Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 77, Issue 8
Displaying 1-15 of 15 articles from this issue
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  • CT Scan of Pathology and Effect of Therapy in Otitis Media with Effusion in Childhood
    Katsuhisa Ikeda, Tokio Sakurai, Toshimitsu Kobayashi, Kazutomo Kawamot ...
    1984 Volume 77 Issue 8 Pages 1565-1572
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1565
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    In a study of the middle ear cleft in otitis media with effusion (OME), high-resolution computed tomography was performed in 51 patients aged 3 to 13 years. The patients were divided into the following three groups; group I, fresh cases without any treatment; group II, recurrent or chronic cases; group III, cases with sequelae as a result of OME.
    1) In group I, the entire middle ear cavity was occupied with material of soft-tissue density in 18 out of 21 ears. The incidence of soft-tissue density was 100% in the mastoid air cells, 95% in the mastoid antrum, 93% in the attic and 88% in the tympanic cavity. The percentage thus rose with the distance from the tympanic cavity.
    2) There was no significant difference in the incidence of soft-tissue density between groups I and II.
    3) In group III, the mastoid air cells showed density, while the other regions had adequate air-containing spaces.
    4) Even after myringotomy and aspiration of the fluid in group I, density was found in the mastoid air cells in 100% of the cases. Density in the mastoid antrum, attic and tympanic cavity was present in 43%, 21% and 21% of the cases, respectively. These results suggest that lesions are likely to persist in regions away from the orifice of myringotomy and that this therapy can not eliminate all of the lesions. In group II, the soft-tissue density in the middle ear was eliminated by myringotomy better than in group I.
    5) The effect of ventilating tubes on the mastoid air cells was not determined and requires further studies.
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  • A Follow-up Study of Middle Ear Surgery from 1978 to 1983
    Kotaro Ukai, Yasuo Sakakura, Mikikazu Yamagiwa, Yuichi Majima, Yasuro ...
    1984 Volume 77 Issue 8 Pages 1573-1584
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1573
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    The results of surgery on 163 ears from 1978 to 1983 were studied. Of the 127 patients who answered our questionnaire, 20.1% complained of ear discharge and 24.8% of these had hearing deterioration. Of the total of 161 ears, which were examined by otoscopy and pure-tone audiometry, 44.7% underwent surgery for cholesteatoma; 45.4% for chronic suppurative otitis media; 5.9% for tuberculosis of the middle ear. Of those ears, 88 were treated with intact canal wall tympanoplasty, 30 ears with classical tympanoplasty, and 43 ears with reconstructed canal wall tympanoplasty. Perforation of the reconstructed ear drum recurrenced in 15.7% and ear discharge in 18.1% of the total: in 19.8% of the ears treated with intact canal wall tympanoplasty, in 28.9% of those with reconstructed canal wall tympanoplasty, and in 33.3% of those with classical tympanoplasty. Long-term hearing results were satisfactory; only 9.5% of the patients had a deterioration of hearing postoperatively while in 59.5% hearing was improved.
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  • Three Cases of Adenocarcinoma in the Nose and Paranasal Sinuses
    Hisayoshi Miyamoto, Yozo Orita, Hidekazu Yamamoto, Chikao Inagaki
    1984 Volume 77 Issue 8 Pages 1585-1590
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1585
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    The incidence of cancer in the paranasal sinuses is about 25% of the malignant tumors of the head and neck region.
    Most of them are squamous cell carcinomas, but adenocarcinoma is also recognized.
    —We have treated three patients with adenocarcinoma in the nasal cavity and paranasal sinuses.
    1) Case 1: A 70-year-old man treated by total maxillectomy and radiation has been alive for six years.
    2) Case 2: A 49-year-old man treated by only partial maxillectomy has been alive for four years and one month.
    3) Case 3: A 25-year-old man treated by chemo-radio-surgical therapy, died of recurrence and general metastasis.
    Surgical therapy should be tried, because radiation is not completely effective, except in cases of adenoacanthoma.
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  • Clinical Study of Allergic Rhinitis in August and September, 1983
    Keizo Koyama, Yoshio Seno, Masao Naito, Akio Suzuki, Fuki Toda, Masata ...
