Practica Oto-Rhino-Laryngologica

Relationship Between Auditory Brainstem Response Abnormalities and Pure Tone Audiogram

Toshiaki Yagi, Shunkichi Baba

1984 Volume 77 Issue 2 Pages 381-387
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.381

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Pure tone audiograms of 26 patients (37 ears) with ABR (auditory brainstem response) abnormalities were analyzed. The ABR abnormalities were partial wave disappearance (wave I, wave I-III, and wave I-IV responses) and marked prolongation of the interwave latency, wave I to V. The pure tone threshold of 12 patients (14 ears) with only wave I response was of various degrees, from normal to scale out. However, most of the patients had moderate to severe hearing loss, so the mean hearing level was 52.5dB. Only four patients showed wave I-III responses, and their mean pure tone threshold was 26.8dB. Nine patients (10 ears) showed wave I-IV responses, and their pure tone threshold was almost normal. The mean value was 14.8dB. Marked prolongation of interwave latency was observed in eight patients (9 ears), and the pure tone threshold in these was relatively high, 41.7dB, especially in those who showed prolongation of interwave latency between wave I and III. The threshold of pure tone audiometry in these patients was 64dB.
Thus, pstients who have peripheral (mainly cochlear nerve) lesions of the auditory pathway show abnormalities in both ABR and pure tone audiometry. On the other hand, patients who have central (brainstem) lesions of the auditory pathway exhibit abnormal ABR, but normal or near normal hearing threshold.

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Nystagmus Alternans-A case report

Mamoru Suzuki, Midoriko Ishida, Ototaka Kaki, Yasuo Harada

1984 Volume 77 Issue 2 Pages 389-394
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.389

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A case of nystagmus alternans is reported. The patient is a 14 year-old girl who has been complaining of unsteady gait for the past 10 years. Neurotological examination revealed active spontaneous nystagmus of which direction alternated every 70 to 100 seconds. Optokinetic nystagmus was markedly inhibited, but caloric response was present bilaterally. Neurological examination showed unsteadiness of the body, adiadochokinesis and hypermetria of the upper extremities, all of which indicate cerebellar ataxia. A lesion in the cerebellum or its neighboring structures was presumably responsible for the nystagmus alternans in this case.

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An Autopsy Case of Malignant Histiocytoma in the Ethmoid Sinus

Akihiro Higuchi, Hiroomi Takahashi, Takaharu Shimizu, Noriko Miyamoto

1984 Volume 77 Issue 2 Pages 395-400
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.395

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The patient, a 41-old female, had a maxillary-ethmoid sinectomy and intranasal ethmoidectomy about three years earlier in our hospital. She returned complaining of right cheeck pain and swelling. Right maxillary sinectomy was performed to remove a postoperative maxillary cyst.
The histopathological diagnosis was malignant histiocytoma in the ethmoid sinus. Radiation therapy and chemotherapy were given, but the patient died after three months.
Autopsy showedd metastases in the larynx, trachea, main bronchus, breast, heart, and uterus, but none in the reticulo-endothelial system, i. e. lymph nodes, bone marrow, liver or spleen.
Because the metastase of this tumor were different from the usual pattern, we think this is a very rare case.

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Malignant Fibrous Histiocytoma of the Maxillary Sinus

Yasushi Naito, Kazuo Makimoto, Akira Tamada, Mayuki Goto, Hideyuki Hai ...

1984 Volume 77 Issue 2 Pages 401-407
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.401

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A case of malignant fibrous histiocytoma (MFH) of the maxillary sinus is reported. An 85-year-old man was referred to our OPD clinic because of pain and swelling in the left maxillary region. Radiological investigation showed a tumor of the left maxillary sinus invading the surrounding tissue with bone destruction. Following partial maxillectomy, the patient received radiotherapy, chemotherapy and several additional surgical operations (including Laser surgery). However, local lesions recurred repeatedly. The patient died from general emaciation at his home.
The maxillary sinus is an uncommon site for MFH. We reviewed 24 such cases previously reported. In the treatment of MFH of the maxillary sinus, we cannot hope for much from radiotherapy or chemotherapy. Wide surgical excision is recommended as the primary therapy.

