Practica Oto-Rhino-Laryngologica

Immunological Studies on Head and Neck Cancer

Takeru Ishikawa

1981 Volume 74 Issue 8 Pages 1679-1690
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1679

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Recent advances in cancer immunology were reviewed in the first half of this paper.
Using syngeneic animals, the biological activities of lymphocyte in attacking cancer cells have precisely been analysed. However, several fundamental problems in human cancer immunology still remain obscure. Especially in the case of human solid tumors including head and neck cancer, there has been scarsely clear proof that human autologous lymphocytes respond and specifically attack cancer cells.
The last half of this report, explained that human autologous T-lymphocyte cytotoxicity to cultured squamous cell cancer cell had been successfully induced in our laboratory, and the possibility of specific immune therapy of the head and neck cancer was discussed. In addition to those, data found in our laboratory about natural killer (NK) activity and regional lymph node metastasis were briefly demonstrated.

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Test of Vestibulo-Ocular Reflex Using Horizontal Vision-Reversal Prisms and Visual Suppression Test

Motohiro Shimizu, Toshiaki Yagi, Shuji Sekine, Shunkichi Baba, Yuzuru ...

1981 Volume 74 Issue 8 Pages 1691-1696
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1691

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The vestibulo-ocular reflex (VOR) using vision reversal prisms and the visual suppression (VS) of caloric nystagmus were studied in 20 patients with cerebellar lesions. The abnormal response in the VOR using vision reversal prisms was classified into three groups, type A, B and C (Fig. 1). Among these twenty patients, eight, three and nine cases showed type A, B and C, respectively. In the VS test 16 cases were of the cerebellar type and three cases of the brain stem type, but one case was of normal response on both sides.
The results of the two tests, i. e., VOR test and VS test conducted in the 20 patients, were analysed along with the anatomical lesions, which were confirmed by neurotological examination, CT-scan and/or surgery. The anatomical locations of the lesions which were diagnosed on the basis of the VOR test and VS test were identical in seventeen cases, but were different in three cases. And one of these three cases showed the type C response in the VOR test, but was normal in the VS test.
From the above-mentioned results, it can be stated that both VOR test and VS test are capable of detecting abnormalities in the vestibulo-ocular reflex arc. However, the dysfunction in the cerebellar learning process can be detected only by the VOR test.

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BSR Findings in Healthy Adults with Normal Hearing and Patients with Intracranial Diseases

Setsuko Morinaka, Etsuo Yamamoto

1981 Volume 74 Issue 8 Pages 1697-1714
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1697

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(1) In healthy adults with normal hearing, the test for BSR (brain stem response) was carried out under various conditions and the following was determined as suitable conditions for the detection of abnormalities of BSR. These conditions included i) interval of stimulation using click signals (semi sine waves of 4KHz): 100msec, ii) computer averaging: 2000 times and iii) the range of frequency: from 3000Hz to 0.53Hz.
(2) In patients with lesions of the intracranial region, particularly those of the pontine angle region and the brain stem, results from the test for BSR were discussed, with regard to the disappearance of waves, prolongation of the latency from the 1st wave to the 5th wave and deformity of waves. Through the above examination, the following facts were noted:
1) Patients who showed normal and/or slight disturbance of hearing in the pure tone audiometry sometimes developed abnormal findings in BSR and vice versa.
2) Patients who showed severe symptoms due to dysfunction of the central nervous system were not always accompanied by disturbances of BSR.
3) A certain group of patients with lesions of the central nervous system showed a positive correlation between changes in nervous symptoms and the above mentioned latency in BSR.

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Clinical Application of ABR (Auditory Brainstem Response) in the Diagnosis of Intracranial Disease

Mutsumi Hosoya, Waichiro Ohyama, Shinro Itoh, Hideaki Suzuki, Tsunemas ...

1981 Volume 74 Issue 8 Pages 1715-1725
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1715

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The auditory brainstem response (ABR) was examined in patients with intracranial diseases. As a diagnostic index, the ABR considered to give far more valuable and objective information on cerebellopontine-angle lesions (acoustic neuroma, cerebellopontine-angle meningioma, pons dysfunction) than for other central nerve disturbances. In most of the former cases, ABR patterns were characterized by disappearance or distortions of waves, so the diagnostic values of latencies (e. g. the prolongation of wave V) cannot be so clear as we supposed. The noteworthy fact is that metamorphosis of the wave V on contralateral stimulation which is an important phenomenon shows brainstem dysfunctions objectively. The above fact suggests the predominance of cross fibers in the acoustic nerve within the brainstem.

