Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 77, Issue 3
Displaying 1-20 of 20 articles from this issue
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  • Differential Diagnosis of Cerebellopontine Angle Tumors: Acoustic Neurinoma, Meningioma and Epidermoid
    Iue Peing Zahao
    1984 Volume 77 Issue 3 Pages 695-705
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.695
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    In the cerebellopontine angle, there are several different types of brain tumors. Acoustic neurinoma, meningioma and epidermoid are seen most frequently. Clinically, the differential diagnosis of these three brain tumors is very important. In this report, we present diagnostic characteristics of these brain tumors in the cerebellopontine angle. Instead of reporting typical cases, we venture to present atypical examples of each brain tumor, which are usually difficult to differentiate. Neurotological criteria for differential diagnosis of these brain tumors are proposed, in order to clarify the differential diagnostic features.
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  • Operative Technique for Facial Nerve Neurinoma
    Etsuo Yamamoto, Michitaka Iwanaga, Hiroko Nishimura, Morio Yamauchi
    1984 Volume 77 Issue 3 Pages 707-713
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.707
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    Operative techniques used for very small facial nerve neurinomas about 2mm in length located in the horizontal portion were presented. In case 1, the tumor protruded into the tympanic cavity from the eroded bony wall of the fallopian canal at the level of the oval window. The nerve including the tumor was excised, and a 5mm graft taken from the great auricular nerve was transplanted between the cut ends of the normal facial nerve. In case 2, the tumor protruded from the facial canal and was located between the stapedial cruses. The facial nerve was transected at the vertical portion and was lifted. After excision of the superficial tumor, end to end anastomosis was performed between the sectioned ends. Postoperative facial movements were satisfactory in both cases.
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  • Audiologic Tests Results in 43 Patients with Acoustic Tumors
    Satoru Hosokawa, Tetsuzo Inoue, Fumihisa Hiraide, Kazuhiro Hojyo, Yuic ...
    1984 Volume 77 Issue 3 Pages 715-722
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.715
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    Audiologic tests were performed on 43 patients with acoustic tumors and the results were correlated with tumor size. The tumor were classified as small, medium, large and very large. Seven of 11 patients with onset of tumor more than 6 years ago had severe hearing loss of more than 60dB HL (JIS), and twelve of 20 patients with onset less than one year ago had moderate hearing loss of less than 60dB HL. Patients with large tumors had more severe hearing loss. Many of the patients diagnosed early had relatively mild hearing impairment.
    We found more cochlear deafness with samll tumor and a gradient toward retrocochlear finding with increasing tumor size. We performed the auditory brainstem responses (ABR) test on 32 patients with acoustic tumors. There was either a delay or absence of wave V, and no response included any components other wave I. Although the ABR test is a valuable adjuncts, two of these 32 patients (6%) had false-negative ABR findings. They had cochlear deafness with smaller tumors. ABR is extremely helpful, but it dose not replace other neurological diagnostic tools.
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  • Endolymphatic Hydrops-Its Diagnosis and Treatment-
    Setsuko Takemori, Tsuneko Hirota, Hiroshi Matsubara
    1984 Volume 77 Issue 3 Pages 723-728
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.723
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    An intravenous infusion of 500ml of glycerol and normal saline was given over 90 minutes for the diagnosis and treatment of inner ear diseases such as Ménière's disease, sudden deafness, etc. Audiometry was performed before and one hour after the end of infusion. If the average hearing at 250, 500 and 1, 000Hz improved by more than 5dB, the glycerol infusion was considerd to be effective. Caloric nystagmus was evoked by 20ml of cold water for 20sec and recorded by electronystagmography with the eyes open in the dark. The mean values of the maximum slow phase velocity of caloric nystagmus before and after the infusion were compared.
    The hearing in 60 cases of Ménière's diseases showed improvement in 37% of the cases. In 21 cases of sudden deafness, the hearing improved in 52%. In all 8 cases of sudden deafness at the lower frequency (250, 500 and 1, 000Hz) the hearing improved. In 16 cases of sensorineural hearing loss, the hearing improved in 44%. The slow phase velocity of caloric nystagmus showed no improvement after the glycerol infusion.
