Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 79, Issue 1
Displaying 1-24 of 24 articles from this issue
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  • Long Term Results of the Endocochlear Shunt Operation
    Yasuya NOMURA, Masashi SUGASAWA, Takashi FUKAYA, Takashi FUTAKI
    1986 Volume 79 Issue 1 Pages 1-8
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.1
    JOURNAL FREE ACCESS
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    Long term results of the endocochlear shunt operation were evaluated in 20 earswith Meniere's disease, sudden deafness and delayed endolymphatic hydrops. Observation periods ranged from 7 months to 3 years and 2 months.
    The procedure gave a great relief to patients who complained of fullness of the earand loudness intolerance. Vertigo was successfully controlled in 71%. Audiological examinations revealed that hearing was practically unchanged in 65%. Closure of a fistula in the round window membrane was important for prevention of occurrence of the perilymphatic fistula which is a late complication of the surgical procedure. The operation can be indicated to patients with cochlear Meniere's disease, Meniere'sdisease with good hearing and delayed endolymphatic hydrops.
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  • Silicone Injection for Paralyzed and/or Atrophic Vocal Folds
    [in Japanese], [in Japanese], [in Japanese]
    1986 Volume 79 Issue 1 Pages 10-11
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.10
    JOURNAL FREE ACCESS
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  • Current Clinical Evaluation of Pathological Eye Movements in Midline or Symmetric CNS Lesions
    Eiji SAKATA, Kyoko OHTSU, Hiroshi NAKAZAWA, Kouki NAKAIGAWA, Yoshihiro ...
    1986 Volume 79 Issue 1 Pages 13-27
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.13
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    Neurotological diagnosis, unlike diagnoses in the field of internal medicine whichdepend on clinical laboratories, owes much of its success to neurological examinationsperformed by neurotologists themselves.
    Such diagnosis therefore has a“man-made flavor”, frequently reflecting clearlythe differences in diagnostic ability among the physicians.
    The present communication summarizes new developments in the clinical diagnosis of pathological eye movements during the last 2-3 years.
    The significance of the following signs in bilateral vestibular lesions or other symmetrical lesions is discussed:
    1) Acquired pendular wandering eye-movement
    2) Fixation jerks
    3) Spontaneous and transitory eyeball burst or seizure
    4) Vertical rebound nystagmus
    5) Optokinetic vertical ocular dysmetria
    6) Divergence nystagmus
    7) Counter-rolling, pure rotatory positioning nystagmus
    8) Inversion of optokinetic after-nystagmus (OKAN)
    9) Vertical congenital nystagmus and inversion of optokinetic nystagmus (OKN)
    10) Treatment of congenital nystagmus
    11) Vertical spontaneous nystagmus to lower eyelid, so-called“downbeat nystagmus”
    12) Downbeat nystagmus seen in bilateral labyrinthine dysfunction
    Our clinical experience with abnormal eye movements is described. We invitecritical comments and hope that our accumulated data on several cases along with theresults of experimental studies will contribute to the progress of neurotology as the“neurology of the posterior fossa”becomes better known.
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  • Ossicular Disruption due to Indirect Injury of Head Trauma
    Etsuo YAMAMOTO, Hiroko NISHIMURA, Setsuko MORINAKA, Michitaka IWANAGA
    1986 Volume 79 Issue 1 Pages 29-35
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.29
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    Six cases with ossicular disruption due to indirect injury of head trauma are reported. Facial nerve paralysis was present in all 6, and 5 patients underwent facialnerve decompression because they showed no signs of recovery. Satisfactory hearing (within 4adB) was achieved in all 6 by ossicular reconstruction, and facial nerve function (over 30 points in the paralysis score) was restored by decompression surgery. The etiology, diagnosis, timing and technique of surgery are discussed.