    1984 Volume 77 Issue 8 Pages 1591-1597
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1591
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    In 1983, the incidence of allergic rhinitis in our clinic increased, especially in August and September.
    We were interested in the response for this seasonal increased of nasal attacks.
    The subjects with severe attacks were studied clinically and skin tested with several antigens. The air pollens in front of clinic was examined for, and the temperature and weather changes were recorded.
    1) The most frequent antigens giving positive skin tests were Housedust, Comporsitae and Alternaria in this order.
    2) The most common pollens in August and September were Artemisia and various grass pollens.
    3) The reasons for the increased attacks in this period were considered to be pollens in the air and wide temperature swings.
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  • Two Cases of Angiofibroma of the Nasal Cavity
    Kazuo Sakurai, Shigeki Mori, Kensei Naito, Kosei Iwami, Akihiko Takasu ...
    1984 Volume 77 Issue 8 Pages 1599-1604
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1599
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    Case 1. A 37-year-old male complained of epistaxis and nasal obstruction on the left side. X-ray examination showed a tumor in the left nasal cavity, but the paranasal sinuses were clear. The tumor was removed, and the histopathological diagnosis was angiofibroma.
    Case 2. A 37-year-old female complained of epistaxis and nasal obstruction on the left side. The tumor was deep red with an irregular surface. X-ray examination showed clear paranasal sinuses. We removed the tumor under local anesthesia. The histopathological diagnosis was angiofibroma.
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  • Trial Biopsy of Human Olfactory Mucosa
    Satoshi Hasegawa, Masuo Yamagishi, Yuichi Nakano
    1984 Volume 77 Issue 8 Pages 1605-1609
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1605
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    We have devised an instrument to obtain small biopsy specimens of human olfactory mucosa and did trial biopsies of 10 patients during nasal operations for chronic sinusitis under local or general anesthesia.
    The biopsy instrument was advanced through the naris along the septum to the olfactory cleft. The cutting edge was pressed against the olfactory area of the septum, and the instrument was carefully withdrawn with the mucosal specimen. This procedure was performed successfully with no adverse effects. On the average, about three blocks of specimens were obtained to find one that contained olfactory mucosa. There was minimal change but no distinctly abnormal finding in an olfactory mucosa specimen examined by electron microscope. This method may be useful for investigations of human olfactory dysfunction.
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  • Two Cases of Malignant Lymphoma of the Frontal Sinus
    Keiichi Kadowaki, Michiaki Yokoyama, Tetsuro Tsujita, Hiroshi Kouzaki
    1984 Volume 77 Issue 8 Pages 1611-1616
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1611
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    Case 1. A 30-year-old male complained of swelling of the forehead and exophthalmus. He was treated with irradiation and chemotherapy, but died 18 months later.
    Cpse 2. A 60-year-old male complained of swelling of the forehead. He was succesfully treated with surgical excision, irradiation and chemotherapy and is living and well with no recurrence or metastasis 18 months later.
    The authors reviewed six cases of malingant lymphoma of the frontal sinus reported in Japan during the past 51 years. The mortality of malingant lymphoma of the parasinuses has been very high in Japan.
    Case 2 was treated with combined therapy with good results. It is thought that combined therapy is effective for malignant lymphoma of the frontal sinus.
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  • Large Hemangioma of the Larynx
    A Case Report
    Chikara Nishimoto, Masaaki Miyamae, Yoshihiko Kohda, Rieko Nakanishi, ...
    1984 Volume 77 Issue 8 Pages 1617-1622
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1617
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    The patient was a 47-year-old male with dyspnea, clouding of consciousness and hoarseness. Under Macintosh laryngoscopy and fiberscopy, a large dark-red tumor was found narrowing the air way. Laryngofissure revealed an extended tumor from the false cord to the arytenoid area on the right side. The tumor was removed together with the surrouding normal tissues. Two points of normal tissue near the tumor were coagulated by an electric coagulator. The incision was performed between them, so there was little bleeding. The normal laryngeal mucosa, which had overlain the tumor, was preserved and replaced to cover the raw surface.
    Histological examination revealed hemangioma cavernosa.
