Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 81, Issue 11
Displaying 1-20 of 20 articles from this issue
  • Yoshio Koike, Hiroo Inamura
    1988 Volume 81 Issue 11 Pages 1541-1553
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Stennert (1981) reported excellent cure rates (96%) for Bell's palsy treated with low-molecular dextran in combination with high doses of steroid to improve the microcirculation.
    The present study was undertaken to evaluate the effectiveness of high doses steroid. Electrophysiological and histological studies were also done on guinea pigs.
    To 36 patients with Bell's palsy who had complete facial paralysis, treatment was performed according to Stennert's protocol and the course of recovery and the ENoG values were monitored. ENoG values measured on consecutive days indicated that no patients had complete denervation. Recovery was complete in all but one patient.
    In guinea pigs with facial palsy produced by compression of the facial nerve at the level of the stylomastoid foramen, the recovery process was analyzed from the changing patterns of electrophysiological and histological findings. The results proved that the administration of high doses of prednisolone prevented the progress of wallerian degeneration.
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  • [in Japanese], [in Japanese], [in Japanese]
    1988 Volume 81 Issue 11 Pages 1554-1555
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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  • -A Case Report-
    Shoji Nishiyama, Shunji Takeuchi, Taizo Takeda, Haruo Saito
    1988 Volume 81 Issue 11 Pages 1557-1562
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Brain abscess and septicemia are life-threatening diseases, which are sometimes complications of chronic otitis media. This paper describes difficulties encountered in a 49-year-old male patient. It took a long time to establish the causative organism in spite of repeated cultures, and discontinuation of antibiotics to obtain positive cultures resulted in DIC and renal failure. The source of the septicemia was an epidural abscess, which developed after a radical mastoidectomy. Granulation tissue covering the epidural abscess looked healthy under high magnification of an operating microscope. The abscess could not be visualized with CT because of the pyramidal bone. The inflammation was controlled by resection of the epidural abscess and administration of chloramphenicol. The authors point out the local masking effect of antibiotics and advise early use of chloramphenicol when it is difficult to control intracranial infections.
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  • -A Case Report-
    Juichi Ito, Tomoyuki Haji, Michio Kawano, Mariko Takeuchi, Iwao Honjo
    1988 Volume 81 Issue 11 Pages 1563-1568
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 22-channel cochlear implant was placed in a deaf patient who had fallen from a height of 3m and was diagnosed as having bilateral temporal bone fracture by high resolution CT. The round window through which the electrode leads should have been inserted could not be found because the membranous portion of the round window had become a bony wall. It was necessary to drill through it before the 22 electrodes could be inserted into the cochlea.
    Three weeks after surgery rehabilitation was started. The vowel and consonant confusion tests and speech tracking test were useful to assess the recovery of hearing ability. The results of speech sentence comprehension were satisfactory, and this cochlear implant also made possible the psychological recovery of this patient.
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  • -Discussion of So-Called “Vascular Sudden Deaf ness”-
    Akinori Itoh, Kyoko Ohtsu, Eiji Sakata
    1988 Volume 81 Issue 11 Pages 1569-1580
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Circulatory failure is considered to be one of the causes of sudden deafness. We describe here 4 patients with hearing impairment associated with lesions in the vertebrobasilar artery system.
    Patient No. 1 had bilateral sudden deafness on two occasions—a very rare occurrence. Severe bilateral vertebroarterial stenosis was demonstrated by vertebral angiography. Patient No. 2 experienced sudden deafness on the left. A defect of the left vertebral artery was found on vertebral angiography. Patient No. 3 had right sudden deafness accompanied by facial paralysis. CT scan revealed cerebellar infarction on that side; the cause of deafness was defined as a vascular accident involving the right inferior anterior cerebellar artery. Patient No. 4 complained mainly of dizziness, tinnitus and deafness. Although hearing impairment was evaluated as mild by pure-tone audiometry, there was an abnormalitiy of ABR. Hemorrhagic infarction was found in the right cerebellum by CT scan, so vascular accident involving the right superior cerebellar artery was diagnosed.
