Practica Oto-Rhino-Laryngologica

Causes and a Treatment of Sensorineural Hearing Impairment

Yoshiaki NAKAI

1986 Volume 79 Issue 2 Pages 175-188
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.175

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Sensorineural hearing impairment is usually due to a lesion in the inner ear, but the cause is unclear in about half of the cases. Various clinical studies and basic research have gradually clarified the cause, and the percentage of unknown causes has decreased. In this study, the cause of hearing impairment was investigated clinically and various aspects of sensorineural hearing impairment due to inner ear lesions of unknown etiology were analyzed. Furthermore the extent to which diabetes mellitus, streptomycin, chronic alcoholism, etc. damage the inner ear was clarified.
Much basic research has been conducted on inner ear disease starting in the late 1800s, and considerable detailed information is now available. On the basis of this information and our basic research, we used pharmacotherapy (Loop diuretic and Vitamin Therapy: L-V Therapy) and obtained good clinical results.

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Open Method Tympanoplasty

-Management of the External Canal and Mastoid Cavity-

[in Japanese]

1986 Volume 79 Issue 2 Pages 190-191
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.190

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Primary Position Spontaneous Vertical Nystagmus; Pathophysiology and Review of the Literature

-Upbeat Nystagmus, Downbeat Nystagmus, and Alternating Vertical Nystagmus Treated by the Authors-

Kanji BABA, Eiji SAKATA, Hiroshi NAKAZAWA, Naoko ITO, Kyoko OHTSU

1986 Volume 79 Issue 2 Pages 193-212
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.193

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In their study of the literature, the authors found 41 cases of primary position upbeat nystagmus (PPUN) and over 250 of primary position downbeat nystagmus (PPDN). We have treated 2 patients with PPUN due to chronic alcoholism and malnutrition, and one with PPDN. There are two types of PPUN, brainstem type and cerebellar type, as with PPDN. The characteristics of the nystagmus are described.
A study of the lesion due to chronic alcoholism suggests that spontaneous vertical nystagmus in which the direction changes during convergence or in the course of the disease is specific for this disorder.

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Surgical Treatment of External Auditory Canal Cholesteatoma

Etsuo YAMAMOTO, Michitaka IWANAGA, Kayoko SATO

1986 Volume 79 Issue 2 Pages 213-218
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.213

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Two patients, an 8-year-old female and a 66-year-old male with external auditory canal cholesteatoma involving the anteroinferior bony canal wall were treated surgically. No recurrence of cholesteatoma was noted about 3 years after surgery. A modified radical mastoidectomy was performed and the cholesteatoma was removed with any adjacent dead bone under direct vision. The bony defect was filled with temporal bone fragments and covered with a homograft cartilage plate and temporal fascia.

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A Case of Otosclerosis of Sudden Onset

Kunio YANOHARA, Nobuaki YAMASHITA, Shigeru MIYOSHI, Michi HYUGA, Takes ...

1986 Volume 79 Issue 2 Pages 219-224
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.219

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The patient was a 33-year-old female who noted sudden hearing loss of her left ear while she was listening to her stereo. She was treated first as a case of sudden deafness because of its sudden onset.
Afterward detailed examinations revealed otosclerosis. Patients with otosclerosis usually lose their hearing ability slowly in over a long period. This case is a rare one of otosclerosis with sudden hearing loss.

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A Case of Ceruminous Adenoma

Keisaku TABUCHI, Etsuo YAMAMOTO, Shinsuke ITO, Kazunori MORI

1986 Volume 79 Issue 2 Pages 225-231
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.225

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Ceruminous adenoma is very rare, especially in the bony portion. A case of Ceruminous adenoma is reported. The tumor was located in the bony portion of the right external auditory canal. Local excision was performed. The post operative course has been uneventful with no recurrence after one year and three months.