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Evaluation of Voice and Phonation after Conley's Glottic Reconstruction

Tomoyuki Haji, Tatsuro Tsujita, Masahiro Tanabe, Iwao Honjo

1984 Volume 77 Issue 2 Pages 409-415
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.409

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Conley's glottic reconstruction was used in five patients with unilateral and one patient with bilateral glottic laryngeal cancer, and voice and phonation were examined after surgery.
The voice of patients operated on unilaterally were very hoarse soon after surgery, but the voice became less hoarse about three weeks after surgery as edema of the reconstructed golttis decreased. Phonation was satisfactory, also.
On the other hand, in a patient operated on bilaterally, extreme hoarseness continued for a long time, but the voice improved about six months after surgery as the surface of the reconstructed glottis became soft. Phonation became nearly normal, too.
The cause of hoarseness after Conley's glottic reconstruction and its advantages over other treatments such as irradiation are discussed.

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Treatment of Tracheal Stenosis Caused by Tracheostomy and Endotracheal Intubation

Kunio Yanohara, Fumihiko Sato, Makoto Hyuga, Ikuo Hisa, Yuichi Suzuki, ...

1984 Volume 77 Issue 2 Pages 417-421
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.417

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Five cases of tracheal stenosis caused by tracheostomy and endotracheal intubation are described. The authors always prepare silicone tubes and cut them appropriately to fit the tracheal stenosis. It is easier and more effective to treat the various parts of the tracheal stenosis separately. The period of intubation was from 3 months to 4.5 years. The tube must be carefully removed after hospitalization.

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Bilateral Multiple Basal Cell Adenomas of the Parotid Gland

Yuichi Kurono, Tatsuya Fujiyoshi, Toyoharu Umehara, Shoichi Maeda, Gor ...

1984 Volume 77 Issue 2 Pages 423-428
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.423

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Bilateral multiple basal cell adenomas of the parotid gland were found in a 77-year-old woman. The patient was referred with a 6 year history of painless and slowly growing masses in both parotid areas. Bilateral removal of the parotid masses was perfomed. Surgery revealed the presence of four isolated masses; one in each of the superficial and deep lobes on the right side, and two in the left superficial lobe. Histologic examination showed tubular type basal cell adenoma. Bilateral parotid gland tumors have rarely been reported. They are chiefly Warthin's tumors. The incidence of basal cell adenoma of the parotid gland is about 2%, but a review of the literature indicates that bilateral or multiple occurrence of this type of adenoma is extremely rare.

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Nerve Endings of the Outer Hair Cells in the Organ of Corti

Examined by Scanning Electron Microscope

Dominggus Mangape

1984 Volume 77 Issue 2 Pages 429-439
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.429

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With the use of double sided adhesive tape in the microdissection, the space of Nuel in all turns of the cochlea can be exposed and observed by scanning electron microscope. The nerve endings in the basal turn were exposed entirely in the endolymphatic space, whereas in the upper turns almost all nerve endings were covered by the Deiters cell bulge. A gradual decrease in the number and size of nerve endings from the lower basal turn toward the apical turn was observed. In the basal turn, there were about 6-12 nerve endings on the surface of the lower pole of the outer hair cell. The size of the majority of these nerve endings was between 1 and 3.5 micrometers. In the apical turn, about 4-6 nerve endings with diameters of 0.5 to 2 micrometers were seen around the tip of the lower pole of the outer hair cell. The shape of the nerve endings also changed from spindle shaped in the basal turn to gradually rounded in the upper turns. In addition to the well known nerve endings on the lower pole of the outer hair cells, nerve endings located high on the outer hair cells were also observed. These high nerve endings varied in size and were located at various distances from the lower pole of the outer hair cell.
In guinea pigs treated with high doses of streptornycin or kanamycin, there was no pathological change of the nerve endings 24 hours after ten consecutive days of treatment or after the completion of injections given every other day. Although the nerve endings seemed to be more resistant to these ototoxic drugs, the outer hair cells consistently showed shrinkage, especially at the basal location where an ototoxic effect on the hair cell cilia was also observed. It appears that shrinkage of the outer hair cells may be an early sign of an ototoxic effect on the organ of corti.

