Practica Oto-Rhino-Laryngologica

A Clinical Observation of Middle Ear Surgery

Mikio Yagizawa, Tadao Nishimura, Akihiko Takasu, Masao Naitoh, Hitoki ...

1983 Volume 76 Issue 3special Pages 985-990
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_985

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In the past five years from January 1976 to December 1980 a total of 82 patients received middle ear surgery in our clinic. Of the 82, 46 had cholesteatomas (57%) and 34 had chronic suppurative otitis media (41%). Cancer of the middle ear was found in only 2 (2%).
The results are summarized as follows.
1) The number of patients with middle ear surgery was about 0.5% of the total number of patients.
2) There were 49 males and 33 females (3:2) and the majority of the patients were in the 2nd, 3rd and 4th decades of life.
3) Operations with the open method were performed on 53 (69%) and with the closed method on 24 cases (31%).

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A Bacteriological Study of Acute Purulent Otitis Media in Children

Masao Naito, Akio Suzuki, Takao Kuwauchi, Hitoki Matsunaga, Shigeki Mo ...

1983 Volume 76 Issue 3special Pages 991-997
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_991

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A bacteriological study was carried out on middle ear discharge in 157 cases of fresh acute purulent otitis media in children. The middle ear discharge was collected with sterile cotton swabs after paracentesis and cultured in chocolate agar medium, sheep blood agar medium and DHL medium.
The results were as follows.
1) The most frequent organism found independently was Haemophilus influenzae (32% of 119 strains) and next in frequency was Streptococcus pneumoniae (29%) followed by Staphylococcus epidermidis (16%) and Staphylococcus aureus (8%). Streptococcus pyogenes was found in 3%.
2) The number of mixed isolates were 38 and Staphylococcus epidermidis was found in 74% of these cases.
3) Haemophilus influenzae and Streptococcus pneumoniae were a very important causative pathogen of acute purulent otitis media.
Ampicillin (ABPC) is the antibiotic of choice.

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Statistical Observation of Perceptive Deafness in the Past 10 Years in Our Clinic

Toshio Kuno, Tadao Nishimura, Shigenobu Iwata

1983 Volume 76 Issue 3special Pages 998-1002
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_998

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Statistical observation was conducted on perceptive deafness in 3743 patients in the past ten years at the Department of Otolaryngology of Fujita Gakuen University Hospital. The sex ratio was in favor of males. (2290 males, 1453 females.). The peak age was in the fifties, and there was wide distribution around it. The type of hearing loss, most frequently found was the perceptive deafness which showed a decending type toward high pitch sounds. In terms of pathogenesis 40.8% was of unknown origin and 31.3% was account of old age.

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Clinical Observation of Thirty-seven Patients with Malignancies in the Nasal Cavity and the Paranasal Sinus

Kensei Naito, Tadao Nishimura, Mikio Yagisawa, Hitoshi Toda, Teiji Oka ...

1983 Volume 76 Issue 3special Pages 1003-1011
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1003

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Thirty-seven patients with malignancies in the nasal cavity and the paranasal sinus were investigated retrospectively at our institution during the period from 1973 to 1982. Our series were discussed clinically.
Twenty-five patients were males and twelve females, males being predominant. Their ages ranged from 33 to 85 years. The tumors were located preferentially in the maxillary antrum (89.2%). Squamous cell carcinoma (33 cases), malignant melanoma (2 cases), adenoid cystic carcinoma (1 case), mucoepidermoid carcinoma (1 case), fibrosarcoma (1 case) and malignant hemangiopericytoma (1 case) were observed pathologically. The chief complaints were swelling of the cheek, nasal obstruction, epistaxis and neuralgia in the face. The major group of the maxillary antrum malignancy series classified by the TNM classification according to the JJC (Japanese Joint Committee) were mostly progressive cases, with 75.7% in Stage III and 21.2% in Stage IV.
The prognosis of all the patients was as follows.
Crude survival rate was 54.1%, three-year survival rate 38.9% and five-year survival rate 37.5%. In older and progressive cases, the prognosis tended to be poor.
Local invasion of the malignant neoplasm into the brain was one of the main causes of treatment failure in our series.