    In the past we have described forms of hearing impairment due to cerebrovascular disorders. Our present findings suggest that as otologists we should examine not only the labyrinthine artery, but also its upstream arteries, such as the inferior anterior cerebellar artery and the vertebro-basilar artery system, whenever we encounter sudden deafness in daily practice and suspect a vascular disorder to be the cause. In other words, we should always keep in mind the possibility of concomitant central nervous system lesions.
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  • Tohru Tsuzuki, Tadashi Fujioka
    1988 Volume 81 Issue 11 Pages 1581-1586
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    This paper describes the effect of hyperbaric oxygen therapy of 27 patients with sudden deafness treated at Hiratsuka City Hospital Department of Otolaryngology during the past three years.
    Steroid, ATP and 76% urografin were given to all patients, and some were given urokinase.
    Some recovery of hearing was noted in 14 patients, but in 13 cases the treatment had no effect. Hyperbaric oxygen therapy was used in 9 of these 13 patients, within 26 days of the onset of deafness.
    Two of these 9 patients recovered completely, 2 were much improved, 3 were somewhat improved and 2 remained deaf. In the 7 patients who improved, improvement started during the hyperbaric oxygen therapy.
    Four patients who failed to respond to drug therapy and no hyperbaric oxygen therapy. Three of these 4 remained deaf, but the other improved spontaneously.
    We conclude that hyperbaric oxygen therapy has a beneficial effect on sudden deafness.
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  • Masaru Shirato, Takeshi Kanaya, Toshihiko Kamito, Tokuji Unno
    1988 Volume 81 Issue 11 Pages 1587-1594
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    To clarify the difference between the vestibulo-ocular system and the vestibulospinal system, we analyzed the relationship between nystagmus and body sway induced by caloric stimulation. The subjects were 8 healthy males who were asked to maintain an upright standing position with eyes closed on the platform. Caloric stimulation was applied to the right ear with cold water (20°C). Eye movement was recorded by electronystagmography. Body sway was analyzed from the output of the X and Y axis components from the platform.
    1) Increase in the amplitude of body sway corresponded closely with nystagmus intensity during caloric stimulation.
    2) The parameters of left-right body sway were significantly positively correlated with the parameters of nystagmus.
    3) No difference was observed in the velocity of body sway in either axis.
    4) The directionality of body sway still remained after the caloric nystagmus had disappeared.
    These results indicate that unilateral caloric stimulation has two effects on body equilibrium. One is a direct stimulus of the labyrinth which induces postural deviation during caloric stimulation. The other is a disturbance of the postural control system which induces body oscillation. The latter effect persists even after caloric nystagmus has disappeared.
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  • Toshio Kamimura, Jiro Hozawa, Kaoru Ishikawa, Fumiaki Fujiwara, Yutaka ...
    1988 Volume 81 Issue 11 Pages 1595-1601
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Five patients with syphilis of the labyrinth were treated with corticosteroids, and their hearing was tested before and after treatment.
    1) Those with rapid hearing loss in the early stage showed improvement of 12.1±6.8dB in the pure tone audiogram after treatment.
    2) Hearing improvement of those, who had no progressive hearing loss was 2.2±6.4dB.
    3) The difference between the two groups was statistically significant (p=0.05).
    4) The effect of steroid therapy on hearing loss generally noted within the first 10 days.
    Therefore, it seems rational to avoid the long term use of steroids, because of possible side-effects. Adequate anti-syphilitic therapy must also be used.
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  • -Immunohistochemical Findings-
    Masuo Yamagishi, Hideo Nakamura, Shoji Suzuki, Satoshi Hasegawa, Yuich ...
    1988 Volume 81 Issue 11 Pages 1603-1608
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Immunohistochemical examinations were performed on the olfactory mucosa of two patients with olfactory disturbance of unknown origin. One patient was a 58-year-old female who had gradually lost her sense of smell during the last five years. The other was a 56-year-old male who had lost his sense of smell eight months earlier.