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  • Two Cases of McCune-Albright Syndrome
    Noriko Inagaki, Mikikazu Yamagiwa, Yasuo Sakakura, Yasuro Miyoshi
    1984 Volume 77 Issue 8 Pages 1623-1630
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1623
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    McCune-Albright Syndrome is characterized by polyostotic fibrous dysplasia of bone, pigmented spots of the skin and sexual precocity, principally in females. The pathogenesis of this syndrome is not clear.
    The authors describe two cases of this syndrome. Both were 6-year-old girls with facial deformity who resembled each other. Thickened skull and cloudy paranasal sinuses were seen on conventional X-rays and computed tomography.
    The literature on this syndrome is reviewed with special reference to the diagnosis, prognosis and treatment of the condition.
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  • Role of the Round Window Membrane in Inner Ear Function
    Hidehiko Sasa, Toshio Yamashita, Ko-so Yo, Tadami Kumazawa, Kunihiko N ...
    1984 Volume 77 Issue 8 Pages 1631-1640
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1631
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    After closure of the round window membrane of guinea pigs by various adhesive agents (histoacryl, alonalfa and dental cement), inner ear function was observed by cochlear microphonics (CM) and action potential (AP). At the same time, perilymphatic oxygen tension in the scala tympani was measured by polarographic methods.
    In addition to these chronic experiments, dynamic changes of the perilymphatic oxygen tension were measured during the flow of air, pure oxygen and nitrogen under general anesthesia.
    1) CM and AP fell significantly after three weeks, but did not change just after or three days after closure of the round window membrane.
    2) The perilymphatic oxygen tension increased significantly after a flow of pure oxygen, but decreased after nitrogen.
    3) The perilymphatic oxygen tension of the closed side three weeks after closure of the round window membrane decreased to about 50% that of the non-closed side.
    We assume that these results were caused by the decrease of oxygen supply caused by closure of the round window membrane.
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  • Effect of Diuretics on Inner Ear Fluid Electrolytes
    Naoyuki Kanoh
    1984 Volume 77 Issue 8 Pages 1641-1658
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1641
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    Under sodium pentobarbital anesthesia (20-30mg/kg, I. P.), normal guinea pigs were given furosemide and/or glycerol. Serum, cerebrospinal fluid (CSF) and inner ear fluid from the scala tympani perilymph, scala vestibuli perilymph, and scala media endolymph were collected. The sodium and potassium concentrations were determined by microflame photometer (I. L. 443 Instrumentation Lab.).
    1. Both sodium and potassium concentrations in the serum, CSF, scala tympani perilymph and scala vestibuli perilymph showed characteristic and individual levels.
    2. Furosemide (15mg/kg, I. V.) caused a marked increase in the sodium concentration in the scala tympani and the vestibuli perilymph, and a slight increase in the CSF; there was no significant change in the serum. The potassium concentration was increased in the scala tympani and vestibuli perilymph; there was no significant change in the CSF or serum. The increase in sodium concentration was considered to be a result of dehydration.
    3. Glycerol (1.0ml/kg, I. V.) increased the sodium concentration in the CSF and in the scala tympani perilymph; no significant change was observed in the serum, the scala vestibuli perilymph or in the cochlear endolymph. Potassium concentration was increased only in the scala vestibuli perilymph.
    4. Glycerol (50%, 12ml/kg, P. O.) increased the sodium concentration in the CSF, scala tympani and scala vestibuli perilymph and scala media endolymph; no significant change was observed in the serum. Potassium concentration was increased only in the scala tympani perilymph.
    The increase of sodium was considered to be the result of dehydration caused by the osmotic effect of glycerol. This action is slower and stronger after oral administration than after intravenous injection.
    The present study suggests that the inner ear fluids in Meniere's disease (endolymphatic hydrops) might be concentrated by the administration of diuretics, and that in the treatment of Meniere's disease, oral administration is more effective than intravenous injection.
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  • Degeneration and Regeneration of the Olfactory Epithelium in the Mouse
    A Scanning Electron Microscopic Study
    Yoshinori Kikuya
    1984 Volume 77 Issue 8 Pages 1659-1680
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1659
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    Morphological changes of the olfactory epithelium in the mouse due to aging, formaldehyde gas and sectioning of the fila olfactoria were studied by scanning electron microscopy.
