Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 76, Issue 10
Displaying 1-19 of 19 articles from this issue
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  • A Hypothetical Mechanism of Sound Susceptibility in the Organ of Corti and Ménière's Disease
    Yozo Orita
    1983 Volume 76 Issue 10 Pages 2459-2467
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2459
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    The author studied the organ of Corti from various angles by means of microdissection of the cochleae in humans, dogs, guinea pigs and hamsters using the surface preparation technique and proposed a hypothesis for the mechanism of the sound susceptibility in the organ of Corti, based on the analysis of the results and consideration of the literature.
    After explaining the outline of this hypothesis, the author applied it to Ménière's disease, using the results of the observation of the organ of Corti. There is also a theoretical description of the mechanism of the cochlear symptoms which are characteristic clinical facts of this disease, that is, the recruitment phenomenon, low tone sensory (cochlear) hearing loss and the changes which develop as time goes by.
    It has been considered that this hypothesis and the results of the observation of the organ of Corti can be applied practically and clinically.
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  • Surgically Improved Sensory Deafness in Four Cases of Round Window Membrane Rupture
    Izuo Nishioka, Kiyofumi Gyo, Naoaki Yanagihara
    1983 Volume 76 Issue 10 Pages 2469-2475
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2469
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    This is a report of four cases of perilymphatic fistulae in which profound sensory deafness was improved by surgical repair of the ruptured round window membranes. The age of the patients ranged from 8 to 18 years old and the preoperative hearing levels from 49dB to total deafness. A slap in the face in two cases, athletic sports in one and falling down in one preceded the deafness and vertigo of sudden onset. Exploratory tympanotomy was performed of 13, 17, 19 and 69 days, respectively, after the onset. In all the cases, perilymphatic leakage of very small amounts was confirmed. The ruptured window membranes were closed using the tragus perichondrium in three patients, and fascia with adipose tissue in the remaining one. Hearing improvement was remarkable especially in two patients, who regained almost normal hearing. The surgical prognosis for hearing is far more promising in children than in adults as long as the surgery is carried out at the appropriate time.
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  • Frequency Characteristics of Stapedial Reflex
    Nobuya Yagi, Tatsuya Fukazawa, Yoshinobu Hirono
    1983 Volume 76 Issue 10 Pages 2477-2484
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2477
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    Frequency characteristics of the stapedial reflex was determined by application of contralateral sound stimulation modulated sine wave at several frequencies.
    In the case of 23 normal subjects, the stapedial reflex showed responses similar to signal sine wave up to 1.04Hz. From 1.04Hz to 3.20Hz, stapedial reflex decreased in amplitude following -6.7dB/oct line. Beyond 3.10Hz, amplitude of the stapedial reflex decreased rapidly with -26.8dB/oct line.
    Facial paralysis usually accompanied stapedial muscle paralysis. On the way to recovery, the reflex showed the same pattern of frequency response, but its amplitude was less than the normal side.
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  • Blindfolded Vertical Writing Test on Patients with Vestibular Impairment
    Shortening or Elongation of the Writing Axes
    Saburo Takahashi, Kyoko Morisaki, Kazuko Usui, Miyoko Yanagida, Toshim ...
    1983 Volume 76 Issue 10 Pages 2485-2493
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2485
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    The blindfolded vertical writing test using the right hand was conducted on eight patients with definite vestibular impairment. This included three cases of inner-ear impairment due to Streptomycin sulfate, one case of vestibular neuritis and four cases of Ménière's disease.
    The test showed four patients to have abnormal deviations, and five patients with shortening or elongation of the writing axes that was considered to be abnormal when compared to a normal control group. In total, seven of the eight were evaluated to be abnormal.
    Simultaneous to this writing test, the arm-tonus-reaction (ATR) test was given to five patients. For patients with a shortened writing axis, the right upper limb of ATR was located in the upper position, whereas for the elongated writing axis patients, it was located in the lower position.
    The authors therefore studied upper limb deviations in seven healthy male subjects in their twenties:
    With the posture for the ATR as an index, the deviations of the upper limb were observed after rotating each semicircular canal. From this observation it was shown that stimulation of only the lateral semicircular canal produced the deviation specifically to the left or right, and that stimulation of the vertical semicircular canal produced deviation of the upper limb to the upper or lower positions, i. e. raising or lowering of the upper limb was produced.
