Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 82, Issue 1
Displaying 1-22 of 22 articles from this issue
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  • Epithelial Hyperplasia of the Larynx
    Takemoto Shin, Hiroshi Watanabe, Norifumi Maehaara
    1989 Volume 82 Issue 1 Pages 1-11
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.1
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    Thirty cases of epithelial hyperplasia of the larynx following CO2 laser surgery in our department were evaluated histologically from November 1981 to May 1988. Furthermore, the ras oncogenes are implicated in the onset of some human tumors, and in cellular proliferation and terminal differentiation. Therefore, the ras-p21 proteins were immunohistochemically identified from the human specimens of carcinoma in situ and epithelial hyperplasia (dysplasia) by the Abidin-Biotin-peroxidase complex staining method which was strongly activated by ras expression. These results were in ascertaining for ras-p21 protein to be a signal of malignancy in positive staining rate. Over 70% of positive rate of staining in high grade dysplasia was compared with 40% of positive rate in low grade dysplasia. Furthermore, the phonatory functions following laser vaporization from the superficial layer of the propria mucosa to the deep layer (vocal ligament) in accordance with the severity of malignancy were examined and compared. The results were in keeping a rhythmical vibratory pattern of the mucous membrane when laser vaporization being limited into the vocal ligament.
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  • obliterative Method
    [in Japanese], [in Japanese]
    1989 Volume 82 Issue 1 Pages 12-13
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.12
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  • Speech Audiometry before and after Tympanoplasty
    Yuzuru Kobayashi, Ayako Sakuma, Yuko Ishida, Tomokazu Kamio
    1989 Volume 82 Issue 1 Pages 15-20
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.15
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    The speech reception threshold and maximum discrimination score were analyzed in 158 patients with chronic otitis media before and after tympanoplasty.
    The air conduction threshold improved significantly in low and middle frequencies after tympanoplasty. The speech reception threshold also improved significantly, but the maximum discrimination score, did not change significantly.
    In the patients with improved speech reception threshold after tympanoplasty, the air conduction threshold was improved in the low and middle frequencies. In the same patients, however, there was no improvement in the high frequencies. On the other hand, in patients whose speech reception threshold was worsened after tympanoplasty, the air conduction threshold did not change in the low and middle frequencies and was aggravated in the high frequencies.
    In 60% of the patients whose air conduction threshold improved after tympanoplasty, the speech reception threshold also improved, while in only 20% of the patients whose air conduction threshold was aggravated after tympanoplasty, the speech reception threshold was also aggravated.
    These results suggest that both pure tone audiometry and speech audiometry are necessary to evaluate hearing differences before and after tympanoplasty.
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  • Analysis of Tympanometry in Hearing Impaired School Children
    Fumiko Sonoda, Yasuteru Yamanaka, Kazuhiro Ohta, Yoshiyuki Kitaoku, Ta ...
    1989 Volume 82 Issue 1 Pages 21-27
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.21
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    Tympanometric and otoscopic evaluations were performed in 56 children with sensorineural hearing loss, aged 4 to 11 years.
    Type B tympanograms were found in 17.2% of the 4-to 6-year-old group, and 0% of the 7-to 11-year-old group.
    The children with type B tympanogram were re-examined in Nara Medical University, and otitis media with effusion (OME) was diagnosed in 4 (13.8%) of the 29 younger children (4-to 6-year-old).
    The incidence of OME in children with sensorineural hearing loss seemed to be almost the same as in healthy children. The incidence of OME was high in younger children.
    OME seemed to raise the hearing threshold in the younger group.
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  • Clinical Values in Inversive Type of Optokinetic After-Nystagmus (OKAN)
    Kazuhiro Teramoto, Eiji Sakata, Kyoko Ohtsu
    1989 Volume 82 Issue 1 Pages 29-37
    Published: January 01, 1989
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.29
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    1) We examined patients with bilateral lesions in the otolith-semicircular canals, vertebro-basilar artery insufficiency and cerebellar atrophy who showed the inversive type of OKAN, and we discuss the clinical value of the inversive type of OKAN.
    2) As in animal experiments, patients with bilateral lesions in the otolith-semicircular canals also show the inversive type of OKAN.