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Contralateral and Ipsilateral Evoked Electromyography of the Orbicularis Oris Muscle in Normal and Intraternporal Facial Palsies

Jyu NIN, Naoaki YANAGIHARA, Hirotoshi TOKUHASHI

1986 Volume 79 Issue 2 Pages 233-237
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.233

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We performed contralateral and ipsilateral evoked electromyography (EMG) of the orbicularis oris muscle in 9 normal subjects and 32 patients with facial palsies; 22 with Bell's palsy and 10 with Ramsay Hunt's syndrome. In the normal subjects, the amplitude ratio of the contralateral to the ipsilateral evoked EMG ranged from 1:5 to 1:2. In 15 of the patients with facial palsy, the amplitude ratios exceeded the normal range. The amplitude ratios in the denervated group tended to be larger than those in the nondenervated group. These results suggest that contralateral facial nerve fibers innervating beyond the midline might intensify to assist the function of the affected facial nerve.

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Aerosolization of Bacterial Polyvalent Vaccine

Yoshinobu SATO, Noboru HYO, Hiroshi TAKANO, Satoshi OKUDA

1986 Volume 79 Issue 2 Pages 239-244
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.239

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Polyvalent antigen vaccine injections containing several types of bacteria or their autolysates are valuable in the treatment of chronic paranasal sinusitis and nasal allergy.
Broncasma Berna, one of the effective vaccines when aerosolized and inhaled nasally, was as effective as when injected.
The particle size distribution of the vaccine aerosols generated by NE-U10B, a common clinical ultrasonic nebulizer, was demonstrated by the naphthol green B replica method with a cascade impactor.
The reasonability of the vaccine aerosols in the particle size distribution is discussed and evaluated in relation to their intra-sinal deposition

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Osteoid-osteoma of the Frontal Sinus Associated with Eye Symptoms; a Case Report

Tadashi KOJIMA, Noboru YAMANAKA, Kohji ASAKURA, Noriyuki SATO

1986 Volume 79 Issue 2 Pages 245-252
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.245

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Osteoid-osteoma is sometimes reported in Western countries, but is very rare in Japan. Osteoid-osteoma of paranasal sinuses is a rare disease anywhere in the world. We report here the first case in Japan of osteoid-osteoma of the frontal sinus associated with eye symptoms. The patient was a 13-year-old boy with exophthalmus, decreased visual acuity and diplopia. The patient was treated by surgical removal of the tumor by Killian's technique. The defect of the upper orbital edge was repaired with iliac bone fragments. We also present a statistical analysis of osteoma and osteoid osteoma of paranasal sinuses origin.

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A Metastatic Orbital Tumor from Hepatocellular Carcinoma

-A Case Report-

Mayuki GOTO, Naoyuki KANO, Kazuo MAKIMOTO, Tsuguo AMEMIYA, Akira HASHI ...

1986 Volume 79 Issue 2 Pages 253-257
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.253

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Metastatic tumors of the orbit are considered to be much rarer than orbital tumors which originate in the lacrimal apparatus or paranasal sinuses. A 56-year-old male was admitted with right exophthalmus due to a tumor situated in the lateral portion of the orbit. Pathologic examination after exploratory operation revealed probable metastatic hepatocellular carcinoma. Despite chemotherapy and radiation therapy to the orbit, he deteriorated gradually and died in hepatic coma. Autopsy showed multiple hepatocellular carcinomas with metastases to the right orbit, right cerebral lobe and dura mater, and right adrenal gland.

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Clearing Function of the Cleft Palate Nose

I. Mucociliary Function of the Nasal Floor on the Side of the Cleft

Tsuneki NOZOE, Michiaki HIRAMOTO, Kazuya MATSUDA

1986 Volume 79 Issue 2 Pages 259-265
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.259

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To examine the clearing function of the cleft palate nose, mucociliary transportation rates of the nasal floor were measured on the side of the cleft.
Following palatoplasty in 10 cases of complete cleft palate, mucociliary transportation rates measured by nasal scintigraphy were found to be significantly lower than normal. On the other hand, in one case of incomplete and one of soft palate cleft, transportation rates were normal.
Nasal fiberscopy and pathological study showed granulomas with nonciliated stratified squamous epithelium on the nasal floor in all cases of complete cleft palate, but not in other types of cleft palate.
The formation of granulomas and reduced mucociliary function of the nasal floor probably reduce the clearing function of the cleft palate nose.

