isolated from 62 out of 760 patients.
2) Those anaerobic bacteria were mainly Peptococcus 40%, Bacteroides 22%, Peptostreptococcus 7.8%, Fusobacterium 6% and Veillonella 6%.
3) 97.5% of all anaerobic strains were non-spored.
4) Pure anaerobic bacteria were found at 6 cases out of the 62 patients, on the other hand, 56 cases were accompanied by 128 strains, aerobic bacteria. Those aerobic bacteria were mainly Staph. aureus 6.3%, Staph. epidermides 18.1%, Corynebacterium 20.4%, Pseudomonas aeruginosa 7.8% and Proteus mirabilis 17.3%.
General features of pure aerobic bacterial infection show a high detection of Staph. aureus and low rate of P. mirabilis, corynebacterium, Staph. epidermidis. However, in those with both aerobic and anaerobic bacteria, evidence of Staph. aureus decreased and P. mirabilis, corynebacterium and Staph. epidermides increased, comparatively.
5) In the 62 cases which revealed an anaerobic bacterial infection, cholesteatoma accounted for 34%, granulation 20%, and postoperative recurrent cases 13%.

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Effect of Optic Canal Decompression on Blindness due to Optic Canal Fracture

Shizuo Komune, Tamotsu Morimitsu, Masayuki Nandate

1979 Volume 72 Issue 3 Pages 387-390
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.387

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A 27 year old man fell to the pavement from the second story. He found that his right visual acuity had vanished by the next morning. Right optic canal decompression was performed 34 hours after the injury occurred. His vision was restored to v. d 0.2 on the 15th day after operation, but the lower portion of the visual field remained impaired.
It is generally considered that optic canal decompression is not effective for blindness due to optic canal fracture, however, there are few cases when such is effective.

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A Study on Immunotherapy of Malignant Tumors of the Head and Neck

Kazuyuki Asaoka

1979 Volume 72 Issue 3 Pages 391-412
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.391

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Fifty-five patients with cancer of the head and neck were treated in the Oto-rhinolaryngology Department of Keio University in the period between Oct., 1974 and Dec., 1977. These patients were divided into the immunotherapy group, where immune activators (OK-432, PS-K, SSM) were long administered after radical treatment of cancer, and the control group, and immunotherapy was analyzed in the light of clinical progresses and immunologic parameters. Findings that served as immunologic parameters were CH₅₀, PPD response and peripheral blood lymphocyte count. Administration of immunologic activators was aimed at reduction in size of tumor or arrest of its growth in the non-radical therapy group, and prevention of recurrence and metastasis in the radical therapy group.
The results were as follows:
1. OK-432, PS-K or SSM had no tumor-reducing effect in the non-radical therapy group (cancer-bearing patients).
2. Immunologic findings suggest that OK-432, PS-K and SSM have prophylactic effects against recurrence and metastasis.
3. The immunologic response of cancer in vivo is not always advantageous to the body. Administration of immune activators may not, therefore, be indicated in some cases. Further studies are necessary in this respect.
4. To enhance the effect for tumor shrinkage and prevention of recurrence or metastasis, immunochemotherapy requires further study.

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Treatment of Hyperthyroidism with a combination of a β-Blocking Drug and an Antithyroid Agent

Yasuo Koike, Fumihiko Ohta, Masakatsu Toda

1979 Volume 72 Issue 3 Pages 413-418
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.413

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Fifteen patients with hyperthyroidism were treated with a combination of a β-blocking drug (bupranolol) and an antithyroid agent (methimazole). This combination proved to be quite effective in improving subjective symptoms such as palpitation, hyper-sweating, and fatigue. An apparent remission of objective signs such as fingertremor and tachycardia were also observed. It was concluded that this combined therapy may be one of the most useful treatments for thyrotoxicosis.