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  • Eustachian Tube Function in Patients with Otitis Media Chronica
    Haruo TAKAHASHI, Etsuo YAMAMOTO, Yoshinobu HIRONO, Iwao HONJO
    1986 Volume 79 Issue 1 Pages 37-44
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.37
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    Eustachain tube function was examined by the inflation-deflation test in 25 patients (29 ears) with otitis media chronica (OMC). In comparison with four normal controls, both passive and active ventilation functions of the tube in OMC were impaired, especially active ventilation. Patients with otorrhea showed more impairment of both active and passive ventilation function than did those with dry ears. Patients treated with tympanoplasty type III or IV showed more impaired active ventilation function than did those treated with tympanoplasty type I. These results indicate that the degree of impairment of Eustachian tube function is nearly proportional to the degree of pathological change in OMC.
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  • Abnormal Amplitude Increment in Evoked Electromyograms of Facial Muscles in the Acute Phase of Facial Palsy
    Jyu NIN, Naoaki YANAGIHARA, Kohshiro NAKAMURA
    1986 Volume 79 Issue 1 Pages 45-50
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.45
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    In the very acute phase of Bell's palsy and Ramsay Hunt's syndrome, the amplitudes of evoked electromyograms of the orbicularis oculi and oris muscles not rarely appear to extend beyond the upper limit of normal. This abnormally large amplitude declinedvery sharply, and in the second week of the diseases, the amplitude returned to normal or even decreased below normal in 6 patients, 4 out of the 76 patients with Bell's palsyand 2 of the 16 with Hunt's examined in our clinic. In these 6 patients, there was noevidence of denervation, and the facial palsy continued to be incomplete throughout thecourse of the disease. Thus, the abnormally large amplitude was a sign of favorableprognosis of the facial palsy. The results suggest that the facial nerve becomes transiently hyperexitable after moderate damage of the intratemporal area.
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  • A Case of Bilateral Simultaneous Facial Palsy
    Masaya YOKOTA, Takeo KUSUMOTO, Kazuya KINOSITA, Toshihide TABATA
    1986 Volume 79 Issue 1 Pages 51-56
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.51
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    Bilateral facial nerve palsy is a rare disease. In the past 30 years only 11 cases of bilateral simultaneous Bell's palsy have been reported, and only three were completely simutaneous.
    This is a case report of bilateral complete simultaneous Bell's palsy.
    The patient was a 27-year-old man. On March 18, 1984, he noted facial nerve palsythat occurred simultaneously on both sides. He visited us with a complaint of difficultyin talking on April 24, 1984. Bell's palsy was diagnosed, because physical findings and laboratory examinations showed no evidence of systemic diseases. About 6 months after onset, his palsy had subsided almost completely bilaterally following conservative treatment.
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  • Post-Traumatic Bilateral Atresia of the External Auditory Canals
    Kimiko OHISHI, Hiroshi ITO, Yuichi MAJIMA, Yasuo SAKAKURA, Yasuro MIYO ...
    1986 Volume 79 Issue 1 Pages 57-62
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.57
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    A patient developed atresia of both external auditory canals following a traffic accident. Bilateral atresia of the auditory canals is very rare and has never been reported in Japan. The occluded portions of the canals were resected through a postauricular approach. In the right external auditory canal, a cholesteatoma-like accumulation was found behind the obstruction. The operation restored the hearing in both ears tonearly normal. Twenty-two cases of post-traumatic atresia of an external auditory canalreported to date in Japan are reviewed, and the pathology, pathogenesis and treatment are discussed.
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  • Lateral Saccular Cyst
    -A Case Report-
    Takaki MIWA, Takashi KOMORI, Kikuo TOKUDA, Yozo OKABE, Mitsuru FURUKAW ...
    1986 Volume 79 Issue 1 Pages 63-66
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.63
    JOURNAL FREE ACCESS
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    A 28-year old man who had been complaining ofhoarseness noted a solid protrudingdeformity in the right thyroid ala. Laryngoscopic examination revealed a cystic massin the right supraglottic area. Cervical CT-scan showed a low density mass in theparaglottic area, which suggested a lateral saccular cyst. The cyst was successfullyremoved by a thyrotomy approach and the patient has been free from his symptoms.Histological examination of the resected specimen showed that the cyst was lined withrespiratory epithelium.
