Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 75, Issue 2special
Displaying 1-40 of 40 articles from this issue
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  • Permanent Electrodes of Cochlear Microphonics In Guinea Pigs
    Kiyoto Kanagawa, Takayuki Tokimoto
    1982 Volume 75 Issue 2special Pages 455-463
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_455
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    Until now, it has been more difficult to maintain satisfactorily permanent electrodes for cochlear microphonic (CM) measurements in guinea pigs than in cats or rabbits. We implanted Teflon-coated electrodes on the round window of the cochlea in 40 guinea pigs, and also implanted electrodes for the recording of brain stem responses in their skulls. Using these, we recorded the auditory brain stem response (ABR) and CM potentials daily for about three months. The recorded amplitudes of the ABR and CM potentials dropped suddenly about a day after the operation, but returned to their original levels in about two weeks, and remained stable thereafter.
    During this initial two-week period, CM potentials and ABR were also measured by bone conduction. These ABR values remained steady, and the CM amplitudes were reduced but were larger than those measured by air conduction. These results suggest that postoperative serous exudate caused a decrease in the CM amplitudes to be measured.
    We found permanent electrodes for CM measurements in guinea pigs to be reliable and useful for many auditory experiments.
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  • Studies on CM and ABR by Bone Conduction in Guinea Pigs
    Kiyoto Kanagawa, Takayuki Tokimoto
    1982 Volume 75 Issue 2special Pages 464-475
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_464
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    Using permanent electrodes for measuring the auditory brain stem response (ABR) and cochlear microphonics (CM), we carried out basic experiments in 31 guinea pigs to determine optimal techniques and conditions for bone conduction stimulation.
    The best position for stimulation was found to be the intersection of the median line and the interaural line. The most appropriate force and tip size of the probe of the bone receiver were determined to be about 300g and 2mm2, respectively.
    Furthermore, we made experimental hearing damage in the conductive systems of the external, middle and inner ear and created sensori-neural hearing loss with kanamycin (KM). We obtained input-output relation curves of ABR and CM by air and bone conductions in these animals, respectively and observed the change in hearing threshold in each operation.
    We also studied the hearing of the animals showing the symptoms of otitis media and tympanosclerosis in comparison with the above-mentioned results.
    The availability and significance of measuring bone conduction hearing in experimental animals is discussed.
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  • Our ostium-enlarging technique in maxillary sinus surgery
    Masatoshi Nishio
    1982 Volume 75 Issue 2special Pages 476-500
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_476
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    A new operative procedure for the radical treatment of maxillary sinusitis was first tried in the Department of Otolaryngology, Kobe University School of Medicine in May 1967, in which the maxillary sinus ostium was enlarged and the middle meatus opened, instead of establishing a counter opening in the inferior meatus. Since then, 5 patients were similarly treated in the Department. Furthermore, 108 cases in which the same operative procedure was applied, were experienced during 7 years in the Department of Otolaryngology, Osaka Dental University.
    One hundred and thirteen patients were similarly treated in the last 9 years. The present report describes the clinical significance of the procedure, and discusses it based on an experimental nasal-maxillary model.
    1) Operative procedure: In the radical operation of maxillary sinusitis, after complete removal of the mucous membrane of the maxillary sinus, (a) the bone wall of the inferior meatus, (b) the bone of the inferior concha of the hiatus sinus maxillaris, i. e. Crista conchae, (c) the membranous part of the hiatus sinus maxillaris, and (d) mucus membrane of the middle meatus side of the inferior concha, are removed in that order. At the completion of the operation, it is confirmed that the free edge of the middle concha and the nasal septum can be seen from the maxillary sinus side.
    Namely, the hiatus sinus maxillaris is anatomically opened.
    2) The post-operative regeneration tissue in the sinus develops from the lateral inferior side, and is eventually replaced by connective tissue in 3 months to 3 years. The regenerated maxillary sinus can be roentogenographically seen as an excavation connected with the middle meatus.
    3) According to questionnaires, our patients are progressing favofably.
    4) In an experimental model with an enlarged sinus ostium, ventilation within the maxillary sinus is well done on expiration.
    5) No later complication such as postoperative maxillary cyst is noted.
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  • A clinical and histopathological study of local recurrence of carcinoma of the tongue after radiation therapy
    Takashi Fukazawa
    1982 Volume 75 Issue 2special Pages 501-515
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_501
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    A total of 144 patients with squamous cell carcinoma of the tongue treated by irradiation during the 14-year period from 1966 to 1980 were analyzed.
    The patients were classified into 3 groups according to the response to therapy, i. e. remission, recurrence and residual groups. Forty-two patients (29%) had recurrence and twenty-six (18%) had residual tumor. The 5-year determinant survival rate for the former is 48% and 43% for the latter.
    No correlation was found among the clinical factors in the recurrence group. However, in every recurrent case of Ra interstitial irradiation, a “cold area” was found near the center of the tumor using the computerized irradiation dose distribution map. In a recurrent case after intraoral electron therapy, tumor cells were found to involve the genioglossal muscle undernearth the primary lesion during microscopic evaluation of the sections.
    Biopsied specimens were available from 82 patients and were analyzed histopathologically according to Willén's method. Significant differences were observed in the nuclear polymorphism, mode of invasion, stage of invasion, and cellular response between the remission and recurrence groups, and between the remission and residual groups.
    Based on the above findings, it appears that tongue cancers with a Willén's score of 9 or less have the best prognosis following radiotherapy.
    Using the alpha-naphtyl acetate esterase staining and alkaline phosphatase staining techniques, T-lymphocytes were located at or near the tumor nest and B-lymphocytes were found far from the tumor nest, respectively.
