耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
77 巻, 7 号
選択された号の論文の16件中1~16を表示しています
  • 細川 智, 井上 鐵三, 北條 和博, 相馬 博志, 中野 雄一
    1984 年 77 巻 7 号 p. 1413-1420
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Three patients with brainstem neoplasms had cerebellopontine angle symptoms and unilateral cerebellopontine angle shadows on conventional CT scans. As there were involved facial, acoustic and trigeminal nerves in clinical symptoms, cerebellopontine angle syndrome was diagnosed and acoustic tumor was suspected. Otoneurological tests showed unilateral perceptive deafness with retrocochlear lesions, and the gaze test showed Bruns-Cushing type nystagmus.
    In 19 patients with brainstem lesions, the ABR test results were all abnormal: loss of each component in 74% and prolonged latency of wave V in 24%. Most of the ABR test results in cases of intramedullary lesions with space-occupying effects in the brainstem were abnormalities in the presence and latency of wave V. It is concluded that the ABR test is helpful in determining the sites of intrinsic brainstem lesions.
  • 杉田 麟也, 河村 正三, 藤巻 豊, 渡辺 勲, 出口 浩一
    1984 年 77 巻 7 号 p. 1421-1428
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Aural fistula is a congenital deformity of the external ear and is more common in Orientals than in Caucasians. Infection tends to occur, and conservative treatment with antibiotics is preferable to surgical drainage. Twenty-eight cases of infected aural fistula were studied from 1981 to 1983; 15 species and 51 strains of bacteria were isolated. Nonspore forming facultative anaerobes were detected in 20 cases. The chief pathogens were Peptococcus 33.3%, Staphyloccus aureus 9.8%, and Bacteroides 7.8%.
    The Intial antibiotics selected statistically (by the theory of Expected Efficacy Index, EEI) were cefmetazole and lincomycin (injection) or clindamycin (oral).
  • 卜部 信行, 杉原 三郎, 山本 哲夫, 藤田 和寿, 角 滋子
    1984 年 77 巻 7 号 p. 1429-1436
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Lidocaine (60mg for males, 40mg for females) injected intravenously in sixty-eight patients who complained of tinnitus.
    The patients were divided into four groups according to their responses.
    In twenty-four cases (35.3%), the tinnitus was abolished entirely. In twenty-nine cases (42.6%), the tinnitus was reduced partially. In eight cases (11.8%), the tinnitus was stationary. In seven cases (10.3%), the tinnitus increased. In the “Old Age” group and the “Low pitch tinnitus” group, intravenous lidocaine was more effective.
    Of forty-nine patients who were given intravenous lidocaine at least four times, twenty-eight (57.1%) received partial relief for a long time.
    The ABR findings suggested that intravenous lidocaine suppressed tinnitus by anesthesia of the brainstem.
  • 水野 正浩
    1984 年 77 巻 7 号 p. 1437-1442
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Ten cases of so-called psychogenic vertigo are described.
    These cases were classified into three groups according to the neurotological findings and organic disorders.
    Group A showed no abnormal neurotological findings or any organic disorders.
    Group B showed abnormal neurotological findings without any organic disorders.
    Group C showed abnormal neurotological findings and organic disorders, but these organic disorders were not the cause of the vertigo.
    Dysequilibrium and hearing impairment were common but nystagmus, canal paresis and abnormal OKN or ETT were not observed.
    Diagnosis was not easy in some cases, so several diagnostic problems are discussed.
  • 藤谷 哲造, 井上 健造, 岡田 聰, 高見 寿夫
    1984 年 77 巻 7 号 p. 1443-1450
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Rhinoscleroma is endemic in eastern Europe, North and Central Africa, and South and Central America. It is a rare disease in Japan. In 1917, Kuzume first reported a Japanese case of scleroma of the pharynx. Until 1982, only 3 Japanese cases had been reported. Rhinoscleroma is a chronic granulomatous infection predominantly affecting the upper respiratory tract. The patient presented here is a 41-year-old Japanese female. Her chief complaint is nasal deformity and nodular swelling of the nasal vestibule. Physical examination revealed: narrow nostrils, hard nasal wings, tumefaction of the left nostril, crusting of the nasal cavity, nodular swelling of the posterior wall of the naso- and mesopharynx, and scarring of the lateral wall of the pharynx. Laboratory findings were normal. The TB skin test was negative. A biopsy of the inferior turbinate showed a marked subepithelial infiltration with lymphocytes, plasma cells and macrophages. A PAS stain of the specimen showed large vacuolated histiocytes containing Klebsiella organisms (so-called Mikulicz cells). Klebsiella, Streptococcus agalactiae and Escherichia coli were recovered from the nasal secretion, and Klebsiella rhinoscleromatis was identified biochemically. The patient was treated with total doses of 20g of streptomycin and 8.4g of minocyclin and at the time of this writing is clinically free of disease.
