Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 78, Issue 4
Displaying 1-25 of 25 articles from this issue
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  • Technique of Middle Ear Surgery in Relation to Inner Ear Damage
    Isao Takimoto
    1985 Volume 78 Issue 4 Pages 465-476
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.465
    JOURNAL FREE ACCESS
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    To reduce the incidence of inner ear damage related to surgery on the middle ear, the author investigated drug-ototoxicity following middle ear infusion and acoustic trauma due to the cutting burr and chisel.
    1) Chlorhexidine, a disinfectant, affected the conductive systems in the inner ear, such as perilymph and endolymph, and vascular stria.
    Aminoglycosides affected the organ of Corti directly.
    2) To prevent damage to the inner ear fluid or organ of Corti, the author recommends the use of diluted disinfectant or washing out soon after infusion rather than the application of steroid hormones which failed to reduce experimental drug-induced inner ear damage.
    3) Acoustic trauma caused by the cutting burr in contact with the incus was noted, but damage when contact with the middle ear wall was rare. Changes in the organ of Corti started on the second and third turn and then extended to the basal turn.
    4) Suction near the round window had no effect on inner ear.
    5) Clinically, the influence of burr drilling on tinnitus, bone conduction and vertigo was less severe. But we must avoid prolonged use of the burr with strong pressure.
    6) Manipulation of the stapes or its surroundings and of the perilabyrinthine cells seemed to affect the ear relatively often.
    7) The author prefers not to preserve cholesteatoma matrix over the labyrinthine fistula but to remove it to prevent cholesteatoma invasion into the labyrinth.
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  • Congenital Defect of the Stapes Footplate
    [in Japanese], [in Japanese], [in Japanese]
    1985 Volume 78 Issue 4 Pages 478-479
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.478
    JOURNAL FREE ACCESS
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  • Clinical Features of Sudden Deafness in Patients with Impaired Hearing of High Tones
    Makito Okamoto, Tetsuya Shitara
    1985 Volume 78 Issue 4 Pages 481-487
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.481
    JOURNAL FREE ACCESS
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    Although there are several types of sudden idiopathic sensori-neural hearing loss, this study focused on patients who had impaired mainly hearing of high tones due to sensori-neural hearing loss of the following types:
    1. suddenly onset cured within a few days,
    2. in those with lesions limited to the basal turn of the cochlea,
    3. sudden idiopathic inner ear lesion of the semicircular canal, vestibule and basal turn of the cochlea,
    4. increasing over a few days,
    5. due to obstruction of the vestibulo-cochlear artery,
    6. due to a perilymph fistula.
    The following practical clinical factors should be considered:
    At the onset was there barotrauma, drug intoxication or sound injury? From the onset to the first examination was the patient subjectively aware of a change in his level of hearing? To determinate the cause, supraliminal hearing tests, obserbations of positional and positioning nystagmus and caloric tests should be performed in the early stage of the disease. Anti-coagulant therapy was administered to one patient suspected of having arterial obstruction, and probe tympanotomy was needed by the patient who was suspected of having a perilymph fistula.
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  • Ossiculoplasty with Ceramic Implants (CORP); Reasons for Failure
    Etsuo Yamamoto, Michitaka Iwanaga, Michiyuki Kita, Setsuko Morinaka
    1985 Volume 78 Issue 4 Pages 489-494
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.489
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    The stability of CORP in the middle ear was evaluated in 162 ears in which CORPs (CORP-P 87 ears, CORP-T 75 ears) were implanted during the past 4 years. Most CORPs could be placed successfully in the middle ear. The CORP was extruded from 8 ears (4.9%) and displaced in 6 ears (3.7%). These failures are considered to be due mainly to postoperative tubal dysfunction and recurrence of disease. CORPs should not be used in cases in which these conditions can be anticipated.
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  • Eustachian Tubal Opening and Closing and Nasal Pressure Changes during Toynbee's Maneuver (4)
    in combination with sonotubometry
    Jin Okubo, Isamu Watanabe, Norihiko Ishikawa, Mitsunobu Shibusawa, Hir ...