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  • A Clinico-pathological Study of Reirradiation for Relapsed
    Laryngeal Carcinoma Following Initial Radical Irradiation
    Takashi Maki
    1982 Volume 75 Issue 2special Pages 516-529
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_516
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    Four hundred and fifty-three cases of squamous cell carcinoma of the larynx were treated during the period from 1969 to 1978 at the Department of Otolaryngology, Kobe University Hospital. Two hundred and flinty-cases were treated by irradiation therapy and one hundred and five cases developed local recurrence following initial irradiation. In 17 cases radical reirradiation was performed for local recurrence. Seven cases were successful and ten unsuccessful. Eight of the latter received total laryngectomy with good results.
    In all of the unsuccessful reirradiation cases, the involvement of the anterior commissure was macroscopically evident before the initial irradiation and the reirradiation, and in the removed specimen observed microscopically following the failure of reirradiation. In the successful reirradiation cases on the other hand, the anterior commissure was not involved on clinical examination. Based on the above-mentioned fact, the choice of reirradiation for the relapsed laryngeal carcinoma should be confined to those in whom the involvement of the anterior commissure is completely deniable.
    On histopathological study, the effect of irradiation is different in each specimen examined regardless of the similarity in type and amount of irradiation. A centripetal shrinkage of the tumor was not seen in any microscopically examined specimens, but islands of the tumor left in the primarily involved area was the marked finding which was obtained.
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  • The Suppressor Factor in House Dust Nasal Allergy
    Hiroshi Ogasawara, Jumpei Kimura, Masayoshi Kumon, Takeo Kumoi
    1982 Volume 75 Issue 2special Pages 530-535
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_530
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    The effect of specific immunotherapy on the lymphocyte response was investigated in 18 untreated and 16 treated patients with house dust nasal allergy, and 5 non-atopic control subjects. The suppressor factor was induced with Dermatophagoides farinae (D. farinae) and the suppression of lymphocyte proliferative response (LPR) and the secretion of anti-D. farinae IgE antibody were measured.
    The percentages of suppression in the treated and control group were higher than in the untreated group. The suppressor factor reduced the LPR to D. farinae and the secretion of IgE antibody. In a previous study, the LPR to non-specific pokeweed mitogen and phytohemagglutinin were equal in three groups (allergic untreated and treated, and controls). The suppressor factor may be specific for D. farinae. In patients with high IgE antibody, even though immunotherapy was also used, the percentage of suppression was not increased satisfactorily.
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  • Bacteria in Dental Sinusitis
    Manabu Mohri, Masatoshi Nisnio, Kaoru Shimazu, Masaki Yoshimatsu, Kazu ...
    1982 Volume 75 Issue 2special Pages 536-542
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_536
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    Antral secretions from 67 patients with dental sinusitis were examined bacteriologically. The results were summerized as follows:
    1) From the 67 patients, 22 species and 113 strains were isolated.
    2) Mixed infections with two, three and four species were found in 33 of the total cases. Fourteen of them were a mixture of Staphylococcus aureus and Esherichia coli. Twelve showed a mixture of aerobic and anaerobic bacteria.
    3) Aerobic bacteria were isolated with higher incidence than anaerobic bacteria. Aerobic bacteria were isolated and composed of 17 species and 94 strains. Staphylococcus aureus was the most frequent species, followed by α-Streptococcus, Esherichia coli and Pseudomonas aeruginosa. In anaerobic bacteria, 5 species and 19 strains were isolated in descending order of Peptococcus, Veillonella and Peptostreptococcus.
    4) From 49 patients in the acute stage, 19 species and 87 strains were isolated, Staphylococcus aureus was the most frequent species. From 18 patients in the chronic stage, 15 species and 26 strains were isolated, Pseudomonas aeruginosa was the most frequent species and Staphylococcus aureus had a low incidence.
    5) No difference was found between bacteriological findings in dental sinusitis and nasal sinusitis. In other words, the bacteria participating in this disease are approximately similar to those in nasal sinusitis. No special bacteria are present in this disease.
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  • Diagnosis of Acoustic Tumor by CT-Scanning
    Tetsu Tabuchi, Satomi Taniguchi, Mutsuo Amatsu, Seishi Hakozaki
    1982 Volume 75 Issue 2special Pages 543-549
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_543
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    Early diagnosis of acoustic tumors plays an important role in minimizing the disorder caused by operation and in the aspect of rehabilitation. It can be said that the otorhinolaryngologists' mission is to make an early diagnosis of acoustic tumors. A present, however, unfortunately, acoustic tumors are only rarely detected at the stage where the affected area is confined to the internal auditory meatus, i. e, so-called “ear tumor”. In many cases of early acoustic tumors, there are no abnormal objective findings except perceptive deafness and a reduced or extinct response on caloric nystagmus examination. On many occasions, neuro-otolbgical examination does not lead to a definite diagnosis of acoustic tumor but only suggests its presence. Therefore, we cannot but resort to diagnostic imaging in order to confirm the presence or absence of a tumor. As a next step, CT is performed following plain roentogenography, pluridirectional tomography, etc. Conventional CT where the limits of the detectable image in the diameter of the tumor have been considered to be 1.5-2cm is, however, not helpful for early diagnosis. For this reason, we have been troubled with a gap between what the functional test results indicate and CT-findings. We are now equipped with CT (from the Review of metrizamide cisternograms produced by GE CT/T) which seems to adequately fill such a gap and be useful for early diagnosis of acoustic tumors. We believe that CT-scan will reveal a greater number of cases of “ear tumor”.
