Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 74, Issue 10
Displaying 1-15 of 15 articles from this issue
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  • Surgical Treatment of Middle Ear Cholesteatoma
    Naoaki Yanagihara
    1981 Volume 74 Issue 10 Pages 2179-2185
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2179
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    Reassessment of the advantages and disadvantages of intact canal wall tympanoplasty in the treatment of middle ear cholesteatoma has been required since an unexpectedly high rate of recurrence was noted several years after operation. Reexploration of the ears in which recurrence developed has revealed the factors associated with recurrence. To eliminate these factors, the following technical improvements have been introduced: 1) a more radical control of the diseased cells, 2) improvement of visualization by using the facial recess approach, 3) staging the surgery if necessary, 4) removal of unhealthy canal skin, and 5) closure of a small defect of the tympanic scute with a flap of cartilage. Indications of the intact canal wall tympanoplasty with the facial recess approach and the tympanoplasty with conservative radical mastoidectomy were described. Follow-up studies of 2 to 5 years confirmed a significant improvement in surgical results. In any type of middle ear reconstructive surgery, the possibility of recurrence of the cholesteatoma can not be eliminated perfectly. Emphasis is placed on the importance of selection of the appropriate surgical technique according to the correct indication.
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  • Consideration of Nystagmus and Abnormal Signs of the Oculomotor System Observed in a Patient with Spasmodic Torticollis
    Fumiaki Fujiwara, Jiro Hozawa, Shigeki Kamata, Takashi Ishida, Keiji F ...
    1981 Volume 74 Issue 10 Pages 2187-2194
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2187
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    Pre- and postoperative neurotological findings in a patient who was treated by excision of the bilateral upper cervical radices and spinal accessory nerves were discussed.
    Before the operation, the head of this patient was kept in the “left turning position” by spasmodic contraction of the right sternocleidomastoid muscle and the patient showed “stepping deviation” to the right. By correcting the head to the normal position, right beating nystagmus was provoked and inhibition of optokinetic nystagmus was observed.
    After the operation, a degree of spasmodic torticollis was eliminated and abnormal signs of oculomotor system were remarkably abated. Moreover, the neck torsion test (Jongkees) showed normal eye-deviation.
    From these findings, it was concluded that nystagmus and abnormal signs of the oculomotor system observed in this patient were caused by the hypertonic state of the deep muscles of the neck.
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  • A Case of Autoimmune Sensorineural Hearing Loss
    Yomiko Kanno, Yasushi Matsumoto, Naoaki Yanagihara
    1981 Volume 74 Issue 10 Pages 2195-2200
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2195
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    A 46-year-old woman initially complained of left tinnitus and hearing loss and her audiogram showed mild mixed hearing loss. Myringotomy revealed serious fluid in the middle ear. Two months later, she had cough and continuous low grade fever. Based on radiographic and bronchoscopic findings, right lower lobectomy was performed under the diagnosis of pulmonary cancer. An autoimmune disease was confirmed by the histopathological investigation of the resected lung. After the operation, progressive bilateral sensorineural hearing loss and nonspecific inflammation of the nose and the left ear drum developed. Administration of predonisolone and cyclophosphamide dramatically improved all her signs and symptoms, including sensorineural hearing loss, which was attributed to the autoimmune disease. A review of the literature on hearing disturbance associated with autoimmune disease was presented.
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  • The Problems of Serous Otitis Media Associated with Sensorineural Hearing Loss in Children
    Eiichi Tsumuraya, Yasushi Ishibashi, Natsue Suzuki, Keiko Takeshita, J ...
    1981 Volume 74 Issue 10 Pages 2201-2208
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2201
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    Tympanometric and otoscopic evaluations were performed on 47 children with sensorineural hearing loss. Twenty-one (45%) of the children were at risk for effusion on at least one occasion during the study.
    It is likely that conductive components can lead to delay in the diagnosis of an underlying sensorineural hearing loss. The effect of conductive hearing loss secondary to serous otitis media in children with sensorineural hearing loss is more profound than those in normal children.
    Proposals are made for the use of tympanometry as a screening procedure for the detection of serous otitis media among children with sensorineural hearing loss.
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  • Tuberculosis of the Paranasal Sinus
    A Case Report and Literature Review
    Toshishige Kido, Masutoshi Nishikawa, Hideki Ohyama, Toru Sekitani
    1981 Volume 74 Issue 10 Pages 2209-2215
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2209
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    A rare case of solitary tuberculosis at the right paranasal sinus in a 56-year-old male who had complained of nasal obstruction on the right side was reported. A substance resembling granulation, suspected to be a tumorous lump, was removed from the maxillary sinus with some difficulties.
