Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 78, Issue 6special
Displaying 1-19 of 19 articles from this issue
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  • Sensory-neural Hearing Loss in Acute Otitis Media
    Hiromichi Ishigami, Takahiko Nomura, Kazumi Yamada
    1985 Volume 78 Issue 6special Pages 1185-1196
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1185
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    We describe 10 adult patients with acute otitis media complicated by mild to moderately severe sensory-neural hearing loss. Healing was achieved by extensive use of I. V. infusion of ATP and other treatments except in a few patients with persistent partial high-tone hearing loss. Sensory-neural hearing loss is believed to be caused by viral infection, especially influenza virus, but it is difficult to confirm this by serum antibody titers.
    We advise early audiometric testing of patients suspected of hearing loss, since we can not detect sensory-neural hearing impairment by otoscopy.
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  • Cholesterol Granuloma in Experimental Animal and Human Otitis Media
    Shigeru Inafuku, Isao Takimoto, Kishiko Sugiyama, Ichio Inuzuka, Tsuto ...
    1985 Volume 78 Issue 6special Pages 1197-1203
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1197
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    Histological examination of 36 samples of spontaneous otitis media in mice showed cholesterol granulomas in the middle ear cleft of 7. The cholesterol granuloma was found inside the round window niche and the oval window niche in almost closed ear cleft, but cholesteatomatic otitis media was not found, and the samples showed changes in the organ of Corti.
    In the clinical study of middle ear surgery, granuloma was found not in the oval or round window niche but in the mastoid cells, or inside closed cleft apart from the middle ear cleft.
    The authors conclude that cholesterol granulomas develop where ventilation is insufficient and that inflammation promotes such a process secondarily. Cholesterol granuloma does not develop into cholesteatomatic otitis media.
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  • The Role of Bacterial Infection in the Pathogenesis of Chronic Otitis Media with Effusion in Children
    Takahiko Nomura
    1985 Volume 78 Issue 6special Pages 1204-1213
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1204
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    A bacteriological study was conducted of middle ear effusions from children who had chronic otitis media with effusion.
    Forty-three percent of 117 effusions were found to contain bacteria, and 17% contained bacteria called “probable pathogens” (Haemophilus influenzae and Streptococcus pneumoniae) according to Riding et al.
    The fact that 49% of the bacteria-negative effusions contained neutrophilic leukocytes points to the high incidence of infectious cases of chronic otitis media with effusion in children, even when bacterial cultures are not positive.
    The significance of bacterial infection in the pathogenesis of chronic otitis media with effusion in children is discussed in relation to bacteria isolated from acute purulent otitis media and rhinosinusitis.
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  • Surgery for Chronic Ear Disease in Children
    Kazumi Yamada, Isao Takimoto, Hiromichi Ishigami, Shigeru Inafuku, Ich ...
    1985 Volume 78 Issue 6special Pages 1214-1219
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1214
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    This paper describes a retrospective study of 44 children (50 ears) whose first ear operation was performed during the past four years.
    The most common disease was acquired cholesteatoma (27 cases), followed by 15 ears with simple chronic infection and 6 with cholesterol granulomas.
    On the basis of the analysis of cholesteatomas, the authors emphasize that cholesteatomas in children under the age of six years are more progressive and destructive, so early diagnosis and early operation are essential.
    The operative procedures for each disease and the postoperative results are discussed briefly.
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  • A Case Report of Harada's Disease with Equilibrium Disorder
    Ichio Inuzuka, Isao Takimoto, Shigeru Inafuku, Kishiko Sugiyama, Yoshi ...
    1985 Volume 78 Issue 6special Pages 1220-1227
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1220
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    Harada's disease is well known as a systemic disorder of pigment cells especially in the uveal tract, retina and meninges. Signs of integumentary (vitiligo, poliosis and alopecia) and auditory involvement (dysacousia, tinnitus and vertigo) are common.
    The authors report a case of Harada's disease with equilibrium disorder.
    The patient was a 36-year-old man, who complained of hyperemia of his eye balls and deterioration of his visual acuity and was admitted to the department of ophthalmology of our hospital. A diagnosis of Harada's disease was made, and he was treated with steroid therapy. His visual acuity improved, but he suffered from a sudden onset of vertigo 13 days after admission.
    Several neuro-otological findings and some therapeutic features are discussed.
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  • The Surgical Management of Labyrinthine Fistulae in Chronic Otitis Media
    Kishiko Sugiyama, Isao Takimoto, Shigeru Inafuku, Kazumi Yamada
    1985 Volume 78 Issue 6special Pages 1228-1234
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1228
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    Surgery was performed on 369 ears with inflammatory diseases; labyrinthine fistula was present in 22 of them. All 22 had cholesteatoma. Fourteen were true fistulae and 8 were only blue lines. In 21 of the 22 ears the cholesteatoma matrix was removed. In one case in which the only hearing ear was on the affected side, the cholesteatoma matrix was left over the fistula, but in this case hearing was later destroyed by invasion of the inner ear by the cholesteatoma.