    Thus, the intravenous infusion of 500ml of glycerol and normal saline can be used in the diagnosis and treatment of endolymphatic hydrops.
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  • Neurotological Studies of Hemodialysis Patients
    Minoru Toriyama, Noriyuki Ueno, Ken Kitamura, Keizou Koide
    1984 Volume 77 Issue 3 Pages 729-736
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.729
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    Hearing and vestibular tests were performed in 41 hemodialysis patients. 1) In 54 of the 82 ears, hearing loss was noted, and 30 patients complained of vertigo or dizziness. 2) Of ears with disturbed hearing, 40 were in patients with vertigo or dizziness. Thus 66% of the ears of those vertigo or dizziness had some hearing loss. 3) There were various types of vertigo and dizziness, but in most of these patients the RBC was under 2, 000, 000. 4) Vestibular function examinations showed abnormal, positional and positioning nystagmus in four patients, and two patients had paresis of the cannal. 5) After hemodialysis, transient central balance disturbances were demonstrated in two patients by eyetracking and optokinetic pattern tests.
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  • Clinical and Epidemiological Studies of Nasal Allergy
    Takuo Nobori, Masaru Ohyama, Kenji Katsuta, Ikuo Ohno, Makoto Yamamoto ...
    1984 Volume 77 Issue 3 Pages 737-747
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.737
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    Otolaryngological screening examinations were performed on about 20, 000 school children for 13 consecutive years since 1970 in northern Kagoshima Prefecture (Sueyoshi-cho), a non-air-polluted area.
    During the past 7 years these results were compared with those of Usuki-primary-school children in Kagoshima city and in Okierabu Island. A higher incidence of nasal allergy was found in Sueyoshi-cho than in Kagoshima City or Okierabu Island.
    The rhinoscopic findings of the subjects examined in this study revealed a gradual rise in the incidence of nasal allergy during the past 7 years.
    Of all the allergens tested, house dust was the substance most often suspected of causing nasal allergy in both Sueyoshi-cho and Kagoshima City.
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  • Nasal Neurinoma with Intracranial Extension. A Case Report
    Eiichi Tanaka, Fumihisa Hiraide, Tetsuzo Inoue, Masamichi Sawada, Sato ...
    1984 Volume 77 Issue 3 Pages 749-755
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.749
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    Neurinoma originating in the nasal cavity and paranasal sinuses is rare. We had a patient with a neurinoma arising from the ethmoid sinus and extending into the anterior cranial fossa. A 45-year-old woman was admitted to the Department of Otolaryngology of the National Defense Medical College with the chief complaint of right nasal obstruction. Anterior rhinoscopy showed a necrotic mass filling the anterior part of the nasal cavity. Biopsy from the surface of the mass revealed histological features suggestive of neurinoma. Under general anesthesia, Denker's operation was performed to extirpate the neoplasm. However, the tumor extended into the anterior cranial fossa and could not be removed because it was firmly adherent to the dura. The remainder of the neoplasm was removed completely through a frontal cranial approach and a lateral rhinotomy approach. The histological section of the tumor showed a typical neurinoma, demonstrating Antoni A and B types of cell pattern.
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  • Treatment of Carcinoma of the Tongue and the Floor of the Mouth
    Takaaki Noguchi, Keiko Kado, Toshishige Kido, Yoshihiko Okinaka, Atsuo ...
    1984 Volume 77 Issue 3 Pages 757-764
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.757
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    During the years 1978 through 1982, 22 previously untreated patients with carcinoma of the tongue and the floor of the mouth were treated at the Department of Otorhinolaryngology, Yamaguchi University.
    1. For treating the patients who have T1 or T2 lesions without cervical lymph node metastasis, radiotherapy with or without intracavitary irradiation is indicated. Surgical therapy after preoperative irradiation is indicated for treating patients who have cervical lymph node metastasis.