    In the first patient, neuron-specific enolase (NSE) and glia-specific S-100 protein (S 100) immunoreactivity could not be found in the epithelium or lamina propria. Only cytokeratin (CK) immunoreactivity was seen in all cell layers throughout the epithelium. In the second patient, a number of NSE-immunoreactive cells were found in the epithelium. Intense staining of anti-S-100 antiserum was seen in the nerve bundles and Bowman's glands in the lamina propria. CK immunoreactivity was seen regularly in one layer of cells on the basement membrane. These results showed that the olfactory epithelium was completely degenerated and replaced with squamous epithelium in case 1. In case 2, the mucosa retained its normal morphology and function.
    Immunohistochemical examinations are useful in determining the origin of hyposmia and anosmia when the etiology is in doubt.
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  • Morihir Irifune, Hitoshi Ogino, Satoshi Ogino, Tohru Matsunaga
    1988 Volume 81 Issue 11 Pages 1609-1616
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Autonomic nervous function was studied in patients with nasal hyperreactivity (allergic rhinitis and vasomotor rhinitis). The R-R intervals in the EGG were calculated and Aschner's test and Shellong's test were performed as autonomic nervous function tests. The results of these tests were compared with those of normal subjects or patients with other diseases (Menier's disease, discomfort of the throat). The coefficient of variation of R-R intervals (R-Rcv), showed the nasal hyperreactive group did not differ from the other three groups. In patients with nasal allergy the onset of hyperreactive symptoms correlated positively with low level R-Rcv. Aschner's test and Shellong's test results in the nasal huperreactive group showed no abnormality of parasympathetic function, but sympathetic activity was greater than in the normal group. The onset of hyperreactive symptoms in patients with nasal allergy appear to be closely related to increased generalized sympathetic activity.
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  • Hirokuni Otsuka, Masaki Ohnishi, Akinori Mezawa, Kimihiro Okubo, Minor ...
    1988 Volume 81 Issue 11 Pages 1617-1622
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The present study was designed to demonstrate changes in the number of metachromatic cells in the nasal mucosal surface caused by immunotherapy, which plays an important role in the treatment of allergic nasal symptoms.
    We examined basophils and eosinophils in nasal secretions and mast cells in the nasal mucosal epithelium, basophils and eosinophils in the peripheral blood, and the level of specific IgE antibody in the serum before treatment and every month during hyposensitization of 14 patients with perennial nasal allergy. These patients were divided into two groups: A) excellent or good response and B) slight or no response.
    In Group A the number of basophils and mast cells in the epithelium was much lower 2 or 3 months after the start of treatment than in Group B. The number of eosinophils in the nasal secretion dropped more rapidly than that in the peripheral blood. The level of specific IgE antibody in the serum of groups did not changes during treatment.
    These results suggested that the improvement of nasal symptoms by immunotherapy is due to the decrease in number of metachromatic cells on the nasal mucosal surface.
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  • Yasuyuki Ishikawa, Michio Kawano, Iwao Honjo, Ryoichi Amitani
    1988 Volume 81 Issue 11 Pages 1623-1630
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Cleft palate patients often have sinusitis, but the cause of this sinusitis is not known. To clarify the cause of sinusitis in cleft palate patients, we investigated the incidence of sinusitis with regard to the type of cleft, the degree of septal deviation, velopharyngeal function, and presence of a pharyngeal flap. We also examined the laterality of sinusitis in unilateral cleft lip and palate patients. Furthermore, we examined the development of the maxillary sinuses, nasal mucociliary transport by the saccharin method and ciliary beating frequency of ciliated cells taken from the nasal septum in cleft palate patients and normal subjects.
    1) The incidence of sinusitis was not related to the type of cleft, the degree of septal deviation, velopharyngeal function, or presence of a pharyngeal flap. In unilateral cleft lip and palate patients, the laterality of sinusitis was not related to the cleft side. Therefore, we considered that contamination of the nasal cavity through the cleft and incompetent velopharynx were not cause of sinusitis; neither was the stagnation of nasal secretion in the presence of a pharyngeal flap nor obstruction of the maxillary ostium by a middle turbinate secondary to a deviated septum.
