Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 84, Issue 1
Displaying 1-20 of 20 articles from this issue
  • Minoru Okuda
    1991 Volume 84 Issue 1 Pages 1-7
    Published: January 01, 1991
    Released on J-STAGE: December 12, 2011
    JOURNAL FREE ACCESS
    Many anti-allergic drugs for the treatment of allergic rhinitis are manufactured or available for sale in Japan. These include topical steroids, cromolyn sodium-like compounds (mast cell stabilizing agents), and non-sedative antihistamines. However, the mode of action and classification of these drugs are still contraversial. No definitive evidence has yet been presented supporting the assertion that mast cell stabilizing agents inhibit allergen induced chemical mediator release from the human nasal mucosal mast cell. Some mast cell stabilizing agents also have the antihistaminic effect that antihistamines do, and some anti-histamines inhibit chemical mediator release like mast cell stabilizing agents do. Further studies using human nasal mast cells are required to clarify the mode of action of each drug.
    We have performed clinical trials of many anti-allergic drugs using a standardized double blind intergroup comparative method in patients with perennial allergic rhinitis. For general improvement of allergic symptoms, mast cell stabilizing agents such as tranilast, traxanox, and azelastine were superior to inactive placebo; ketotifen, oxatomide and tranilast were also superior to clemastine fumarate ; and, tranilast was comparable to amlexanox, tazanolast, traxanox and repirinast; topical amlexanox and ketotifen were also comparable to cromolyn sodium.
    New anti-histamines such as terfenadine and astemizole were comparable to ketotifen, and loratazine was comparable to mequitazine for general improvement of allergic symptoms.
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  • [in Japanese]
    1991 Volume 84 Issue 1 Pages 8-9
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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  • Juichi Ito, Junji Sakakibara, Iwao Hnojo, Yasushi Iwasaki, Yoshiharu Y ...
    1991 Volume 84 Issue 1 Pages 11-15
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The activities of the auditory cortex of patients with severe sensorineural hearing loss were investigated by positron emission computed tomography (PET). The activity of the auditory cortex of a patient with residual hearing was nearly normal. In nearly deaf patients it was low, and the longer the duration of deaf period the lower was the activity. The activity of a prelingual deaf patient was low, not only in the primary auditory cortex but also in the secondary auditory cortex.
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  • Hideki Matsuoka, Masataka Murakami, Tatsuya Goto, Fumiki Nin, Kazuo Ue ...
    1991 Volume 84 Issue 1 Pages 17-25
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Surgery, primarily tympanoplasty, was performed on 1051 ears from April 1977 to March 1989. Two-thirds of the patients were aged 30 to 60. There was no sex difference in any age group. Chronic otitis media was observed in 45.2% and cholesteatomatous otitis media in 33.7%. Including the ears that needed reoperation or secondary operation, 931 ears (88.6%) were operated on for problems related to chronic otitis media; tympanoplasty was performed in 885 of them. In the ears with chronic otitis media, operation was type I in 60.8% and modified type III in 16.5%. In ears with cholesteatomatous otitis media, operation was type Tin 30.7% and modified type III in 30.4%.
    Hearing was good in 86.9% after type I operation, in 77.2% after modified type III operation, and in 45.3% after modified type IV operation. No difference was observed in the columellae used other than the cartilage and auditory ossicles. Recurrence was observed frequently in the ears followed for a long time after posterior walll preserving operations for cholesteatomatous otitis media.
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  • Masataka Murakami, Hideki Matsuoka, Tatsuya Goto, Fumiki Nin, Satoshi ...
    1991 Volume 84 Issue 1 Pages 27-31
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Epipharyngeal squamous cell carcinoma developed 10 years after an angiofibroma disappeared following a course of radiation therapy and 20 cryosurgical treatments to control recurrent nasopharyngeal angiofibroma.
