Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 77, Issue 6
Displaying 1-18 of 18 articles from this issue
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  • Early Diagnosis of Small Acoustic Tumors
    Satoru Hosokawa, Tetsuzo Inouye, Fumihisa Hiraide, Hiroshi Sohma, Haru ...
    1984 Volume 77 Issue 6 Pages 1267-1276
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1267
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    This paper is reported about the otoneurological findings and the neuroradiological results containing air or metrizamide CT cisternograpy in the six patients with acoustic tumors less than 1.5cm in size located within the internal auditory canal (intracanal type) or projecting into the cerebellopontine cisterna (cisternal type).
    1. The six patients had asymmetric neurosensory type hearing impairment and more recruitment phenomena than signs of retrocochlear lesions on the basis of false negative results in this research. Therefore, the ABR test should be used only a screening test.
    2. The three patients were tested by electronystagmography and their response to the bilateral caloric test was normal.
    3. Petrous tomograms revealed an enlargement of the internal auditory canal in only three of these patients. Conventional CT scans gave false negative results in five patients. A new radiological technique, air or metrizamide CT cisternography, revealed small acoustic tumors in all six patients. These were confirmed at surgery.
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  • Cirsoid Angioma of the Left Auricle; a Case Report
    Kazunori Okamoto, Hiroshi Okamura, Michiaki Hiramoto
    1984 Volume 77 Issue 6 Pages 1277-1282
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1277
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    A cirsoid angioma of the left auricle was removed by surgical. The patient was a 35-year-old man who complained pulsating tinnitus in the left ear. Physical examination showed a soft, hot, pulsating mass in the left auricle. Selective external carotid angiography revealed that the posterior auricular artery with venous drainage was tortuid and enlarged. Ligation of the feeding artery and partial removal of the angioma were successfully performed. The importance of angiography for diagnosis and choice of treatment is emphasized.
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  • Temporal Bone Histopathology Following Hemodialysis and Renal Transplantation
    Ken Kitamura, Minoru Toriyama
    1984 Volume 77 Issue 6 Pages 1283-1289
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1283
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    At autopsy the inner ear of a patient who had received periodic hemodialysis and a cadaver kidney transplantation showed severe edematous changes in both the stria vascularis and the dark cell areas of all semicircular canals. Reissner's membrane was slightly collapsed. The organ of Corti as well as all maculae and cristae showed normal populations of hair cells. This histopathological appearance was similar to the ototoxic effect of loop diuretics. The zonulae occludentes between the marginal cells of the stria vascularis show signs of increased permeability following the administration of loop diuretics. Significant changes in osmolarity have also been shown to modify the permeability of the zonulae occludentes. During hemodialysis an osmotic gradient may occur in the inner ear as well as in the brain, and this osmotic gradient in the inner ear due to hemodialysis may increase the permeability of the zonulae occludentes producing extracellular edema in the stria vascularis and dark cell areas.
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  • Reconstruction of Bony Meatus with Alumina Ceramics (Bioceram®)
    Preliminary Report
    Taizo Takeda, Haruo Saito, Chikashi Mizukami, Kaoru Uchida
    1984 Volume 77 Issue 6 Pages 1291-1297
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1291
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    Open techniques of middle ear surgery can eradicate lesions more completely than closed techniques, but debris accumulation in the widely excavated mastoid bowl is a disadvantage.
    An alternative method to the closed techniques is reconstruction of the posterior canal wall with various materials.
    Better functional results have usually been obtained by immediate reconstruction of the posterior canal wall.
    Alumina ceramics (Bioceram®) was used to reconstruct the posterior canal wall after open tympanoplasty in 10 cases. The results were satisfactory both functionally and otoscopically.
    The technique is especially effective in cases in which there is extensive pathology in the epitympanum and in the aditus ad antrum.
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  • A Clinical Study of Psychogenic Hearing Loss
    Yasuo Mizuta, Wataru Ohshima, Toshiyuki Ono, Katsuhisa Kamitani, Keigo ...
    1984 Volume 77 Issue 6 Pages 1299-1313
    Published: June 01, 1984
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1299
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    Psychogenic problems are gradually increasing in many medical fields along with recent rises in complexities of society and home life. We think that psychogenic hearing loss also is not exceptional. Therefore, we analyzed 16 patients with psychogenic hearing loss seen during the past ten years in the Department of Otolaryngology of Kyoto Prefectural University of Medicine.
    1) The patients were 7 to 15 years of age, 10 females and 6 males. Recently, however, the number of male patients has been gradually increasing.