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One-stage Reconstruction of Hypopharyngo-esophagus by D-P Flap

Susumu TAMAKI, Masaki OHMURA, Yasuyuki TASAKA, Iwao HONJOH

1986 Volume 79 Issue 2 Pages 267-272
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.267

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A new surgical technique for one-stage reconstruction of the hypopharyngo-esophagus is described. As in the previous reconstruction method by a D-P flap, the esophagus is anastomosed through a vertical slit at the center of the D-P flap.
The epithelium of the proximal part of the D-P flap is removed and covered by the skin flap of the anterior neck in one stage. This surgical procedure was performed in patients with hypopharyngeal or extensive laryngeal cancer. The operation is rather easy and safe compared with previous techniques. No esophageal fistula developed after the operation.

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Pulmonary Tuberculosis and Recurrent Laryngeal Nerve Paralysis

Mitsuo MATSUZAKI, Fumihide ITO, Yoshihito YASUOKA, Hideo ISHII

1986 Volume 79 Issue 2 Pages 273-281
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.273

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Antituberculosis drugs and thoracic surgery have reduced the incidence of recurrent laryngeal nerve paralysis due to pulmonary tuberculosis. The onset and course of this condition may also have changed, but no details have been reported yet. During the past 10 years, 12 patients with this paralysis have visited our clinic.
1) They represent only 0.4% of the total of 299 patients with recurrent laryngeal nerve paralysis seen during this period.
2) There were no patients bilateral paralysis and 11 of the 12 had paralysis on the left side.
3) The pulmonary lesion and laryngeal paralysis were on the same side except in one patient who had left laryngeal paralysis and right pulmonary tuberculosis.
4) There was an interval of 20-30 years between the onset of pulmonary tuberculosis (at 32.2 years of age on the average) and the development of recurrent laryngeal nerve paralysis (at 58.6 years of age old on the average). Since it occurs in an older age group it must be differentiated from lung cancer.
5) The common findings of CT-scan examination in 3 cases were shifting of the mediastinum to the left, diminished left thoracic space, and thickening of the pleura. These findings indicate that the cause of this paralysis is pressure and retraction of the nerve by scar tissue. We consider, moreover, that the vulnerability of the recurrent laryngeal nerve might have been increased by chronic local circulatory disturbance, because the nerve was usually surrounded by scar tissue.

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Laryngeal Foreign Body in Infant; A Case Report

Yukio TODA, Shoichiro OOTAKA, Kumi NAKAJIMA, Hiroshi IWASAWA, Isamu TA ...

1986 Volume 79 Issue 2 Pages 283-290
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.283

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Recently we treated a 15-month-old female with a plastic toy fixed in the glottis.
In the past 25 years, 14 infants with laryngeal obstruction by a foreign body have been reported in Japan. The type and site of obstruction of the foreign bodies and the duration of their enlodgement were investigated.
In 12 of the 14 patients, the foreign bodies were some form of food, and in 13, the foreign body was radiolucent. In half of the patients, the foreign body had been present for more than a month.
Among the many examinations used, auscultation and soft lateral roentgenograms of the neck seemed to be the most useful in the diagnosis of this condition.
Laryngeal foreign bodies accounted for 0-4% of the total number of foreign bodies in the respiratory tract. In cooperation with pediatricians and radiologists, otolaryngologists can improve the accuracy of diagnosing this disease.
Otolaryngologists should always suspect foreign bodies and perform direct laryngoscopy when children with stridor are examined.