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A New Measurement of Fundamental Frequency of Speech Sounds

Ken Okamoto, Akio Yoshida, Hiroshi Takyu, Jinro Inoue

1984 Volume 77 Issue 2 Pages 441-449
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.441

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The fundamental frequency of speech sounds is usually measured acoustically with a piano. A new method has been developed using an FFT narrow band frequency analyser and microcomputer which can measure them more precisely.
The result of analysis was showed by pitch name through convert into temperament. The authors purpose that the mode regards as fundamental frequency of speech sounds and 90% range of the frequency distribution regards as range of speech. Because these parameters could be shown as a pattern, the characteristics of the speaking voice could also be demonstrated.

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Objective Evaluation of Normal and Hoarse Voices

Nobuaki Hiraoka, Yasuhiro Kitazoe, Hisashi Ueta, Shinzo Tanaka, Masahi ...

1984 Volume 77 Issue 2 Pages 451-456
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.451

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Both normal and hoarse voices were analyzed by the harmonic intensity P_H of the voice spectrum obtained from a stable portion of the sustained vowel /a/. The quantity P_H was defined as a percent ratio of the harmonic intensities (not including the fundamental frequency) to the total voice intensities. The fundamental and its harmonic frequencies were determined automatically with the aid of Fourier analysis. Normal voices have values of P_H greater than 67% at a 5% significance level. Using this criterion, 27 of 30 hoarse voices were positive, i. e. a detection rate of 90%.

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Clinical Evaluation of IAP (Immunosuppressive Acidic Protein) in the Serum of Patients with Malignant Tumor of the Head and Neck

Noriko Kane, Mitsuo Mukudai, Yoshihiro Dake, Daisuke Iwahashi, Hiromu ...

1984 Volume 77 Issue 2 Pages 457-463
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.457

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Immunosuppressive Acidic Protein (IAP) in the serum of 58 patients with malignant tumor and 13 normal individuals was quantitatively determined by single radial immunodiffusion. The IAP values in 46 epidermoid carcinomas and 12 malignant lymphomas ranged from 697.4+350.8μg/ml to 829.0+372.0μg/ml, significantly higher than those of normal individuals (389.2+93.1μg/ml). The upper limit of normal is usually considered to be 500μg/ml. The IAP value rises as the clinical stage of the tumor advances.
Actually, the highest value of IAP in stage IV patients was 888.2μg/ml, and 81.8% of the patients had IAP values above 500μg/ml. An additional experiment showed that natural killer activity of lymphocytes from the patients with malignant tumors correlated well the IAP levels.
It is concluded that IAP values not only reflect the immune state of tumor patients, but also are very useful in clinical diagnosis.

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Total IgE in Nasal Secretions of Patients with Allergic Rhinitis

Fumio Iwao, Akira Kikuchi, Isao Kato, Yoshio Koike

1984 Volume 77 Issue 2 Pages 465-469
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.465

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Total immunoglobulin E (IgE) in the serum and nasal secretion was determined by the Paper disk radioimmunosorbent test (PRIST) in 26 patients with allergic rhintitis. In samples of nasal secretion collected without provocation, the mean value of IgE was 128±207IU/ml. The average value of the serum IgE was appoximately four times as high, but there was no significant correlation between serum and nasal secretion IgE. The amount of IgE in nasal secretion was larger than we had expected. If enough nasal secretion can be collected, RAST can be used to determine antigen more accurately.