    The lesion grew rapidly and extensively into the cranial fossa through a bone defect in the skull base, which had been produced by the previous angiofibroma. The epipharyngeal cancer was considered to have been caused by the radiation therapy, since the histological origin of squamous cell carcinoma differs from that of angiofibroma or sarcoma.
    A review of the medical literature disclosed 4 cases of sarcomatous transformation of angiofibroma, and 2 documented cases of radiation-induced cancer, although epipharyngeal cancer has never been reported.
    Early biopsy should be performed without fear of a bleeding tendency when a new bleeding tumor appears, even if a previous angiofibroma has been successfully treated.
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  • Satoshi Katagiri, Kenji Dejima, Hiroshi Takenaka, Miho Nakao, Shigeru ...
    1991 Volume 84 Issue 1 Pages 35-40
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We examined 131 patients with Japanese cedar pollinosis in our hospital from 1986 to 1989. Paranasal sinusitis was found by x-ray in 30%. The incidence of sinusitis in these patients tended to increase with the duration of exposure to the pollen. The results suggest that sinusitis in patients with Japanese cedar pollinosis is a reversible disorder caused by exposure to the pollen.
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  • Shigeru Kikuchi, Harumi Suzaki, Akihiko Aoki, Osamu Ito, Yasuya Nomura
    1991 Volume 84 Issue 1 Pages 41-47
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Twenty six adult patients with chronic sinusitis who had undergone Caldwell-Luc operation and received conservative therapy for a long time, but still complained of nasal symptoms, were treated with 400-600mg of erythromycin (EM) per day for 7.9 months on the average.
    1) Rhinorrhea was reduced in 60.0%, postnasal drip in 50.0%, nasal obstruction in 60.0%, hyposmia in 11.8% and sense of dullness in the head in 100%.
    2) Rhinoscopy showed reduced mucosal swelling in 10.5%, lower volume of rhinorrhea in 80.0%, better quality of rhinorrhea in 70.0% and reduced postnasal drip in 85.7%.
    3) This therapy was effective even when EM-resistant bacteria such as Hemophilus influenzae were present.
    4) No significant side effects were noted in any of the patients during this therapy. Long-term low-dose EM therapy is useful in the treatment of chronic sinusitis. We consider that its effect is not due to its antibacterial activity but to some as yet unknown mechanism.
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  • Tatsuya Sadaoka, Soichi Motoyama, Kunihiro Sugita, Kazuo Makimoto
    1991 Volume 84 Issue 1 Pages 49-53
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Dermoid cysts of the head and neck are relatively rare. We recently treated a patient with dermoid cyst of the floor of the mouth with profuse purulent discharge.
    The patient is a 27-year-old actress who visited our hospital complaining of severe pain and swelling in the left submandibular region. During treatment with intravenous injection of antibiotics, a profuse purulent discharge appeared in the floor of the mouth. The inflammation subsided gradually, and the clinical course was favorable. After the inflammation had cleared completely, the remaining cyst-like lesion was resected via an external approach through the left submandibular region under general anesthesia. The histopathological diagnosis was dermoid cyst. When a cyst in the floor of the mouth is punctured for diagnotic or therapeutic purposes, early surgical removal is recommended to avoid the problems of inflammation which may occur due to contamination.
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  • Katsuhiko Fukamoto, Rinya Sugita
    1991 Volume 84 Issue 1 Pages 55-60
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Case 1 was a 39-yr-old male who presented with sore throat. Examination revealed that the right tonsil alone was swollen, and an elastic hard mass and swollen submandibular gland were palpated in the right upper neck area. CT scan revealed a calcified body in the right tonsil. Tonsillectomy was performed, and a large stone was removed. It was 28×18×18mm in size and 6.0gm, in weight. Chemical analysis revealed CaPO4 72%, CaCO3 8% and protein 20%.