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Ten Cases of Inverted Papilloma in the Nasal and Paranasal Cavities

Hitoshi Toda, Tadao Nishimura, Akihiko Takasu, Masao Naitoh, Yukimoto ...

1983 Volume 76 Issue 3special Pages 1012-1022
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1012

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Inverted papilloma in the nasal and paranasal cavities is a rare disease and is also very difficult to distinguish from other nasal tumors. Generally speaking it seems to be characterized by multiple recurrences and tends to become malignant.
Clinical and pathological studies of inverted papilloma growing in the nasal cavity and paranasal sinuses were performed in 10 patients treated in the last 6 years in our clinic.
The results were as follows.
They consisted of 8 males and 2 females, and the mean age was 50.2 years ranging from 32 to 79. The chief complaint was mainly nasal obstruction caused by the papillomatous mass. Inverted papillomas in 3 patients were pathologically associated with a slight degree of mitosis, an irregular from of nuclei and also hyperkeratosis. For treatment, patients performed radical operation and 3 had additional irradiation of 40Gy. Recurrence of this disease has been recognized in 2 cases up to the present.

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Measurement of Nasal Resistance Using the Forced Oscillation Method

Yukimoto Horibe, Shigenobu Iwata, Tadao Nishimura, Masao Naito, Teiji ...

1983 Volume 76 Issue 3special Pages 1023-1030
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1023

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Nasal resistance of forty normal subjects were studied in terms of respiratory resistance using the forced oscillation method during nose breathing at quiet breathing.
In nose breathing, two different nasal attachments were used in this test, one is a nasal mask, the other a nasal adaptor which we devised for this test.
The equipment was used Nihon Koden's oscillation unit S8295 and the oscillation frequencies were 3, 5, 7 and 9Hz.
The flow and pressure curves were recorded on the recording papers on the visigraph.
The resultant vector of impedance includes not only resistance and compliance but also inertance of respiratory on flow. We called these values nasal impedance instead of nasal resistance. This impedance vector which have amount and angle was changed by frequency and characteristics of the attachments. Results in normal subjects were as follows.
1) 3Hz, 4.01; 5Hz, 2.78; 7Hz, 3.24 and 9Hz, 2.49cmH₂O/L/sec. using the mask
2) 3Hz, 3.65; 5Hz, 3.32; 7Hz, 2.88 and 9Hz, 2.87cmH₂O/L/sec. using the nasal adaptor.
There were wide variations of nasal impedance between the subjects, but the changes were smaller when using the nasal adaptor than using the nasal mask.

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Bacterial Examination of Chronic Sinusitis

Masashi Yaida, Masao Naitoh, Shigenobu Iwata, Tadao Nishimura, Yasuo N ...

1983 Volume 76 Issue 3special Pages 1031-1038
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1031

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Aerobic and anaerobic bacterial examination in chronic sinusitis was performed using the specimens from maxillary sinuses collected during operation using sterilized syringes and “Kenki-porter” (porter for culture of anaerobic bacteria), and also extracted maxillary membranes were examined pathologically. Two hundreds and twenty-one strains of bacteria were obtained.
The results were as follows:
1) The rate of incidence of bacteria from the maxillary sinuses was 73%. Aerobic bacteria occupied 90% and anaerobic bacteria 10% of all the cultured bacteria.
2) The most frequently found was Staphylococcus epidermidis (19%), followed by α-Streptococcus (16%), Haemophilus influenzae (13%), and Staphylococcus aureus (7%) in patients with chronic sinusitis.
3) Streptococcus pneumoniae in chronic cases was less frequent than those in acute cases. Indigenous bacteria was frequently found in chronic conditions were highly founded rather than in acute conditions.
4) Pathologically, bacteria was found more frequently in the infiltrated type of mucous membrane, than that in other pathological types of mucosa.

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Clinical Evaluation of Nasal Allergy on the Basis of Questionnaries Issued to the Patients

Keizoh Koyama, Yoshio Senoh, Masao Naitoh, Kensei Naitoh, Hitoshi Toda ...