    3) Unlike the animal experiments however, patients with cerebellar disturbances also show the inversive type of OKAN.
    In these patients, there is an imbalance between the brainstem and the eye movement system which leads to a decomposition of the cerebellar eye movement integration system causing the inversive type of OKAN.
    4) The inversive type of OKAN points to disturbances of integration and compensation when bilateral lesions in the otolith-semicircular canals or lesions in the central vestibular system affect visual-vestibular interaction.
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  • Evaluation of Imbalance of vestibulo-Ocular Reflex
    Shinsuke Ito, Shuichi Odahara, Nozomu Inoue, Keiko Hisatomi, Katsuya Y ...
    1989 Volume 82 Issue 1 Pages 39-43
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.39
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    A new visual test to evaluate imbalance of the vestibulo-ocular reflex was devised. Patients with unilateral vestibular disorder were asked to look at vertical parallel stripes on five different scales while shaking their heads at one hertz in about 40 degrees in a horizontal plane. The viewed object on a certain scale was mixed up during head rotations to the affected side but remained clear during rotations to the intact side. It was thought that this scale indicated the degree of imbalance of labyrinthine function.
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  • Influence of External Auditory Canal Pressure on Head Movement of Patients with Meniere's Disease
    Yasushi Naito, Noriaki Tabayashi, Juichi Ito, Nobuya Yagi, Iwao Honjo
    1989 Volume 82 Issue 1 Pages 45-49
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.45
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    Positive and negative pressure was applied to the external auditory canal of patients with Meniere's disease, and their head movement was monitored to assess the influence of the pressure on their standing posture. Both external auditory canals were made airtight, and pressure of ±300mmH2O was applied to one ear. Positive pressure in Meniere's affected ears accelerated the head deviation toward the contralateral side, while that in other groups (normal volunteers, Meniere's unaffected ears, BPPV patients, Meniere's affected ears with pressure loaded to the middle ear) accelerated the deviation to the pressure loaded side. When negative pressure was applied, no significant difference was noted among those groups. Acceleration of head deviation to the contralateral side by positive external auditory canal pressure appeared to be specific to Meniere's disease. Endolymphatic hydrops or vestibulofibrosis could be related to these phenomena.
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  • Autoimmune Inner Ear Dysfunction in Harada Disease
    Yukiko Iino, Atsuhito Nakai, Naya Wang, Minoru Toriyama
    1989 Volume 82 Issue 1 Pages 51-59
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.51
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    Vogt-Koyanagi-Harada disease is an autoimmune disorder involving melanocytes in the eye, ear, skin and meninges. We report a 35-year-old female who complained tinnitus, fluctuating hearing loss and vertigo following sudden onset of uveitis. Neurotological examinations revealed that these ear symptoms were of inner ear origin, and her clinical course resembled that of Meniere's disease. These clinical findings suggested that the dysfunction of the inner ear is caused by endolymphatic hydrops, which resulted from autoimmune response against melanocytes.
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  • Large Cholesteatoma Misdiagnosed as Bell's Palsy
    -A Case Report-
    Yoshiaki Tsuta, Kiyotaka Murata, Chikara Nishimoto, Fumihiko Ohta
    1989 Volume 82 Issue 1 Pages 61-66
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.61
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    A 13-year-old boy developded peripheral facial nerve palsy. The eardrums appeared intact. A diagnosis of Bell's palsy was made by his family doctor, and conservative treatment resulted in temporary improvement, but facial nerve palsy later recurred. In our otological, clinic a large bone defect was found along the facial nerve in its petrous and horizontal portion. The cholesteatoma was removed surgically. Peripheral facial nerve palsy with an intact tympanic membrane is not always Bell's palsy.
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  • Tuberculosis of the Nasal Vestibule and Skin of the Lip
    -A Case Report-
    Shun Lai Miao
    1989 Volume 82 Issue 1 Pages 67-70
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.67
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    Reported here is a case of tuberculosis of the nasal vestibule and skin of the left upper lip.
    The diagnosis was made only after multiple biopsies. We used local intradermal injections of streptomycin for 45 days. The patient recovered completely and has been followed for 3 years without any recurrence.