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  • A case of brain abscess caused by maxillofacial injuries
    Toru Minatogawa, Takeo Kumoi, Kimiyuki Ikeda, Tatsuo Morimura
    1982 Volume 75 Issue 2special Pages 550-556
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_550
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    A 17-year-old boy was referred to our hospital because of multiple maxillofacial skeletal fractures, visual loss in his left eye and a lacerated wound of the left upper eyelid sustained ten days previously when he ran into a pavement tree while riding his motorbicycle. Open reduction of the fractures and endonasal surgery for the fracture of the optic bony canal on the left were performed. Almost a month postoperatively, the patient returned with fever and swelling of his left upper eyelid and this abscess formation at the site of the lacerated wound in his left upper eyelid recurred many times during the following period of one year. Brain abscess in the left frontal lobe communicating with the upper eyelid was finally found and this was excised by frontal craniotomy.
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  • A Report of Forty Cases of Traumatic Facial Palsy: Conservative vs. Surgical Treatment
    Seishi Hakozaki, Mutsuo Amatsu, Toshio Matsui, Hideo Hosomi
    1982 Volume 75 Issue 2special Pages 557-566
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_557
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    Fifty-six patients of traumatic facial palsy were treated in our hospital during an eleven year period from May 1970 to April 1981.
    The clinical courses of 40 patients were analyzed and compared. Facial nerve decompression was done in 14 patients and 26 were treated conservatively, the other 16 patients were lost to follow-up.
    From this study, the following results were obtained:
    1) The rate of complete recovery in traumatic facial palsy was 58% (23/40).
    2) In the conservative treatment group, all the patients with incomplete paralysis recovered completely. In those with complete paralysis, there was complete recovery if the initial nerve excitability was normal. In those with abnormal nerve excitability, complete recovery was observed if signs of recovery could be elicited within 25 days from the onset of palsy. However, those with signs of recovery only after two months had exceedingly poor recovery.
    3) In the surgically treated group, there was better recovery than in the conservative group even if the nerve excitability was abnormal. However, those in whom surgery was conducted 2 months after the onset of palsy had poor recovery.
    4) Therefore, surgery is indicated in the following cases:
    a) those with no response to NET b) in those with some response to NET but no signs of recovery after one month from onset
    The nerve excitability test is a good guide in determining the necessity for surgical intervention.
    5) Better results were obtained in children than in adults. Seven out of ten children (70%) completely regained facial movement.
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  • The results of steroid treatment for Bell's palsy and Ramsay Hunt's syndrome
    Hiroshi Iritani, Minoru Kinishi, Seishi Hakozaki, Toshio Matsi, Tsuguo ...
    1982 Volume 75 Issue 2special Pages 567-571
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_567
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    Steroid therapy has been given to patients with Bell's palsy and Ramsay Hunt's syndrome. The recovery results for those with complete paralysis treated with steroids within two weeks after the disease onset were compared with those receiving non-steroid therapy. Timing for steroid therapy was discussed.
    Of the patients with Bell's palsy, 49% obtained full recovery with steroid therapy, while 37% did so with non-steroid therapy. Especially, in those receiving steroids within one week after the onset, the full recovery rate was high, and the NET scaleout rate was low.
    In patients with Ramsay Hunt's syndrome, however, no satisfactory results were obtained. The full recovery rate of the steroid treatment group was 17%, while the non-steroid group was 38%. However, 35% of those receiving steroids could obtain fair recovery, which the non-steroid treatment group could not obtain at all.
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  • A case of myasthenia gravis with bilateral facial palsy and rhinolalia aperta
    Toshio Matsui, Mutsuo Amatsu
    1982 Volume 75 Issue 2special Pages 572-574
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_572
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    A case of bilateral facial palsy and rhinolalia aperta in a thirty-one-year old female is reported.
    The patient had been unable to close her eyes for 4 years prior to consultation and subsequently complained of hypernasality of voice 2 years thereafter with a problem of aspiration occurring 6 months prior to consultation. On physical examination, bilateral facial palsy was observed as evidenced by the patient's inability to crease her forehead, wrinkle her nose, or close and blink her eyes. The rest of the physical examination revealed normal findings. Facial nerve testing, Schirmer's test and electrogustometry were normal but no stapedial reflex was elicited on either side. Blood chemistry, brain CT-scan, EEG and ophthalmological examination revealed no significant abnormalities.
    The difficulty in establishing the diagnosis was discussed. Electromyography and Tensilon test results documented the diagnosis of myasthenia gravis.
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  • Tympanoplasty Using an Osteoplastic Flap
    Satomi Taniguchi, Shigemi Suzuki, Fumihiko Matsuyama, Masaru Horii, Yu ...
    1982 Volume 75 Issue 2special Pages 575-581
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_575
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    Tympanoplasty using an osteoplastic flap was performed on 59 ears between March 1976 and December 1979. In 19 ears, reoperation was done on account of the attic retraction or other factors. Three had collapsed bone flaps which were atrophic and deformed. Of this series, two residual cholesteatomas and an iatrogenic cholesteatoma were found. As one of the causes of the retraction in the attic area, fibrosis and granulation tissue arising from the denuded bone area seens to be a very important factor, which resembles a naso-frontal duct in chronic frontal sinusitis.
    The techniques for making and replacing the bone flap are described.
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  • A report on a radical mastoidectomized patient who received an allograft stapes
    Takeo Kumoi, Hiroshi Ogasawara, Yoshio Umetani, Hiroshi Nagamoto
    1982 Volume 75 Issue 2special Pages 582-587
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_582
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    There are only a few reports of allograft stapes transplantation in the human oval window in the literature.
    This type of tympanoplasty was performed on a patient previously subjected to radical middle ear surgery in whom no ossicles were present. Satisfactory hearing improvement was attained and thus the allograft stapes surgery is considered to be an alternative method for the commonly used incudal or alloplastic columella.