    Histopathological examination of the lesion revealed findings which were most compatible with tuberculosis. Postoperative examination for other tuberculous lesions was performed, but no detectable tuberculous lesion was located.
    This case was reported in detail and the literature on tuberculosis of the paranasal sinuses was reviewed.
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  • The Intersinus Septum Cell and Fronto-ethmoidal Mucocele
    Toshitaka Iinuma, Hiroyuki Oosawa, Shigeo Goto, Mikio Tanaka
    1981 Volume 74 Issue 10 Pages 2217-2225
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2217
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    Fifty-four patients of fronto-ethmoidal mucoceles were admitted and operated on from 1976 to 1980 at our hospital. These comprise three groups, Group 1 with 18 patients who had undergone extranasal frontal sinusectomy in the past, Group 2 with 19 patients who had received either Caldwell-Luc operation or endonasal ethmoidectomy in the past, and Group 3 of 17 patients with chronic sinusitis who had not received nasal surgery in the past.
    The age average at the present surgery was 42.6 for Group 1, 34.6 for Group 2 and 44.1 for Group 3. The difference between Group 2 and either Group 1 or Group 3 was statistically significant. Among signs and symptoms, local swelling had the highest incidence for Group 1, which was statistically different. Exophthalmus had the highest incidence for both Groups 3 and 2, which was statistically different from Group 1. The highest incidence of diplopia was seen in the order of Group 3, Group 1 and Group 2 and the difference between Group 3 and Group 2 was statistically significant.
    Impaired vision, local pain and headache did not show significant differences among the three groups.
    Intersinus septum cells were seen in 39% of Group 1, 47% of Group 2 and 24% of Group 3; recessus lateralis in 72%, 79% and 82%; bulla frontali s in 17%, 32% and 24%; crista galli cells in 11%, 11% and none; pars nasalis of the frontal sinus itself in 5%, 11% and 12%. The incidence of these anatomical structures which are related to the pathogenesis of the mucocele did not show any statistically significant differences among the three groups. A bibliographical study was made for the intersinus septum cell reviewing 28 reports from the past. The incidence of the cell in the normal subjects and in those with mucoceles was 5.2 to 19.0% and 18.8 to 37.0%. Topography of the intersinus septum cell was also studied.
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  • A Case Report of Severe Impairment of Visual Acuity Caused by Frontal Sinusitis
    Yukinori Ichino, Takashi Watanabe, Takeru Ishikawa, Yuriko Takahama, H ...
    1981 Volume 74 Issue 10 Pages 2227-2234
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2227
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    This paper reported a case of acute frontal sinusitis which had resulted in severe impairment of visual acuity. A 33-year-old male patient visited our hospital on November 18, 1980. The chief complaint was severe impairment of visual acuity which had begun eight days before the first visit. He also complained of orbital pain, proptosis, immobility and chemosis. X-ray and coronal CT demonstrated mass formation which infiltrated from the frontal sinus to the left orbita. The fundus had a fern-like pattern along the retinal artery.
    Suspecting orbital involvement, frontal and ethmoidal sinectomies were performed. It was revealed that almost all of the orbital periosteum was stripped off the orbital bone and there was a small perforation in the frontal bone.
    After operation, he was given corticosteroids, vasodilators, anticoagulants, and large doses of antibiotics. His visual acuity recovered gradually and became 0.05 forty days after operation.
    It was suspected that the severe sight impairment in this case resulted from both the circulatory disturbance of cilliary and retinal arteries, and the inflammation and atrophy of the optic nerve.
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  • EMI Units for Sinusitis and Maxillary Cancer
    Shigeyuki Ichihara, Takayuki Ichihara, Senri Ando, Hiroaki Takahasi, K ...
    1981 Volume 74 Issue 10 Pages 2235-2240
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2235
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    The significance of EMI units for differential diagnosis between maxillary sinusitis and cancer was studied using an EMI 5005/12 CT scanner. The materials studied were 13 cases of sinusitis and 13 cancers with 9 normal pterygoideus lateralis muscles as the control.
