Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 83, Issue 4
Displaying 1-22 of 22 articles from this issue
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  • Is Snoring a Disease
    Hiroaki Takahashi
    1990 Volume 83 Issue 4 Pages 513-519
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.513
    JOURNAL FREE ACCESS
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    Snoring is an abnormal sonorous breathing sound which occurs during sleep caused by obstructive conditions of various degrees of severity in the upper airway.
    The problems of snoring can be divided into two categories. One is the stenosis which causes snoring, and the other is the sound of snoring itself.
    Excessive airway stenosis causes frequent apnea, which leads to various complications. Sleep apnea syndrome is recognized as a life-threatening condition that requires immediate treatment.
    What is not recognized by physicians is the problem caused by the sound of snoring. The sonorous sound annoys the bed-partner or co-sleepers, and their complaints often make the snorer reluctant to sleep with other people. In an extreme case, the sound may prevent a patient from being admitted to a hospital. Therefore, snoring which does not accompany apnea should also be treated as a serious disease.
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  • [title in Japanese]
    [in Japanese], [in Japanese]
    1990 Volume 83 Issue 4 Pages 520-521
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.520
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  • Metastatic Brain Stem Tumors Diagnosed by Otorhinolaryngologists
    Yasushi Ohta, Ken Kitamura, Yasuhiro Kudo, Junichi Ishitoya
    1990 Volume 83 Issue 4 Pages 523-529
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.523
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    We describe two cases of metastatic brain stem tumors diagnosed by otorhinolaryngologists. Although metastatic brain stem tumors are rarely encountered in otorhinolaryngology clinics, their possible presence must always be kept in mind. The first patient was a 64-year-old male with left facial palsy. Neurootological examinations revealed bilateral medial longitudinal fasciculus syndrome and left gaze disturbance. Neuroradiological, CT and MRI examinations showed lesions in the brain stem and around a lateral ventricle. These lesions were diagnosed to be metastatic from lung carcinoma. The second patient was a 56-year-old male with bloody otorrhea from chronic external otitis caused by atomic bomb burns. His optokinetic nystagmus response was found to be abnormal, and he also numbness of the right hand and of the skin around the mouth. A brain stem tumor was demonstrated by CT scan. At autopsy, a brain stem tumor was found metastatic from a lung carcinoma which had been resected two years before his death.
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  • Clinical Efficacy of Head Shaking Nystagmus
    Tetsuaki Kawase, Sho Hashimoto, Shuji Koike, Yukiko Hirasawa, Tomonori ...
    1990 Volume 83 Issue 4 Pages 531-536
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.531
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    The clinical efficacy of head shaking nystagmus (HSN) were studied in 170 patients complaining of vertigo, dizziness or hearing loss. The over all provocation rate of HSN was 69% (117/170), which was much higher than that of spontaneous, positional or positioning nystagmus. Even in patients tested long after a vertigo attack, HSN was easily provoked. In the majority (95%) of the patients with caloric abnormality, the deficiency type of HSN (briskly beating nystagmus immediately after head shaking) towards the contralateral side of canal paresis (CP) was observed. The number of nystagmus beats increased as head shaking continued. These results suggest that HSN is provoked by the accumulation of dominant stimulation to the normal lateral semicircular canal.
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  • Cochlear Implant and Electrical Stimulation Test of the Cochlea
    Kozo Kumakawa, Kumiko Yukawa, Osamu Takahashi, Sotaro Funasaka
    1990 Volume 83 Issue 4 Pages 537-547
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.537
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    Electrical stimulation of the cochlea with a transtympanic needle electrode is of clinical interest in patient selection before a Cochlear implant operation. This electrical promontory testing (PT) was used in 101 ears with profound deafness.
    1) Auditory sensation was reported in 74 ears (73%) with profound deafness. Positive results of PT decreased with the duration of deafness.