    1985 Volume 78 Issue 4 Pages 495-499
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.495
    JOURNAL FREE ACCESS
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    The Eustachian tube opens and closes in response to swallowing movements. Sonotubometry records these opening and closing movements as changes in sound pressure. Moreover, it shows that the timing of the opening and closing of the Eustachian tube varies with the material swallowed (saliva, Barium, liquid, etc.) even in healthy adults. These differences effect the interpretation of the test results. We considered that the soft palate might have some relationship to nasal closure when the nasopharynx is closed in response to swallowing movements.
    Since the contribution of the soft palate to nasopharyngeal closing can be estimated by observing pressure changes, its relationship to the tubal opening and closing time was examined by combining various swallowing movements with sonotubometry during Toynbee's maneuver. It was found that the incease in intranasal pressure during saliva swallowing was lower than that during liquid swallowing; however, its decrease was greater. This may indicate that the soft palate is moved more voluntarily during swallowing behavior which requires an increased negative pressure of the pharynx. It was further estimated that the movement of various muscular groups involved in the tubal opening may also be activated, ultimately providing more positive results sonotubometry.
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  • Clinical Evaluation of NMR-CT in Rhinology
    Takuo Maeyama, Masaru Ohyama, Shigeru Furuta, Hisashi Saito, Toshiro F ...
    1985 Volume 78 Issue 4 Pages 501-512
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.501
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    Thirteen patients with nasal and paranasal sinus diseases were examined with nuclear magnetic resonance computed tomography (NMR-CT).
    1. The NMR appearance of the pathological features in the paranasal sinuses was much clearer than the X-ray CT appearance because there were no image artifacts due to bone and air.
    2. Mucosal pathology and the quality of secretions in the sinuses could be demonstrated by measuring hydrogen proton density and the T1 value.
    3. NMR is a useful tool in deciding further investigations and operative approaches because tumor invasion can be analyzed three dimensionally.
    4. Bone destruction and calcification cannot be visualized by NMR, since no signals from bone are recorded in this process.
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  • Nuclear Magnetic Resonance Imaging of the Paranasal Sinuses, Pharynx and Oral Cavity
    Toshiaki Ikeda, Takashi Fukaya, Yasuya Nomura, Kouki Yoshikawa
    1985 Volume 78 Issue 4 Pages 513-523
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.513
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    Nuclear magnetic resonance computed tomography (NMR-CT) was performed in patients with diseases of the paranasal sinuses, pharynx and oral cavity, including inflammation, aspergillosis, cyst and cancer. Compared with X-ray computed tomography (CT), NMR-CT is free of artifacts of bone, air and dental materials, has better contrast resolution and differentiation of mucosal thickening from fluid and tumor, and can be obtained in the coronal, axial or sagittal planes with patient in the supine position with improved anatomical location of lesions.
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  • Oncocytic Microcystic Papillary Adenoma in the Nasal Cavity; a Case Report
    Osamu Tanaka, Kazuhiro Ota, Tsutomu Hoshiya, Yukikazu Hyo, Takashi Mat ...
    1985 Volume 78 Issue 4 Pages 525-532
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.525
    JOURNAL FREE ACCESS
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    A 57-year-old woman presented with a two month history of left nasal obstruction. Anterior rhinoscopy revealed a large soft mass in the left nasal cavity. Denker's operation demonstrated that the tumor arose in the left nose but the maxillary and ethmoid sinuses were not involved by the tumor.
    Under light microscopy, the tumor cells were arranged in papillae, showed distinct granular eosinophilia and small empty spaces in their cytoplasm. P. A. S. stains were positive for empty spaces, and P. T. A. H. stains were positive for cytoplasmic granules.
    Electron microscopy showed intercellular and intracellular canaliculi in the tumor cells with numerous microvilli; their cytoplasm was packed with mitochondria of various sizes. On the free borders of the tumor cells cilia were seen occasionally. This tumor was diagnosed oncocytic microcystic papillary adenoma from these histological findings. The histogenesis of this tumor is discussed.
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  • Malignant Transformation in a Giant Mixed Tumor of the Parotid
    Yuzo Yamamoto, Akira Miyasou, Kohei Wada, Hiroaki Takahashi, Kazuo Tak ...
    1985 Volume 78 Issue 4 Pages 533-538
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.533
    JOURNAL FREE ACCESS
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    It is generally thought that primary mixed tumors must be very rare and nearly all are really examples of malignant transformation of one of the component epithelial types. We report an interesting case of a giant mixed tumor of the parotid with malignant change.