    From these findings, it was considered that deviation to the left and right during the writing test suggested impairment of the lateral semicircular canal, and that the shortening or elongation of the writing axes showed impairment of the vertical semicircular canal.
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  • A Clinical Study of Recurrent and Metastatic Cases of Maxillary Sinus Cancer
    Tetsuro Honda, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1983 Volume 76 Issue 10 Pages 2495-2500
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2495
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    Of the 33 cases of newly found squamous cell carcinomas in the maxillary sinus, evaluation was made of 16 patients who had recurrence or metastasis.
    1. All the cases in the age group of 40-49 years old had recurrences or metastases.
    2. Eleven of the 16 cases were of poorly differentiated squamous cell carcinoma.
    3. Two patients with T2 had metastasis to the lungs and one to the liver. Metastasis should always be sought even when the original lesion is well controlled.
    4. Recurrence or metastasis develops about 6 months after the primary therapy. One patient, however, had a metastasis to the liver after 3 years and 9 months. This case suggests the necessity for long-term follow-up.
    5. The therapy for recurrence was total resection of the maxillary sinus in 4 of the 5 patients with T4. The prognosis for recurrent cases was poor, and 5 of the 8 patients died.
    6. Of the 5 patients with metastasis to the cervical region, only one patient died.
    7. A therapeutic regimen with emphasis on functional and morphological preservation calls for a close follow-up over a long period.
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  • Decibel: Pitfall in Phoniatric Research
    Nobuhiko Isshiki
    1983 Volume 76 Issue 10 Pages 2501-2503
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2501
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    In connection with the evaluation of vocal efficiency, discussion has developed whether a decibel value of SPL can be divided by the flow rate, or whether such calculation is meaningful or not for the evaluation of vocal efficiency.
    The proposal for such calculation was refuted on the basis of the definition of decibel.
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  • Respiratory Function After Laterofixation of Vocal Fold For Bilateral Recurrent Nerve Paralysis
    Hiroshi Okamura, Eiji Yumoto, Yumi Sasaki, Yomiko Kono
    1983 Volume 76 Issue 10 Pages 2505-2513
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2505
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    Five cases of bilateral recurrent nerve paralysis were surgically treated by laterofixation of the vocal fold, and the respiratory function was investigated pre- and post-operatively. The authors emphasized that the primary aim of laterofixation of the vocal fold for bilateral recurrent nerve paralysis is the restoration of the respiratory function through the natural airway, even if the postoperative phonatory function deteriorated. Based on this point of view, the authors attempted to secure the maximum lateralization of the vocal fold. Although the phonatory function was moderately impaired, it was tolerable for daily use. Because it was observed that the glottis narrowed by the adduction of the contralateral vocal fold during phonation. Especially when the mobility of the contralateral vocal fold remained, the glottal gap during phonation was negligible owing to the compensatory adduction.
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  • A Case of Juvenile Nasopharyngeal Angiofibroma
    Haruhiro Hayashi, Satoshi Hasegawa, Mahito Ito, Junichi Yoshida, Toru ...
    1983 Volume 76 Issue 10 Pages 2515-2519
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2515
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    Juvenile nasopharyngeal angiofibromas, which occur rarely in pubescent males, are treated with surgery, radiotherapy or hormonal therapy.
    A 21-year-old male who complained of nasal obstruction was found to have a large nasopharyngeal tumor at the Osaka University Hospital. This paper deals with the surgical experience with CO2, LASER and cryotherapy on this patient. The effect of CO2 LASER surgery was of no value in decreasing bleeding, whereas cryotherapy was utilized for decreasing the tumor size while controlling bleeding.
    Additionally, this tumor was analyzed for the presence of androgen receptors, but no receptors were identified.
    There has been no evidence of residual or recurrent tumor for 16 months.
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  • Four Cases of Parapharyngeal Mixed Tumors Originating in the Parotid Gland
    Yuko Shiba, Fumihiko Matsuyama, Masaru Horii, Satomi Taniguchi, Gentar ...