1983 Volume 76 Issue 3special Pages 1039-1049
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1039

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Nine hundred and sixty-eight patients with allergic rhinitis were clinically analyzed in our clinic from 1977 to 1981.
In this period, the number of patients with allergic rhinitis increased year and year, but the ratio of this disease did not always increase in relation to number of outpatients. This ratio was calculated to be 4.5% by allergic rhinitis dividendly.
According to our data, the onset of allergic complaints in male subjects were mainly found to be 10 years old or younger, while in females they began at slightly older ages. The distribution of this disease was such that more than 60% of allergic outpatients visited our clinic from the vicinity of our hospital located in the country, others coming from cities.
In non-seasonal rhinitis, the onset of allergic symptoms was at younger ages in male subjects in comparison with seasonal rhinitis, while in seasonal rhinitis, the onset of allergic symptoms was at ages (20-30 years) in females.
About 47% of those patients had been associated with other allergic diseases and half of those patients also had a family history of allergy.

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A Case of Hemangiopericytoma in the Maxillary Sinus

Katsuaki Nagai, Akihiko Takasu, Kensei Naito, Kazuo Sakurai, Keizo Koy ...

1983 Volume 76 Issue 3special Pages 1050-1057
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1050

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In nasal and paranasal malignant tumors, non-epithelial tumors are frequently observed rather than squamous cell carcinoma.
Recently, we treated a rare case of hemangiopericytoma originating in the left maxillary sinus.
As reported the clinical findings are described and statistical analysis of this disease in the literature is also made.
The patient was a 62-year-old male who complained of epistaxis. At first, his nasal cavities showed no pathologic tumors, and X-ray examination revealed no particular changes in his paranasal sinuses.
Four months afterwards, he felt swelling and pain in the region of his left cheek without visible disturbance, and X-ray films showed a diffusely clouded shadow in his left maxillary sinus.
Several biopsies were performed from the sinus tumor, and the first pathological report indicated no malignancy, but his clinical signs strongly suggested a malignant tumor. Therefore, chemotherapy was administered and the diagnosis of hemangiopericytoma originating from the paranasal sinus was pathologically made during treatment.
Six months afterwards, he died of rapid recurrence and secondary general metastasis in spite of surgery, radiation and chemotherapy. We analysed the clinical pathological findings in 8 patients with hemangiopericytoma in the nasal and paranasal cavities in Japan.

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Spontaneous Expulsion of a Machine Gun Bullet from the Sphenoid Sinus after 40 Years

Hisashi Kuroyanagi, Mikio Yagizawa, Yasuo Nakanishi, Takao Kuwauchi, T ...

1983 Volume 76 Issue 3special Pages 1058-1062
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1058

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A 62-years-old male patient had complained of otorrhea and hearing loss in his right ear without any other symptoms. He was shot in the left cheek by a machine gun at the age of 22 during World War II. At that time, his army surgeon suggested that the foreign body went into the sphenoid sinus through the maxillary cavity, but treatment was aimed at the trismus only. Thereafter, he had not had any trouble in his life. Twenty-three after this accident, otorrhea, hearing loss, and disturbance of vision on the right side developed. In 1965, he under went an operation at a national hospital to remove the bullet, but extraction was not successful. Since then, he did not wish to have another surgical operation at any other hospital. He had been treated for otitis media chronica sinistra only. On May 28, 1981, while sleeping he spit out the bullet which was enclosed in granulation. The literature was searched for reports of other foreign bodies in the sinuses were in literature and they are summarized in this paper. This case is interesting in that a foreign body in the sphenoid sinus remained as body as almost 40 years, and was spontaneously expelled through the mouth.

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Three Cases of Cysts in the Posterior Paranasal Sirius with Visual Disturbance

Hidetsugu Kojima, Akihiko Takasu, Hisashi Kuroyanagi, Teiji Okada, Tad ...

1983 Volume 76 Issue 3special Pages 1063-1070
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1063

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Three cases of cysts in the posterior paranasal sinus that caused disturbance of the eyes were reported.
The first case was a man, aged 54, complaining of right visual disturbance and continuous frontal headache.
The patient recovered completely from headache but not from the disturbance of visual acuity and visual field after the operation.
The second case, a man, aged 35, complained of severe headache and right visual disturbance. The patient recovered in 5 weeks by the established drainage of the sphenoidal sinus.
The third case was a man, aged 37, complaining of a severe throbbing headache, left-sided ptosis and the disturbance of left-ocular movement caused by oculomotor paresis. This case had no significant past history such as trauma or sinus operation. Two weeks after the appearance of double vision, ethomoidectomy and sphenoidectomy were performed. Headache disappeared the next day, and oculomotor paresis on the left side was well alleviated 16 days later.