    The human allograft stapes was offered for use by this patient courtesy of the Hyogo Ear Bank (Nishinomiya-city, Japan).
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  • A Surgical Case of Van der Hoeve's Syndrome
    Toshio Matsui, Mutsuo Amatsu
    1982 Volume 75 Issue 2special Pages 588-592
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_588
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    A case of Van der Hoeve's syndrome in a 50-year-old Japanese female is reported.
    Pure tone audiometry showed a 70dB hearing loss in the right ear and 60dB in the left. The stapedial reflex was absent in the left ear. Her tympanogram was type A with a deep notch in the right ear whereas in the left, it was type A with a slight notch. On the basis of these findings, dissociation of the internal region of the neck of the right stapes and ankylosis of the left stapes were suspected.
    At operation, it was observed that the right posterior crus was fractured spontaneously and the left stapedial footplate was immobile. Histological examination revealed poor bone organization and osteoporotic changes in the stapedial crura.
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  • Report of Perforation of the tympanic membrane due to explosion of gun powder
    Hirokazu Morimoto, Kenzo Inoue
    1982 Volume 75 Issue 2special Pages 593-597
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_593
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    Three high school students, 16 years of age, experienced sudden explosion while experimenting with gun powder. The major damage was burn on their faces and bilateral rupture of the tympanic membranes. The perforations were repaired surgically and conservatively.
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  • Audiological findings seen in a case of trigeminal neurinoma
    pitfalls in audiological diagnosis of retrocochlear lesions
    Hiroshi Hattori
    1982 Volume 75 Issue 2special Pages 598-604
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_598
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    The patient, a 27-year-old female, showed remarkable fluctuations in audiological findings during the period of 4 years of treatment, which included one V-P shunt operation and 3-time tumor exstirpation by suboccipital craniotomy. The threshold for continuous pure tones fluctuate from normal to complete loss, speech discriminations from 95% to 0%, the TTS from (-) to (+) and sometimes discrepancies between speech discrimination and TTS were found. Even when the patient showed a normal audiogram, very good discrimination and negative TTS, a decruitment phenomenon and loss of tonality was found in the lower frequency range. Some hazards of overlooking the presence of retrocochlear lesions were discussed.
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  • Cryosurgery for Chronic Sinusitis
    Keiko Yamabe, Motoko Masuda, Akira Hohki
    1982 Volume 75 Issue 2special Pages 605-609
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_605
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    The traditional radical operation for chronic sinusitis had occasionally a complication of post-operative maxillary cysts, and various methods to avoid this problem have been tried recently. Since 1975, 12 patients with chronic sinusitis have been treated at the Cryosurgical Clinic of Kobe University Hospital. The cryosurgical unit was devised to freeze the abnormal mucous membrane of the maxillary sinus. At first a small hole was made at the lateral wall of the meatus nasi inferior or the fossa canina, and next a special probe was inserted through this hole to freeze the maxillary sinus with liquid nitrogen. Before and after the treatment, we evaluated the effectiveness using morphological and functional tests. In nine cases, the treatment was evaluated to have been effective. These results suggest the usefulness of cryosurgery for chronic sinusitis. This is a preliminary report of our study.
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  • Prognosis of maxillary sinus cancer in recent seven-year period
    Gentaro Mizojiri, Yusuke Shimizu, Seishi Hakozaki
    1982 Volume 75 Issue 2special Pages 610-615
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_610
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    The prognosis of maxillary sinus cancer in recent seven year period was discussed. The study of 107 patients of primary maxillary sinus cancer revealed that the five-year survival rate was 47%. The most common cause of death was local tumor and, therefore, sure treatment for local tumors is required. What is important is the selection of patients who do not need radical operations.
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  • Primary tuberculosis of the nasal cavity
    Tetsuo Takahara, Takashi Maki, Tetsuzo Fujitani, Hirokazu Morimoto
    1982 Volume 75 Issue 2special Pages 616-619
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_616
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    A woman, aged 43, came to the out-patient department complaining of progressive right nasal obstruction and epistaxis. Nasal examination showed granulomas with crusts in the bilateral Kiesselbach areas and anterior end of the right inferior turbinate. We took this tissue for biopsy, and sections showed tuberculosis of the nasal mucosa.
    She had no past history of pulmonary tuberculosis and X-rays of the chest and sinuses were reported normal. Whole-body examination showed no other suspected tuberculous focus. She was cured by general chemotherapy only using streptomycin, INAH and RFP. She has been followed up for the past two years and is symptom-free, with no local or general signs of recurrence.
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  • A Proposal for Secure Tonsillectomy
    Hideo Hosomi
    1982 Volume 75 Issue 2special Pages 620-627
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_620
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    One hundred and thirty-three tonsillectomies conducted in the last three and a half years of which 79 were performed under general anesthesia, were presented and discussed from the standpoints of security in performing the operation and postoperative management.
    It is most important that the operation be performed in a supine position even when topical anesthesia is used to prevent the state of orthostatic hypotension and to monitor the heart rate, respiration and blood pressure during the operation. There is no difficulty in performing the operation in a supine position under topical anesthesia.
    The intravenous drip infusion via the plastic catheter is indispensable during the operation. The use of an electric coagulater makes hemostasis easy and sure.
    To avoid such postoperative complications as pain, fever and bleeding, we recommend bilateral tonsillectomy should be performed in two steps with an interval of five to seven days, particularly in elderly patients.
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  • Cryosurgery for Chronic Tonsillitis and Chronic Pharyngitis
    Motoko Masuda, Akira Hoki, Keiko Yamabe
    1982 Volume 75 Issue 2special Pages 628-633
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_628
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    During the period from December 1974 to October 1981, we have treated 210 cases of chronic tonsillitis and chronic pharyngitis, which consist of 115 males and 75 females who are from 4- to 72-year-old at the Cryosurgical Clinic of Kobe University Hospital.