    1983 Volume 76 Issue 10 Pages 2521-2527
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2521
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    Tumors of the parapharyngeal space are relatively rare. Parotid gland tumor and neurogenic tumor account for 80per cent of them.
    We have treated four patients with parapharyngeal benign mixed tumors originating in the parotid gland. Two had dumb-bell shaped tumors, and the parotid portions were swollen. These tumors arose in the retromandibular portion of the parotid gland and extended into the parapharyngeal space through the stylomandibular tunnel.
    The other two patients had round tumors, and the parotid portions were not swollen. These tumors arose in the stylomandibular process of the parotid gland or inferior extension of the parotid gland inferior to the stylomandibular ligament. They also extended into the parapharyngeal space.
    In all four patients, there was bulging of the soft palate and tonsillar fossa. The tumors were elastic, hard and movable on bimanual examination.
    Surgical removal of the parapharyngeal mixed tumors should be done by an external approach because of the small risk of hemorrhage and nerve injury as well as the advantage of sufficient exposure. A transparotid approach is appropriate for dumb-bell tumors and a transcervical approach for round tumors.
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  • The Effect of Peroral Glycerol Administration on Inner Ear Fluid Electrolytes
    Naoyuki Kanoh, Kzuo Makimoto
    1983 Volume 76 Issue 10 Pages 2529-2535
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2529
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    Under sodium pentobarbital anesthesia (25-35mg/kg), serum, cerebrospinal fluid (CSF) and inner ear fluids from scala tympani perilymph, scala vestibuli perilymph, and scala media endolymph were collected from normal guinea pigs after the oral administration of glycerol (50%, 12ml/kg). The sodium and potassium concentrations were determined by microflame photometry. Increases in sodium concentration were found in CSF, scala tympani perilymph, scala vestibuli perilymph, and scala media endolymph, while no significant change was observed in serum. These sodium increases were considered to be due to the dehydration caused by glycerol, an osmotic agent. Potassium concentration was increased only in scala tympani perilymph. The action of glycerol is slower and stronger after oral administration than intravenous injection.
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  • Observation of the Ear in a Deaf Dog with Waardenburg's Syndrome
    Yozo Orita, Yoichi Okita, Ryuji Nagano, Chikao Inagaki, Hidekazu Yamam ...
    1983 Volume 76 Issue 10 Pages 2537-2542
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2537
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    The authors used a deaf dog of Waardenburg's syndrome for the study of the ear.
    Under general anesthesia, part of the head was perfused in vivo with 1% paraformaldehyde and 3% glutaraldehyde. After the removed temporal bones (inner ears) were again perfused with 2% osmic acid from the round window to the oval window, specimens of the membranous labyrinths were prepared by means of the surface preparation technique, to be observed under phase-contrast-and scanning electon-microscopes.
    The results were, regardless of the existence of heterochromia iridum, as follows: the hair cells of the organ of Corti had all disappeared; that is, total degeneration of the organ of Corti and remnants of supporting cells, especially pillar cells, were observed on the basilar membrane. The cochlear duct had collapsed and Reissner's membrane was adherent to the upper surface of the tectorial membrane. The stria vascularis was found to have atrophied.
    There was also a noteworthy finding of conspicuous calcification on the upper surface of the tectorial membrane.
    It appears that this hereditary deaf syndrome is characterized by degeneration of the membranous labyrinths with remarkable calcification of the tectorial membrane. The authors considered its pathological mechanism to be related to hereditary mucopolysaccharidosis.
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  • A Study of Macrographism
    Investigation of vertigo of central origin and of normal subjects after drinking alcohol
    Hideki Ohyama
    1983 Volume 76 Issue 10 Pages 2543-2564
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2543
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    Macrographism is one of the abnormal findings manifested in the Square Drawing Test (SDT), and its clinical significance has not yet been investigated efficiently. The purposes of this study are to establish its statistical definition, to clarify its clinical significance and also to speculate on the mechanism of macrographism. For the first step, normographism is defined by means of statistical analysis of SDT data obtained from 130 healthy adult subjects. Macrographism is practically defined as having an increase of 20% or more of the length of every line of number 4 square than that of normographism. Fifty-two macrographic cases with vertigo were selected from 975 patients who were examined otoneurologically from January 1979 to December 1981 at Yamaguchi University Hospital. These 52 macrographic cases could be divided into 3 groups: 37 with vertigo of central origin, 7 of otogenic vertigo and the remaining 8 patients of non-central, non-otogenic vertigo.