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Cross-Face Nerve Grafting in Facial Paralysis following Extirpation of Acoustic Tumor

Etsuo Yamamoto, Junko Yamashita, Masahiro Tanabe, Hiroko Nishimura, Mi ...

1981 Volume 74 Issue 8 Pages 1727-1741
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1727

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The author's method and postoperative results of Cross-Face Nerve Grafting were reported. This method of operation was performed on unilateral facial palsy after extirpation of cerebello-pontine angle tumor in which the facial nerve could not be preserved and a central stump of facial nerve was not available at surgery. No postoperative complications and no weakness of the facial nerve function on the healthy side were seen. In 5 cases which were observed over 4 years after surgery, defenitive neurotisation of transplants was confirmed according to clinical and electrophysiological tests. No cases showed symmetric movement of reinnervated muscles. However, satisfactory eye closure, eating and speaking were obtained in all five cases. Indication and other problems of this technique were discussed.

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Tympanoplasty in Children with Chronic Otitis Media

Michitaka Iwanaga, Michiyuki Kita, Haruo Takahashi, Sinji Nonaka, Hiro ...

1981 Volume 74 Issue 8 Pages 1743-1747
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1743

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Tympanoplasty was performed in 100 children with chronic otitis media. In 80 cases otitis media was found to have been established before the patients were 6 years of age. On observation of infectious microorganism, Proteus groups were found to be in the highest percentage, followed by Staphylococcus aureus. Pathological examination of granulation tissue in children revealed the same percentage of pathological types as in adults. Preoperatively, particular care should be given to children with allergic rhinitis and adenoid vegetation.

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Eleven Cases of Lateral Cervical Cysts

Kozo Watanuki, Tomonori Takasaka, Jun Kusakari, [in Japanese], [in Jap ...

1981 Volume 74 Issue 8 Pages 1749-1759
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1749

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In the Department of Otolaryngology, Tohoku University Hospital, 11 cases of lateral cervical cysts were treated during the last 8 years: 4 were male and 7 female. Three cases, all of which were female, had the fistulae derived from the first branchial groove. Six cases had cysts that probably originated from the second or the third branchial groove, both associated with the cervical sinus. The other two cases were thought to be derived from the third branchial pouch. The clinical features of three cases were presented with reference to their origin, differential diagnosis and treatment.

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A Statistical Analysis of Differentiated Thyroid Cancer

Tatsuya Fukazawa, Eiichi Fujimura, Naoyuki Kanoh, Kazuo Makimoto

1981 Volume 74 Issue 8 Pages 1761-1766
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1761

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Differentiated thyroid cancer is regarded to be of low grade malignancy with a good prognosis. We made statistical analyses of 138 cases of differentiated thyroid cancer treated in Kyoto University during the past ten years.
Our study proved the propriety of the standard surgical procedures for thyroid cancer. These established indications of surgical procedure for various stages of the cancer were found to have been properly followed in our series. This could conceivably be related to a lower recurrence rate in our series.

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Xeroradiography in Otolaryngology

Itaru Yamamichi, Shigeru Miyoshi

1981 Volume 74 Issue 8 Pages 1767-1773
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1767

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It has been reported that xeroradiography yields effective radiographic imaging of breast cancer because of the edge effect of having wide latitude and high contrast. We have applied this xeroradiographic technique to the head and neck region and taken pictures of more than one hundred cases in the National Hospital of Maizuru.
Good results have been obtained in such regions as the larynx, thyroid gland, trachea, esophagus, neck lymphnodes and salivary glands.
A shortcoming of this technique is that larger exposure doses are required compared with conventional radiography. Radiation exposure will be reduced with higher kilovoltage and heavier filtration of the x-ray beam.

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Effect of Chotosan on Incurable Tinnitus

Koichi Tanaka, Midori Tsuda, Kazuo Konishi, Kauan Chen Cang

1981 Volume 74 Issue 8 Pages 1775-1780
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1775

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Patients complaining of tinnitus were treated with Chotosan at the Department of Otorhinolaryngology, Osaka University Hospital from January to October in 1979. This drug was administered regardless of whether the patient was evaluated strictly as having what is called sho (proof) in Chinese Medicine which justifies the use of this drug.
In 17.9% of the patients the medicine was rated to be effective or markedly effective and the rate of effectiveness increased to 50% when “slightly effective” was included.
Chotosan does not require large quantities for administration, has no side effects at all, and patients themselves wish to have it continuously, therefore it seems worth considering in treating patients with tinnitus.

