Practica Oto-Rhino-Laryngologica

Peripheral Facial Paralysis and the Thread Lacrimation Test

Nobuya Yagi, Yasuyuki Ishikawa, Tatsuya Fukazawa

1981 Volume 74 Issue 9 Pages 1817-1825
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1817

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Shirmer's test is widely accepted for determining the lacrimal function because of its ease of handling. However, it is not used for clinically testing the facial nerve function, for it is time-consuming and its result is not consistent. Kurihashi, in 1975, reported a new thread lacrimation test. A piece of cotton thread dyed with 10% fluorescin at one end, is inserted into and left under the lateral side of the formix for 60 seconds. The color of fluorescin stretches due to lacrimation.
We examined and evaluated the degree of facial paralysis with the above-mentioned thread lacrimation test, the paralysis score method and the integrated EMG method in 34 cases of peripheral facial paralysis. In the process of recovery from facial paralysis, we found three patterns of recovery in the thread lacrimatiom test: normal type, hyperfunction type and hypofunction type. The value of the normal type (29.4%) fell in the normal range (60-140%) throughout the recovery process. The hyperfunction type (55.9%) showed high values (over 140%) before or during the recovery course. The hypofunction type (8.8%) showed low values (under 60%) in the initial phase of paralysis.
We found no definite relation between the lacrimation test results and the recovery of facial paralysis as examined with the paralysis score method or the integrated EMG method. However, so much as 55.9% of facial paralysis had transient hyperlacrimation before or during the recovery course of facial paralysis, it seems that hyperlacrimation has some relation to the recovery from facial nerve damage.

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Recording of Auditory Brainstem Responses Using an Epipharynx Electrode as the Reference (Negative)

Morio Yamauchi, Etsuo Yamamoto, Hajime Nakamura, Kozo Ohta

1981 Volume 74 Issue 9 Pages 1827-1834
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1827

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Auditory brainstem responses were recorded in 8 normal adult subjects by two different recording methods. The difference between the two methods was the position of the reference (negative) electrode, the earlobe ipsilateral to stimulation for one method and the epipharynx for the other, with the vertex electrodes as the common active (positive) and the nasion electrodes as the common ground. The waveforms and amplitudes of each component obtained by each recording method were compaired between the two, and the following results were obtained;
1) As for the probability of wave I, the method in which the epipharynx serves as the reference was less sensitive than the other method in which the earlobe serves as the reference.
2) As for the probability of wave V, however, the former method was more sensitive than the latter method, resulting in easy identification of wave V as well as in improvement of its threshold for detection.
3) The interference of the myogenic response of the post-auricular muscle in the later half of ABR was less in the former method than that in the latter.

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A Case of Gangrenous Stomatitis

Kotaro Uno, Takuya Yamamoto, Hiroaki Takahashi

1981 Volume 74 Issue 9 Pages 1835-1839
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1835

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Gangrenous stomatitis, so-called noma or cancrum oris, is necrotic inflammation which rapidly spreads over the oral mucous membrane. While gangrenous stomatitis is sometimes encountered in extremely emaciated children, it is very rare in adults.
A case of gangrenous stomatitis in a 68-year-old woman with the chief complaints of sore throat and functional disorder caused by scar formation is reported with a review of the world literature. The chief complaints were alleviated with the use of a steroid agent and antibiotics.
Since gangrenous stomatitis was rarely reported from the USA, Europe or Japan during the last century, this seems to be a very unusual case.

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A Case Report of Adenomatoid Odontogenic Tumor

Mahito Itoh, Shun-ichi Sakai, Masami Murata, Ryoji Sasaki

1981 Volume 74 Issue 9 Pages 1841-1847
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1841

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A 12-year-old girl complaining of left cheek swelling and nasal obstruction was found to have a tumor in the maxillary sinus. X-ray films revealed an embedded tooth and calcification in the tumor. Histopathologically the tumor excised proved to be a adenomatoid odontogenic tumor. The characteristic feature of this disease as revealed in 44 Japanese cases is compatible with that reported by Philipsen & Birn, who referred to 77 American cases of this tumor and reported that the disease occurred frequently in the incisor-cuspid regions of the maxilla of young girls in the second decade of life.

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A Study of Laryngeal Cancer in Senile Patients

Takashi Kondo, Yoshitaka Kawabe

1981 Volume 74 Issue 9 Pages 1849-1857
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1849

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With the greater increase oflife expectancy in recent years, the incidence of laryngeal cancer among the aged has also increased. The authors report 76 cases of laryngeal cancer among patients aged 70 years or more. Radical irradiation was administered to 47 patients, while total laryngetomy was performed on 28 cases and partial laryngetomy only on one patient.
In treating these patients, other geriatric affections should be evaluated, as they could become risk factors. It is also important to pay due attention to the psychological attitudes of elderly patients.
The five-year crude survival rate and absolute survival rate were 50.7% and 66.7% respectively.