    The clinical significance of macrographism is then investigated using the otoneurological data from 37 patients with vertigo of central origin. These vertigo patients are suspected to have diffuse lesions in the brainstem and cerebellum judging from the presence of perverted nystagmus, saccadic eye movement and suppressed optokinetic nystagmus. Sixteen patients with vertigo of central origin had directional preponderance in examinations for spontaneous and provoked nystagmus and they were suspected to have a unilateral lesion in the posterior fossa or cerebral lesion.
    The alcohol drinking test was then performed. Seventeen healthy adult subjects showed macrographism, in which the variation of data paralleled the alcohol concentration in the breath. The cerebral lesion could be regarded as one of the causes of macrographism judging from the presence of directional preponderance and the pharmacological effect of alcohol in the central nervous system.
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  • Vector Statokinesigram
    A New Method of Analysis of Human Body Sway
    Tatsuya Okuzono
    1983 Volume 76 Issue 10 Pages 2565-2580
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2565
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    The vector statokinesigram (abbr. V-Skg.) is a graphic record of the magnitude and direction of the electronic voltage of body sway converted through an A/D converter, which is computed by means of a microcomputer consisting of a specially designed program. This program displays on a CRT 72 radial lines arranged 5 degrees apart. The magnitude of each radial line is then displayed and printed. The computed pattern of V-Skg. reveals favourably the changes and differences in the magnitude and direction of body sway. This new method was used to study the body sway of healthy young dults, healthy elderly subjects and patients with dysequilibrium.
    1) Twenty-nine healthy adults, average age 25.8 years (range 19 to 32) were examined by Skg. and analysed by means of the computer-technique for “V-Skg.”. According to the patterns of Skg. and V-Skg., they were classified into six groups; centripetal type, diffuse type, antero-posterior type, multicentric type, lateral-swaying type and “more stable-with eyes closed” type. The total length of the sway path and vector analyses of 18 directions (20 degrees apart) were summed up to calculate the normal range (mean value with standard deviation), and the occurrence rates of all cases in each group were listed.
    2) Sixty-five healthy aged persons, average age 72.6 years (range 62 to 84) were examined and analysed in the same way. There were several differences in total length of sway path and of parameter in V-Skg. between the young adults and aged persons.
    3) Eight patients with dysequilibrium (of peripheral and of central origin) were examined and compared to the normal groups of each type. There were significant increases in body sway compared to lateral-swaying in V-Skg. of the peripheral origin. There were also marked increases in body sway to antero-posterior in V-Skg. of the central origin.
    4) The clinical data, and results of Skg. and V-Skg. of two representative cases are described in more detail. V-Skg. showed significantly even small changes in directional predominance in body sway on a corresponding radial—direction and magnitude, which could not be demonstrated on an ordinary Skg..
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  • Maximum Phonation Time in High Altitude
    Isao Uno, Hiroaki Takahashi
    1983 Volume 76 Issue 10 Pages 2581-2588
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2581
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    Measurement of the maximum phonation time is a very simple method for evaluating some aspects of phonetic function, and it is generally accepted that the duration depends on glottic, subglottic, and supraglottic conditions. However, as phonation takes place at expiration, which is part of respiration, the maximum phonation time may also depend on PaO2 and PaCO2 in special conditions such as in high altitudes where atomospheric pressure and, in turn, alveolar oxygen pressure are low.
    In order to study this, maximum phonation time, breath holding time, and vital capacity were measured at Mt. Tsurugi in Japan and at Mt. Kolahoi in India in several subjects and compared with those in the normal atomospheric enviroment.
    The maximum phonation time and breath holding time decreased as the altitude became higher, and as the term of stay became longer, while FVC and FEV1.0% did not change remarkably.
    The authors suspected that the mechanism of the phenomenon originated from (1) low PaO2 due to low PAO2, (2) low PaCO2 due to hyperventilation, and (3) alkalosis due to low PaCO2.