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  • Partial Laryngopharyngectomy Followed by Secondary Reconstruction for Carcinoma of the Piriform Sinus
    Minoru HIRANO, Shigejiro KURITA
    1986 Volume 79 Issue 1 Pages 67-71
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.67
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    In selected cases of piriform sinus carcinoma, total laryngectomy is not necessarilyrequired to eradicate the disease. Partial laryngectomy consisting of ipsilateral removalof the supraglottis frequently suffices to eradicate the carcinoma. Total laryngectomy has been performed in such cases because severe aspiration occurs after partialremoval. This paper describes a technique of partial laryngopharyngectomy followed by secondary reconstruction. In the first step, we remove the piriform sinus, one thirdto one half of the epiglottis, the aryepiglottic fold, the arytenoid region, the false fold, most or all of the arytenoid cartilage, half of the hyoid bone, and approximately one thirdof the thyroid cartilage ipsilaterally. The larynx and pharynx are kept open by suturingthe mucosa to the cervical skin. The second step, or reconstructive surgery, employstwo hinge flaps and a DP flap. One of the hinge flaps is used to line the larynx, andthe other lines the hypopharynx. In part, the two flaps are sutured back to reconstruct the aryepiglottic fold, i. e. to form a wall between the larynx and the pharynx. The cervical wound is then covered by the DP flap.
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  • The Accuracy of RI Scintigrams in the Diagnosis of Head and Neck Tumors
    Fumihide OMURA, Masae ZUSHI, Yukako SHIMOMURA, Satomi TANIGUCHI
    1986 Volume 79 Issue 1 Pages 73-83
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.73
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    The accuracy of Ga scintigrams and bone scintigrams in finding metastatic lesionswas evaluated.
    Ga scintigrams were performed 89 times and bone scintigrams 26 times on 67 patients with malignant tumors of the head and neck.
    The rate of correct diagnosis of metastatic lesions by Ga scintigrams was 72%, false positives 15%, false negatives 20%, sensitivity 0.80 and specificity 0.85.
    The rate of correct diagnosis by bone scintigrams was 81%, false positive 20%, false negative 0, sensitivity 1.0 and specificity 0.80.
    Correct diagnosis is aided by scintigrams, which are in accord with the clinical courseand the findings on biopsy, surgery and/or autopsy.
    Although Ga scintigrams showed false positive or false negative results due to factors such as inflammation, irradiation, operation and activity or histology of tumors, they are very useful in finding metastatic lesions, especially in the lung.
    Bone scintigrams had a higher rate of false positives, but no false negatives, so their sensitivity is high.
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  • Tracheotomy for infectious Mononucleosis
    Hiroshi IWAI, Chiyonori INO, Nobuya YAGI
    1986 Volume 79 Issue 1 Pages 85-89
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.85
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    Infectious mononucleosis (IM) is a disease which generally has a good prognosis, but there may be several severe complications: ruptured spleen, Guillain-Barré syndrome, airway obstruction, etc.
    A 21-year-old female patient suffering from IM with the chief complaint of dyspnea was found to have extremely swollen tonsils and adenoids. Parenteral steroid therapy was not effective, so we performed a tracheotomy.
    It is important to determine the cause of dyspnea. The medical and surgical therapy of airway obstruction in IM are discussed.
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  • Statistical Survey of Patients' Satisfaction with the Results of Cleft Lip and Palate Repair (Part Two)
    Nobuyuki NONAKA, Michio KAWANO, Fujie HAGIO, Miyoko YAMADA, Nobuhiko I ...