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Measurement of Lymphocyte Subpopulations in the Human Tonsils and Peripheral Blood

By the Mixed Rosette Assay with SRBC and Immunobeads

Teiji Okada, Tadao Nishimura, Yukimoto Horibe, Masamichi Kondoh, Hisak ...

1983 Volume 76 Issue 3special Pages 1071-1080
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1071

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Lymphocyte subpopulations in the palatine tonsil, pharyngeal tonsil and peripheral blood were investigated using the mixed rosette assay with SRBC and immunobeads. Part of T-cells are counted as B cells under the conventional separate assay performed by using E or EAC rosette. However, the above method precludes such erroneous counting, and four subpopulations of lymphocytes were microscopically observed on the same field. This study showed that unlike the previous findings, tonsillar lymphocytes were not B-cell-rich. Furthermore, it was suggested that the percentages of tonsillar lymphocyte subpopulations depended greatly upon the patient's age (children or adults), or the size and condition of the tonsils. The tonsillar lymphocyte subpopulation seemed to be T-cell-rich in adult patients who had the submerged tonsils and had no recent history of tonsillitis. Similar experiments could not be conducted with children because of the absence of evidently submerged tonsils in most cases. Tonsillar lymphocytes were T-cell-rich in some patients who also had adenoids. However, this study could not clarify the type of adenoid in which the tonsillar lymphocyte population was T-cell-rich.

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Effect for Other Organ by Adeno-Tonsillectomy

Yasuo Nakanishi, Tadao Nishimura, Mikio Yagisawa, Sato Ino, Katsuyuki ...

1983 Volume 76 Issue 3special Pages 1081-1086
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1081

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Tonsillectomy is one of the most effective treatments for habitual tonsillitis and is one of most popular operations performed by otolaryngologists. However, in recent years, many paper appeared on tonsillar immunological function. There have been discussions focused especially on indications for surgical removal of tonsils or adenoids in children.
Four hundred and one patients tonsillectomized at this hospital in the last 8 years were followed up by the questionnaire method.
Some children who suffered from chronic sinusitis or conductive hearing impairment prior to operation were analyzed.
The subjects of investigation were 12 cases of conductive hearing impairment and 24 cases of chronic sinusitis.
The results were as follows:
1) The rate of improvement of serous otitis media was 83.3% (10 cases), which is quite satisfactory.
2) The operation in 24 patients of chronic sinusitis was extremely effective in patient, effective in four unchanged in fifteen and worse in four.
3) There was no relationship between the change in X-ray and that in subjective symptoms.
4) Subjective symptoms of patients with chronic sinusitis were alleviated in 50% after adenotonsillectomy.

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Infantile Nephritis and Tonsillectomy

Sato Ino, Tadao Nishimura, Yasuo Nakanishi, Hitoki Matsunaga, Katsuyuk ...

1983 Volume 76 Issue 3special Pages 1087-1096
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1087

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In this paper, the role of tonsillectomy and the tonsillar provocation test for infantile nephritis was described.
Thirty-seven infantile nephritis patients who consulted our outpatient clinic of otolaryngology were studied.
The tonsillar provocation test was performed in 29 patients, but the test was positive in only three with changes on urinary findings. These three patients received tonsillectomy, which was effective in one and ineffective in the others.
In all the patients whose nephritis was aggravated after tonsillitis or fever, tonsillectomy was effective. Tonsillectomy was also effective in patients who clearly had acute tonsillitis before the onset of nephritis.
In many cases, the ASO level went down after tonsillectomy, and in no case was the ASO level elevated over the normal level after tonsillectomy.
In the post-infectious group, the patients whose ASO and/or ASK level were high at the onset of nephritis had a high tendency to heal.

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Reconstructive Surgery Following Partial Laryngectomy

Shigenobu Iwata, Tadao Nishimura, Teruo Takasu, Mikio Yagizawa, Masao ...