    These cases were examined and the results were as follows:
    1) Selection of the cryosurgical unit depends on the degree of tonsilar hypertrophy. For grade I (Mackenzie) tonsilar hypertrophy, the cryosurgical unit using N2O gas is effective and suitable, and for grade II, liquid nitrogen.
    2) The merit of cryosurgery is that cryotonsillectomy is easily and repeatedly performable without bleeding and pharyngitis can be treated.
    3) There are some demerits of cryosurgery. The tonsilar tissue is not perfectly resected. Sometimes, some patients with severe tonsillitis have temporary fever, and the condition of other patients with palmar and plantar pustulosis becomes more serious after cryosurgery.
    4) Additional cryosurgery (twice or more) has been done in 27.8% of all the patients.
    5) In the second therapy, we have treated re-inflammation of the residual tissue and compensatory tonsillitis and pharyngitis.
    6) Those with fever, sore throat, elevated ASLO level, slight fever, proteinuria or hematuria show a tendency to become better than those with nephritis or palmar and plantar pustulosis.
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  • The effectiveness of combination therapy (irradiation and chemotherapy) for malignant lymphoma in the palatine tonsill
    Tetsuo Takahara, Tetsuzo Fujitani, Hiroshi Hattori, Yoshinari Imajo, H ...
    1982 Volume 75 Issue 2special Pages 634-640
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_634
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    The prognosis of malignant lymphoma is generally poor. Here we evaluate the combination therapy (irradiation and chemotherapy) for malignant lymphoma in the palatine tonsill.
    From 1966 to 1971, 61 patients of malignant lymphoma were treated by radiotherapy alone. The 1-, 2- and 3-year survival rates of these patients were 64, 47 and 36%. Since 1972, 49 patients have been treated by combination therapy. Vincristine 0.02mg/kg/week intravenously, Endoxan 10mg/kg/2 weeks intravenously and Predonisolone 60mg/day for 5 days every two weeks by mouth were administered to patients for 6 weeks from the beginning of the treatment and the patients were boosted once every 6 months for maintenance therapy by the same method for 2 years. The 1-, 2- and 3-year survival rates were 82, 60 and 60%. The difference in the survival curve between the radiotherapy group and the combination therapy was significant. (P>0.1) In the Stage I group, the difference in the survival rate between the two groups was not significant. The survival rate of 0-1 year and 2-3 years of Stage II with the combination therapy was significantly higher than that with radiation therapy alone. The prognosis of Stage III and IV patients without chemotherapy was remarkably poor but that with chemotherapy has been improved.
    We consider it necessary for Stage II, III and IV patients to continue the combination therapy for more than 2 years. The tumor cells of patients were classified into T, B and Non-T, Non-B lymphoma by the immunological method. Fifteen patients were B-cell-type, 7 were Non-T, Non-B cell-type and 3 were T-cell-type. The prognosis of Non-T, Non-B lymphoma is better than that of B and T-lymphoma. The prognosis of T-cell lymphoma in the palatine tonsill is better than that in other areas.
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  • The Results of the Treatment for Carcinoma of the Hypopharynx and Cervical Esophagus
    Mutsuo Amatsu, Toshio Matsui, Takashi Maki, Takashi Fukazawa, Kiyoto K ...
    1982 Volume 75 Issue 2special Pages 641-650
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_641
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    One hundred and forty-nine patients were diagnosed as having hypopharyngeal cancer in the past sixteen years. One hundred and thirty-eight cases were followed up for this study, of whom 129 had been treated by us. The analysis of the methods and results of the treatment is presented in this paper. The results and conclusions obtained were as follows.
    1. According to UICC classification (1974), 138 cases were situated as follows: 89, piriform sinus; 37, pharyngo-oesophageal junction; and 12, posterior pharyngeal wall.
    2. The treatment methods applied to the 138 cases were: irradiation alone, 71 cases (radical irradiation, 48; and palliative irradiation, 23); surgery alone, 17 cases; irradiation plus surgery, 41 cases (relapsed cases following radical irradiation, 26; and preoperative irradiation 15); and the untreated, 9 cases.
    3. Surgical treatments applied to the 58 local carcinomas were composed of pharyngoesophagectomy in 26 with the reconstruction of the esophagus, pharyngolaryngectomy in 27, partial resection of the larynx and pharynx in 3, partial resection of the pharynx in 1 and partial resection of the esophagus in 1.
    4. The essential method of the reconstruction of the esophagus following pharyngolaryngoesophagectomy was the use of a deltopectoral flap in the past nine years.
    5. The most frequent surgical method applied to the piriform sinus cancers was pharyngolaryngectomy, whereas in most of the cancers located in the pharyngo-oesophageal junction pharyngolaryngoesophagectomy was the essential method.
    6. Radical neck dissection was applied to 55 of the 58 patients treated surgically, of whom 37 were unilateral and 18 were bilateral.
    7. The five-year survival rate for all the patients was 25.6%. The necessity of a well-coordinated treatment system including irradiation, surgery and chemotherapy for the elevation of the survival rate was emphasized.
    8. The most frequent cause of death in the patients treated surgically was local recurrence and more than ninty percent of the cause of death were associated with the original disease such as local recurrence, recurrence of the cervical lymph node and distant metastasis.
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  • Two Cases of Double Primary Cancers Involving the Hypopharynx and Larynx
    Kunihiko Makino, Toshio Matsui, Takashi Maki, Takashi Fukazawa, Kiyoto ...