    In 16 ears bone conduction hearing was retained postoperatively, and in 8 ears it improved. In cases of labyrinthine fistula, we recommend removal of the cholesteatoma matrix covering the fistula.
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  • Evaluation of Infants and Young Children with Hearing Loss Not Diagnosed in Its Early Stages
    Yoshiko Yamamoto, Kishiko Sugiyama, Hiromichi Ishigami, Isao Takimoto
    1985 Volume 78 Issue 6special Pages 1235-1246
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1235
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    One hundred and twenty-three infants and young children whose hearing loss had not been detected before 3 years of age were analyzed. Hearing loss was assessed by the conditioned orientation response, peep show test and auditory brain stem response.
    Of the 123 children, 70 had a normal intelligence quotient (IQ), 24 had border-line mental retardation (MR) and 29 had manifest MR, including Down's syndrome in 7 cases, cerebral palsy in 9, emotional disorder in 3 and no systemic diseases in 10. Of those with a normal IQ, 29 had severe, 40 had moderate and one had mild hearing loss. This was of the gradual type in 34 cases, abrupt high tone loss type in 15, horizontal type in 12 and other types in 9. Patients with severe hearing loss tended to attend our clinic soon after hearing loss was first suspected. Adequate advice had not been obtained from the former consulting otologists in 13 of the 80 patients whose hearing loss was first detected in our clinic. No complications influencing hearing acuity were found in 3 of the 13 cases mentioned above. Hearing loss had first been detected in primary school in 12 of the 70 cases without MR, including 2 cases of severe, 9 of moderate and one of mild hearing loss.
    The importance of early detection and early start of training to prevent further impairment of speech and intelligence development should be recognized by families, teachers, otologists and pediatricians. Screening tests for hearing impairment should be promoted at public health centers.
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  • Experimental Study of Head Trauma
    Hirohiko Kawade, Isao Takimoto, Shigeru Inafuku, Ichio Inuzuka
    1985 Volume 78 Issue 6special Pages 1247-1261
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1247
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    In order to clarify injury of the inner ear and of the brain after head trauma, we observed morphological changes in guinea pigs immediately after experimentary induced trauma. The relationship between morphological changes and function were studied in some of the animal with the use of the auditory brain stem response (ABR).
    1) The presence or absence of skull fracture lines and histological changes were examined in 12 guinea pigs.
    2) Histological changes immediatly after death due to a blow to the parietal region were examined in five guinea pigs.
    3) Eighteen guinea pigs were allowed to survive for two to five days after blows were inflicted to the parietal and temporal regions, and changes occurring while the head was mobilized or immobilized were examined.
    4) Histological changes and ABR were examined after a direct blow to the bulla in 10 guinea pigs (Nembutal was injected intraperitoneally for anesthesia.)
    The main disorders found were hemorrhagic changes in the brain stem and subarachnoid region and in the tympanic canal and cochlear window. Animals with concussion after a blow to the bulla showed no marked changes in ABR, but two of the five with a fractured bulla showed changes in ABR that were suspected of being central. Although it is somehat dangerous to compare head trauma in guinea pigs with that in man, it is considered highly possible that central hemorrhagic changes are present even when the injury seems to be only peripheral.
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  • Neuro-muscular Disease and Sensorineural Hearing Loss
    Mizuyo Hori, Isao Takimoto, Shigeru Inafuku, Kishiko Sugiyama
    1985 Volume 78 Issue 6special Pages 1262-1269
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1262
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    Four cases of neuro-musclar disease with sensorineural hearing loss are reported. Case 1. Charcot-Marie-Tooth disease. A 58-year-old man had no subjective hearing impairment, but ABR showed objective changes. During the course of examination for his neuro-musclar disease, he suffered sudden deafness, but recovered completely soon after. He had had a similar attack and recovery about 10 years earlier. It seems that the patient has fragile inner ears. ABR showed clear prolongation of the latent period from I to V waves.
    Case 2. Charcot-Marie-Tooth disease. A 20-year-old man did not complain of hearig loss, and an audiogram was normal, but the ABR showed moderate prolongation of the latent period from I to V waves.
    Case 3. Refsum's disease. A 24-year-old woman had noted hearing impairment at the age of 15 years. Audiometry disclosed that hearing loss was probably due to sensory damage.