    2) The frequent audiographic finding was “horizontal type” (16 ears), followed by “deaf type” (6 ears), “gradually decreasing high tone type” (4 ears), and “saucer type.’ (4 ears). In 80% hearing loss was bilateral.
    3) We recognized the usefulness of auditory brainstem responses (ABR) and the stapedius reflex in diagnosing this type of hearing loss.
    4) Nine patients were conscious of their hearing loss, and in 6 patients it was found during school examination.
    5) In 9 patients there were family or school problems to account for psychogenic hearing loss, but in 7 patients (1 male and 6 females), no such environmental factors were recognized.
    6) The prognosis was usually good, regardless of the course whether or not the patient was conscious of the hearing loss.
    7) It is emphasized that otolaryngologists have sufficient knowledge to diagnose and treat psychogenic hearing loss.
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  • An Overview of the Optokinetic after Nystagmus (OKAN) Examination
    Rinya Sugita, Shozo Kawamura, Katsusaburo Aoki, Toshiko Abe, Isao Wata ...
    1984 Volume 77 Issue 6 Pages 1315-1322
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1315
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    The optokinetic after nystagmus (OKAN) examination is sensitive in detecting any imbalances in the vestibular system. OKAN examination is routinely perfomed on patients complaining of vertigo and dizziness at Juntendo University Hospital.
    The author noted a few problems in judging the directional preponderancy (DP) of the OKAN examination. In determining DP, several factors should be taken into account: maintainencc time of the first phase after nystamgus, frequency of nystagmus, second and third phase after nystagmus, and eye-speed in the slow phase of nystagmus. Many types of DP have been reported. Except for one case, DP and spontaneous nystagmus exhibited the same direction.
    While the OKAN examination is generally performed and considered very usual when spontaneous nystagmus is not present, it can also be used in cases where there is spontaneous nystagmus.
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  • Clinical Observations of Elderly Patients with Vertigo and/or Dizziness 1st Report
    With Special Reference to Statistical Observations
    Hajime Nakagawa, Kanemasa Mizukoshi, Yukio Watanabe, Naoki Ohashi, Hid ...
    1984 Volume 77 Issue 6 Pages 1323-1329
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1323
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    Among the 736 patients seen in the Neurootological Clinic of the Toyama Medical & Pharmaceutical University Hospital during 1981-1982, 152 (20.7%) were over 60 years of age with vertigo, dizziness and/or dysequilibrium. The clinical characteristics of this group of elderly patients were analyzed statistically.
    1) The incidence of vertigo due to central nervous system lesions, especially cerebro-vascular disorders, increased with age, while that of peripheral vestibular lesions, such as Meniere's disease, sudden deafness or BPPV, decreased with age. The ratio of central to peripheral vestibular lesions was 2:1 in this group of elderly patients.
    2) In the elderly patients with cerebro-vascular disorders, the Schellong test was often positive, indicating autonomic dysfunction of blood flow autoregulation.
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  • Three Cases of Nasopharyngeal Angiofibroma
    Manabu Nakahara, Toru Suzuki, Hiroomi Takahashi, Tetsuya Shitara
    1984 Volume 77 Issue 6 Pages 1331-1338
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1331
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    Nasopharyngeal angiofibroma occur most frequently in young males and are clinically regarded as malignant tumors because of their vigorous by expanding growth, their to bleed tendency and their high rate of recurrence.
    In this paper, we report 3 cases of nasopharyngeal angiofibroma treated during the past 11 years in Kitasato University Hospital.
    One patient had a postoperative recurrence at a site different from that of the original tumor. Such a case has rately been reported.
    In this case, we removed the tumor by a transoral approach.
    It is concluded that for medium-sized tumors with only slight adhesions this transoral approach is effective.
    To control bleeding after the resection, the wound was covered with a piece of fastia lata.
    Since this method is relatively simple and satisfactory, it can be recommended.
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  • A Case of Primary Tuberculosis of the Tonsil
    Kozo Furukawa, Hiroomi Takahashi, Tetsuya Shitara, Akihiro Ikegami, Ka ...
    1984 Volume 77 Issue 6 Pages 1339-1344
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1339
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    A 27-year-old woman developed a sore throat on April 27, 1980.
    This became progressively worse and she sought medical attention. She was seen by a physician who diagnosed acute tonsillitis. She was referred to the Departments of Otolaryngology, Kitasato University Hospital on May 25, 1980. Physical examination revealed a healthy young woman in no distress except for swelling of both tonsils. Submaxillary lymph nodes 2x2 cm were palpable bilaterally. Microscopic study of the biopsied specimen revealed tuberculosis of the tonsil.