    EMI units of 320×320 matrix were changed into 64×64 matrix, by averaging of 25 (5×5) points. The mean value and standard deviation of EMI units in the region of interest (R. O. I.) for sinusitis were 18.4 and 8.01, respectively, 24.6 and 12.18 for cancer, 21.1 and 4.83 for the normal pterygoideus lateralis muscle.
    The conclusions were as follows: (1) The mean value of EMI units for maxillary cancer was higher than maxillary sinusitis. (2) The variances of EMI units for both cancer and sinusitis were higher than the normal pterygoideus lateralis muscle. The reason seems to be as follows: in the case of cancer, the bone tissue may be involved in the cancer tissue, while in the case of sinusitis, inflammatory secretion or swelling of the mucous membrane exist in the sinus depending on the type of the disease.
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  • Evaluation of Effectiveness of Arytenoid Adduction Technique
    Shinzo Tanaka, Masahiro Tanabe, Nobuhiko Isshiki
    1981 Volume 74 Issue 10 Pages 2241-2248
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2241
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    The arytenoid adduction technique (Isshiki) was performed under local anesthesia on thirteen patients with unilateral vocal cord paralysis. The technique is especially indicated for a wide, gllottal chink and when there is a difference in the level of the two cords. The surgical procedure is rather simple and easy and allows adjustment of the degree of arytenoid adduction during surgery to produce the best voice obtainable.
    In all thirteen cases, the postoperative results were satisfactory in laryngeal appearance, acoustic analysis, and aerodynamic examination. The relatively longterm results (longer than ten months) were also good in all cases except one with vocal cord atrophy.
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  • Neurovascular Compression of the Vestibular Nerve in a Patient with Vertigo
    Takashi Futaki, Masanori Morimoto, Tomoyoshi Yoza, Yuzo Fujita
    1981 Volume 74 Issue 10 Pages 2249-2256
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2249
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    A 71-year-old woman had complained of vertigenous attacks three times during this decade, ataxic deviation in walking and tinnitus in the right ear with normal hearing. The intracanalicullar acoustic neuroma was most strongly suspected because of the abscent caloric reaction and slight dilation of the right internal auditory canal in Stenver's view. Meatocysternography was performed and yielded a small non-filling space.
    During surgical treatment with a suboccipital approach, no acoustic tumor was noted but a neurovascular compression of the arterial loop to the root of the vestibular nerve was revealed. The gelatin foam was placed to keep the compressed loop away from the nerve trunk as a prosthesis. After an uneventful postoperative course, nystagmus, ataxia and tinnitus were alleviated.
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  • The Effect of Normal Saline Injection on the Concentration of Electrolytes in Guinea Pig Perilymph
    Naoyuki Kanoh, Kazuo Makimoto, Masaki Ohmura, Nobuya Yagi
    1981 Volume 74 Issue 10 Pages 2257-2262
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2257
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    Serum, cerebrospinal fluid (CSF), scala vestibuli perilymph and scala tympani perilymph were collected from 104 normal anesthetized guinea pigs (Sodium Pentobarbital 20-30mg/kg I. P.) both before and after intravenous administration of normal saline (1.5ml/kg), and the sodium and potassium concentrations were assessed using a microflame photometer.
    Increase in the sodium concentration was observed in scala vestibuli perilymph, while there was no significant change in scala tympani perilymph, CSF and serum.
    The potassium concentration did not significantly change in perilymph, CSF and serum.
    The results of the present study indicate that a relatively small amount of injected normal saline affects the concentration of electrolytes in scala vestibuli perilymph. Thus, each perilymphatic space seems to have its own characteristic system in electrolyte transport.
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  • Binaural Interaction in Auditory Brainstem Responses
    Effect of Contralateral White Noise on the Click-evoked ABR
    Morio Yamauchi, Etsuo Yamamoto, Hajime Nakamura, Michitaka Iwanaga
    1981 Volume 74 Issue 10 Pages 2263-2273
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2263
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    Binaural interaction in auditory brainstem responses (ABR) was studied in 11 normal-hearing adult subjects. Binaurally stimulating experiments in the ABR-recording from the subjects were composed of clicks at 90dBHL presented to one ear for evoking ABR and a continuous white noise at 40dB, 80dB or at silent control presented simultaneously to the contralateral ear. This method was designed to detect an alteration of the click-evoked ABR through an interference or desynchronization effect of the noise presented to the contralateral ear at a level of the brainstem where the binaural interaction took place. Among the results were the following: 1) Latencies of waves I, III, V and VI, and peak-to-peak amplitudes of waves I and III did not change with the level of the white noise presented to the contralateral ear, but the amplitudes of both waves V and VI changed significantly (p<0.01). 2) Peak-to-peak amplitudes for both waves V and VI were reduced by 22% and 50% in voltage when the level of the white noise to the contralateral ear was raised from 40dB to 80dB, respectively. These results suggest that the neural organization of the binaural interaction takes places at the level where waves V and VI are generated.