    2. For treating patients with T3 or T4 lesions, surgical therapy is indicated.
    3. Surgical therapy includes hemiglossectomy at the minimum, upper marginal mandibulectomy and radical neck dissection. The safety margin around cancer extripation is 1.5cm at the minimum, but in patients with invasion of the lateral wall of the oropharynx the safety margin should be more than 1.5cm. In males the oral defect is reconstructed by a PM M-C flap, while in females reconstruction by an LD M-C flap is better. In radical neck dissection, removal of the lymph nodes under the posterior belly of the digastric muscle is important.
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  • Five Cases of Lateral Neck Tumor Which Were Difficult to Diagnose
    Takeo Kusumoto, Koichi Ushiro, Tokichiro Mitoma, Iwao Honjo, Tomoshige ...
    1984 Volume 77 Issue 3 Pages 765-771
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.765
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    Among the 239 patients who came to our clinic with lateral neck tumors during the past 4 years, the pre-operative diagnosis was difficult in 17 cases. Five representative cases are described whithreference to their clinical courses: malignant lymphoma of the neck, cervical lymphadenitis, metastatic tumor of the neck and neurinoma. Recent advances such as CT scan and RI scintigraphy have made it easier to each diagnosis. However, neck tumors which are difficult to diagnose despite a number of examinations, should be operated on so that appropriate can be started early.
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  • Extramedullary Plasmacytoma of a Submandibular Lymphnode
    Tetsuo Kozawa, Yoshinori Chikamori, Hiroshi Okamura, Takaaki Ohmori
    1984 Volume 77 Issue 3 Pages 773-778
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.773
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    A case of extramedullary plasmacytoma originating in a submandibular lymphnode is reported togther with a review of the literatuer on this rare disease.
    A 56 year-old male complained of a painless and gradually growing mass in the left submandibular region.
    For both diagnostic and therapeutic purposes, the tumor was surgically removed and examined histologically. The tumor was completely encapsulated, and the histological study showed an extramedullary plasmacytoma with amyloid deposits in the stroma. The PAP technique revealed that the tumor cells produced kappa light chain and partially Ig-G.
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  • Aural Manifestations in Two Cases of Leukemia
    Naobumi Nonomura, Kinya Ohtake
    1984 Volume 77 Issue 3 Pages 779-784
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.779
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    Cace 1: An 11-month-old boy was admitted to Yamagata Central Hospital because of right acute otitis media which was resistant to antibiotics. The blood examination revealed acute myelogenous leukemia. During treatment, right facial palsy appeared. The middle ear abnormality responded to anticancer drugs and antibiotics.
    Case 2: A 13-year old boy with acute lymphocytic leukemia was treated with anticancer drugs and developed pancytopenia, followed by left acute otits media and sudden right sided deafness suspected to be due to inner ear hemorrhage, then epistaxis, petechiae, and stomatitis. Administration of platelets, blood and antibiotics cured the otitis media, and hearing was markedly improved bilaterally.
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  • Development of Inner Ear Fluid Electrolytes in Guinea Pigs
    Naoyuki Kanoh, Yehoash Raphael, Masaki Ohmura, Tatuya Fukazawa, Yoshin ...
    1984 Volume 77 Issue 3 Pages 785-791
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.785
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    Under sodium pentobarbital anesthesia (25-35mg/kg, I. P.), cochlear endolymph, scala tympani perilymph and scala vestibuli perilymph were collected from guinea pig fetuses (33 ears) neonates (23 ears) and mature animals (42 ears). Sodium and potassium concentrations were assessed using microflame photometry.
    1. Na and K levels in the cochlear endolymph were already established by the 49th day of gestation, earlier than in any other mammals except human beings.
    2. The potassium concentration in the scala tympani perilymph in the fetus was high and almost the same as that in the scala vestibuli perilymph. However, this level decreased after birth, and the potassium level in the scala tympani fell to its characteristic concentration.