    1986 Volume 79 Issue 1 Pages 91-98
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.91
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    Questionnaires including 14 items were sent to 320 patients with cleft lip and/or palate, including submucous cleft palate and congenital velopharyngeal closure incompetence. There were 215 (67.2%) response. We reported in part 1 the 8 items dealing with the psychological aspects of the patients and their parents. This paper reports the other 6 items about the satisfaction with the operative results. 9. Results of cleft lip and nose repair
    The response was ‘satisfied’ in 10% and ‘satisfied but hoping for further improvement’ in 70%.
    10. Results of palate surgery
    About 25% were satisfied and about 70% nearly satisfied but hoping for further improvement.
    11. Speech
    Thirty percent were satisfied and 50% answered that their speech was intelligible but sometimes distorted.
    12. Dental and orthodontic problems
    About 70% of cleft lip and palate patients desired orthodontic treatment for malocclusion.
    13. Utilization of special medical insurance for children with congenital malformation The utilization rate was 80%.
    14. Requests of the hospital
    Systematic treatment or training, including explanations, were desired by the ma- jority of the patients.
    In summary, the above results showed that many patients or their parents hope for further improvement though they expressed satisfaction. Some patients with excessive demands above the possibilities of current medical techniques should be advised of the free situation.
    However, these demands and requests from the patients should be received frankly and respectfully so that medical care can be improved in the future.
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  • Diagnosis and Treatment of Thyroid Diseases
    [in Japanese]
    1986 Volume 79 Issue 1 Pages 99-122
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.99
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  • [title in Japanese]
    [in Japanese], [in Japanese]
    1986 Volume 79 Issue 1 Pages 101-105
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.101
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  • [title in Japanese]
    [in Japanese]
    1986 Volume 79 Issue 1 Pages 106-110
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.106
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1986 Volume 79 Issue 1 Pages 111-114
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.111
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  • [title in Japanese]
    [in Japanese]
    1986 Volume 79 Issue 1 Pages 114-118
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.114
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  • [title in Japanese]
    [in Japanese]
    1986 Volume 79 Issue 1 Pages 118-122
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.118
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  • Scanning Electron Microscopic Study of Vestibular Sensory Cells and Nerve Endings in Bullfrogs
    Ryozo YABUTA
    1986 Volume 79 Issue 1 Pages 123-134
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.123
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    Vestibular sensory organs have been examined various types of microscopes. The scanning electron microscope (SEM), with which three dimensional observation is possible, has been used in numerous studies of the surface microstructure of vestibular sensory organs. Recently, improvements in instruments and techniques for SEM have made possible a more detailed and accurate description of the ultrastructure of the vestibular sensory organs.
    The vestibular sensory cells and nerve elements in bullfrogs were observed by means of the Osmium-DMSO-Osmium method and SEM.
    1. It was possible to observe by SEM the three dimensional structure of the vestibular sensory cells, cytoplasmic organelles, and nerve elements by means of the cracking method.
    2. Only type 2 cells were observed in the vestibular epithelium in the bullfrog.
    3. The nerves distributed in the sensory cells were found to bifurcate from the trunk and change abruptly into thin nerves which led to nerve endings.
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  • Tree Pollens and Nasal Allergy (IV)
    -Airborne Tree Pollens on the Roof of Wakayama Red Cross Hospital-
    Tadao ENOMOTO, Takako IKOMA, Keiko FURUKAWA, Daisuke IWAHASHI, Hiroshi ...
    1986 Volume 79 Issue 1 Pages 135-142
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.135
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    Determination of airborne pollens is essential for understanding tree pollinosis. Therefore, we installed the Durhum standard pollen examiner on the roof of the Wakayama Red Cross Hospital to determine airborne pollens over a long period of time.
    This paper lists the counts of airborne pollens of Japanese cedar, Japanese cypress and pine from February to May, 1985, and correlates Japanese cedar pollinosis with meteorological data in Wakayama city.
    Methods of estimating airborne pollens described by several investigators showed a probable high count of airborne pollens as judged by last year's weather phenomena. In Wakayama city in the pollen season this year, Japanese cedar pollens amounted to 577/cm2 and the highest daily count was 58/cm2. A comparison could not be made becuase of lack of previous data in Wakayama. However, on the basis of the yearly change in numbers of patients with Japanese cedar pollinosis at our hospital and the results of measurements by other investigators, the pollen count this year was probably lower than average.