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  • A Double Blind Controlled Trial on Azunol-S in the Treatment of Pharyngitis and Stomatitis
    Kazuo Takeda, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    1981 Volume 74 Issue 10 Pages 2275-2292
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2275
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    The efficacy and safety of Azunol-S (AZ-S) were compared with those of an inert placebo (AZ-S-P) in the treatment of pharyngitis and stomatitis (including glossitis) in a multicentered double blind clinical trial. A tablet of AZ-S or AZ-S-P was inserted into the labiogingival region of the upper jaw. The procedure was performed 4 times a day for 7 days. Patients' impressions and change of the inserted region were checked.
    1. A total number of 160 patients was enrolled at 8 collaborating hospital clinics. One hundred and fifty-nine patients (including 8 drop-outs) of the 160 patients were available for statistical analysis of the effect (Chi-square and Wilcoxon's ranked sum tests): 42 patients received AZ-S, 40 of the 82 pharyngitis patients received AZ-S-P and the remaining patients received AZ-S, 38 of the 77 patients of stomatitis received AZ-S-P.
    2. As for the final global judgment in pharyngitis and stomatitis, AZ-S was more effective than AZ-S-P at P<0.05 in both Chi-square and Wilcoxon's ranked sum tests.
    3. AZ-S brought more relief of spontaneous pain, strange feeling, swallow pain, redness and swelling than AZ-S-P in pharyngitis. (P<0.05 or P<0.01 Wilcoxon ranked sum test)
    4. AZ-S brought more relief of stimulus pain, redness, strange feeling, touch pain and spontaneous pain than AZ-S-P in stomatitis. (P<0.05 or P<0.01 Wilcoxon ranked sum test)
    5. No general or local side effects were found with AZ-S or AZ-S-P.
    6. When an AZ-S or AZ-S-P tablet was inserted into the labiogingival region of the upper jaw, it remained stable. Patients did not complain of unpleasant feeling and had no speech difficulties.
    Consequently the AZ-S tablet was recognized as a useful new drug.
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  • Effects of Intal on Apple Pollinosis
    Masaru Hakamada, Jiro Hozawa, Hisaki Saito, Shigeki Kamata, Keiji Fuku ...
    1981 Volume 74 Issue 10 Pages 2293-2300
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2293
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    The effect of Intal was examined in 15 patients with apple pollinosis. Twenty milligrams of this powder was insufflated into the nasal cavity of each patient 4 times a day for 3 weeks.
    The effects on nasal symptoms were as follows:
    1) The frequency of sneezing decreased significantly in 86.6% of all the cases. Decrease in nasal secretion was found in 53.3%. Alleviation of nasal obstruction was experienced in 40.0%.
    2) The number of those with alleviation of all the nasal symptoms was 66.7%.
    3) These effects began to appear 3 days after the administration of this drug and became remarkable within 2 weeks.
    4) Side effects were not seen in any of the patients.
    From these results, Intal was considered to be an effective drug for apple pollinosis.
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  • Administration of Mecobalamin after Surgical Repair of the Facial Nerve
    Yasushi Matsumoto, Naoaki Yanagihara, Hiroshi Okamura
    1981 Volume 74 Issue 10 Pages 2301-2307
    Published: October 01, 1981
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.74.2301
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    Mecobalamin, 1500μg/day, was administered to the eleven patients on whom surgical repair of the facial nerve had been done. On nine patients, eight with Bell's palsy and one with Ramsay Hunt's syndrome, an intratemporal decompression operation was carried out one month or more after the onset. Their palsies were complete and the nerves were proved to be seriously degenerated. On two patients extratemporal facial nerve grafting was performed immediately after removal of the parotid tumor. Administration of mecobalamin continued for more than three months, an average of 27 weeks, after the operation. Comparing with our previous result of operation, we have noted favourable effects on the restoration of the facial nerve function. Although further clinical and experimental verification is needed, this preliminary study has suggested that the drug potentially promotes regeneration of the facial nerve.
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