    The local pathological findings disappeared within a month after the start of treatment against Tbc.
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  • Analysis of Carcinoma of the Tonsils
    Akira Tamada, Kazuo Makimoto, Hiroshi Iwasaki, Hideaki Tsuruhara, Shun ...
    1984 Volume 77 Issue 6 Pages 1345-1352
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1345
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    Tonsillar carcinoma has been very rare in the past in Japan, although it is very common in western countries. Its incidence has, however, increased recently even in Japan. We compared its rate of incidence from 1971 to 1976 with that from 1977 to 1982 in Kyoto University Hospital and found an 18 fold increase. It still accounts for only 15% of Head and Neck cancers in Japan. The total number of patients with Head and Neck cancer were almost the same in these 2 periods. Of all the cases of tonsillar carcinoma 85% were squamous cell carcinoma; malignant lymphoma was the next in frequency. Keratinizing and nonkeratinizing squamous cell carcinoma were reported in equal numbers. Stage IV was most common, followed by stage III. The average age of the patients was 57.7 years, and the male to female ratio was 2 to 1. About 94% of the lesions were in the tonsillar fossa, and most of the rest in the retromolar trigone.
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  • Immunosuppressive Acid Protein Values in Patients with Malignant Tumors of the Head and Neck
    Hirotaka Ito, Nobuhito Muto, Yasuo Suzuki, Masaru Tsuzuki
    1984 Volume 77 Issue 6 Pages 1353-1357
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1353
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    The authors determined immunosupperssive acid-protein (IAP) in 49 patients with epithelial malignant tumors of the head and neck. The mean value in 14 hospitalized patients now under treatment was 659.29μg/ml, whereas that in outpatients under observation was 510.57μg/ml. The former value was significantly above normal. Otherwise, the mean value in patients with pustulosis palmaris et plantaris was 573.85μg/ml, and that in those with infantile infections was 1050μg/ml.
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  • Metastatic Tumor of the Neck as the First Sign of Cancer
    Shizuo Komune, Tamotsu Morimitsu
    1984 Volume 77 Issue 6 Pages 1359-1365
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1359
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    A survey was conducted of 102 patients whose only clinical sign was a tumor of the neck on their first visit to our institution. In 17 of them, the diagnosis proved to be metastatic carcinoma of the neck; in 5 of them the primary site could not be determined. Histological examinations of the metastatic lymphnodes revealed squamous cell carcinoma (52%), adenocarcinoma (19%), transitional cell carcinoma (19%) and carcinoma symplex (10%). The average survival time was 11.5 months in the 5 patients whose primary sites were unknown, and all died within 2 years after their first vistit. Of the 12 patients with metastatic cervical tumors whose primary lesions were discovered, 6 died, and 6 are still alive. The average survival time of the 6 who died was 33.3
    months. Patients with multiple metastatic tumors in the lower cervical or supraclavicular region have a poorer prognosis than do those with a single metastatic tumor in the upper cervical region.
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  • Auditory Responses of Neonates to Intra-uterine Sound, with Special Reference to its Use in Screening for Hearing Impairment
    Yutaka Kato, Sayoko Tanaka, Toshihide Tabata
    1984 Volume 77 Issue 6 Pages 1367-1373
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1367
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    The subjects were 152 infants aged 2 hours to 31 days who were exposed to intrauterine sound of 1/3 octave band with frequencies of 400Hz to 4000Hz when they were fussy. Most of them were soothed at a mean level of 90dB (SPL).
    The hearing of 69 of the 152 infants was evaluated by the auditory brain stem evoked response. The infants who responded to intra-uterine sound were also capable of auditory brain stem evoked response. In the present experiment, hearing impairment was discovered in two babies at a very early age.
    It was confirmed that intra-uterine sound could be used to screen infants for severe hearing impairment.
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  • Comparison of the X-ray Mucous Membrane Function Test and Quantitative Surface Ultrastructure in Chronic Sinusitis
    Hiroshi Ito, Yuichi Majima, Yasuo Sakakura, Yasuro Miyoshi
    1984 Volume 77 Issue 6 Pages 1375-1380
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1375
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    Quantitative scanning electron microscopy was used to examine the maxillary sinus mucosa of 18 patients (20 specimens) with chronic maxillary sinusitis, and the results were compared with those of the X-ray mucous membrane function test (X-MFT). In the scanning electron microscopic study, the epithelial surfaces occupied by cilia were calculated by an image analyzer. The pathologic condition of the maxillary sinus was evaluated by the radiographic appearance after the introduction of contrast medium into the maxillary sinus. The X-ray images (X-MFT) were classified as mild, moderate and severe. The epithelial surface occupied by cilia in the mild, moderate and severe lesions was 96.5±3.5%, 92.5±8.3% and 37.±31.7%, respectively. The ciliated area decreased exponentially with the severity as evaluated by the contrast X-ray study. Eleven specimens of maxillary sinus mucosa were obtained by biopsy through the inferior nasal meatus with Nishihata forceps, and nine specimens were obtained during radical surgery. There was no significant difference in the area occupied by cilia in the tissues obtained by these two methods. The results indicate that the quantitative scanning electron microscopic appearance of the maxillary sinus mucosa is useful in the evaluation of pathologic conditions of the maxillary sinus mucosa.