    1982 Volume 75 Issue 2special Pages 651-658
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_651
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    Two cases of double primary cancers involving the hypopharynx and larynx were observed at the Department of Otorhinolaryngology, Kobe University. The first case was a 64-year-old male with simultaneous hypopharyngeal and laryngeal cancers. The second case was a man, aged 63, who initially had laryngeal cancer and developed hypopharyngeal cancer seven years after the irradiation of the initial lesion.
    Seven double primary cancers were found in 141 cases (5%) of hypopharyngeal cancers from January 1965 to March 1981. The hypopharynx and larynx were both involved in two cases. Only six cases, including our present report of double primary cancers involving the hypopharynx and larynx, have been reported in the Japanese literature. Three were double primary simultaneous cancers while three were metachronous.
    In the three double primary simultaneous cancers, the hypopharyngeal cancers were asymptomatic, and in two, the hypopharyngeal lesions were not detectable on indirect laryngoscopy. The three cases of double primary metachronous cancers were hypopharyngeal cancers believed to be induced by the irradiation for primary laryngeal lesions.
    Therefore, in hypopharyngeal cancer patients, the possibility of double primary cancers should be kept in mind. A thorough examination is mandatory before initiation of therapy. The same is true for laryngeal cancer patients. Furthermore, in irradiated laryngeal cancer patients, the physician must be vigilant for radiation-induced cancers especially those of the hypopharynx and cervical esophagus.
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  • Congeital Velopharyngeal Insufficiency Without Cleft Palate and Submucous Cleft Palate
    Akira Kimura
    1982 Volume 75 Issue 2special Pages 659-664
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_659
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    I compared the 53 patients with congenital velopharyngeal insufficiency without cleft palate with the 29 patients with submucous cleft palate.
    Velopharyngeall insufficiency without cleft palate (53 patients):
    1) They were divided into two groups according to the characteristic shapes of their palates, that was non-cleft palate and pseudo cleft palate. In the non-cleft palate patient, the palate showed normal or broad uvula, normal looking soft palate, and flat edge of the hard palate. On the other hand, in the pseudo cleft palate patient, the palate showed bifid uvula, thin muscular layer on median raphe, and a slight notch in the hard palate.
    2) In their history, birth asphyxia was found in 27 patients, congenital heart disease in 13 patients, convulsive seijure in ten, chronic otitis media in seven, and speech retardation in 48 patients.
    3) Twenty-eight patients looked alike, and they were divided into two groups according to their characteristic facial signs, the humorous type and the nervous type.
    4) Muscular atrophy of the soft palate was proved on pathological examination.
    5) In a total of fifty patients repair was ultimately achieved by pharyngeal flap operation. It was concluded that the push-back operation was an ineffectual procedure in reducing velopharyngeal insufficiency, whereas the pharyngeal flap operation was an effective treatment.
    6) There was a marked post-operative improvement in speech in 39 patients, fair improvement in 11 patients, no improvement in 3 patients.
    Submucous cleft palate (29 patients):
    1) The palate shows a bifid uvula, no muscular layer on median raphe, and a large defect in the hard palate.
    2) In their history, asphyxia was found in 4 patients, speech retardation in 10 patients. Neither congenital heart disease nor convulsive seijure were found in any patients.
    3) There was no facial resemblance.
    4) Muscular atroply of the soft palate was not proved in these patients.
    5) The push-back operation was effective in 17 patients.
    6) There was a marked post-operative improvement in speech in 27 patients and fair improvement in two patients.
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  • Congenital Velopharyngeal Incompetence Without Cleft Palate, Involving Typical Faces
    Akira Kimura
    1982 Volume 75 Issue 2special Pages 665-671
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_665
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    I have found and treated 53 patients with congenital velopharyngeal incompetence without cleft palate from 1968 to 1981. There were 24 males and 29 females ranging in age from 2 to 15 years.
    Their speech was nasal in quality and indistinct. Twenty-eight of the 53 patients looked alike, and they were divided into two groups according to the characteristics of their faces. I called one group (14 patients) the humorous type, and the other (14 patients) the nervous type. The faces of the humorous type were characterized by round eyes and retruded mandible. On the other hand, those of the nervous type were characterized by palpebral fissure with an upward obliquity and plump upper eyelids. Push-back operations were performed in six patients with no consequent improvement. For the repair of velopharyngeal incompetence, pharyngeal flap operations were performed successfully in a total of 50 patients. There was no difference in speech result, not only between the typical face group and the other, but also between the humorous group and the nervous group.
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  • A clinical evaluation of preventive radiotherapy for the neck metastasis of tongue cancer
    Tetsuzo Fujitani, Seishi Hakozaki, Itaru Nishiwaki, Hiroshi Hattori, Y ...
    1982 Volume 75 Issue 2special Pages 672-676
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_672
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    Forty patients of Tx No squamous cell carcinoma of mobile tongue were treated at Kobe University, Departments of Otolaryngology and Radiology between November 1975 and October 1980. Twenty-three patients had preventive neck irradiation prior to the local treatment. Six of these patients subsequently developed a neck nodal metastasis. The primary lesion was uncontrolled in 4 of these 23 cases.
    Eight of the 17 without neck irradiation subsequently developed a neck nodal metastasis within 1 year and the primary lesion was uncontrolled in 7 of these 17 cases. The rate of lymph node metastasis in T1 and T2 patients with neck irradiation was significantly lower than that in those without neck irradiation. Post-irradiation necrosis of the mandible occurred in 3 of the 23 patients with preventive irradiation. We consider that the preventive neck irradiation for the patients with T1 and T2, No tongue cancer is effective in destroying subclinical metastasis and the mandible should not be included in the irradiation field.