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Mucous-producing Adenopapillary (Non-epidermoid) Carcinoma of the Parotid Gland

Naoyuki Kanoh, Hideyuki Haebara, Yasuyuki Tasaka, Akira Tamada, Kazuo ...

1981 Volume 74 Issue 9 Pages 1859-1864
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1859

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A rare parotid tumor, mucous-producing adenopapillary (non-epidermoid) carcinoma was reported clinicopathologically. It was interesting that this tumor had at the same time three histopathological features, papillary, mucous and solid epithelial structures. Histogenesis was mainly discussed.

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Synchronized Chemotherapy with Bleomycin, Vincristine, Endoxan, Methotrexate, FH Predonin and Adriamycin (Bleo-VEMF'HA)

Masanao Ohkawa, Kazuo Makimoto, Tamio Yamauchi, Shuichi Hida, Yoichi T ...

1981 Volume 74 Issue 9 Pages 1865-1876
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1865

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The detailed principle and theory of cell kinetics, which were derived from analysis by flow-micro-fluorometry, reveal significant implications for cancer chemotherapy. Bleo-VEMF'HA sequential synchronized chemotherapy has been established under the expectation that cancer cells will theoretically be synchronized first at the G2 phase and next at the S phase, according to cell kinetics.
Fifteen patients with head and neck cancer received this chemotherapy.
Of the 15, 7were 1-A, 7, 1-B, and 1, 0-A, according to Karnosky's evaluation. The total response rate was 93%. Two cases of malignant lymphoma showed complete remission.
Bleo-VEMF'HA sequential synchronized chemotherapy has been discussed on this theoretical base, and has been demonstrated to be a very effective therapy for head and neck cancer.

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Midde Ear Muscle Reflex as a Test for Facial Nerve Paralysis

Takayuki Nakayama

1981 Volume 74 Issue 9 Pages 1877-1895
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1877

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The middle ear muscle reflex of 50 patients with facial paralysis was compared with the results of other facial nerve tests, to determine its validity as an objective test for facial paralysis. An additional experiment was made in 3 cats to determine the time lag between the middle ear muscle reflex and the evoked electro-myogram. The middle ear muscle reflex was recorded through simultaneous summation of the pressure in the external ear canal and the impedance of tympanic membrane. At the same time, other tests for facial paralysis (EMG., evoked EMG., NET, and facial paralysis score) were carried out. It was found that the middle ear muscle reflex closely correlated with the score of facial paralysis and evoked EMG, but not with NET. The results indicated that the measurement of middle ear muscle reflex permit an objective evaluation of facial paralysis. The advantage of this test simplicity and objectivity. Disadvantages are involvement of the tensor tympani muscle in the reflex wave, and omission of weak reflex. The method of simultaneous summation of pressure and impedance contributed to minimize these disadvantages. The animal experiment disclosed that a time lag between the middle ear muscle reflex and the evoked EMG was 67.7hr, when the facial nerve was disected at the horizontal section. The middle ear muscle reflex seemed to be useful especially in early cases of facial paralysis, because the reflex is evoked by the stimulus to the central nervous system, while the evoked EMG is a test of a more peripheral facial nerve. In conclusion, the middle ear muscle reflex is useful in evaluating the degree of facial paralysis rather than topognosis.

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Histological Evaluation of Otolith in Human Temporal Bones

Katsuhiro Hirakawa, Tetsuo Ishii

1981 Volume 74 Issue 9 Pages 1897-1903
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1897

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Histological observation was made on otoconia in celloidin serial sections of temporal bones of 76 cases (117 ears). The purpose of this investigation was to study the preservation of otoconia by examining postmortem changes and artifacts.
The major results and conclusions are as follows:
1) The preservation of otoconia was dependent on the degree of postmortem changes of the other inner ear structures. The maculae of the saccules showed greater loss or changes of otoconia than did those of the utricles.
2) Detatchment, partial and complete loss of otoconia from the macula comprised histologic changes of otoconia. Detatchment of otoconia was considered to be a postmortem change or artifact, and partial or complete loss was considered to be pathological.
3) The otoconial changes of the utricle which were found in the temporal bones that were well preserved and fixed were considered to be pathological.
4) The otoconial changes of the saccule may be pathological but must be evaluated carefully.

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Effect of Cerocral on the Vertigo Patient

Tatsuya Okuzono, [in Japanese], [in Japanese], [in Japanese], [in Japa ...