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Studies on in Vitro Antibacterial Activity of a New Penicillin Derivative Antibiotic, Apalcillin, Stability of Solution and Local Application against Purulent Otitis Media

Takehiko Iwasawa

1979 Volume 72 Issue 3 Pages 419-432
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.419

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Antibacterial activity, stability of solution and clinical evaluation of a new semisynthetic penicillin, Apalcillin, were performed. The results obtained are as follows:
1) In vitro antibacterial activity: The minimal inhibitory concentration (MIC) of Apalcillin was measured by an agar plate dilution method using heart infusion agar. Apalcillin had the same antibacterial spectrum as seen with other penicillin antibiotics. The MIC of Apalcillin against 60 strains of Staphylococcus aureus isolated from otorrhoea was distributed over a range of 0.78 to 50μg/ml, with a peak observed particularly at 3.13μg/ml. The MIC of Apalcillin was 0.78 to 50μg/ml against Proteus mirabilis, Escherichia coli and Klebsiella pneumoniae. The MIC against 60 strains of Pseudomonas aeruginosa was 0.78 to 50μg/ml, showing its peak at 3.13μg/ml.
2) Stability of Apalcillin solution: As to the stability of 20mg/ml of Apalcillin there was no change in its colour, pH and antibacterial activity when the solution was kept at 5°C and 37°C for 14 days.
3) Results of clinical treatment: When administration of Apalcillin was applied locally in 30 cases of acute or chronic purulent otitis media, results were good in 22 cases, fair in 6 cases and poor in 2. When good and fair effects were considered together, the rate of effectiveness was 93 per cent. No side effect was observed when Apalcillin solution was locally applied.

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Gastrointestinal Complaints due to oral Ingestion of Aminobenzyl Penicillin (ABPC), A Gastric Irritant, were Successfully Reduced by Co-Administration of Dogmatyl^®, An Anti-Ulcer Agent Acting on the Hypothalamus

Akimasa Nakamura

1979 Volume 72 Issue 3 Pages 433-437
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.433

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Patients with otorhinolaryngological related infections were treated with 750mg of ABPC given in three divided doses, either alone or with 3 capsules of Dogmatyl, for 4 or more days. The patients were observed for development of gastrointestinal disorders including loss of appetite, nausea, vomiting, gastric distress, heartburn, belching, loose stool, and sensation of fullness in the abdomen.
The overall incidence of these disorders was considerably lower in patients who were concomitantly given Dogmatyl (15%, i. e. 8 in 52) than in patients given ABPC alone (27%, i. e. 14 in 52).
As for the incidence of loose stool, the difference between the two groups was even greater: 10% (5 in 52) and 21% (11 in 52), respectively.

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A Newly Devised Box for the Caloric Test in Cats

Isao Kato, Masaru Aoyagi, Tadashi Kawasaki, Yu Sato

1979 Volume 72 Issue 3 Pages 439-445
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.439

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We devised a new animal box with which the caloric test can be easily performed in the awake cat.
The animal box has the following advantages:
1) This device is suitable for all adult cats of various sizes in which a steel bar could be passed through both the canines.
2) With the animal box standing upright, the horizontal semicircular canal lay in an optimal position, and the caloric test could be easily performed in the awake cat.
3) This device is suitable for the positional test. Any desired position is feasible.
4) It was also advantageous for the optokinetic test, because bars or clamps do not interfere with movements of the cat.

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Preservation of hearing industrial and noise

Hiroshi Hattori

1979 Volume 72 Issue 3 Pages 447
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.447

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Clinical diagnosis of noise-induced deafness

Yutaka Onchi

1979 Volume 72 Issue 3 Pages 448-454
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.448

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Otological aspects of the origin of noise-induced deafness

Susumu Shida

1979 Volume 72 Issue 3 Pages 454-460
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.454

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Auditory changes following duration of noise and/or exposure of the human body to vibration

Toshihiko Yokoyama

1979 Volume 72 Issue 3 Pages 461-464
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.461

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Noise criteria for conservation of hearing acuity

Takao Yamamoto

1979 Volume 72 Issue 3 Pages 465-468
Published: 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.465

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