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  • Fiberscopic Observation of the Lateral Nasal Window in Caldwell-Luc Operation
    Koji Yajin, Hiroyuki Takahashi, Yoshihiko Kono, [in Japanese], [in Jap ...
    1989 Volume 82 Issue 1 Pages 71-77
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.71
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    Three kinds of lateral nasal window in Caldwell-Luc operation were observed fiberscopically for 3 years after surgery in 3 7 patients with chronic maxillary sinusitis with ethrr oiditis and postoperative maxillary cyst.
    When the lateral nasal mucosa was removed, the window narrowed circumferentially. The anterior and inferior edge of the window showed marked extension postero-superiorly, leaving a small round opening in the postero-superior part of the lateral nasal wall 8-12 months after surgery.
    When a Boenninghaus flap was laid on the maxillary floor, narrowing of the window was minimum and the contour of the window was well maintained for more than 2 years after surgery. This was also true when two flaps were made, one of which was based superiorly and the other was based inferiorly. However, the window became half blocked from the sinus side because of rapid formation of granulation, resulting in a crescent-shaped opening in the postero-superior part of the lateral nasal wall.
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  • Intraorbital Wooden Foreign Body Penetrating an Ethmoid Sinus
    Takashi Yokoi, Eiji Yumoto, Satoru Kuroki
    1989 Volume 82 Issue 1 Pages 79-83
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.79
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    A 48-year-old man riding a motorcycle ran into a pine tree and suffered a small injury of the left medial lower eyelid. He consulted his family doctor and was told that his wound was too small to be sutured. The skin closed, but after a while a purulent discharge and fistula formation occurred at the same site. Three months after the injury he was referred to our hospital. Computed tomography revealed that an intraorbital foreign body had penetrated the ethmoid sinus. Under local anesthesia a left medial canthal incision was performed. The wooden foreign body, 4.5cm long and 4mm in diameter, was removed from the surrounding granulation tissue in the orbit. Two weeks later, a small wooden fragment was spontaneously extruded from the operative wound. In this case, the foreign body had not been found for a long time because i t penetrated the posterior ethmoid sinus without any damage of the visual organs. No matter how small an eyelid injury is, one should be aware of the possibility of deeper damage and of persistent foreign bodies. In this case computed tomography was helpful in the diagnosis of the radiolucent wooden foreign body in the orbit and in the ethmoid sinus.
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  • Osteogenic Tumors in the Maxillofacial Area
    -Report of Four Cases-
    Keizo Tate, Minoru Hashizume, Shoji Nishiyama, Seiji Kishimoto
    1989 Volume 82 Issue 1 Pages 85-91
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.85
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    Osteogenic and odontogenic tumors in the maxillofacial area sometimes involve the orbit or skull base and are clinically malignant, even if the histology is benign.
    We report four cases of such extensive tumors: fibrous dysplasia, cementifying pibroma, osteoma and chondroma.
    Our patients are described and the past literature is reviewed. Ophthalmological and multiple craniall nerve symptoms are frequently noted, so these tumors are considered to be clinically malignant.
    These tumors cannot readily be diagnosed by conventional X-ray examinations. Bone target CT scans revealed characteristic patterns in each of our patients. Therefore, we recommend bone target CT scans for the differential diagnosis of osteogenic and odontogenic tumors.
    Treatment is also discussed. Conservative operations for cosmetic and functional restoration are appropriate for these histologically benign tumors.
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  • Three-Dimensional Computer Graphics of the Larynx
    -A Case of Laryngeal Trauma-
    Kazunori Mori, Hisayoshi Kojima, Iwao Honjo, Etsuo Yamamoto
    1989 Volume 82 Issue 1 Pages 93-98
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.93
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    A traumatized larynx was examined from various points of view with computer graphics. For reconstructing the three-dimensional structures of the larynx, CT scan films were used. Following digitization of each slice, the X and Y coordinates were standardized and the Z coordinates were calculated. Then each structure (fractured thyroid cartilage, cricoid cartilage, perichondrium and so on) was drawn with shading of the hidden structures.