    2) A retrospective study of PT in 13 ears after cochlear implantation showed that electrical stimulation by 50 and 100Hz pulse bursts induced sound sensation in all ears. No positive correlation, however, was found between the threshold, the maximum acceptance level, and the dynamic range in PT and those obtained using the implanted electrode in the scala tympani.
    3) PT at several points on the promontory produced different thresholds, and placement of the electrode within the round window niche showed the lowest current threshold among them.
    It is concluded that PT is a qualitative test, and that electrical stimulation at the round window niche should be performed to avoid false negative responses and to get an accurate threshold level. In addtion, problems of PT in evaluating the candidates for a cochlear implant are discussed.
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  • Magnetic Resonance Image of the Human Temporal Bone
    Izumi Koizuka, Mitsuhito Sano, Takeshi Kubo, Toru Matsunaga, Yoshiteru ...
    1990 Volume 83 Issue 4 Pages 549-555
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.549
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    Magnetic Resonance Imaging (MRI) has the potential to show normal anatomy and pathological changes in many of the body's organ systems. As with all imaging techniques, precise knowledge of the normal anatomy of a region is indispensable to diagnose disease states. In this study, human temporal bone blocks were studied with both MRI and light microscopy. All turns of the cochlea and the basement membranes of each turn were identified successfully with MRI. Part of the horizontal semicircular duct was also depicted with MRI.
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  • Wegener's Granulomatosis with Facial Nerve Paralysis
    A Case Report
    Hiroaki Ichijo, Jiro Hozawa, Syuji Ota
    1990 Volume 83 Issue 4 Pages 557-562
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.557
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    A 44-year-old female with Wegener's granulomatosis (WG) complained of bilateral otalgia and right facial nerve paralysis. The tympanic cavity and the antrum were filled with granulation tissue. The diagnosis was determined by a biopsy of nasal mucosa and laboratory data.
    Bilateral symmetrical otalgia and aural discharge did not suggest malignant ear disease.
    Moreover, the lack of characteristic WG's symptoms and histological findings made the diagnosis difficult in this case.
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  • Postoperative Maxillary Cyst with Patent Lateral Nasal Window
    Koji Yajin, Yutaka Nagasawa, Akira Nagasawa, Ryo Omura, Shin Masuda, K ...
    1990 Volume 83 Issue 4 Pages 563-569
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.563
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    Four patients with postoperative maxillary cyst and patent lateral nasal window were examined fiberscopically and radiologically. The window of two patients remained widely open (more than 4.2mm in diameter), but that of other two had a narrow opening less than 4.2mm. Three of the 4 patients had a recurrence of maxillary cyst 3 to 5 years after the first surgery to remove the cyst.
    Fiberscopic examination revealed a patent window in all cases, but 3 windows were shown to be closed by radiological examination.
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  • Postoperative Early Application of Plain Facial Prostheses
    Mayuki Goto, Yasuyuki Tasaka, Hideyuki Fukushima
    1990 Volume 83 Issue 4 Pages 571-576
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.571
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    Early application of a plain facial prosthesis was developed for patients after total maxillectomy and orbital exenteration for maxillary cancer. These prostheses, which have no artificial eyes, are easy to make and can be retained with an eyepatch. The apparatus is useful for much earlier rehabilitation before the fitting of a regular facial prosthesis.
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  • Malignant Fibrous Histiocytoma of the Maxillary Sinus
    Akinori Kida, Toru Furusaka, Ryuichi Kametani, Tatsuo Sawada
    1990 Volume 83 Issue 4 Pages 577-587
    Published: April 01, 1990
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.577
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    A 42-year-old male with early malignant fibrous histiocytoma (MFH) of the maxillary sinus was treated with subtotal resection of the maxilla and has had no recurrence for 7 years and 9 months after surgery.
    Forty-four cases of MFH of the maxillary sinus in Japan have been reported up to 1988. The incidence is higher in males than in females. The age distribution of most of the patients ranged from 30 to 69 years. The storiform-pleomorphic type accounted for 75% of the cases.
    The first-choice treatment is surgery, and radiotherapy and chemotherapy should be employed as adj uvant treatment.
