Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 79, Issue 6
Displaying 1-19 of 19 articles from this issue
  • Minoru OKUDA, Kosaku SAKAGUCHI
    1986 Volume 79 Issue 6 Pages 867-879
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A group study of parotid tumors was conducted. An epidemiological study revealed that annual incidence of the disease is 1.76 per 100, 000 people, and that 75% of the patients were treated by otolaryngologists. A histopathological study revealed that 23% of the tumors were malignant, and 55.4% were pleomorphic adenoma generally originating from the reserve cells of the secretory duct. This adenoma often invaded the surrounding capsule or proliferated irregularly like a malignant tumor, suggesting a possible cause of occasional postoperative recurrences. Patients with malignant tumors, such as mucoepidermoid tumor, adenoid cystic carcinoma and adenocarcinoma, showed varying clinical courses; therefore, these lesions should be subclassified from the point of view of prognosis.
    To differentiate benign from malignant preoperatively, clinical examination, different methods of imaging and needle biopsy were evaluated. By these tests a wrong diagnosis was made in about 15% of benign tumors and in about 20% of malignant. Among these, sialo-computer tomography was the most useful for localizing a tumor mass in the parotid.
    Parotidectomy with preservation of the facial nerve was indicated not only for benign tumors but also for malignancies of low grade extension and for mucoepidermoid or acinic cell tumors. In the majority of patients facial nerve paresis due to surgical injury subsided within three months when the nerve was not sectioned.
    Frey's syndrome occurred in the half of patients after operation.
    Combined treatment of surgery with irradiation and anticancer drugs was presumed to be useful for prevention of recurrence and metastasis in cancer.
    The crude five-year survival rate for patients with parotid carcinoma was 23%. Some patients with distance metastasis survived for a long time.
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  • [in Japanese]
    1986 Volume 79 Issue 6 Pages 880-881
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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  • Mikiko AKINAGA, Etsuo UMEDA, Hirohide YOSHIOKA, Mineko TSUCHIDA, Minor ...
    1986 Volume 79 Issue 6 Pages 883-891
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 18-year-old male was examined for bilateral hearing loss. His pure tone audiometer test showed normal hearing, but his speech discrimination score was 15% in the right ear and 20% in the left.
    Electronystagmography showed an abnormal eye movement which we suspected to be ocular myoclonus.
    A CT scan showed a pineal gland tumor and enlarged ventricles. His intracranial pressure was above 380 mmHg; the exact level could not be measured.
    After his intracranial pressure had been reduced to normal by drainage, his speech discrimination score recovered and the abnormal eye movement also declined.
    We considered that the lesion causing those symptoms was located around the inferior colliculus.
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  • -A Report of Three Cases-
    Noriko KOMIYA, Koichi YAMASHITA, Sumio ARAKI, Masami TAKANO, Toshimasa ...
    1986 Volume 79 Issue 6 Pages 893-900
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A clap of thunder caused ear trauma in three construction workers. All three had eardrum perforations and a temporary threshold shift of hearing, one had a permanent threshold shift at higher frequencies. Individual differences were observed in severity of the injury. The eardrum perforations healed almost completely within one month. During the course of healing, temporary thickening of the edge of the perforation and its migration outwards to the margin of the eardrum were observed. The course of recovery of the temporary threshold shift showed an exponential curve. Permanent threshold shift were observed only in the left ear of one patient.
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  • -A Preliminary Report-
    Yasushi NAITO, Iwao HONJO, Kazumasa NISHIMURA, Kanji TORIZUKA
    1986 Volume 79 Issue 6 Pages 901-906
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We found magnetic resonance imaging is capable of displaying the normal anatomy around the eustachian tube such as the eustachian tube cartilage, tensor veli palatini muscle, and levator veli palatini muscle. In addition, MR images of tonsillar malignant lymphoma with secretory otitis media disclosed a relationship between the morphological changes of the eustachian tube and middle ear disease.