1983 Volume 76 Issue 3special Pages 1097-1104
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1097

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Twenty-one patients with glottal cancer (T₁-T₃) were operated on by a new method of laryngeal reconstruction following vertical partial laryngectomy.
In order to make pseudo vocal cords, we used the pedicled thyrohyoid, sternohyoid, and occasionally sternoclide muscles depending on degree of defect after the removal of tumor. These muscles were cut at the level of the hyoid bone. Then, they become lower-type pedicled muscle flaps.
These muscle flaps were connected by suture to make the thyrohyoid muscle replace the outer surface of the muscle bundle. The end of these pedicle muscles joined to the arytenoid cartilage bended through the anterior corner of thyroid cartilage. The fixation of these muscles to the cricothyroid membrane was performed to avoid the displacement of the reconstructed pseudoglottis against the normal vocal level. And these muscle flaps were covered by advancement of hypopharyngeal mucosa.
No patients had recurrence locally or generally, and they had no complaints on respiration or deglutition, although their voices were limited to phonate loudly.

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A Retrospective Clinical Evaluation of 126 Patients with Laryngeal Carcinoma

Akio Suzuki, Shigenobu Iwata, Tadao Nishimura, Akihiko Takasu, Mikio Y ...

1983 Volume 76 Issue 3special Pages 1105-1115
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1105

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One hundred and twenty-six patients with laryngeal carcinomas were clinically analyzed who visited our clinic from September 1973 to August 1982 of there 118 were followed retrospectively.
The results in this study were as follows;
1) The three- and five-year survival rates were 77% and 71%, respectively.
2) There were 95 cases of the glottic type, 25 of the supraglottic, and 6 cases of the subglottic.
3) According to the classification of stage, there were 65 patients in stage I or II. Thirtysix of them have been well controlled by radiotherapy only without 2 patients. Eighteen patients were treated with reconstruction after partial laryngectomy and postoperative irradiation. The other 11 were treated with total laryngectomy. The crude survival rates for each of them were calculated to be 89%, 100% and 82%, respectively. In 53 patients at stages III and IV, 17 were treated with total laryngectomy and preand post-operative irradiation. The crude survival rate for them was 94%.
4) In 36 patients who received radiation and are classified to be T1 and T2, 2 had recurrence, but 17 treated with reconstruction after partial laryngectomy maintained comfortable conditions for speech and respiration without tumor recurrence. Mainly discussed how to choose the best way of treatment for glottic T1 and T2, i. e. weather to select initial radiation or reconstruction after partial laryngectomy.
5) Our data showed that neck dissection might be necessary for good results even when there is no evidence of neck metastasis.

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Twenty-three Cases of Laryngeal Papillomas

Shigeki Mori, Akihiko Takasu, Takao Kuwauchi, Akio Suzuki, Hisashi Kur ...

1983 Volume 76 Issue 3special Pages 1116-1126
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1116

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Twenty-three patients with laryngeal papillomas and papillomatosis were examined and the clinical and pathological findings in the last nine years at our clinic are presented.
There were 18 males and 5 females; 5 were juvenile and the others were adults. The multiple type of laryngeal papillomas was found in four young and one adult patients.
Pathologically, the epithelia in six cases showed remarkable hyperkeratosis with papillomatous invasion into the basal membrane, suggestive of malignancy. Two of them were harboring occult cancer according to detailed re-examination.
After several years, papillomas in the larynx were altered to cancer in the other patients.
Electron microscopy performed in some patients did not reveal virus particles in the nucleus of epithelial cells in this disease.

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Laryngeal Tuberculosis

Takao Kuwauchi, Shigenobu Iwata, Tadao Nishimura, Mikio Yagizawa, Masa ...

1983 Volume 76 Issue 3special Pages 1127-1132
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1127

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A statistical study was performed of 26 cases of laryngeal tuberculosis. Six were treated in our clinic. The other 20 cases were collected from the Japanese literature from 1972 to 1981. The results were as follows:
1) Patients affected tended to be older, ranging from 39 to 67 years, with the mean age being 52.6.
2) Such slight subjective complaints were recognized as hoarseness, sore throat, and pain on swallowing.
3) There were remarkable granulomatous lesions in the larynx rather than lesions of inflammation. The incidence of this granulomatous lesion was about 60%.
4) To diagnose laryngeal tuberculosis, information from chest X-ray, sputum examination, and personal and family histories are as useful as laryngeal biopsy.