    Case 4. Refsum's disease. A 20-year-old man, brother of case 3, younger noted hearing loss at the age of 15, presumably due to his sensory disorder. Audiometry resembled that of case 3.
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  • Equilibrium Function in Cases of Sudden Deafness
    Keiko Fujibayashi, Isao Takimoto, Shigeru Inafuku
    1985 Volume 78 Issue 6special Pages 1270-1276
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1270
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    From Jan. 1977 to Sept. 1984, 71 patients 73 ears with sudden deafness who were admitted to the hospital of Aichi Medical University were classified into 4 groups: Group A, 16 patients with both nystagmus and vertigo; Group B, 4 with nystagmus but no vertigo; Group C, 9 with vertigo but no nystagmus; Group D, 40 with neither nystagmus nor vertigo. Of the 73 ears, 2 did not fit into any of groups.
    The course of hearing improvement and vestibular function were examined in each group. Hearing acuity did not improve much in Group A. In all cases in which nystagmus worsened during treatment, hearing did not improve.
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  • Statistical Observations on Clinical Diagnosis in Patients with Bell's Palsy and Ramsay Hunt's Syndrome
    Keiko Fujibayashi, Kazumi Yamada, Isao Takimoto, Ichio Inuzuka, Shiger ...
    1985 Volume 78 Issue 6special Pages 1277-1289
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1277
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    The authors present the following criteria for the differentiation of Hunt's syndrome from Bell's palsy.
    A) Hunt's syndrome is characterized by manifest herpetic eruptions or by a high serum antibody titer against varicella zoster virus.
    B) Incomplete Hunt's syndrome is defined as evident involvement of other cranial nerves with V11 nerve palsy.
    C) Bell's palsy is simple facial nerve palsy of unknown etiology.
    From April 1977 to April 1984, 56 cases of facial nerve palsy were examined within two weeks of onset.
    There were 19 cases of Hunt's syndrome, 14 of incomplete Hunt's syndrome, 14 of Bell's palsy, and 9 others.
    The authors emphasize that equilibrium tests must be performed, even if the patient has no vertigo, in order to make a correct diagnosis.
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  • Experimental Study and Clinical Application of Hydroxyapatite in Middle Ear Surgery
    Masahiko Hara, Isao Takimoto, Shigeru Inafuku, Kazumi Yamada, Ichio In ...
    1985 Volume 78 Issue 6special Pages 1285-1292
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1285
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    Recently, hydroxyapatite (H. A.) has often been used to reconstruct the bony defect in middle ear surgery. We used H. A. in 30 clinical cases: in 10 cases to reconstruct the posterior canal, in 16 cases (6 cases overlap with others) to obliterate the mastoid cavity, and in 10 cases to separate the mastoid and the attic. In 3 cases H. A. was later removed because infection, which led to circulatory failure in the skin over the mastoid. The other 27 are contented with H. A. Thus H. A. seems to be useful as a middle ear implant.
    To evaluate the safety of H. A, we embedded it in a hole drilled in the bullae of adult guinea pigs. One month later, these animals were sacrificed under ether anesthesia, and the bullae were examined histologically by light microscope.
    1) The embedded H. A. was tightly surrounded by soft tissue, in which no giant cells were observed. Therefore, it seems that no foreign body reaction occurred.
    2) There was no evidence of bone formation on any surface of the embedded H. A., but bone induction was accelerated by H. A..
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  • A Study of Traumatic Perforation of the Eardrum
    Kaneto Yoshikawa, Isao Takimoto, Hiromichi Ishigami, Kazumi Yamada
    1985 Volume 78 Issue 6special Pages 1293-1301
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1293
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    During the past 3 years 62 patients were treated for traumatic perforation of the tympanum.
    1) The chief complaint was mainly earache or bleeding from the ear if the perforation was due to direct injury during removal of earwax.
    On the other hand, many patients with indirect injuries, such as those due to a slap on the cheek or the ear, had a sensation of ear-fullness or hearing impairment.
    2) Many of the patients were in the second decade of age, and in these perforation was apt to be due to a slap on the cheek or the ear.
    3) In 34 patients the perforation was in the antero-inferior part of the eardrum, and in 6 in the postero-inferior part.
    4) Spontaneous healing, that is, closure of a perforation smaller than one fourth of a quadrant of the eardrum, usually occurred within about 9 days.
    Large perforations, one fourth to one half of a quadrant, required about 16 days to heal.
    Very large perforations, one half to one quadrant in size, needed about 24 days to heal.
    5) Hearing acuity seemed to be related to the size and location of the perforation.
    6) The procedures and planning of therapy at our ENT clinic are discussed.
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  • Nasal Septal Abscess
    A Case Report
    Kazumi Yamada, Isao Takimoto, Shigeru Inafuku, Tsutomu Enatsu, Hirohik ...