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  • Tatsuzo TAIRA, Nobuhiko ISSHIKI, Michio KAWANO
    1986 Volume 79 Issue 6 Pages 907-914
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Precise estimation of velopharyngeal function is the essential first step in treating cleft palate speech either by surgery or by speech therapy.
    The methods in use at our daily clinic include assessment of speech, oral inspection, rhinometric mirror, pneumotachography, velopharyngeal radiography, videonasoendofiberscopy, videofluororadiography, and computerized tomography. Evaluation of velopharyngeal function on the basis of auditory impressions, especially of nasality, is clinically important but requires accumulated experience. This paper emphasizes the usefulness of 3 methods in particular: videonasoendofiberscopy, videofluororadiography and computerized tomography.
    Videonasoendofiberscopy provides direct visual information on velopharyngeal closure during speech activity, but quantitative analysis is impossible. There is also a problem in reproducibility and reliability due to possible different positions of the fiberscope on each test.
    Videofluororadiography permits dynamic and quantitative assessment of velopharyngeal closure when the video-images are repeatedly displayed for measurement. Two directional projections -lateral and anteroposterior- are recommended for full understanding of the velopharyngeal function. Videofluororadiography is also advantageous in that the relation between velopharyngeal function and articulatory lingual movement can be well visualized.
    Modern computerized tomography can demonstrate the velopharyngeal aperture on a calibrated scale.
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  • Kosaku SAKAGUCHI, Fumio SAKAGUCHI, Katsuro USHIJIMA
    1986 Volume 79 Issue 6 Pages 915-921
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Nasal surface basophilic cells were investigated as a parameter of nasal allergy, in addition to the conventional tests. Nasal scrapings were obtained by a small currette from the surface of the inferior concha of 136 patients with nasal allergy, smeared on glass slides, fixed with 99% methylalcohol and stained with Hansel's solution for 40-50 seconds.
    The basophilic cells were counted. If more than 10 cells were seen, the test was considered positive. The surface basophilic cell test was positive in 94% of perennial allergy patients with a positive reaction to antigen challenge, in 67% of perennial patients with a negative challenge reaction and in 74% of seasonal patients with a positive challenge reaction.
    These figures show that this test is not superior to eosinophils in nasal smears, but is superior to serum IgE levels and peripheral eosinophilic leucocyte counts. When both surface basophilic cells and eosinophilic nasal smears are examined, a higher positive rate should be obtained in nasal allergy tests.
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  • Haruhiko ISHIDA, Akira HOKI, Kenichi YAMAGATA, Kazuhiro FUJIMOTO, Tets ...
    1986 Volume 79 Issue 6 Pages 923-929
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Five patients with hematoma in the nasal cavity and sinuses who had complained of unilateral nasal obstruction or nasal bleeding were examined. One of them had exophthalmus, and CT scan showed destruction of the wall of the maxillary sinus, deviation of the right pterygoid process, and invasion of tumor into the right orbit and right nasal cavity. Our first diagnosis was maxillary cancer, but a biopsy of the nasal cavity lesion showed necrosis, as did repeated biopsies of the maxillary sinus obtained after exploratory antrotomy. The final diagnosis was hematoma in a maxillary sinus.
    There are no specific symptoms or signs of hematoma in the nasal cavity and sinuses. Therefore a definitive diagnosis must be based on histologi.cal evidence of hemangioma, polyp, etc. In some cases, biopsy reveals necrosis. It is very difficult to distinguish this from maxillary malignant tumors. In those cases which we can not diagnose definitely by endonasal biopsy, exploratory antrotomy is advisable, with biopsy for accurate histological diagnosis.
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  • Masakazu KAWAI, Satoshi HASEGAWA, Kinya OOTAKE
    1986 Volume 79 Issue 6 Pages 931-935
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Gas gangrene is very rare, especially in ENT clinics. Only one case of cervical gas gangrene due to clostridium perfringens after acute tonsillitis has been reported, by Mukai et al.