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Intal Therapy in Allergic Rhinitis

Yozo Orita, Yoichi Okita, Ryuji Nagano, Chikao Inagaki, Hidekazu Yamam ...

1981 Volume 74 Issue 8 Pages 1781-1789
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1781

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In the light of several years' experience with Intal therapy in the treatment of allergic rhinitis, we have found that the key factor for successful treatment is to ensure the patient's full understanding of the nature of the drug, prior to the commencement of this therapy. We therefore discuss how patients should be guided and present an analysis of 180 patients to whom Intal was administered. The following results were obtained:
1. The age of the patients at the beginning of the treatment period ranged from 3 to 62 years. Sixty-four percent of the male patients were under 20 years of age. In the female group, 75% were between the ages of 10 and 39 years. This distribution is believed to be due to constitutional differences between the sexes.
The largest number of patients was in the 10-19 age group, lower in the 20-29 age group, but slightly increasing again in the 30-39 age group. Thereafter, the numbers declined, there being only one male patient in the 60+age group.
2. No side effects were observed, except for one patient in whom irritation symptoms necessitated withdrawal of the drug. These results are in accordance with other published work.
3. The monthly Intal capsule consumption of 77 patients treated for periods ranging from 6 months to 4 years and 4 months was analysed. The analysis showed that the average monthly requirement necessary to control the symptoms, gradually and steadily decreased over the course of time. These results reconfirm the high degree of efficacy and safety of Intal from an aspect which has not so far been reported in published papers.

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Growth, Development and Aging of the Vocal Fold

Minoru Hirano, Shigejiro Kurita, Yuichi Toh

1981 Volume 74 Issue 8 Pages 1791-1802
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1791

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We investigated 88 human larynges obtained from autopsy cases. Their age ranged from zero (newborn) to the seventh decade. The results are as follows:
(1) The length of the vocal fold was 2.5-3mm in newborns. It was defined as the distance between the anterior commissure and the posterior end of the ventricle. It increased with the age up to 20 years. In adults, the vocal fold length was 17-21mm in males and 11-15mm in females.
(2) The length of the membraneous portion was 1.3-2mm in newborns. It also increased with age up to 20 years. In adults, the length of the membraneous portion was 14.5-18mm in males and 8.5 to 12mm in females.
(3) The length of the cartilaginous portion was 1.1-1.8mm in newborns. It increased with age. Its increase, however, was much less than that of the membraneous portion. Therefore, the ratio of the membraneous portion to that of the cartilaginous portion was much greater in adults than in young children.
(4) The thickness of the mucosa was 0.75-0.95mm in newborns. It slightly increased with the age.
(5) There was no vocal ligament in newborns. There were only immature maculae flavae. An immature ligamentous structure appeared at the ages of 1 to 4. Differentiation of the two layers in the ligament, i. e. the layer of elastic fibers and that of collagen fibers, occurred at the age of 6 to 12. The vocal ligament appeared to become mature before 20 years of age.
(6) With aging, significant histological changes occurred in the lamina propria of the vocal fold mucosa. The superficial layer thickened because of edema. The intermediate layer thinned because of the atrophy of the elastic fibers. The deep layer thickened due to a fibrotic increase of the collagenous fibers.

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Observations on the Immunological Parameters of Laryngeal Cancer Patients

Kazuo Makimoto, Akira Tamada, Seiji Kishimoto, Naoyuki Kanoh, Takashi ...

1981 Volume 74 Issue 8 Pages 1803-1815
Published: August 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1803

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Observation of 36 laryngeal cancer patients was made with respect to a set of immunological parameters in the periods before and after treatment, including long-term follow up. Several trends observed in this series were as follows: 1) In the pretreatment group, T-cell %, lymphocyte blastoid reaction (PHA, Con. A) and skin reaction (PHA, PPD) were generally kept in the normal ranges; however, T-cell count and lymphocyte count were reduced in a great portion of the patients. 2) In the no recurrence group, T-cell count, lymphocyte count, IgG-FcR/T-cell (T_γ) and skin reaction were normal in many cases. The recurrence group showed decrease in T-cell %, T-cell count and lymphocyte count. 3) When the data were compared before and after surgery, T-cell count, lymphocyte count and PPD skin reaction were found to increase after surgery in some cases. In a few cases, however, reduction was noted in T-cell %, B-cell %, lymphocyte count and skin reaction for a long time after surgery. 4) Radiation therapy did not seem to induce substantial effects in T-cell % and skin reaction.

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