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  • Multicentric Carcinoma in the Oral Cavity and Pharynx
    A Report of Eight Cases
    Koji Okamoto, Kayoko Sato, Kinya Uno, Satoshi Koike
    1990 Volume 83 Issue 4 Pages 589-594
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.589
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    We studied the clinical charactristics of multicentric carcinoma in the oral cavity and pharynx. During a period of 12 years from 1977 to 1988 at Shikoku Cancer Center Hospital, 8 out of 332 patients (2.4%) with squamous cell carcinoma of the oral region (oral cavity and oropharynx) had multicentric carcinomas. In 5 patients the cancers developed synchronously and in 3 at different times.
    Smoking and alcohol drinking were considered to be significant factors related to the carcinogenesis of multicentric carcinoma, although the concept of field carcinogenesis advocated by Slaughter was also considered.
    However, we could not rule out the role of radiation in the patients who had had radiotherapy and then developed nonsynchronous multicentric cancer.
    For patients in the high risk group because of a history of smoking and drinking, initial multimodal therapy and long term following-up should be emphasized to improve the clinical outcome.
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  • Evaluation of Vocal Fold Stiffness with Fiberscopy
    Shinzo Tanaka, Minoru Hirano
    1990 Volume 83 Issue 4 Pages 595-599
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.595
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    For the purpose of evaluating the stiffness of the pathological vocal folds in vivo, a fiberscopic device was developed. It consisted of a laryngeal fiberscope and a suction tube connected to the forceps channel of the fiberscope. The tube had a small hole in the side wall and the tip of the tube was closed. The forceps channel was connected to an aspirator, and the vocal fold was sucked vertically under fiberscopic observation using a video recording system. From a pair of video images before and after the vocal fold was sucked in, the suction distance was measured, and the stiffness was calculated.
    A normal subject and patients with various laryngeal disorders were examined. The stiffness of the normal vocal fold was 3 to 4g/cm. In the cases of laryngeal carcinoma, scarring after laryngeal injury and sulcus vocalis, the stiffness of the lesion was significantly greater than normal. The data suggest that the evaluation of the vocal fold stiffness with a fiberscope is useful in diagnosing the degree and extent of high stiff lesions in the vocal fold.
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  • Follow-up Study of Patients Treated with Silicone Injection into the Vocal Fold
    Toru Tsuzuki, Hiroyuki Fukuda, Tadashi Fujioka, Etsuyo Takayama, Masah ...
    1990 Volume 83 Issue 4 Pages 601-605
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.601
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    From 1977 through 1934, Silicone Fluid or RTVS was injected into the vocal folds of 54 patients, and no foreign body reaction was observed. And histological study was performed on the larynx which had been injected with RTVS 12 years ago. The silicone was covered by a thin capsule of connective tissue. Foreign body giant cells, and migration or absorption of silicone were not observed. From the facts mentioned above, it appears that silicone can be safely injected into vocal folds.
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  • Massive Bleeding after Neo-adjuvant Chemotherapy of Laryngeal Cancer
    A Case Report
    Tadahiko Saiki, Toshihiro Mori, Eiji Yumoto, Hiroshi Okamura
    1990 Volume 83 Issue 4 Pages 607-612
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.607
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    A 61-year-old man, suffering from a supraglottic laryngeal cancer (T3N0M0), had massive bleeding after neo-adjuvant chemotherapy and radiation therapy (12Gy) . He was treated with two courses of neo-adjuvant chemotherapy with Carboplatin and Peplomycin. Two weeks after the last treatment, radiation therapy was started and after 12Gy of radiation massive bleeding occurred suddenly from the tumor.
    Therefore we had to perform emergency total laryngectomy. Histological examination revealed that the cause of massive bleeding was extensive necrosis of the cancer caused by the chemotherapy. Retrospectively, it seemed that the only symptom of extensive necrosis was recurrent pain in the tumor region. We conclude that it is important to pay attention to recurrent pain after chemotherapy.