    We report a case of gas gangrene due to synergistic infection (r-streptococcus and veillonella alkalescens) after acute peritonsillitis. A 58 year old man came to the hospital complaining of sore throat. Rt. tonsillar and peritonsillar swelling and purulent plugs were seen. He was treated with antibiotics for peritonsillar abscess.
    Nine days after the onset, he was hospitalized for a rt. neck tumor. Despite of antibiotic therapy, the neck tumor grew gradually. Twelve days after the onset, crepitation was felt beneath the skin of the neck, and a cervical X-ray film revealed gas in the soft tissue, a so called “bubble shadow”. Inspite of intensive care, drainage, tracheostomy and etc., he died fourteen days after the onset. Culture of the neck abscess grew out r-streptococcus (aerobic culture), and veillonella alkalescens (anerobic culture). A gram stain of muscle tissue revealed numerous gram positive cocci in the muscle cells.
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  • Hisashi YOKOI, Hiroshi TAKAMUE, Keiko MURAHASHI, Yukio UEDA, Akikazu I ...
    1986 Volume 79 Issue 6 Pages 937-942
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 15-year-old male was refferred to us in November 1982 with a one-month history of swelling of the neck on the left side. Biopsy was performed, but the diagnosis was not clear histologically. Under general anesthesia, the tumor was removed surgically, except for the areas which had invaded the carotid artery and skull base. Histological diagnosis was malignant schwannoma. Six thousand rads of 60Co were administered to his neck postoperatively. Four months after operation, a chest X-ray revealed multiple coin lesions of both lungs. He received combination chemotherapy consisting of DTIC, ACNU and VCR, but died of pneumonia five months after surgery.
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  • Teruhiro OGAWA, Takashi KAWAKAMI, Masayuki NAITO, Satoshi KOIKE, Shosu ...
    1986 Volume 79 Issue 6 Pages 943-948
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Raeder's syndrome is defined as a part of Homer's syndrome, in which only the 3rd sympathetic nerve is damaged. The 3rd nerve arises from the superior cervical ganglion and goes to the eyes. Raeder's syndrome lacks the anhidrosis of the face and the heterochromia iridis present in Homer's syndrome.
    We have examined two patients with Raeder's syndrome, a 62-year-old female with malignant lymphoma and a left cervical mass, and a 40-year-old male with a Schwannoma of the left side of the neck. Two cases of squamous cell carcinoma with marked cervical metastasis in the terminal stage and similar symptoms of Raeder's syndrome are also discussed.
    The most reliable method of differentiating the two syndromes is the pupillary drug test with sympathomimetic drugs. We used 1% phenylephrine. In Raeder's syndrome, marked dilatation of the pupils and improvement of ptosis were noticed.
    When we see Homer's syndrome patients with a cervical mass, this test should be used to better locate the tumor.
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  • -Report of a Case-
    Yasushi MURAKAMI, Masahiro MIZUNO, Ming-jen CHOW, Yoshihiro MURANUSHI
    1986 Volume 79 Issue 6 Pages 949-954
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Lipoma of the parotid gland, which consists of mature adipose cells, is a rare benign tumor observed in about 1 % of tumors of the parotid gland.
    On the other hand, infiltration of the parotid gland by adipose cells has been described by various terms since Gilman and co-workers reported “fatty infiltration of the parotid gland” in 1956.
    This condition has been called “fatty infiltration, ” “sialosis” or “lipomatosis” by different authors because the definition of such lesions has not yet established.
    We recently treated a patient suffering from lipoma of the parotid gland accompanied by lipomatosis of the parotid gland. This 35-year-old male patient first visited our department in May of 1984 with the chief complaint of a painless tumor in the left parotid area.