    The patient was a 78-year-old woman who showed characteristics of malignant transformation, such as a long clinical course of pre-existing benign tumor, sudden growth of the tumor, age and female sex.
    It is possible that persistent infection with mumps virus at an early age might have played a part in the etiology of this tumor.
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  • Primary Squamous Cell Carcinoma of the Thyroid Gland; a Case Report
    Shinji Ohhira, Hideharu Aruga, Minoru Ishida, Wataru Yoshihara
    1985 Volume 78 Issue 4 Pages 539-544
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.539
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    This report describes the diagnosis and treatment of a 73-year-old woman with squamous cell carcinoma of the thyroid gland.
    1) Primary squamous cell carcinoma of the thyroid gland is very rare, accounting for about 1.1% (Goldman) of all malignant tumors of the thyroid gland.
    2) We detected neither papillary adenocarcinoma nor squamous cell dysplasia of the thyroid gland which might be precursors of squamous cell carcinoma.
    3) Squamous cell carcinoma of the thyroid gland does not respond to either Pepleomycin or radiation therapy, and the prognosis is very poor.
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  • Re-valuation of Treatments for Bell's Palsy
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 545-546
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.545
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 546-547
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.546
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 547-548
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.547
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 549-550
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.549
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 551-552
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.551
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 552-553
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.552
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 554-555
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.554
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  • [title in Japanese]
    [in Japanese], [in Japanese]
    1985 Volume 78 Issue 4 Pages 555-556
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.555
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 556-557
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.556
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  • [title in Japanese]
    [in Japanese]
    1985 Volume 78 Issue 4 Pages 558-559
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.558
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  • Cisplatin Ototoxicity
    Ichiro Morita, Satoru Hosokawa, Fumihisa Hiraide, Tetsuzo Inouye
    1985 Volume 78 Issue 4 Pages 561-568
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.561
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    The electrophysiological and histopathological changes in the cochleas caused by the administration of cis-DDP (cis-diamminedichloroplatinum) were studied in guinea pigs. Hearing function was evaluated by ABR, and morphological studies were conducted by scanning electron microscope. The sensitivity of the cochlea to cis-DDP was dose-dependent. Hearing impairment was stronger in the group treated with a single high dose than in the group treated with multiple injections, and it was stronger in the group given 4 doses of 3mg/kg cis-DDP twice a week than in the group given 12 doses of 1mg/kg. Recovery of the ABR occurred in some animals given a single dose of 9mg/kg cis-DDP intramuscularly. The outer hair cells in the basal and second turns were mainly damaged, especially those in the first and the second rows. The inner hair cells were rarely damaged. There was a close correlation between the loss of cochlear hair cells and suppression of ABR; however, mild cochlear damage was observed in the guinea pigs which had no hearing impairment.
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  • Some Observations on the Origin of Anoxia-sensitive Negative EP in the Guinea Pig Cochlea
    Toshimitsu Kobayashi, Jun Kusakari, Kazutomo Kawamoto
    1985 Volume 78 Issue 4 Pages 569-576
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.569
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    The site responsible for the generation of the anoxia-sensitive negative potential (ASNP) observable after the administration of loop diuretics was studied in the cochlea of guinea pigs.
    1. The development of ASNP was fundamentally the same, whichever perilymphatic scala was perfused with furosemide prior to the induction of anoxia.
    2. Perfusion of the scala vestibuli with NaCN, which was started when the EP approached maximum negativity after the intravenous injection cf furosemide, elicited this potential even in the presence of the control perfusion in the scala tympani.
    3. This potential was not inhibited by the perfusion of the scala tympani with highly oxygenated artificial perilymph which theoretically provides enough oxygenation of the organ of Corti.
    4. The development of this potential was inhibited by the addition of ouabain to the perfusate with ethacrynic acid. This confirms the observations of Sellick and Johnstone.
    The four findings listed above seem to indicate that the site responsible for the generation of ASNP is the stria vascularis rather than the organ of corti.
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  • Otitis Media with Effusion and Endotoxin
    Yoshihiro Dake, Hiroshi Nakanishi, Takeo Kusumoto, Takashi Jinnin, Tos ...