    2) There was no difference in the size of the maxillary sinus between the control group and the cleft group. Therefore, underdevelopment of the maxillary sinus did not appear to be a cause of sinusitis in cleft palate patients.
    3) Nasal mucociliary transport was impaired in cleft palate patients, and this impairment was thought to be a cause of the high incidence of sinusitis in cleft palate patients.
    The frequency of ciliary beating was lower in the cleft group than in the control group, but further investigation is necessary to determine whether the lowered ciliary beating frequency is a factor in the impairment of nasal mucociliary transport.
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  • Noriya Kakitsuba, Tatsuya Sadaoka, Souichi Motoyama, Hiroaki Takahashi
    1988 Volume 81 Issue 11 Pages 1631-1637
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Sleep study is important for the diagnosis of the sleep apnea syndrome (SAS), but it is somewhat difficult to perform and cannot be used to all patients with SAS. We propose a modified test, which may be easier and more useful.
    Patients are sedated with diazepam, and pernasal endoscopy is carried out to reveal the contracted portion of the upper respiratory tract and/or the origin of the snore. The frequency of apneic episodes is recorded at the same time. We examined six patients, three with sleep apnea syndrome and three with simple snoring, both with and without diazepam sedation.
    1) Apneic episodes were increased by diazepam treatment in SAS patients, but they were unchanged in simple snorers.
    2) The duration of apnea in SAS patients was not affected by diazepam treatment.
    3) The other characteristics of apnea ordinarily seen in SAS patients were not affected by diazepam.
    It is concluded that our new test can be useful in the diagnosis of SAS and the demonstration of the cause of snoring and the location of contractions of the air way.
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  • Hisayoshi Kojima, Akihiko Fujita, Tomoko Okumura, Myoujo Kanaji, Iwao ...
    1988 Volume 81 Issue 11 Pages 1639-1644
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Various surgical procedures such as mucous flaps, skin flaps and muscle flaps have been designed for glottic reconstruction following vertical partial laryngectomy. In order to obtain a good phonatory function, adequate glottic closure during phonatoon is necessary. A thyroid gland flap was devised and applied clinically to a case. This new surgical technique is described in this paper.
    The upper pole of the thyroid gland was dissected and elevated together with the superior thyroid artery and vein so as to make a thyroid flap. After removal of the cancerous lesion by vertical partial laryngectomy, the flap was placed in the wound to compensate for the loss of bulk and relined by an island cervical skin flap. Good phonatory function was obtained without any disturbance of respiration and deglutition.
    The thyroid gland flap can be adjusted to the size of the defect, easily placed in the larynx, and is less likely to shrink than other flaps because of its abundant blood suply. Therefore, the flap was assumed to be suitable to reconstruct the glottis after vertical partial laryngectomy.
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  • -Combined Sonotubometry and Fluoroscopy of the Soft Palate-
    Norihiko Ishikawa
    1988 Volume 81 Issue 11 Pages 1645-1654
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The human Eustachian tube is known to open and close with spontaneous swallowing, providing ventilation of the tympanic cavity and mastoid cells. There have been few reports on the relationship between movement of the soft palate and opening/closing of the Eustachian tube with swallowing. This paper presents a study of this relationship by combining sonotubometry and fluoroscopy of the soft palate.
    During swallowing, the soft palate is raised rapidly posterior-superiorly to close the rhinopharynx. When the soft palate reaches a maximum level, or slightly thereafter, the Eustachian tube opens.
    Observations of the opening and closing ability of the Eustachian tube and soft palate movement during swallowing of saliva revealed a positive sonotubometric pattern in 80% of 40 ears of 20 healthy adult males. This pattern was positive in 65% of 40 ears of 20 healthy females during swallowing of liquid and in 77.5% during residual swallowing.
    Differences in the movement of the soft palate were examined by Toynbee's method during the swallowing of liquid and of saliva, and changes in intranasal pressure and sonotubometry were recorded simultaneously. The soft palate rose higher when liquid was swallowed than when saliva was swallowed, but after the swallowing of liquid it resumed its original state more slowly. There was also a slight difference in the timing of opening and closing of the Eustachian tube: it opened during the swallowing of saliva and closed after the intranasal pressure became negative, but during the swallowing of liquid it tended to close while the intranasal pressure was still positive.