    We will follow airborne pollens for a long term to help estimate the airborne pollen count in relation to meteorological data.
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  • Effect of in vivo Treatment with Histamine-Gammaglobulin-
    Conjugate and Histamine Contents of Several Tissues in Sensitized Guinea Pigs
    Morihiro IRIFUNE, Satoshi OGINO, Tamotsu HARADA, Ichiro OHKAWACHI, Tor ...
    1986 Volume 79 Issue 1 Pages 143-149
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.143
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    The effect of HG (Histamine-Gammaglobulin-Conjugate), which has been used to treat allergic rhinitis, was studied in actively sensitized Hartley guinea pigs weighing 200-300g.
    After a sensitizing application of 10% TDI (toluene diisocyanate) to the noses of guinea pigs, we confirmed sensitization by applying 5% TDI. Eight sensitized and seven nonsensitized guinea pigs received subcutaneous injections of HG or saline.
    Symptom scores were recorded, and the therapeutic effect was assessed. Furthermore, after challenge of the animals, the histamine content of the blood, the turbinates and the lungs was determined after sacrifice under general anesthesia with pentobarbital sodium.
    Five of the seven treated with HG showed a good response, while none of those injected with saline improved. The group treated with HG had a higher content of histamine in the turbinates and the lungs, but a lower blood level than the control group.
    This experiment on model animals with nasal allergy verified the safety and therapeutic effectiveness of HG. The tissue histamine content suggested that HG inhibits histamine release from mast cells.
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  • Effect of an Anticholinergic Agent, Ipratropium Bromide, on Nasal Ciliary Epithelium
    Hitoshi SAITO, Toshihito TSUBOKAWA, Takehisa SAITO
    1986 Volume 79 Issue 1 Pages 151-159
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.151
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    Ipratropium bromide (IpBr) as an intra-nasal spray has been used to reduce nasal discharge. Its effect on the function and morphology of the nasal ciliary epithelium was investigated.
    Human nasal mucosa cultured in RPMI-1640 medium was used for counting ciliary activity by a photo-electric method. Nasal septal mucosa of C3H mice was employed for morphological observation by a scanning electron microscope.
    It was found that 40μg of IpBr sprayed twice into each nostril, which is the recommended dose of Atrovent®, was harmless. Furthermore, four applications a day appear to be safe from the evidence of elimination from the nasal cavity within 30min. Toxicological studies showed that spraying into both nasal cavities causes no problem.
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  • Clinical Evaluation of MK212G in the Treatment of Pharyngitis and Tonsillitis
    Yasuo HARADA, Koji YAJIN, Katsuhiro HIRAKAWA, Masakaze NAKATA, Shubun ...
    1986 Volume 79 Issue 1 Pages 161-172
    Published: January 01, 1986
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.79.161
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    Patients with pharyngitis and tonsillitis were studied in a randomized double-blind trial to compare the clinical usefulness of MK212G and Isodine gargle.
    1. Of the 71 patients treated with MK212G or Isodine gargle, four were excluded because they were out of protocol. The results in the remaining 32 patients treated with MK212G and 35 patients treated with Isodine gargle were analyzed statistically.
    2. MK212G was effective in 93.8% and Isodine gargle in 85.7%, not a statistically significant difference (x2=3.807 N.S.).
    3. In the MK212G group, one patient complained of oral discomfort and in the Isodine gargle group, two patients had mild nausea and one had vomitting. The difference was not statistically significant (x2=1.165 N. S.).
    4. MK212G was considered to be clinically useful in 87.51% and Isodine gargle in 82.86%, not a statistically significant difference (x2=0.410 N. S.).
    5. The above results suggest that MK212G is as useful as Isodine gargle in the treatment of pharyngitis and tonsillitis.
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