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Experimental and Clinical Studies of the Effect of Cefmenoxime (CMX) Otic Solution on Purulent Otitis Media

Makoto Hashimoto, Kenji Katsuta, Takuo Nobori, Makoto Yamamoto, Kozo F ...

1984 Volume 77 Issue 2 Pages 471-482
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.471

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A study was made of the efficacy and safety of a new cephalosporin antibiotic, Cefmenoxime (CMX) Otic Solution for purulent otitis media.
1. Clinically, the topical administration of 0.5% CMX into the tympanic cavity was effective in 70.0% of the patients, bacteria were eradicated in 80.0% and the usefulness rate was 70.0%, while, 1.0% CMX was effective in 85.7%, bacteria were eradicated in 92.9% and the usefulness rate was 92.9%. The results were therefore satisfactory.
2. CMX had quite a broad spectrum: very effective against gram-positive bacteria, and also effective in complex infections due mainly to gram-negative bacteria and anaerobic bacteria which are usually resistant to other medications.
3. CMX solution was instilled into the tympanic cavity of guinea-pigs, and electrocochleographic and ultramicro morphological changes were evaluated. It was confirmed that CMX produced no cochlear toxicity in contrast to Gentamicin.
4. The results of those experimental and clinical studies indicate that. CMX Otic Solution may be a very effective and safe topical agent.

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The New Determinative Method of Antigen which Induced Allergic Rhinitis in Patients

Yoshio Nishizawa

1984 Volume 77 Issue 2 Pages 483-494
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.483

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This report describes a new method of determining allergens by the degranulation of basophils (metachromatic cells) in nasal smears stimulated with anti-IgE or a specific antigen. This is similar to the method described by Mishima for selecting food allergens. The new method is useful in choosing therapeutic and preventive drugs in the management of allergic rhinitis.
(1) Degranulation occurs when metachromatic cells are stimulated by a-IgE, but not by a-IgA, a-IgD, a-IgG, a-IgM, a κ, or a λ.
It appears only when IgE antibodies in receptors on metachromatic cells are bridged with anti-IgE.
(2) The specific antigen extracted from allergen by Yagura's method and compound 48/80 also induce degranulation of metachromatic cells in nasal smears. The optimal concentration of the specific antigen (protein concentration in the allergen extract) is 25μg/ml, and that of compound 48/80 is 0.05μg/ml.
(3) When metachromatic cells from healthy subjects are stimulated with anti-IgE, 5.2±3.1% of the cells show degranulation. However, when such cells from patients with allergic rhinitis are stimulated with anti-IgE, 84.3±9.6% of cells show degranulation.
(4) Disodium cromoglycate (DSCG) inhibits the specific antigen, and compound 48/80 induces degranulation in metachromatic cells from patients with allergic rhinitis.
(5) DSCG inhibits the degranulation of metachromatic cells when added to metachromatic cells before antigen-stimulation.

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Effect of Combined Use of Mefenamic Acid with Oxazolam on Abnormal Sensation in the Throat

Mikikazu Yamagiwa, Haruki Fukuo, Keizo Fukukita, Yasuo Sakakura, Yasur ...

1984 Volume 77 Issue 2 Pages 495-501
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.495

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Fifty male and 50 female patients with abnormal sensation in the throat were treated with mefenamic acid (Pontal) and oxazolam (Serenal) for 2 weeks. The efficacy of the combination therapy was evaluated by analysing the patients' subjective symptoms. Symptoms were relieved in 68% of the patients in one week, 74% in 2 weeks and 61% in 3 weeks (one week after the cessation of the therapy). Side effects were observed in 14 patients, most of whom reported drowsiness. Without newer preparations, those side effects were eliminated.

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[title in Japanese]

1984 Volume 77 Issue 2 Pages 503-550
Published: 1984
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.77.503

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