    Case 2 was a 54-yr-old female who had been receiving medication for hyperthyroidism for 1.5 years. She presented with a sensation of a foreign body in the pharynx and a swelling in the submandibular angle. Examination revealed that both tonsils were slightly swollen, and a mass measuring about 20mm in diameter, which seemed to be an enlarged submandibular gland, was palpated in the upper neck. CT showed a calcified body in the right tonsil, whereas there was no tumor in the upper neck or enlargement of the submandibular gland. Since the symptoms were only slight, conservative treatment was employed, and no change to chronic tonsillitis has been noted to date.
    The etiology of tonsilloliths is discussed with reference to the literature on salivary, ureternal nasal and paranasal calculus.
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  • Hiroshi Kimura, Hajime Nakagaw, Masatsugu Asai, Yukio Watanabe, Kanema ...
    1991 Volume 84 Issue 1 Pages 61-66
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Recently we treated a patient with a tonsillolith 8.5 grams in weight which is believed to be the heaviest reported in Japan so far. This 26-year-old male patient visited a hospital complaining of pharyngeal pain with no difficulty in swallowing or trismus. A diagnosis of peritonsillar abscess was made from the local findings. Prior to this episode a stony mass had been expelled from right tonsil spontaneously. Tonsillectomy was indicated for the history chronic angina and recurrent peritonsillar abscess. On the morning of admission the tonsillolith was expelled spontaneously, but tonsillectomy was performed because of chronic angina. The operative findings suggested that the stone had been in the right upper region between the capsule of the tonsil and the superior constrictor muscle. It was yellowish gray and measured 30×26×16mm. Chemical analysis revealed calcium phoshate. In the world literature there have been about 20 reports of large tonsilloliths. This is the largest reported so far in Japan. Our observations and previous reports suggest that recurrent inflammation of the tonsils and peritonsillar tissues promote the accumulation of inflammatory debris in tonsillar crypts, which then become the organic nidus for stone formation. Salts from the saliva may precipitate to form tonsilloliths that gradually increase in size.
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  • Kiminori Sato, Shigejiro Kurita, Masayoshi Kage
    1991 Volume 84 Issue 1 Pages 67-71
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A rare case of lymphoid hyperplasia (pseudolymphoma) of the larynx is reported. The patient was a 51-year old female. She complained of abnormal sensation of the throat since January 1986. She was referred to our clinic on October 1. On admission, swelling of the left false vocal fold was observed. The surface of the false vocal fold was smooth and covered with normal epithelium. No cervical lymphnode swelling was palpated. On CT scan, a low density tumor was detected in the submucosa of the left false vocal fold. Operation was performed on October 5. After suprahyoid pharyngotomy, the tumor was enucleated. It was elastic soft, 30mm×16mm×10mm in size, and yellowish white in color. Histological examination revealed lymphoid hyperplasia (pseudolymphoma) of the larynx. The patient has lived without any evidence of lymphoreticular disease for two years and six months. The English and Japanese literature on lymphoid hyperplasia of the larynx is reviewed.
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  • Futoshi Matsushita, Masashi Suzuki, Noritake Watanabe, Goro Mogi
    1991 Volume 84 Issue 1 Pages 73-76
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Piriform sinus fistula is a rare congenital anomaly and is known to be a route of infection to the thyroid. We report a case of acute suppurative thyroiditis in a 7-year-old girl. Contrast x-ray films of the esophagus revealed a fistula originating from the apex of the left piriform sinus. This fistula was completely removed by surgery which included hemithyroidectomy under general anesthesia. The fistula ran from the left piriform sinus to the left lobe of the thyroid gland. The lumen of the fistula was lined with stratified squamous epithelium. In cases of acute suppurative thyroiditis or repeated cervical infection due to unknown causes, an esophagogram is necessary to determine a route of infection in the piriform sinus fistula.
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  • Yoshifumi Uno, Ryusuke Saito, Kazunori Nishizaki, Hisako Matsuoka, Mak ...