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Treatment of Tracheal Stenosis Following Tracheostomy Using Silicone T-Tube

Masato Miwa, Tadao Nishimura, Akihiko Takasu, Masao Naitoh, Masashi Ya ...

1983 Volume 76 Issue 3special Pages 1133-1138
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1133

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A case of tracheal stenosis following tracheostomy is presented. A 5-year-old-girl underwent decannulation after tracheostomy. A silicone T-tube was effective for the decannulation. The duration of the silicone T-tube insertion was 6 months. During this period the patient was able to breathe through the nose. She was allowed to stay at home after postoperative observation. Since the time the T-tube was removed, there has been no problem with phonation and respiration.
The insertion of a silicone T-tube is one of the most effective treatments for decannulation in children.

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A Histological and Clinical Study of CO₂ Laser Surgery in Otolaryngology

Tadao Nishimura, Shigenobu Iwata, Akihiko Takasu, Mikio Yagizawa, Masa ...

1983 Volume 76 Issue 3special Pages 1139-1148
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1139

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Since 1981, a histological and clinical study of CO₂ laser surgery has been performed in the Department of Otolaryngology at Fujita-Gakuen University School of Medicine.
The results are as follows.
I. Histological study
(1) A histological study was performed light and electron microscopically after the irradiation of CO₂ laser beams on the human tongue.
(2) A crater-shaped tissue loss caused by rapid vaporization of the water component of the tissue was produced by the stationary irradiation of CO₂ laser beams.
(3) Intracellular destruction was marked in the tissue receiving irradiation of CO₂ laser beams while the circumference of the tissue which had been irradiated was almost free from the influence of irradiation.
II. Clinical study
(1) CO₂ laser surgery was performed on 26 cases composed of head and neck malignancies, benign tumors and the laryngeal web.
(2) CO₂ laser surgery was not only extremely useful for papillomas of the larynx and lip and hemangiomas of the tongue and larynx, but also for the laryngeal web.
(3) It seemed that CO₂ laser surgery should be carefully selected for malignant tumors.
(4) The influence of irradiation of CO₂ laser beams on tissues was local and bleeding was generally negligible.
(5) Postoperative pain from CO₂ laser surgery was generally slight and wound healing was relatively rapid.

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Computed Tomographic Diagnosis of Parotid Gland Tumor

Hitoki Matsunaga, Tadao Nishimura, Akihiko Takasu, Mikio Yagizawa, Aki ...

1983 Volume 76 Issue 3special Pages 1149-1159
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1149

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Investigation with CT has been performed on 20 cases of parotid gland tumors. The intravenous contrast enhancement method was performed in all cases. Six cases were examined by CT and simultaneous sialography.
The results were as follows:
1) If and when the margin of the tumor was indistinct and irregular, malignancy was suspected. However, it was difficult to diagnose malignancy by CT examination only.
2) CT for parotid gland tumor was effective in identifying invasion of tumor into the parapharyngeal space and intracranial space.
3) CT with simultaneous sialography was very effective in locating the parotid gland tumor.
4) CT of axial sections for parotid gland tumor was more reliable if coronaly sections are taken together.
5) CT of malignant and benign tumors were diffusely enhanced by the intravenous contrast enhancement method. However, this was not an indispensable method.

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Study of Congenital Cervical Cysts Encountered in the Past 9 Years

Katsuyuki Murashima, Mikio Yagizawa, Keizoh Koyama, Akihiko Takasu, Ta ...

1983 Volume 76 Issue 3special Pages 1160-1166
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1160

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Fifteen cases of congenital cervical cysts were surgically treated in the last 9 years in our clinic. We analyzed them clinically and pathologically and also studied the literature on this disease.
Our series, includes 6 cases of thyroglossal cysts, 5 of lateral cysts and 4 of dermoid cysts. They consisted of 4 males and 11 females. Their ages ranged from 1 to 31 years, and 8 of 15 were under the age of 10. Although the range of the period between the onset of the first complaint and the seeking of medical service was from several days to 31 years, 11 patients received treatment within a year in our hospital. They complained of painless soft neck tumors in 12 cases, 2 of painful ones, and one of dyspnea with a lateral neck tumor. In lateral cysts, 4 of all the cases were located on the right side of the neck. According to Bailey's classification, 4 were type-I group, and one was type-III. Half of the dermoid cysts were found in the subglossal region and others in the submental region. In thyroglossal cysts, 3 existed in the subhyoid region and others in the anterior hyoid region. As a rule, we perform the Sistrunk method on patients whose cysts or fistulas obviously are adherent to the hyoid bone. Three of our patients under went reoperation due to recurrence.