    3. The Na levels in both perilymphs and the K level in the cochlear endolymph in the fetuses and neonates was lower than in mature animals. Thus, the osmotic concentration in the neonate seemed to be lower than in mature animals.
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  • Effects of Maximum Power Output of Hearing Aids on the Intelligibility of Speech
    Eiko Hirota, Kazuoki Kodera
    1984 Volume 77 Issue 3 Pages 793-801
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.793
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    The effects of changes of maximum power output (MPO) levels of hearing aids on speech discrimination scores were studied in 10 patients with moderate and 10 with moderately severe sensorineural hearing loss. Speech discrimination tests at six intensity levels were performed with four kinds of MPO.
    (1) The lowest MPO level in which reduction of intelligibility was not found was 110dB SPL in patients with moderately severe hearing loss and 100dB SPL in patients with moderate hearing loss. (2) The intelligibility of affricate, fricative and voiceless consonants and semivowels was reduced more than that of other consonants, mainly because of the low level of the MPO setting.
    In order to protect ears from daily noise, it is recommended that MPO levels be set as low as possible within the limits of preserving good intelligibility.
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  • Optokinetic Nystagmus and Vestibular Stimulation in Human Subjects
    Masaru Shirato, Osamu Yanai, Tokuji Unno
    1984 Volume 77 Issue 3 Pages 803-807
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.803
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    In order to study the correlation between the vestibular and oculomotor systems, ten normal healthy adults were tested by the application of an optokinetic stimulus together with a rotatory stimulus. When the direction of the vestibular stimulus matched that of the visual stimulus, the rotatory stimulus with a constant angular acceleration (1°/sec2) clearly increased the optokinetic adaptation limit.
    The labyrinth is stimulated and reacts in promoting optokinetic nystagmus. In other words, the labyrinth supports the optokinetic nystagmus by making a subject catch optokinetic stimuli separately.
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  • Scanning Electron Microscopy of the Process of Regeneration of Coagulated Nasal Mucosa
    Koji Hozawa, Tomonori Takasaka, Kazutomo Kawamoto
    1984 Volume 77 Issue 3 Pages 809-816
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.809
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    Animal experiments were performed to evaluate the clinical efficacy of three hemostatic instruments.: the infrared contact coagulator (I. C. C.), the YAG laser and the conventional electrocoagulator.
    Under general anesthesia with i. v. Nembutal, the maxillary antrums of rabbits were exposed surgically and the hemostatic instrument was applied to the antral wall to coagulate the mucous membrane. After coagulation, the mucous membranes were removed immediately and 3, 6, 9, and 14 days post-operatively. The specimens were fixed in 2.5% glutaraldehyde in 0.1M phosphate buffer, post-osmificated, and observed under a scanning electron microscope (H-450).
    The specimens coagulated with the three instrument did not differ significantly. Irradiation with the I. C. C. for 1.0-1.5 seconds thoroughly coagulated even the deep tissue of the lamina propria, leaving sharp margins between the irradiated zone and the non-irradiated pseudostratified ciliated epithelium.
    Regeneration of the epithelial cells in the irradiated zone started within 3 post-operative days by basal cell transformation towards the non-epithelial portion. On the 6th postoperative day, the irradiated area was completely covered by cuboidal cells, and some non-ciliated cells with short microvilli were visible in the marginal zone. The ciliated cells were still sparse at 6 days, but they gradually increased in number thereafter. On the 10th postoperative day, the irradiated portion was completely covered with almost normal pseudostratified ciliated epithelium.
    These results show that the I. C. C. is a useful hemostatic instrument in cases of anterior nasal hemorrhage.
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  • Acid Mucopolysaccharide and Glycoprotein in the Vocal Fold
    Alterations with Aging
    Koichi Matsuo, Shun Watanabe, Minoru Hirano, Masayuki Kamimura, Yukio ...