    Preoperative examinations showed a lipoma accompanied by lipomatosis of the parotid gland by CT scanning. The patient received superficial parotidectomy under general anesthesia, and no recurrence has been observed 6 months after surgery.
    We discuss the difference between lipoma of the parotid gland and infiltration of the parotid gland by adipose cells, which we call “lipomatosis” and the usefulness of CT scanning in the diagnosis of such lesions.
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  • Yoshinobu HIRONO, Etsuo YAMAMOTO
    1986 Volume 79 Issue 6 Pages 955-961
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The important role of eustachian tube function in the pathogenesis of chronic otitis media and the prognosis of tympanoplasty has been generally accepted. The evaluation of its function in chronic otitis media is indispensable in the management of this disease. The literature concerning the relationship between chronic otitis media and eustachian tube function is reviewed. No established method of evaluation has been found although various methods have been described. It is hoped that a new effective eustachian tube function test can soon be established.
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  • Tatsuo YOSHIOKA
    1986 Volume 79 Issue 6 Pages 963-977
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Corrosion casts of the vestibular vessels were observed under the scanning electron microscope (SEM).
    1) The densest capillary meshes were found in the neuroepithelial areas.
    2) The arterioles are coiled and then enter the subepithelial capillary meshes near the center of the hair cell area. Radial capillary networks are collected into venules at the periphery.
    The vestibular vasculature looks almost like diagramatic drawings when viewed by the light microscope. SEM can demonstrate the three-dimensional structure of the vestibular microcirculation.
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  • Yuko SHIBA, Tetsuzo FUJITANI
    1986 Volume 79 Issue 6 Pages 979-987
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The purpose of this study was to investigate the jS-adrenergic function on the nasal mucosa of the patients with allergic rhinitis who showed positive skin test, positive provocation test and eosinophilia in their nasal secretion.
    The cells, which were scraped from the mucous blanket on the nasal mucosa using a small curette, released histamine after the challenge of allergen (×10 house dust), but this release was inhibited 5 minutes after incubation with 10-4 or 10-5M of 1-isoproterenol. The cells from mucous blanket were also incubated in the Tris ACM buffer with or without 10-5M of 1-isoproterenol, and cyclic AMP levels in the cells were measured using radio-immunoassay. The levels of cyclic AMP incubated with 1-isoproterenol were four times higher than those without 1-isoproterenol.
    Nasal provocation was performed using the disk method. Nasal resistance was measured by the combined rhinomanometry and sneezes, nasal secretion and swelling of the turbinate were observed for 5 minutes after provocation. The increase of nasal airway resistance and allergen-induced nasal symptoms caused by provocation was inhibited after spraying 1-isoproterenol. This responsiveness to 1-isoproterenol as Radrenostimulant suggested that the adenyl cyclase activity and adrenoceptor function of the cells on the nasal mucosa were normal in the patients with nasal allergy.
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  • Susumu YAMAUCHI, Kazuo KATOH, Nobuyuki KOMATSU, Shigeaki SAITOH, Masat ...
    1986 Volume 79 Issue 6 Pages 989-994
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    It is well known that the early diagnosis of maxillary cancer (MC) is very difficult on the basis of its clinical appearance and symptoms, since nasal obstraction, bloody discharge, toothache and loosening of the teeth are common in the early stage.
    A new technique was devised for the isolation and charactrization of maxillary cancer associated antigens (MCAA), since elucidation of MCAA has been one of the major achievements of tumor immunology.
    Frozen sections of MC 10μm thick were applied directly to PAG-plates for isoelectric focusing. Saline extract of tumor tissues and sera were treated in the same manner.
    Specific components at around pH 6.1 were determined on PAG-plates and collected by chromatofocusing. Anti-MCAA rabbit serum was obtained by immunization with the components around pH 6.1 and anti-MCAA IgG serum was purified by protein A sepharose CL-4B.