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  • Clinical Effect of Chinese Drug Shohseiryu-to to Cases of Nasal Allergy
    Yoshihiro Ohashi, Kensaku Zushi, Koichi Kuroki, Masahiro Fukumaru, Mic ...
    1983 Volume 76 Issue 10 Pages 2589-2596
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2589
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    Nasal allergy, one of the typical conditions of atopic allergy, is known to be more frequent. Treatments for nasal allergy include; 1) specific hyposensitization; 2) a non-specific hyposensitization (modulation); 3) an expectant treatment; and 4) a surgical treatment, etc. Usually these treatments are used singly or in combination with each other. They have their advantages and disadvantages, and they often fail in providing satisfactory clinical effects even when given continuously for years. For vasomotor rhinitis, a disease characterized by the same symptoms as nasal allergy, no evident therapy has been established.
    The authprs have achieved fair clinical effects in treatment of cases of nasal allergy and vasomotor rhinitis with granulated Shohseiryu-to extracts. This paper has been prepared to report the results of the study.
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  • The Efficancy of Seaprose-S (Kyorinase Tablet) on Chronic Paranasal Sinuitis
    Isao Takimoto, Shigeru Inafuku, Hiromichi Ishigami, Takahiko Nomura, K ...
    1983 Volume 76 Issue 10 Pages 2597-2603
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2597
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    In this report the effect of Seaprose-S on chronic paranasal sinuitis has been studied. Fours Kyorinase tablets (each containing 10mg of Seaprose-S) were administered daily at four equal doses to 24 patients older than 15 years with chronic paranasal sinusitis, and the efficacy was evaluated after 2 or 4 weeks of administration.
    The subjective symptoms evaluated were rhinorrhea, postnasal drip, nasal obstruction, head heaviness and sense of smell, and the objective signs evaluated were reddening, edema on the nasal mucosa and amounts and properties of nasal secretion. Radiographic diagnosis was also carried out before and after treatment.
    The global utility rate of Kyorinase based on the clinical efficacy and safety was about 60%. Neither adverse effects nor abnormal laboratory findings with respect to hepatic functions or renal functions were observed in any of the cases.
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  • Effect of Serenal (Oxazolam) on Abnormal Sensation in the Throat
    Mikikazu Yamagiwa, Haruki Fukuo, Yasuo Sakakura, Yasuro Miyoshi
    1983 Volume 76 Issue 10 Pages 2605-2613
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2605
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    Thirty-eight patients with abnormal sensation in the throat were treated with Serenal (Oxazolam) administered orally at doses of 60mg per day for 2 weeks, without concomitant treatment with other drugs. Evaluation of the efficacy of the drug was made by analysing the patients' subjective signs and symptoms. The drug was effective in 70% of the patients in a week, in 70% in 2 weeks and in 54% in 3 weeks (one week after the cessation of the drug). The drug was found to be more effective for neurotic patients classified according to the Cornell Medical Index. Side effects such as slight drowsiness or nausea were observed in 16% of the patients.
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  • Transfer of L-AMPC into the Tissue of the Tonsils and its Clinical Effect
    Koichiro Higashi, Akiyoshi Konno, Takayuki Fujiwara, Osamu Itani, Syui ...
    1983 Volume 76 Issue 10 Pages 2615-2623
    Published: October 01, 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.2615
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    The transfer of L-AMPC, a new, long-acting preparation of amoxicillin, into the tissue of the faucial tonsils was investigated in 11 patients undergoing tonsillectomy.
    The concentrations of the drug after single oral administration of 500mg were 0.22-0.37μg/g at 60-150mins. in 4 of 5 subjects, 0.12-0.24μg/g at 275-345mins. in 3 of 6 subjects.
    L-AMPC was orally administered to 23 patients with upper respiratory tract infection at daily doses of 1000mg (b. i. d.) for 7 days. Clinical response was excellent in 6, good in 13, fair in 3 and poor in 1, and the effective rate was 82.6%. No side effects were observed.
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  • Erratum to : Effects of Isosorbide on Meniere's Disease
    1983 Volume 76 Issue 10 Pages e1
    Published: 1983
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.76.10_e1
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