    This method was easy and demonstrated clearly the relationship between the fractured laryngeal cartilage and the air way. This method should be clinically useful in improving the slice width of the CT scan.
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  • Vocal Rehabilitation Following Total Laryngectomy
    Koichi OMORI, Kazuhiko SHOJI, Iwao HONJO
    1989 Volume 82 Issue 1 Pages 99-102
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.99
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    To establish a vocal rehabilitation program following total laryngectomy, we evaluated the vocal restoration status of 59 laryngectomized patients who had been operated on in our hospital from 1976 to 1987. Of the 25 patients who had practiced esophageal speech, 15 were able to speak fluently in about one year, but 10 patients failed to acquire esophageal speech. Of the 11 patients who used a voice prosthesis, 10 achieved good speech. Although esophageal speech is difficult to acquire, it is recognized to be the best way to speak after total laryngectomy. It is easy to speak with the voice prosthesis, which can be used by patients who fail to acquire esophageal speech. On the basis of these results, we propose a vocal rehabilitation program in which esophageal speech and voice prosthesis are the core.
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  • Effects of Nifedipine and EGTA on Endocochlear Potential in the Guinea Pig
    Yukihiro Sato
    1989 Volume 82 Issue 1 Pages 103-108
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.103
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    The endocochlear potential (EP) was measured in guinea pigs given calcium channel blockers and calcium chelating agents. The test solutions were administered either intravenously or by perilymphatic perfusion.
    Blood pressure was monitored during the intravenous infusion of nifedipine. The EP was decreased by intravenous nifedipine. The systemic blood pressure decreased immediately when 1mg/kg of nifedipine was given and the EP started to fall after about 30 sec. While 0.1mg/kg of nifedipine was being infused, the EP remained nearly unchanged until the blood pressure decreased irreversibly. With 0.01mg/kg, neither the blood pressure nor the EP showed any detectable change. It was concluded that the decrease of EP during the intravenous administration of nifedipine is secondary to its hypotensive action.
    During perilymphatic perfusion of nifedipine the EP fell from +70mV to +54mV and then returned to the initial level when the control solution without nifedipine was perfused again.
    EGTA, in a concentration of 10mM decreased the EP but only transiently, and there was a prompt return to the control level. EDTA in a concentration of 4mM had no significant effect on the EP. These results suggest that Ca ions play a role in maintaining the EP.
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  • Nasal Airway Resistance and Septal Deviation in Unilateral Cleft Lip and Palate
    Masaki SAWADA, Nobuhiko ISSHIKI
    1989 Volume 82 Issue 1 Pages 109-118
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.109
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    Nasal resistance was measured aerodynamically through one or both nostrils. Cleft lip nose deformity alone had a negative effect on nasal air-passages, especially on the side of the cleft. Thirty per cent of the patients with cleft lip alone complained of nasal obstruction. Patients with unilateral cleft lip and palate usually have characteristic nasal deformities, including nostril flattening, afar base ptosis and deviation of the nasal columella. In addition, deformity of the nasal cavity is also frequent. CT scans of the nasal septum were analyzed in cleft lip and palate patients. The nasal septum was deviated to the non-cleft side at and around the nostril. This anterior deviation was conspicuous in cases of alveolar cleft. Posteriorly, the nasal septum deviated to the cleft side in both horizontal and vertical planes, especially in cases of cleft hard palate. Posterior septal deviation seems to interfere with nasal respiration much less than anterior nasal deformity.
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  • Acoustic Analysis of Hoarse Voice by Digital Sound Spectrography
    Yumi Sasaki
    1989 Volume 82 Issue 1 Pages 119-131
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.119
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    With the use of a digital sound spectrograph (Digital Sonagraph Model 7800, Kay Elemetric Corp.), clinically useful methods of objective evaluation of hoarse voice were developed. Two parameters, the extent of pitch fluctuation and the amount of noise, were measured in the digital sound spectrogram by the author's simplified methods.
    The extent of the pitch fluctuation of sustained phonation of /a/ (sΔF) was measured on the highest harmonic stripe of the sound spectrogram (0-2kHz range and 11.3Hz filter width). There was a significant correlation between sdF and the maximum pitch fluctuation obtained by the minicomputer system (Pearson r=0.82). The sΔF differentiated 70.4% of the pathologic voice samples from the normal ones.