1981 Volume 74 Issue 9 Pages 1905-1913
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1905

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The therapeutic effect of Cerocral (Ifenprodil) was evaluated after administration of Cerocral 60mg per os/day for 2 weeks to 4 weeks to 21 patients with vertigo (aged from 21 years to 64, averaged 49.0 years). Cerocral was effective in abating vertigo in 75% of the patients within 2 weeks and continued to be effective in 71% of them after 4 weeks, judged both subjectively and objectively.
There was no marked difference between the vertigo of peripheral origin and that of central origin. It is suggested that the drug effect was probably produced at higher organs in the whole vestibular system. From the symptomatological standpoint the patients with vertigo accompanied by shoulder distress, unstableness or mild headache showed considerable improvement.
Neurootologically, nystagmus, both spontaneous and induced nystagmus, especially positional nystagmus, was remarkably affected by the administration of Cerocral.
There has been no noticeable side effect during the drug study.

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Clinical Effect of Azunol-S Tablet (AZ-S) in Mucosal Inflammations of the Oral Cavity, Tonsil and Pharynx

Kazuo Takeda, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...

1981 Volume 74 Issue 9 Pages 1915-1936
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1915

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Pharmacokinetics and clinical utility of Azunol-S tablet (AZ-S tablet: water-soluble Azunol 5mg) were studied.
Pharmacokinetics:
After an Azunol-S tablet was inserted into the labiogingival region of the upper jaw (A) or placed on the tongue (B) in healthy males, the concentration of water-soluble Azunol in saliva was determined.
1) While water-soluble Azunol in saliva remained at a constant level about 90 minutes after administration in case of A, it showed a high level soon after administration and disappeared after 15 minutes in case of B.
2) The volume of saliva in B was larger than in A and the saliva secretion was not influenced in A.
3) The dissolution time was about 90 minutes in A and about 10 minutes in B. Clinical Study:
An Azunol-S tablet was inserted into the labiogingival of the upper jaw of patients having mucosal inflammations of the oral cavity, tonsil, pharynx etc., or having undergone a minor operation for the oral cavity and pharynx at a dose of 1 tablet 4 times daily for 7 days.
1) The total number of patients was 146; pharyngitis 47, stomatitis 35, glossitis 24, tonsilitis 21, gingivitis 8, post-operation for the oral cavity and pharynx 11. Effectiveness (excellent and good responses) was observed in 63.8%, 74.3%, 70.8%, 52.4%, 100% and 54.5%, respectively.
2) In acute cases, effectiveness (excellent and good responses) was observed in 92.3% of glossitis, 83.3% of stomatitis and 62.5% of both pharyngitis and tonsilits. In chronic cases, effectiveness was observed in 66.7% of pharyngitis, 54.5% of stomatitis and 45.5% of glossitis.
3) Spontaneous pain, swallow pain, strange feeling, redness and swelling were greatly improved in acute pharyngitis, and strange feeling and redness were greatly improved in chronic pharyngitis.
4) Strange feeling, redness, swelling, ulcer or erosion, and stinging pain were highly improved in acute stomatitis, and spontaneous pain, strange feeling, redness and swelling were improved in chronic stomatitis.
5) When patients were asked about their feeling for the administration method, most of them answered “good” or “not nervous about it though aware of it”.
6) As to the side effects, 3 out of 146 patients complained of systemic symptoms, but it cannot be concluded that they were attributed to the drug. No local side effects in the oral cavity were reported, and no abnormal laboratory findings were observed. AZ-S tablet is regarded as safe and effective in mucosal inflammations of the oral cavity, tonsil, pharynx or post-operation for the oral cavity and pharynx.

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Clinical Study with Azunol-S Tablet (AZ-S) in Pharyngo-laryngeal and Oral Inflammations

Hideo Saito, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...

1981 Volume 74 Issue 9 Pages 1937-1946
Published: September 01, 1981
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.74.1937

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The Azunol-S tablet (AZ-S: water-soluble Azunol 5mg), to be inserted into the labiogingival region of the upper jaw, was administered to patients having pharyngolaryngeal and oral inflammations or having undergone tonsillectomy at doses of 1-2 tablets, 3-4 times daily for 7 days.
1) The total number of patients was 96; pharyngitis 55, pharyngo-laryngitis 24, tonsillitis 11, post-tonsillectomy 4 and stomatitis 2 cases.
The rate of global effectiveness was 61.5% (excellent and good response) and 88.5% (the above two and moderate response).
2) The rate of global effectiveness in pharyngitis was 61.8% (excellent and good) and 92.7% (the above two and moderate), and that in pharyngo-laryngitis was 50% and 83.3% respectively.
3) Spontaneous pain, swallow pain, strange feeling, redness and swelling were greatly relieved in acute cases of pharyngitis and pharyngo-laryngitis, and spontaneous pain, swallow pain, strange feeling and swelling were alleviated in chronic cases.
4) As to patients' feeling for the administration method of tablets, most of them answered “good” or “not nervous about it though aware of it”.
5) Slight side effects such as gastric disturbance were observed in 3 of the 96 cases. Other systemic or local side effects were not complained of, however.
The AZ-S tablet is regarded as safe and effective in pharyngo-laryngeal and oral inflammations.

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