    1984 Volume 77 Issue 3 Pages 817-822
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.817
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    Acid mucopolysaccharide (AMPS) and glycoprotein consist of long chain, protein-bound polymers of high viscosity. The purpose of this study was to determine whether AMPS and glycoprotein were present in the mucosa of the vocal fold, and if so, to identify the kind of AMPS and to investigate the relationship of AMPS and glycoprotein to age.
    Vocal folds were obtained at autopsy from 27 cadavers aged 4-83 years, 19 males and eight females. The total amount of AMPS in the vocal fold was measured by the Dishe method. The identification of AMPS was done by cellulose acetate stripelectrophoresis and digestion by specific enzyme. Glycoprotein in the vocal fold was determined by the sialic acid TBA method.
    1) The AMPS in the vocal fold was hyaluronic acid in all cases.
    2) AMPS decreased with age (γ=-0.50), rapidly until 30 years of age and then more gradually.
    3) Glycoprotein also decreased with age (γ=-0.56), significantly until the age of 20 and then gradually.
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  • Clinical Effectiveness of Tranilast (N-5') in Nasal Allergy in Children
    Ken Mukai, Kanetaka Murai, Takashi Kawai
    1984 Volume 77 Issue 3 Pages 823-831
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.823
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    N-5', an oral antiallergy drug, was administered to 20 children with nasal allergy of the perennial type in a dose of 5mg/kg/day for 4 weeks.
    1. Objective improvement was noted in 75.0% and subjective relief in 80.0% of the patients. In 15 patients who responded to the drug relief was noted within 2 weeks in 70% and within 3 weeks in all the 15 cases.
    2. Improvement was noted in 55 to 75% of the patients in subjective symptoms and appearance of the nasal mucosa. Sneezing, nasal discharge and nasal obstruction were improved in more than 60%.
    3. Seven out of 11 patients with moderate symptoms were improved to mild or better and all 4 patients with severe symptoms were improved to moderate or better.
    However, no patients with mild symptoms became asymptomatic.
    It is concluded that 10% fine granules of N-5' can be taken well by young children and that the drug is useful in the treatment of nasal allergy of the perennial type.
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  • Evaluation of SAP (Seaprose S) in the Treatment of Sinusitis (1st. Report)
    A Double Blind Trial Comparing SAP with Placebo
    Shunkichi Baba, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
    1984 Volume 77 Issue 3 Pages 833-851
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.833
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    The efficacy of SAP was compared in a double blind study with that of a placebo in patients with chronic sinusitis. The daily dose of SAP was 45mg (3 tablets) and the duration of treatment was 4 weeks. The total number of patients evaluated was 125 in the SAP group and 130 in the placebo group.
    The results were as follows:
    1. The SAP group had a significantly better in global utility rating than the placebo group.
    2. The global improvement rating of the SAP group was significantly better than that of placebo group.
    3. The SAP group showed greater improvement than the placebo group in respect to postnasal drip and to the decrease in viscosity of nasal secretion.
    4. X-rays of the sinuses showed definitely improvement of the right maxillary sinus in the SAP group.
    5. Side-effects were noted in 5.6% of SAP group and in 4.6% of the placebo group, not a significant difference.
    The results of this study suggest that SAP is a useful drug in the treatment of chronic sinusitis.
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  • Histology of Nasal Mucosa after Prolonged Use of Beclomethasone Dipropionate Aerosol
    Tomoyuki Hoshino
    1984 Volume 77 Issue 3 Pages 853-858
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.853
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    The nasal mucosa of a 25-year-old male patient with perennial nasal allergy treated with beclomethasone dipropionate aerosol for a long period was examined by scanning electron microscopy and light microscopy. The biopsy specimen taken from the right inferior concha after the use of the aerosol for 1 year and 10 months and that taken from the left concha after use for 2 years and 3 months showed no abnormal changes except slight thickening of the basement membrane.
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  • Erratum to : Effect of Combined Use of Mefenamic Acid with Oxazolam on Abnormal Sensation in the Throat
    1984 Volume 77 Issue 3 Pages e1
    Published: 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.3_e1
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