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  • CT-Diagnosis for Mass Lesions in the Parotid Gland and Cervical Region
    Fumihiko Matsuyama, Satomi Taniguchi, Masaru Horii, Shigemi Suzuki, Yu ...
    1982 Volume 75 Issue 2special Pages 677-685
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_677
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    Thirty patients suffering from mass lesion in the parotid gland or cervical region were examined by computed tomography (CT).
    The photographed images were compared with the findings and pathological diagnoses obtained by surgical procedures.
    The conclusions were as follows:
    1) Plain CT demonstrated the location of the parotid tumor. Contrast enhancement seemed to delineate the margin of the tumor more clearly.
    2) By contrast enhancement, the branchiogenic cyst was differentiated from the parotid tumor, as a low density mass with an enhanced cyst wall.
    3) Parotid tumors enhanced by contrast material did not always appear as solid tumors.
    4) In some cases, CT numbers indicated the contents of the tumor.
    5) The extension of the tumor to the parapharyngeal space was clearly depicted on CT.
    6) It seemed to be difficult to evaluate the relationship of the parotid tumor to the facial nerve on plain CT.
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  • A Case of Mucoepidermoid Tumor of the Parotid Gland
    Mitsutake Tani, Kuniyuki Yamamoto, Mutsuo Amatsu
    1982 Volume 75 Issue 2special Pages 686-690
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_686
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    A case of mucoepidermoid tumor of the parotid gland was reported. The patient was a 12-year-old girl, who complained of a solid mass in the right infraauricular region which had enlarged progressively without other symptoms.
    By bimanual palpation, a right parotid gland tumor was suspected. To make a correct pre-operative diagnosis, sialography, CT-scanning and ultrasonography were performed.
    The tumor was extirpated surgically without injury to the facial nerve. It was 5×4cm in size and histological examination revealed a mucoepidermoid tumor.
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  • Treatment of Juvenile Laryngeal Papillomatosis
    Sohji Takashima, Tetsuo Takahara, Hiroshi Ogasawara, Akira Hohki
    1982 Volume 75 Issue 2special Pages 691-699
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_691
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    Seven patients with juvenile laryngeal papillomatosis, treated at the Kobe University Hospital, Japan mainly using a combination therapy of microsurgical removal and cryosurgery from 1974 to 1981 were investigated.
    The results are as follows.
    1. Two adults who were diagnosed for the first time in adulthood as having juvenile laryngeal papillomatosis were cured.
    2. One adult who suffered from papillomatosis in childhood and had a recurrence 17 years later is thought to be under control.
    3. One young adult who suffered from papillomatosis and was treated by radiation therapy in childhood died of radiation-induced cancer.
    4. Two children whoes papillomatosis were cured, but one has a vocal cord atresia after the treatment.
    5. One child who has frequent recurrences is under treatment.
    From the above results, the following conclusions were drawn.
    1. There is no absolutely effective therapy for juvenile laryngeal papillomatosis and multidisciplinary treatment is considered to be the best method at present.
    2. Irradiation for this disease especially for children must be avoided.
    3. In order to avoid dissemination, silastic tracheostomy tubes should be used and unnecessary suctioning should be avoided during treatment.
    4. Cryosurgery is superior to surgical resection in that the healing process of the treated area after cryosurgery is better than that after surgical resection. In our case, cryosurgery under local anesthesia was effective in the disseminated papillomatosis in the trachea. But care should be taken not to freeze too much tissue to avoid laryngeal adhesion and tracheal stenosis.
    5. Attention should be given to recurrent nerve palsy and vocal cord atresia probably due to frequent and excessive surgical removal and cryosurgery.
    In such cases, tracheostomy should be performed before operation.
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  • The present state of postlaryngectomy speech of patients treated at our department
    Minoru Kinishi, Mutsuo Amatsu
    1982 Volume 75 Issue 2special Pages 700-704
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_700
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    The present state of postlaryngectomy speech was investigated in ninty-two patients treated at our department. In eighty-two of these patients, the methods of speech production were by way of T-E shunt, artificial larynx and esophageal speech. Forty-two, thirty-three and seven cases were categorized into these three groups, respectively. Regarding the acceptability of speech as examined by the listening test in each group, speech by T-E shunt was superior. Of the seven patients with esophageal speech six had been the unsuccessful cases of T-E shunt speech who could speak using the shunt for a short period after the operation. The main reason why these patients could obtain esophageal speech spontaneously appears to be based on the fact that they could learn the vibration mechanism for esophageal speech during the period of T-E shunt phonation. In this study, the artificial larynx tended to be used in older patients than those of the other groups. In general, the acceptability of artificial speech appears to deteriorate as the patient becomes older.
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  • A Case of Chemodectoma in the Neck
    Kazuhiro Fujimoto, Mutsuo Amatsu, Takashi Fukazawa
    1982 Volume 75 Issue 2special Pages 705-709
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_705
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    A 34-year-old man visited the ENT clinc of Kobe University Hospital with a complaint of 3 months' duration of recent enlargement of a painless mass 6×8cm in size at the right side of the neck.
    Before the patient came to us, he had undergone an open biopsy at another clinic, and its histopathological examination revealed a malignant metastatic tumor. The primary lesion was not detected on the thorough examination not only of the head and neck area but also of the entire body.
    Although the primary lesion was not found, as the tumor had a histopathological malignancy, a radical neck dissection of the right side under general anesthesia was performed. The well-capsulated tumor about 3×2cm in size was located beneath the sternocleidomastoid and separated from the carotid artery. The histopathological examination of the removed specimen at Kobe University Hospital revealed a chemodectoma of the neck.