  • 鼻内所見を中心として
    溝尻 源太郎, 柴 裕子, 藤谷 哲造
    1984 年 77 巻 7 号 p. 1451-1458
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    We examined 21 patients with optic neuropathy caused by paranasal sinus cysts. Their findings on rhinoscopy were classified as follows; 1) normal (2 cases), 2) inflammatory changes of the middle meatus (2 cases), 3) postoperative scar formation of the middle meatus (7 cases), 4) presence of a cyst wall (10 cases).
    Radiographic examination with Rhese's view showed destruction of the optic canal and/or an abnormal shadow in the paranasal sinus surrounding the optic canal in most cases.
    For diagnosis, careful observation of the physical findings and radiographic findings by Rhese's view are important. CT scan is also useful.
    In cases in which the visual disturbance progresses rapidly, probe puncture and/or probe operation is required if the clinical diagnosis has not yet been determined.
  • 近藤 隆, 河辺 義孝
    1984 年 77 巻 7 号 p. 1459-1466
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Distant metastases were observed in 28 cases (6.7%) in a series of 420 patients with laryngeal cancer treated from 1965 to 1980 in the Aichi Cancer Center.
    The probability of distant matastases is higher in patients with advanced primary tumors, i. e. T3 and T4 lesions.
    The most common first sites of distant metastases were the lungs (26 cases), skin, (8 cases), and bone (6 cases).
    Forty-six percent of the metastases were detected by one year and over 90% by four years after surgery.
    Until recently, distant metastases of laryngeal cancer were considered to be rare, but in over 90% of patients with distant metastases, the cause of death was distant metastasis, so early diagnosis and early treatment are necessary.
    We recommend full metastatic screenicg (i. e. chest X-ray, liver scan, bone scan and radiographs) for these patients.
  • 佐々木 良二, 吉田 淳一, 松永 亨
    1984 年 77 巻 7 号 p. 1467-1475
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Vocal cord paralysis (VCP) was seen in 356 patients during a 7-year period in our clinic. Sixty percent of the patients were male. The left vocal cord was affected in 241 cases (68%), the right in 89 cases (25%) and both in 23 cases (6%). In one fourth the cause was thyroid cancer or thyroid surgery. Lung cancer was present in 8% and esophageal surgery in 7%. The cause was unknown in 27%.
    In VCP due to thyroid cancer or thyroid surgery, there was a female preponderance and no difference in incidence between the left and the right vocal cords. The recovery rate was very low. VCP following endotracheal intubation had a very high rate of recovery.
  • 山崎 芳樹, 園部 紀子
    1984 年 77 巻 7 号 p. 1477-1480
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    74才, 女性. 嗄声, 咳嗽, 喘鳴, 呼吸困難で来院. 喉頭全摘出術を行ない, 病理組織学的に検討してみたところ軟骨腫であった. 発生部位は輪状軟骨と考えたい.
  • 斎藤 久樹, 朴沢 二郎, 盛 庸, 福岡 敬二
    1984 年 77 巻 7 号 p. 1481-1488
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    The value of serum immunosuppressive acidic protein (IAP) measured by the single radial immunodiffusion method was evaluated in 180 patients with head and neck cancer. A rise of IAP in untreated patients was noted in 92% of 12 patients with maxillary cancer, in 50% of 14 patients with oral cancer, in 65% of 23 patients with laryngeal cancer, in 71% of 7 patients with hypopharyngeal cancer, and 50% of 8 patients with other head and neck cancers. The serum IAP value rose with the progress of cancer, except in patients with liver cirrhosis. The serum IAP value, which rose temporarily after operation or irradiation therapy, decreased gradually with treatment.
  • 田中 治, 太田 和博, 森 望, 星谷 勤, 兵 行和, 松永 喬
    1984 年 77 巻 7 号 p. 1489-1496
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    Careful and complete removal of vascular tumors is challenging because of the brisk bleeding during operation. Preoperatively we used Gelfoam embolization of the feeding artery in juvenile angiofibroma and in paranasal capillary hemangioma. The intraoperative blood loss averaged 1045ml.
    Angiography is of value to confirm the diagnosis prior to excision and to delineate the extent of the tumor. Embolization may be performed at the same sitting as preoperative treatment. Artificial embolization is described in detail, and preoperative embolization is recommended to make the surgical procedure easier in cases of vascular tumor.
  • 第二報 外リンパ酸素分圧測定によるネコ正円窓膜のガス透過性実験
    笹 英彦, 永原 國彦, 三宅 洋一, 山下 敏夫, 熊沢 忠躬
    1984 年 77 巻 7 号 p. 1497-1512
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    The polarographic technique was used to examine the oxygen permeability of the round window membrane in 14 cats.
    Under general anesthesia, a small hole was drilled in the first turn of the bony wall of the cochlea. An oxygen sensing microelectrode with a tip diameter less than 1μm was inserted through the hole into the scala tympani. Dynamic changes in perilymphatic oxygen tension were measured by applying compressed air, pure oxygen, carbogen (95% O2+5% CO2), and nitrogen gas to the round window membrane via the middle ear cavity.
    1) The gasses easily pass through the round window membrane into the perilymphatic space.
    2) The level of the perilymphatic oxygen tension is in part under the control of the oxygen concentration in the middle ear cavity.