    1985 Volume 78 Issue 4 Pages 577-581
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.577
    JOURNAL FREE ACCESS
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    It is known that the endotoxin of gram negative bacteria is not only antigenic, but also has many biological activities. In this study, endotoxin in human middle ear effusions (MEE) was measured quantitatively by the chromogenic substrate method which is more sensitive and accurate than Limulus assay.
    Fifty samples of MEE from 46 patients aged 2 to 84 years were classified into two groups, 24 mucoid and 26 serous. The endotoxin in the mucoid group was significantly higher (264.6pg/ml) than that in the serous group (27.5pg/ml). This suggests that bacterial endotoxin contributes greatly to induce otitis media with mucoid effusion.
    Audiometry showed that the majority of those with otitis media and mucoid effusion had conductive type deafness, while mixed type deafness was more common in those with serous effusion.
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  • Clinical Efficacy of Kallikrein Tablets in the Treatment of Vertigo
    Multi-center Open Clinical Study: Comparison of Two Different Daily Doses of Kallikrein in the Treatment of Vertigo of Peripheral Origin
    Isamu Watanabe, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
    1985 Volume 78 Issue 4 Pages 583-606_1
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.583
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    A multi-center open clinical study was carried out to evaluate the therapeutic effect of kallikrein tablets in daily doses of 6 or 9 tablets in the treatment of patients with peripheral vestibular vertigo (mainly Meniere's disease). A total of 172 patients in 12 hospitals were treated with kallikrein in daily doses of either 6 or 9 tablets for two weeks or more. The therapeutic effectiveness was evaluated by experienced physicians who analysed the subjective symptoms (mainly vertigo) and the objective findings (balance tests, auditory tests, etc.). Twenty-four patients were excluded from the analysis.
    1) Overall improvement was evaluated on the basis of subjective symptoms and objective findings combined. The percentage of patients rated as slightly or markedly improved was high in both groups, 76% of the 6-tablet group and 79% of the 9-tablet group. In contrast, the percentage of markedly improved and of moderately to markedly improved patients was 4% and 25% in the 6-tablet group and 13% and 42% in the 9-tablet group, respectively. The latter figure is significant (p<0.05).
    2) Adverse reactions were noted in three patients: edema of the hands and headache+increased feeling of left-ear obstruction in two patients in the 6-tablet group and rash on both forearms in one patient in the 9-tablet group. There was no significant difference in the incidence of adverse reactions between the two groups.
    3) The evaluation of usefulness on the basis of overall improvement plus overall safety was rated extremely useful and moderately to markedly useful in 4% and 27% of the 6-tablet group and 15% and 44% of the 9-tablet group, respectively. The latter figure is significant (p<0.05).
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  • Penetration into Sinus Tissue of Orally Administered Pronase
    Minoru Ishida, Hirotsugu Uda, Shigemi Fujisaki, Masahiro Saito, Tsutom ...
    1985 Volume 78 Issue 4 Pages 607-616
    Published: 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.607
    JOURNAL FREE ACCESS
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    PAP (peroxidase/antiperoxidase) staining methods and histopathological examination were used to study the effect and distribution of pronase in mucous membrane biopsies of 20 patients treated surgically for chronic maxillary sinusitis. In 7 of the 20 patients, mucous membranes were first excised from the right maxillary sinus, then pronase was administered orally for one week prior to removal of the mucous membranes from the left maxillary sinus. Eleven patients were given pronase for one week prior to removal of membranes from one sinus only and the two remaining patients were given no pronase at all prior to surgery.
    Histopathological comparison of tissues removed from patients after pronase therapy with those removed from patients prior to or receiving no therapy revealed: 1. inhibition of membrane edema; 2. increased fibrin deposits; 3. diminished eosinophil and lymphocyte infiltration; and, 4. proliferation of mucous glands within the mucoua. These findings suggest the destruction of mediators involved in the inflammatory process and a decrease in the number of bacteria as a result of tissue necrosis and sloughing.
    Strong positive PAP staining demonstrated pronase deposits in: 1. the stroma; 2. the epithelium and the seromucous glands; 3. the lumen of the blood vessels; and, 4. the neutrophiles and macrophages located within the tissue specimen removed after pronase administration. It should be noted, however, that very weak staining was also seen in tissue specimens removed prior to pronase administration.
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