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Intracellular Structure of the Hair Cells and the Supporting Cells of the Organ of Corti in the Guinea Pig

-Three Dimensional Observation by Scanning Electron Microscope-

Toshitada SAKAI

1986 Volume 79 Issue 2 Pages 291-302
Published: February 01, 1986
Released on J-STAGE: December 12, 2011

DOIhttps://doi.org/10.5631/jibirin.79.291

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The freeze fracturing technique followed by maceration with 0.1 % OsO₄ solution (Osmium-DMSO-Osmeium ‹O-D-O› method) was used to prepare specimens for scanning electron microscopy.
Among the cell organelles, the endoplasmic reticulum (ER) of the outer hair cell showed the most characteristic features, such as Hensen's body and subsurface cisterna. The subsurface cisterna which formed a specific network covered the inner surface of the outer hair cell membrane. Hensen's body consisted of cisterna, tubular ER and mitochondria all of which aggregated at the upper part of the outer hair cell.
The inner hair cell was almost the same shape as the outer hair cell, but the characteristic structure of the ER in the outer hair cell was not observed.
Among the supporting cells, the pillar cell, Deiter's cell and Hensen's cell which faced the Corti's lymph had well-developed tubular ER, while Claudius' cell had poorly developed tubular ER.
The O-D-O method employed in this study is the most feasible for scrutinizing intracellular structures of the outer hair cells.

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Fundamental and Clinical Studies of the Rhino-Maxillo Aerodynamic-Grams Used to Measure the Patency of the Maxillary Ostium

Part 1: Method of Examination

Yoshiaki OKUNO

1986 Volume 79 Issue 2 Pages 303-319
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.303

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Determining the patency of the maxillary ostium is very important in the diagnosis of chronic sinusitis.
The usefulness of the Rhino-Maxillo Aerodynamic-Gram (R. M. A. G.) in examining the patency of the maxillary ostium was evaluated in patients with sinusitis, the R. M. A. G. finding were correlated with the results of other examinations.
1) The R. M. A. G. findings reproduce the patency of the maxillary ostium more clearly than the endoscopic, histological or bacteriological findings.
2) No relationship was recognized between the R.M.A.G. findings and the subjective symptoms.
3) A certain correlation was found between the R. M. A. G. findings and the simple radiograms of the ethmoid sinus.
4) There was a positive correlation between R. M. A. G. and X-M. F. T. findings.
It is concluded that R.M.A.G. is a simple method of measurement, high in reproducibility, and is useful in the quantitative analysis of patency of the maxillary ostium.

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Clinical Studies of Fosfomycin Ear Drop Solution

Yutaka FUJIMAKI, Shozo KAWAMURA, Eiichi KATO, Shigekazu TSUBAKI, Takeo ...

1986 Volume 79 Issue 2 Pages 321-329
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.321

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Clinical studies on Fosfomycin ear drop solution (3%) in cases of chronic otitis media (3 cases) and its acute exacerbation (23 cases) showed the following:
1) The overall clinical effect was excellent in 15 cases, good in 5 cases, fair in 3 cases, and poor in 3 cases. The clinical efficacy rate was 76.8%.
2) No side effect was observed in any of the cases.

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Clinical Study of Long Term MS-Antigen 40 Treatment of Nasal Hypersensitivity

Satoshi OGINO, Ichiro OKAWACHI, Tamotsu HARADA, Morihiro IRIFUNE, Toru ...

1986 Volume 79 Issue 2 Pages 331-340
Published: February 01, 1986
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.79.331

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1. Eighteen Patients with nasal hypersensitivity, 9 with nasal allergy and 9 with vasomotor rhinitis were treated with MS-Antigen 40 (MS-A) for more than one year.
2. The overall improvement rates after one year of MS-A treatment were 66.7% in cases of nasal allergy and 88.9% in cases of vasomotor rhinitis.
3. The greater the total dose, the better was the clinical effect.
4. The effect of MS-A was noted within 3 months in many cases.
5. The continuation of MS-A injections was necessary every 2 to 4 weeks for the maintenance of the clinical effect.
6. The mechanism of action of this drug is not clear, but it is probably associated with the stabilization of mast cells.

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