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A Clinical Study of 65 Patients with Thyroid Tumors

Kazuo Sakurai, Shigenobu Iwata, Tadao Nishimura, Akihiko Takasu, Kense ...

1983 Volume 76 Issue 3special Pages 1167-1173
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1167

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Sixty-five patients with thyroid tumors received surgical treatment in our clinic in the 9 years from 1973 to 1982. There were 8 males and 57 females.
1) On histopathological examination, there were 28 cases of cancer (papillary carcinoma 19, follicular carcinoma 5, anaplastic carcinoma 3, and Medullary carcinoma 1), 24 adenoma, 7 adenomatous goiter, and 6 chronic thyroiditis.
2) We usually examine thyroid tumor using plain X-ray, CT-Scanning with enhancement, radio isotope (^99mTcO₄^-, ²⁰¹TlCl) and others before operation. From these examinations, we obtained useful information from the figures compared with ^99mTcO₄^- and ²⁰¹TlCl findings.
3) Calcifications in the thyroid were observed in 13% of the benign tumors and 57% of the malignant tumors on X-ray films in our series.
4) Eleven thyroid cancers (41%) invaded in to the neighboring tissue and 9 of them infiltrated into the laryngeal-tracheal region.

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Two Patients with Eosinophilic Granuloma of the Soft Tissue

Kensei Naitoh, Toshio Senoh, Kazuo Sakurai, Keizo Koyama, Masashi Yaid ...

1983 Volume 76 Issue 3special Pages 1174-1181
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1174

JOURNAL FREE ACCESS

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We investigated two patients with eosinophilic granuloma of the soft tissue clinically and pathologically.
Case No. 1, an 11-year-old boy, visited us in 1981 with a subcutaneous nodule on the right lower jaw. An egg-sized and elastic hard nodule was palpable on the right angle of his lower jaw. X-ray of the jaw and sialography for the right submandibular gland were normal. Serum IgE was elevated (7200IU/ml) and there was 39% eosinophilia while WBC was 6900 per cu.mm. He was diagnosed pathologically to have eosinophilic granuloma of the soft tissue. The nodule at the right lower jaw was resolved and disappeared after he received steroid hormone and specific hyposensitization with house dust.
Case No. 2. a 46-year-old man, had a nodule in his right cheek region since 1978. He had been treated with X-ray and steroid hormone at another infirmary for eosinophilic granuloma of the soft tissue but the lesion had not disappeared completely. When he was given DSCG nasal spray for his nasal allergy at our infirmary, the nodule on his right cheek region gradually decreased and tended to become soft. Atopic allergy seems to be related with the disease in our series, although further substantiation is required.

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Clinical Statistical Review of 37 Cases of Non-Hodgkin's Lymphoma

Akihiko Takasu, Shigenobu Iwata, Tadao Nishimura, Masao Naitoh, Akio S ...

1983 Volume 76 Issue 3special Pages 1182-1188
Published: 1983
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.76.3special_1182

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Thirty-seven patients with non-Hodgkin's lymphoma were treated in the Departments of Otolaryngology and Hematology at Fujita Gakuen University in the past nine years. In this report, they were reviewed using Rappaport's histological classification and the Ann Arbor Hodgkin's disease staging classification, and statistically analyzed according to age, sex, stage and prognosis.
The results of treatment were not as dramatic in patients with unfavorable histology lymphomas such as diffuse histiocytic lymphoma. With reference to stage 2 non-Hodgkin's lymphoma in the head and neck, the median survival was short duration in contradistinction to other stage with approximately 17.2 months following radiotherapy with adjuvant chemotherapy. Therefore, although radiotherapy will continually have a role in the management of patients in stage 1 and 2, the authors considered that more intensive chemotherapy should de adapted, and as a major problem in the management of non-Hodgkin's lymphoma in the head and neck, emphasized that the range of stage 2 was too broad to establish a definite prognosis.

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