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  • Thyroid Cancer in the Patients with Throat Paresthesia
    Kunio Yanohara, Yukinori Miyahara, Akihiko Kato, Yoshio Miyaki, Hiroyu ...
    1990 Volume 83 Issue 4 Pages 613-616
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.613
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    Increasing numbers of patients complain of paresthesia in the throat. Generally they are worried about cancer, and it is our role to rule out malignant disease. In this paper we stress the importance of ultrasonographic examination of the thyroid in patients with paresthesia in the throat. Ultrasonographic examinations of the thyroid were performed in 536 patients with paresthesia and 7 cases of thyroid cancer (1.3%) were diagnosed.
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  • Soft Tissue Roentgenography of Thyroid Tumors
    Osamu Tanaka, Takashi Matsunaga, Hiroshi Miyahara, Yukikazu Hyo
    1990 Volume 83 Issue 4 Pages 617-621
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.617
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    Soft tissue roentgenographic study of thyroid tumors was conducted in 211 patients from 1982 to 1988.
    1) The tumors were benign in 108 patients and malignant in 103.
    2) Tracheal deviation was detected in 51% and calcification in 37%.
    3) Calcification was seen in 25% of benign tumors and in 49% of malignant tumors.
    4) Differentiation between benign and malignant calcifications was often possible.
    5) When thyroid tumor is suspected, soft tissue roentgenographic studies of the neck can be valuable in the differentiation between benign and malignant tumors.
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  • Upper Airway Stenosis in Infants with Cerebral Palsy
    Report of Two Cases
    Masanobu Nishiyama, Noriya Kakitsuba, Soichi Motoyama, Isao Uno, Kazuo ...
    1990 Volume 83 Issue 4 Pages 623-627
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.623
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    Infants with cerebral palsy often have noisy breathing, which is considered to be due to stenosis of the upper airway caused by tonic contraction of the muscles at the level of the tongue base or mesopharynx.
    Recently we treated two infants with cerebral palsy, stridor and dyspnea. The first had hypertrophied adenoids; adenoidectomy was curative. The cause of the second patient's stridor and dyspnea was laryngomalacia. Tracheostomy was necessary in this case.
    These two cases show that such organic diseases are often present in patients with cerebral palsy and can cause noisy breathing and dyspnea. For the exact diagnosis, flexible fiberoscopy is very useful.
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  • Ototoxicity of Isepamicin Sulfate in the Guinea Pig
    Isao Nishida
    1990 Volume 83 Issue 4 Pages 629-638
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.629
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    Isepamicin sulfate (ISP) is a new aminoglycoside antibiotic currently undergoing clinical investigation. The ototoxicity of ISP in the guinea pig was studied by electron microscopy and compared with that of amikacin sulfate (AMK). The effect of the dose of ISP on ototoxicity was also investigated. The animals were given ISP or AMK either by once daily (OD) intramuscular injection of 200mg/kg or by twice daily (BID) injection of 100mg/kg for 28 days. This study revealed that ISP has less ototoxicity than AMK in the organ of Corti, and vestibular changes induced by ISP were much milder than those caused by AMK. In addition, the OD regimen induced less ototoxicity than the BID regimen, indicating that aminoglycoside in an OD therapeutic regimen can be favourably applied for clinical use.
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  • Comparison of Submucous Cleft Palate and Congenital Velopharyngeal Incompetence
    Yutaka Harita, Nobuhiko Isshiki
    1990 Volume 83 Issue 4 Pages 639-658
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.639
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    The differential diagnosis between submucous cleft palate and congenital velopharyngeal incompetence is occasionally rather difficult, because the criteria have not yet been clearly defined.
    If the median part of the soft palate is obviously membranous and thin on inspection or palpation, it can be diagnosed as submucous cleft palate (SMCP). In patients with congenital hypernasality without this sign, the diagnosis is congenital velopharyngeal incompetence (CVPI).