    In the normal olfactory epithelium many cells with stereocilia like microvilli were observed. These cells resembled the fifth cell of the cat found by Andres (1969) and appeared to be mechano-receptors in the olfactory epithelium.
    Morphological changes due to aging were characterized by increase of the respiratory ciliated cells in the olfactory region and retreat of the olfactory epithelium at its boundary with the respiratory epithelium.
    The olfactory epithelium was variously affected after exposure to formaldehyde gas. In areas with severe damage the supporting cells degenerated early. This area regenerated to respiratory ciliated epithelium 14 days after exposure. Areas in which the supporting cells were not affected finally regenerated to olfactory epithelium. Transformation to ciliated cells in the olfactory region after formaldehyde gas exposure suggests that the basal cells of the respiratory and olfactory epithelium and the duct cells of Bowman's gland might be the stem cells of regenerated ciliated cells.
    Neuronal degeneration after sectioning of the fila olfactoria was recognized one day after surgery, and regeneration was noted 14 days after axonotomy. Regeneration to the normal surface structure of the olfactory epithelium was observed 56 days after axonotomy, but regeneration of the whole surface was still imcomplete at this stage. Morphological changes in the surface of the supporting cells were also recognized after surgery, but these findings were probably caused by reactive changes due to disappearance of the mat of the olfactory cilia.
    In several specimens a wide olfactory region was covered with respiratory ciliated epithlium after axonotomy, but it is questionable that these transformations were produced only by sectioning of the fila olfactoria.
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  • Use of Human Fibrin Tissue Adhesive in Middle Ear Surgery
    Akio Imai, Naobumi Nonomura, Yuichi Nakano
    1984 Volume 77 Issue 8 Pages 1681-1686
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1681
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    Tissue adhesion with highly concentrated human fibrinogen was used in 21 ear operations: seven cases of mastoid obliteration, ten canal wall reconstructions, two fascia grafts and three ossicular reconstructions.
    Stabilization of grafted bone and fascial tissue makes subsequent operative manipulation easier and makes the survival of the grafted materials more certain. Thus, this tissue adhesive is very convenient and easy to use. Neither systemic nor local side effects were observed, and the postoperative clinical course was favorable. This human fibrin tissue adhesive can be recommended for use in middle ear surgery.
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  • Chronic Otitis Media, Microbiology and Choice of Therapy
    Kohji Hozawa, Ryo Yuasa, Junichi Kambayashi
    1984 Volume 77 Issue 8 Pages 1687-1691
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1687
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    Microorganisms were cultured from 164 specimens of aural discharge from patients with chronic otitis media, and their sensitivity to antibiotics was tested. Staphylococcus aureus, including AMPC- and ABPC- resistent strains (58%) and Pseudomonas aeruginosa were the main pathogens of chronic otitis media. Of the oral antibiotics tested, fosfomicin showed the highest antibacterial activity against most of the isolated strains.
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  • Clinical Evaluation of Ifenprodil (Cerocral) in the Treatment of Vertigo
    Michihiko Nozue, Masami Yoneyama, Satoru Suzuki
    1984 Volume 77 Issue 8 Pages 1693-1701
    Published: August 01, 1984
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.77.1693
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    Ifenprodil (Cerocral) has been used to improve blood circulation and metabolic activity in the brain. It is well-known that Ifenprodil is effective in cases of circulatory insufficiency of the vertebro-basilar artery. We administered Ifenprodil to 37 patients with vertigo and evaluated its effectiveness on the basis of their subjective symptoms and objective findings.
    1. The rate of effectiveness was 67% in typical Ménière's disease, 56% in atypical Ménière's disease, 73% in benign paroxysmal positional vertigo and 100% in circulatory insufficiency of the vertebro-basilar artery.
    2. The frequency of vertiginous attacks was reduced in 73% of the patients, the intensity of verigo in 86%, the equilibrium disturbance in 81%, nausea and vomiting in 88%, heavyhead and headache in 79%, and stiff shoulders in 73%.
    3. Although many patients had no objective findings, almost all the findings which were noted were reduced.
    4. There were no side effects of this drug. These results suggest that Ifenprodil is useful in the treatment of vertigo.
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