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  • Two Cases of the Branchial Cysts
    Kenichi Yamagata, Fumihiko Matsuyama, Masaru Horii, Satomi Taniguchi
    1982 Volume 75 Issue 2special Pages 710-716
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_710
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    Two cases of branchial cysts were reported.
    Case 1. A 25-year-old female had been complaining of a tumor on the right side of the neck for 7 years.
    Case 2. A 42-year-old male had been complaining of a tumor at the right side of the neck for 3 months.
    These tumors were extirpated surgically. Histologically, a diagnosis of branchial cyst was made seven cases of branchial cysts were observed in the last 10 years (1971-1981) in the Department of Otolaryngology, Kobe Central Municipal Hospital. The literature on branchial cysts was reviewed.
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  • Report of a Case of Giant Hemangioma of the Neck
    Kenichi Yamagata, Fumihiko Matsuyama, Masaru Horii, Toshio Taniguchi
    1982 Volume 75 Issue 2special Pages 717-721
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_717
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    The patient was a 77-year-old woman who had complained of a giant tumor at the right lateral neck. The tumor was extirpated surgically. Histologically a diagnosis of cav nous hemangioma was made.
    The literature on hemangioma is reviewed.
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  • Report of a Case of Carcinoma Arising in a Thyroglossal Duct Remnant
    Shigemi Suzuki, Satomi Taniguchi, Hiroya Uchida
    1982 Volume 75 Issue 2special Pages 722-727
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_722
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    Carcinoma arising in the thyroglossal duct remnant is rare. It is often diagnosed as a thyroglossal duct cyst. In our case, microscopic examination revealed follicular adenocarcinoma in association with ectopic thyroid rests.
    The purpose of this paper is (1) to report one additional case, (2) to review the literature, and (3) to discuss differentiation between a carcinoma arising in the thyroglossal duct remnant and a metastatic carcinoma from the main thyroid gland.
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  • A Case of Subacute Thyroiditis
    Tsuguo Kokan, Keiko Yamabe, Mutsuo Amatsu, Michizo Kishihara
    1982 Volume 75 Issue 2special Pages 728-732
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_728
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    We treated a 42-year-old female with subacute thyroiditis. She suffered from swallowing pain, general fatigue and slight fever. Though an increase in the erythrocyte sediment ratio was noted, the diagnosis was difficult to obtain.
    This short report describes the problem of the diagnosis of subacute thyroiditis and the rapid effect of corticosteroid hormone therapy. We believe that the history and the physical findings of the painful goiter as well as the inflammatory signs led us to the diagnosis of subacute thyroiditis.
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  • The Musculocutaneous Flap for Reconstruction of The Head and Neck
    Masaru Horii, Satomi Taniguchi, Shigemi Suzuki, Fumihiko Matsuyama, Ke ...
    1982 Volume 75 Issue 2special Pages 733-739
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_733
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    The use of the sternomastoid and pectoralis major musculocutaneous flap for head and neck repairs is reported. Eight such flaps have been used successfully for onestage reconstruction of the oral cavity, pharynx and neck. There was, however, necrosis of the flaps in three cases. Two of them had other severe diseases. For good results, it is important to keep the flap firmly attached to the mandible and reduce the dead space in the reconstruction of the oral cavity floor.
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  • C02 Laser for Head and Neck Malignant Tumors
    Akira Hohki, Motoko Masuda, Keiko Yamabe, Tetuka Kijima
    1982 Volume 75 Issue 2special Pages 740-750
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_740
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    Since 1979, 120 patients suffering from head and neck malignant tumors have been treated by means of CO2 laser at the laser clinic of Kobe University Hospital. They were divided into two groups. One hundred and four patients were treated for radical treatment and 14 for palliation. Two patients were unknown cases. The equipment employed was a Medilaser S produced by Mochida Co. A special manipulator with 4 joints was manufactured and used as a trial. To utilize the laser as easily as possible, all patients except one were macrosurgically treated under local anesthesia. To exhaust the smoke resulting from laser irradiation, a big vacuum cleaner was used.
    For the purpose of radical treatment, three methods were applied for fresh and recurrent cases: 1) laser only: All of 21 cases could be locally controlled after the primary therapy. Satisfactory results were obtained using the laser scalpel in tongue cancer. 2) a) combined therapy with cryosurgery: 14 of the 17 cases could be locally controlled after the primary therapy. b) combined therapy with radiotherapy: 9 of the 10 cases could be locally controlled after the primary therapy. This combined therapy was effective for those recurring after ordinary operations. 3) multidisciplinary treatment with radiotherapy, chemotherapy, hyperthermia and cryosurgery. This treatment was applied to the most advanced cases. Forty-one of the 49 cases could be locally controlled after the primary treatment (except the cases of under treatment). In this treatment antrostomy, vaporizing tumor tissues, enlargement of the fenestra, and excision of hard and soft palates invaded by tumor were easily performed by laser surgery. Satisfactory results were obtained in maxillary sinus carcinoma. Laser was effective for prolongation of life and reducing pain in palliative cases. The side effects were negligible.
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  • A Dialectic Study of The Pathology of KI, Action Current
    Akira Kimura
    1982 Volume 75 Issue 2special Pages 751-755
    Published: 1982
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.75.2special_751
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    In ancient India, Ki was considered Vayu, that was a strong corpuscle. In China, Ki was the source of energy. In our country, Ki was estimated to be spirit, mind, or electric energy. I consider that Ki is the action current, and is related to the blood circulation and autonomous nervous system.
    Ki is moving but invisible. It exists only in the living body, not in the dead body. The blood cells move only in the living body, but stop in the dead body. The blood circulation in the body is controlled by the autonomous nervous system. Therefore I hypothesize Ki as the action current moving through the autonomous nervous system.
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