    Velopharyngeal function in SMCP and CVPI was assessed mainly by fluorovideoscopy and nasoendoscopy, which sometimes show a deep pharynx, short palate, or occult submucous cleft palate. The term CVPI usually includes short palate, occult submucous cleft palate, deep pharynx, and large pharynx other than submucous cleft palate.
    Selection of the surgical method to be used was based on analyses of these results with the age factor taken into account.
    Push-back palatoplasty was performed on these patients who were diagnosed as having slight velopharyngeal incompetence in spite of good mobility of the velum and were under 4 years of age.
    For those with moderate to severe velopharyngeal incompetence, the folded pharyngeal flap is usually indicated to secure velopharyngeal function.
    Twenty-four of 34 SMCP patients treated surgically acquired adequate velopharyngeal function and normal speech; in two of the 34 patients slight velopharyngeal incompetency persisted, and the remaining 8 patients could not be followed up after surgery.
    Twenty-four of 30 CVPI patients treated surgically acquired adequate velopharyngeal function, three still had slight velopharyngeal incompetency, and the remaining three are being followed after surgery. Articulation training before and/or after operation is very important. When faulty articulation was corrected before operation, the period for post-operative articulation training was short.
    Seven out of 66 SMCP patients have acquired normal speech through speech therapy alone.
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  • Dilazep Dihydrochloride; Clinical Evaluation of its Effect on Attacks of Vertigo in Meniere's Disease
    Takashi Tokita, Shigenobu Iwata, Ryozo Umeda, Hitoshi Saito, Yasuo Sak ...
    1990 Volume 83 Issue 4 Pages 659-673
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.659
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    Comelian® (dilazep dihydrochloride) was used for six months to treat 80 patients with Meniere's disease, and its effectiveness in preventing attacks of vertigo and its safety were evaluated.
    1) The average number of definitive spells per month was reduced significantly (p>0.001) from 1.45±0.21 (Mean±S. D.) for six months before the start of treatment to 0.65±0.12 during the six month treatment.
    2) The maximum interval between definitive attacks was prolonged significantly (p<0.001) from 69.1±5.6 days for six months before the start of treatment to 120.3±5.8 days during the six month treatment.
    3) The effect of treatment was evaluated by comparing the incidence of vertigo before and after treatment. Complete control of definitive spells was observed in 23 patients (28.8%), substantial control in 30 (37.5%), and limited control in 7 (8.7%).
    4) The global improvement rate was 57.5% for moderate or greater improvement and 78.8% for slight improvement or more.
    5) An adverse reaction was observed in only one patient (rash).
    6) The usefulness of dilazep was rated as 58.8% moderately useful or better and 80% slightly useful or better.
    It is concluded that long term administration of Comeliane is very safe and that it is a very useful drug for patients with Meniere's disease.
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  • Effects of Surgam® on Nasopharyngitis and Pain after Treatment
    -A New Approach to Clinical Evaluation of Topical Antiphlogistic Agents-
    Kimiaki Katori, Shoji Takayasu
    1990 Volume 83 Issue 4 Pages 675-680
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.675
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    Intense symptoms of irritation that occur after application of topical drugs in chronic nasopharyngitis may subjectively run a barely asymptomatic course, but can be closely associated with disorders of the neighboring areas or systemic diseases. These symptoms of local irritation were treated with the antiphlogistic agent Surgam®, and the results were analyzed.
    The approach which was employed in this study differs greatly from conventional methods of determining continuous changes in subjective symptoms and objective signs. It characteristically refers to the intensity of fresh symptoms of irritation (i.e., discontinuous induced reactions) induced by each application of a topical agent as a parameter for drug effect evaluation. The results of this study seem to justify the conclusion that this parameter provides for accurate evaluation of drug effects, thus furnishing a criterion of high clinical value in the evaluation of antiphlogistic agents.
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  • Pleomorphic Adenoma and Adenoid Cystic Carcinoma
    [in Japanese]
    1990 Volume 83 Issue 4 Pages 682-683
    Published: April 01, 1990
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.83.682
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