    The purpose of this study was to demonstrate the location of MCAA in tumor sections and determine its approximate molecular weight. Tissues of 10 out of 11 (91%) cases of MC were stained positively by indirect immunofluorescence and immunoperoxidase techniques. This definitely positive staining was demonstrated on the cell membranes of MC, while in 8 control cases (normal maxillary sinus membrane, paratine tonsil, parotid gland and membranes from patients with chronic paranasal sinusitis) the staining was definitively negative.
    The molecular weight of MCAA was investigated by SDS-PAG and Immune-Blotting. The former showed two components (170k-225k), and the latter detected two components (120k-136k) and one minor component of 76k.
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  • Hitoshi Ogino, Toru Matsunaga
    1986 Volume 79 Issue 6 Pages 995-1004
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The clinical effect of Ifenprodil (Cerocral) was studied in 55 patients who complained of vertigo and dizziness, including 19 cases of Meniere's disease and 7 cases of vestibular Meniere's disease. Duration of the medication ranged from 2 to 69 weeks.
    Subjective symptoms improved in 63.6% of the patients, with improvement of dizziness being higher than that of other symptoms. Improvement of objective findings was 50.0%.
    The global improvement was 60.0% on the 2nd week and 65.5% on the final week of the administrations.
    The accumulative global improvement, excluding patients who dropped out, increased from 60.0% to 77.5% from the 2nd to the 6th week.
    In 15 of 20 patients with Meniere's disease and vestibular Meniere's disease, the mean interval between attacks after administration was prolonged more than twofold as long as that before administration.
    No adverse effects of this drug were observed during this study. Therefore, Ifenprodil appears to be useful for vertiginous patients, especially on vertigo attacks.
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  • Satoshi OGINO, Morihiro IRIFUNE, Tamotsu HARADA, Toru MATSUNAGA, Hirom ...
    1986 Volume 79 Issue 6 Pages 1005-1013
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The clinical effects of MS-A nebulizer therapy were evaluated in 23 patients with nasal hypersensitivity: 13 with nasal allergy (NA) and 10 with vasomotor rhinitis (VMR). The patients received 2 ampules once or twice a week for a total of 8 times.
    The efficacy rate was 61.5% for NA and 60.0% for VMR. The rate of improvement in nasal congestion was 46.2% for NA and 60.0% for VMR. Rhinorrhea decreased in 61.5% of these with NA and 70.0% of those with VMR. Percentages of patients showing a decrease in the number of sneezing attacks was 61.5% for NA and 57.1% for VMR. In half of the patients, the effects of MS-A nebulizer therapy were noted by the 5th application. There was no side effect observed in any subject.
    MS-A nebulizer therapy was considered to be effective for the treatment of nasal hypersensitivity.
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  • Jun-ichi YOSHIDA, Ryoji SASAKI, Toru MATSUNAGA, Masami MURATA, Yoshie ...
    1986 Volume 79 Issue 6 Pages 1015-1024
    Published: June 01, 1986
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The concentration of Cefoperazone (CPZ) in the soft tissues (mucous membrane of the pharynx, trachea and lymph node) and wound exsudates in patients undergoing major head and neck surgery was measured by high-pressure liquid chromatography.
    CPZ (4g) was infused over a 4-hour period. Simultaneous samples of serum and soft tissues were collected in 14 patients at 2 to 4 hours during infusion. CPZ (2g) was administered intravenously twice a day on the following day.
    Mean levels of CPZ in the mucous membrane of the pharynx and trachea and lymph node were 67.2μg/g, 36.0μg/g, 35.8μg/g, respectively. Excretion of CPZ into wound exsudates through the catheter was observed in 12 patients. Mean levels of CPZ in the wound exsudates were 80.7μg/ml (day 1), 35.5μg/ml (day 2), 42.5μg/ml (day 3).
    Clinical use of CPZ in 28 patients undergoing surgery showed no postoperative infection.
    Our experience showed that CPZ was particularly useful in prophylaxis for otolaryngological surgery.
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