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  • A Chemical Investigation of the Contents of Polypoid Vocal Folds
    Koichi Matsuo, Takemoto Shin, Minoru Hirano, Yukio Tanaka, Isoko Takaz ...
    1984 Volume 77 Issue 6 Pages 1381-1386
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1381
    JOURNAL FREE ACCESS
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    Chemical examination of tissue from polypoid vocal folds obtained from 9 patients during endolaryngeal microsurgery showed that the main substances were acid mucopolysaccharide (AMPS) and acid glycoprotein. AMPS and acid glycoprotein were identified cellulose acetate stripelectrophoresis and digestion by specific enzymes.
    1) In all 9 cases the histopathological findings revealed edema.
    2) Hyaluronic acid in AMPS was found in 7 cases and acid glycoprotein in all 9.
    3) The contents were classified into 3 types on the basis of their viscosity: serous type in 5 cases, mucous type in 2, and intermediate type in 2. The serous type contained a relatively large amount of hyaluronic acid (84.14±16.60μg), which was not present in the mucous type, while in the intermediate type, the hyaluronic acid content was low (23, 3ug, 21.6μg).
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  • Ototoxicity Associated with Cisplatin
    Hitoshi Saito, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1984 Volume 77 Issue 6 Pages 1387-1393
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1387
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    Among the patients who were treated by mainly intravenous infusion of cisplatin with a dose of 10mg/m2 or 50mg/m2 body surface area for one or two courses, audiometric analyses were performed in 46 patients whose audiograms could be obtained before and after the treatment.
    A hearing loss of more than 25dB was observed in 13% (6/46) of the patients: 5 (16%) had been given 50mg/m2 and one (7%), 10mg/m2. Hearing impairment at 8000Hz was most conspicuous. Half of the patients with hearing loss recovered to within normal limits. No patient had symptoms of hearing loss and vestibular damage. Only one patient complained of tinnitus.
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  • Clinical Studies on Cefmenoxime Ear Drop Solution
    Haruji Kinoshita, Shunkichi Baba, Yoshito Mori, Tsutomu Hatano
    1984 Volume 77 Issue 6 Pages 1395-1400
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1395
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    Clinical studies on Cefmenoxime ear drop solution in cases of chronic purulent otitis media (18 cases) and its acute exacerbations (6 cases) showed the following:
    1) The overall clinical effect was excellent in 7 cases, good in 10 cases, fair in 3 cases and poor in 4 cases. The clinical effectiveness rate was 70.8%.
    2) Especially in infections due to S. aureus, P. mirabilis or P. inconstans, a satisfactory clinical response was obtained.
    3) No side effects were observed in any case.
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  • Experience with Mequitazine (LM-209), a New Antihistamine
    II. Clinical Study to Compare it with Other Antihistamines in Respect to an Adverse Side Effect (Drowsiness)
    Satoshi Ogino, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1984 Volume 77 Issue 6 Pages 1401-1410
    Published: June 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1401
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    Mequitazine was administered to 72 patients with nasal hypersensitiveness, who complained of “drowsiness” with the use of ordinary antihistamines. Its clinical efficacy and incidence of “drowsiness” were evaluated.
    1) The clinical efficacy of mequitazine was rated as “Effective” in 66.7% and as “Slightly Effective” or better in 87.5% of the cases.
    2) When mequitazine was compared with reference standards “drowsiness” was reported to be slighter in 90%.
    3) With respect to “Usefulness”, mequitazine was equal to ordinary antihistamines but inferior to betamethasone combinations.
    4) Subjective adverse side effects of “drowsiness” and “fatigue” were complained of but judged to be very slight. The subjective symptom of “thirst”, which was attributable to the anticholinergic action of mequitazine, was reported in 5.6% of the cases.
    The general conclusion drawn from these results is that the incidence of the adverse side effect of “drowsiness” is so low that mequitazine is recognized as a useful drug when compared with ordinary antihistamines.
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