    The above results led to the following conclusions: the movement of the soft palate varies with the swallowing pattern, and causes slight differences in the opening and closing ability and timing of the Eustachian tube.
    Finally, the author discusses the mechanism of Eustachian tube dysfunction in cases of adenoid hypertrophy from the stand point of inhibited movement of the soft palate.
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  • -Graft Pretreatment of Anti-Dendritic Cell Antibody and Functional Estimation-
    Hiroshi Iwai, Toshio Yamashita, Muneo Inaba, Susumu Ikehara, Tadami Ku ...
    1988 Volume 81 Issue 11 Pages 1655-1659
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Isolated thyroid follicles of C57BL/6J mice were treated with anti-dendritic cell antibody plus complement in order to eliminate dendritic cells. The follicles were transplanted under the renal capsule of BALB/c mice. Acceptance of the grafts was verified by both histological study and the incorporation of 125I into the grafts 100 days after transplantation. Allografts treated with complement were rejected, whereas allografts treated with the antibody plus complement were accepted. These findings indicate that dendritic cells, but not other Ia positive cells, play a crucial role in the induction of rejection in mouse thyroid allografts, and that the deletion of dendritic cells permits allografts to be accepted.
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  • Shigekatsu Tsubaki
    1988 Volume 81 Issue 11 Pages 1661-1668
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Fosfomycin (FOM) was used to treat 17 patients with sinusitis: 1.0g three times a day for 5 to 14 days.
    9 of 11 patients with acute sinusitis, and 4 of 6 patients with acute exacerbation of chronic sinusitis were 76.5% of the 17 patients.
    The only adverse reaction was diarrhea in 2 patients.
    This was transient in nature and disappeared after the completion of treatment.
    These results indicate that oral FOM is effective in the treatment of sinusitis.
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  • Tetsuaki Kubota, Atsumasa Yoshida, Genjiro Miyao, Hiroyuki Ito
    1988 Volume 81 Issue 11 Pages 1669-1674
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We studied the effects of OFLX in 21 patients with chronic sinusitis with bacteria cultured from their maxillary sinuses.
    OFLX was administered at a dose of 600mg/day for 3 weeks, and clinical and bacteriological examinations were performed. Maxillary tube therapy was also used.
    The rate of cure of infections with positive or gram negative aerobes was 77%, and if anaerobes were present this rate became 85%. The penetration of OFLX into the maxillary membrane was good, and it's concentration was there equal to or higher than the blood level. It is concluded that since OFLX has a broad antibacterial spectrum and good transfer to the sinus membranes, it is an effective drug for treating chronic sinusitis.
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  • Mikikazu Yamagiwa, Masahiko Kubo, Yasuo Sakakura, Haruki Fukuo, Yukiko ...
    1988 Volume 81 Issue 11 Pages 1675-1684
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The majority of patients with abnormal sensation in the thoat have a history of an upper respiratory tract infection, increased apprehension, cancerphobia, depression, etc. Therapy of such patients with an anti-depressant plus an anti-inflammatory agent is expected to be effective.
    The authors administered Sulpiride (150mg/day) and Tiaramide HCl (300mg/day) for two weeks to 114 patients with abnormal sensation in the thoat and evaluated the results. Side effects, such as abdominal symptoms, drowziness or headache, were reported by 9 patients (8%) including 3 patients in whom the medication had to be suspended. The therapeutic effect of the medication was evaluated in the remaining 111 patients at the end of the first and second week of administration and one week after the termination of treatment. It was considered to be effective when the abnormal sensation improved subjectively by 50% or more. The combined therapy was effective in 56% of the 111 patients within one week, in 72% in two weeks and in 73% in three weeks. The therapy was more effective in patients with depressive state and/or mild inflammation in the throat.
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  • [in Japanese]
    1988 Volume 81 Issue 11 Pages 1686-1687
    Published: November 01, 1988
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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