    1985 Volume 78 Issue 6special Pages 1302-1307
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1302
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    Abscess of the nasal septum is rare, but immediate diagnosis and surgical drainage are necessary to prevent significant complications.
    A 1.5-month-old girl was admitted to our hospital with fever, mouth breathing and feeding difficulty. Both nasal cavities were occluded by septum swelling with serous rhinorrhea. In spite of immediate puncture, drainage and administration of antibiotics, she developed meningitis and saddle nose, but she improved gradually and was discharged 19 days after admission.
    Ninety cases (including our case) of nasal septal abscess reported in the Japanese literature from 1914 to 1982 are reviewed.
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  • Bacteriological Findings in Paranasal Sinusitis
    Comparison between Maxillary Sinus and Nasal Cavity
    Takahiro Morimoto, Takahiko Nomura, Kazumi Yamada, Kaneto Yoshikawa, I ...
    1985 Volume 78 Issue 6special Pages 1308-1314
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1308
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    In the conservative treatment of paranasal sinusitis, adequate chemotherapy is very important.
    Bacteriological examinations of maxillary sinus and nasal cavity drainage during the last three years showed that:
    1) Of the bacteria obtained from the maxillary sinus 52.6% were aerobic and 34.8% were anaerobic.
    2) Harmophilus influenzae and Streptococcus pneumoniae were most often found in both maxillary sinus and nasal cavity.
    3) The bacteria in the maxillary sinus and nasal cavity were identical in about 40% of the patients.
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  • Clinical Study of Abnormal Sensation in the Throat
    Tsutomu Enatsu, Shigeru Inafuku, Hiromichi Ishigami, Isao Takimoto
    1985 Volume 78 Issue 6special Pages 1315-1321
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1315
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    From Jan. 1981 to Dec. 1983, 307 outpatients complained of abnormal sensations in the throat. No significant sex difference was noted. Most of them were in the fourth to seventh decades.
    Their complaints were varied, most of them feeling a lump or foreign body sensation. Further examinations revealed paranasal sinusitis in 62 cases, abnormal esophageal roentogenological findings in 22 and serum iron deficiency in 34.
    Of the 307 patients 175 responded to questionnaries: 50 were asymptomatic. The others had some symptoms but tried to ignore them and live with their disease.
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  • Two Cases of Cricoarytenoid Arthritis with Rheumatoid Arthritis
    Kishiko Sugiyama, Isao Takimoto, Shigeru Inafuku, Tsutomu Enatsu
    1985 Volume 78 Issue 6special Pages 1322-1327
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1322
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    Several reports have drawn attention to the presence of rheumatoid arthritis in the larynx. Although dyspnea induced by cricoarytenoid arthritic ankylosis has received attention as a medical emergency, some patients with slightly more severe disease complained of sore throat.
    We treated two patients with cricoarytenoid rheumatoid arthritis who complained of sore throat.
    Case 1. A 51-year-old female who had suffered from rheumatoid arthritis for 12 years complained of severe sore throat and pain on swallowing for several years. Laryngeal examination showed edematous swelling of the right arytenoid region.
    Case 2. A 53-year-old female who had had rheumatoid arthritis for 21 years was referred because of recent vertigo and hearing impairment. During her admission she complained of sore throat. Laryngeal examination showed edematous white-coated swelling of the arytenoids.
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  • Three Cases of Recurrent Ulcers of the Oral Cavity, Pharynx and Larynx
    Hideko Asai, Isao Takimoto, Kazumi Yamada, Kaneto Yoshikawa, Mitsuko N ...
    1985 Volume 78 Issue 6special Pages 1328-1333
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1328
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    Three patients with recurrent ulcers of the oral cavity, pharynx and larynx were resistent to various treatments. In the first case, Behcet's disease was suspected. The second case showed elevation of ESR, positive CRP and increase immunoglobulin and γ-globulin. The third case was treated successfully with steroid hormone.
    These three were thought to have some type of autoimmune disorder. The authors conclude that such patients should be observed carefully in an attempt to clarify the etiology of their disease.
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  • Statistical Analysis of Inpatient at Aichi Medical University
    Mitsuko Nakagami, Keiko Fujibayashi, Mizuyo Hori, Yoshiko Yamamoto, Ic ...
    1985 Volume 78 Issue 6special Pages 1334-1340
    Published: June 10, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.6special_1334
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    The authors analysed statistically 2, 514 inpatients treated from 1978 to 1983 in this department. Diseases of the ear predominated as did operations on the ear: tympanoplasty, auriculoplasty for microtia, decompression to the facial nerve for Ramsay Hunt's syndrome, Bell's palsy and traumatic facial palsy.
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