    3) A gradient in the perilymphatic oxygen tension is present, increasing with the distance from the round window membrane.
  • 平出 文久
    1984 年 77 巻 7 号 p. 1513-1525
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    正常および滲出性中耳炎の中耳粘膜上皮を走査型電子顕微鏡により観察し, 表面微細形態の変化を比較検討した. 正常中耳では線毛細胞は鼓室の底および下方部に密に存在しており, 上皮細胞の70~80%が線毛細胞であった. 線毛細胞は1細胞につき80~200本, 平均120本の線毛を有していた. 線毛の長さは平均7μであった. しかし, 乳突洞, 乳突蜂巣では線毛細胞の密度は粗となってき, 上皮細胞の95%以上が無線毛細胞であった. 従って鼓室下部の線毛細胞は middle ear clearance に重要な役割を果しているものと思われる. 滲出性中耳炎の中耳粘膜では杯細胞の分泌亢進像が観察された. またところどころで細胞表面に小間隙がみとめられ, そこから炎症性細胞とともに上皮下より液体の流出してくる像が観察された. 恐らく上皮下血管由来の液体が中耳腔に流出してきたものと思われる. 線毛細胞の, 特に線毛に形態異常がしばしばみとめられた. 特徴的な線毛の形態異常は短線毛, 線毛数の減少, コブ形成, 癒合線毛, 巨大線毛などであった. これらの異常線毛は middle ear clearance を阻害し, 中耳液の貯留を助長しているものと推測する.
  • 視運動眼振発現に対する回転性前庭刺激の影響
    玉田 彰
    1984 年 77 巻 7 号 p. 1527-1546
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    The mutual interrelationships between the visual-ocular reflex (ViOR) and the vestibulo-ocular reflex (VeOR) are not completely understood yet. Optokinetic nystagmus (OKN) during ViOR was produced by rotating light stripes (Jung type). The whole visual field OKN, peripheral OKN, foveal OKN and hemianopsic OKN were produced with a Miyoshi-Shirato device.
    Rotating nystagmus (RN) during VeOR was induced by a rotating chair.
    OKN and RN were applied simultaneously to the same subject in the same direction and then in the opposite direction and vise versa.
    1) The combined velocity of OKN and RN in the whole visual field was always constant, regardless of the phase of rotation.
    2) When the peripheral OKN and RN were combined in the same direction, the velocity of the peripheral OKN was increased about 10-20%, compared to that in peripheral OKN only.
    In contrast, when the peripheral OKN and RN were combined in the opposite direction, the velocity of the peripheral OKN was decreased about 10-20%.
    3) In most of the subjects it was difficult to produce foveal OKN, and when RN was added to this OKN, the foveal OKN was not changed at all or suppressed in all four phases of rotation.
    4) When the hemianopsic OKN and RN were combined in the same direction, the velocity of the former was increased and when they were in the opposite direction, the velocity of the former was decreased, regardless of whether hemianopsic OKN was temporal or nasal, foveopetal or foveofugal.
  • 兵頭 政光, 柳原 尚明, 村上 信五
    1984 年 77 巻 7 号 p. 1547-1553
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    ヒト濃縮フィブリン接着剤 (Tisseel®) を, 耳鼻科領域の手術23例に使用し, その有用性について検討したので報告した. 従来の合成接着剤に比べて, Tisseel® は次のような利点を持つ. (1) 接着が生理的機序のもとに行われるため異物反応がない. (2)治癒過程で自然吸収される. (3) 接着が徐々に進行するため接着部位の修正が行いやすい. (4) 接着後も適度な弾性を有する. (5) 神経毒作用などの副作用がない. などである.
    使用のための準備に時間と手間がかかる, 使用に際して不便な点がいくつかあるなどの欠点もあるが, ヒト濃縮フィブリン接着剤は耳鼻科領域において, 骨, 軟部組織の接着に非常に有用で, 今後ますます応用が拡大すること, また本剤の使用による新しい手術術式が開発されることが期待される画期的な製剤である.
  • 木村 洋, 長谷川 智彦, 金山 亮治, 原田 浩二, 中村 正, 加藤 功, 戸島 均, 鈴木 八郎
    1984 年 77 巻 7 号 p. 1555-1563
    発行日: 1984/07/01
    公開日: 2011/11/04
    ジャーナル フリー
    The clinical effect of dihydroergotamine (DHE) was studied in 35 patients with orthostatic circulatory disorders and/or peripheral vertigo, principally Meniere's disease. These effects were assessed by subjective and objective parameters. Equilibrium and auditory functions were evaluated before and after medication by the same doctors. The drug dosage was 3-6mg of DHE daily for four weeks.
    1) DHE was effective in 29 of 35 patients (82.8%) as judged by both subjective and objective parameters.
    2) Subjective symptoms improved in 88.5% cases and objective symptoms in 82.8%.
    3) No side-effects were observed during treatment.
    Thus, DHE seemed to be effective and safe in the treatment of orthostatic circulatory disorders with or without peripheral vertigo.
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