    The amount of noise was measured from the section display with a 0-2kHz range, a 22.5Hz filter for male voices and a 37.5Hz filter for female voices. The author defined the area enclosed by the base-line and the line connecting the peaks of the harmonic stripes as the total acoustic energy, and the area enclosed by the base-line and the line connecting the troughs as the acoustic energy of the noise components. The amount of noise in a phonatory sample was expressed by the difference between the former area and the latter area. The values of the amount of noise in the pathologic samples correlated significantly with the psychophysical judgments of the degree of hoarseness (Spearman's r=0.77 in the male samples, 0.74 in the female samples). Moreover, 79.6% of the pathologic samples were differentiated from the normal ones by the two parameters. These results showed that the two parameters obtained from the present methods were reliable and clinically useful indices.
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  • Clinical Evaluation of Tofisopam in the Treatment of Tinnitus
    -Tinnitus and Autonomic Dysf unction-
    Kyosuke Ichikawa, Yasuo Hattori, Kenji Nakamura
    1989 Volume 82 Issue 1 Pages 133-138
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.133
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    Our previous reports dealt with tinnitus and impaired hearing as autonomic dysfunction in the field of otorhinolaryngology. In 46 patients, tinnitus without hearing loss or with impaired hearing of low-pitched sounds was the manifestation of autonomic dysfunction, as diagnosed by Schellong's test and T. M. I. These patients were treated orally with Tofisopam 150mg daily (50mg three times a day), and changes in the severity of tinnitus were monitored. The treatment was markedly effective or somewhat effective in 32 (70%) of the 46 patients. Schellong's test done at intervals of 2 weeks became negative in 70% of the 20 patients. These results indicate that Tofisopam is effective in the treatment of tinnitus.
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  • Clinical Evaluation of MyonaP in Patients with Tinnitus
    Kazuhiro Ohta, Hisami Iwasaki, Takashi Matsunaga, Akihisa Yanagawa, Yo ...
    1989 Volume 82 Issue 1 Pages 139-148
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.139
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    Myonal® was used to treat 36 patients with tinnitus.
    1. The rate of effectiveness was 47.2%.
    2. Myonale was effective in aged patients, patients with presbycusis, and patients with stiff shoulders.
    3. Tinnitus was reduced in most patients with improvement of stiff shoulders and the sense of fullness in the ears.
    4. There were no side effects.
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  • Clinical Evaluation of Ketotifen after Eight Weeks of Administration for Perennial Nasal Allergy
    Kotaro Ukai, Ryo Amesara, Yasuo Sakakura, Yukiko Ito, Kenzo Yagi, Fumi ...
    1989 Volume 82 Issue 1 Pages 149-161
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.149
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    Ketotifen, an anti-allergic drug, was administered orally to 22 patients with perennial nasal allergy twice a day (2mg/day) for 8 weeks, and the following results were obtained:
    1) The overall improvement rate was 54.5%, and the usefulness rate was 50%.
    2) In 63.6% of the patients, its efficacy started within 2 weeks. In 50% of the remaining 36.4% patients, there was no response even after 8 weeks.
    3) Among the nasal symptoms, sneezing was reduced in 68.2%, and nasal obstruction in 63.2%. The relief of nasal obstruction was especially noteworthy.
    4) Among the objective symptoms, decreased nasal secretion was noted in 31.8%, and nasal discomfort in 28.6%. The number of eosinophils in the nasal discharge was decreased in 27.3%.
    5) The patients' diaries indicated marked reduction of nasal symptoms, such as frequency of sneezing attacks, frequency of nose blowing and nasal obstruction 2 to 3 weeks after the start of treatment.
    6) Side effects were reported in 30.4%, drowsiness in 21.7%.
    7) Blood tests showed no abnormalities.
    It is concluded that Ketotifen is clinically useful in the long-term treatment of perennial nasal allergy and is especially effective for nasal obstruction.
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  • Primitive Management on Hoarse Voice
    [in Japanese]
    1989 Volume 82 Issue 1 Pages 162-163
    Published: January 01, 1989
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.82.162
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