    1991 Volume 84 Issue 1 Pages 77-81
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Neoplasms involving the parapharyngeal space are not common but cause and therapeutic problem. We report here a patient with papillary thyroid carcinoma primarily involving the parapharyngeal space and presenting as a parapharyngeal mass.
    We emphasize that it is important to keep in mind the possibility of primary or metastatic malignancy, including thyroid carcinoma, in patients with a parapharyngeal mass.
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  • Osamu Tanaka, Takashi Matsunaga, Hiroshi Miyahara, Katsunari Yane
    1991 Volume 84 Issue 1 Pages 83-87
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The purpose of this study was to test the usefulness of thallium 201 (Tl-201) thyroid scintigraphy in the detection of thyroid malignancies. Early and delayed Tl-201 scintigraphy was done in 135 patients with a clinically solitary thyroid nodule. There were 64 benign tumors and 71 malignant tumors. Scintigraphy was done 10 minutes (early scan) and 2 hours (delayed scan) after the administration of Tl-201.
    With a combination of early and delayed Tl-201 scintigraphy, sensitivity was 57.7% and specificity was 81.2%. Therefore Tl-201 scintigraphy is of limited value for the detection of thyroid malignancies.
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  • Megumi Kumai, Naoki Hatayama, Yutaka Hayashi, Mitsuaki Takahashi, Masa ...
    1991 Volume 84 Issue 1 Pages 89-93
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We report here the effect of activated vitamin D3 (Vit. D3) in postoperative hypoparathyroidism. We performed 42 total thyroidectomies and 43 sub-total thyroidectomies from 1978 to 1989.
    Hypoparathyroidism occurred in 36 patients (85.7%) after total thyroidectomy and 5 (11.6%) after sub-total thyroidectomy. We treated 18 of these patients with Vit. D3 only (43.9%) and 21 with Vit. D3+calcium (51.2%) orally. Treatment with Vit. D3 only is easier and more useful than that with Vit. D3 + calcium in controlling the serum calcium level of patients with hypoparathyroidism.
    We should monitor not only the serum calcium level but also the serum albumin to determine the real serum calcium level.
    With Vit. D3, which we prescribed in doses of 0.5-6.0μg (mean: 2.47±1.45μg) per day, we could control the serum calcium level well in patients with postoperative hypoparatyroidism without a high calcium level in the urine.
    It is probably concluded that Vit. D3 treatment alone is adequate for postoperative hypoparathyroidism patients, who have normal calcium uptake from the digestive tract, and it is the easiest and safest way to control the serum calcium level.
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  • - Review of the Literature -
    Jun Tsuji, Juichi Ito
    1991 Volume 84 Issue 1 Pages 95-103
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The function and morphology of the otolith organs was examined with respect to the information transduction of head tilting and linear acceleration.
    It has generally been accepted that hair cells of the otolith organs are activated when hairs are reflected to the direction of the kinocillium (morphological polarization vector). Head tilting and acceleration stimulate hair cells with the same morphological polarization vector to increase their firing rates. To prove this theory, the correspondence between morphological and functional polarization vectors of otolith hair cells must be demonstrated.
    The functional polarization vectors of the otolith organs were predicted after physiological investigation of the vestibular ganglion (Scarpa's ganglion) cells. A similarity between the functional polarization vector of the superior vestibular ganglion cells and the morphological polarization vector of the utricular macula was suspected. Likewise a relation between the inferior vestibular ganglion cells and the saccular macula was also suspected. By this method, however, the peripheral innervation pattern of the vestibular ganglion cells could not be identified and the functional role of the differentiation of hair cells (types 1 and 2) as well as the significance of existence of striola remain unknown.
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  • Hironobu Kurokawa, Kazunori Okamoto, Eiji Yumoto, Hiroshi Okamura
    1991 Volume 84 Issue 1 Pages 105-112
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The authors reviewed the literature on the mode of vocal fold vibration, which has been considered to be a transmission of the mucosal wave upward from the lower surface of the vocal fold. Many high-speed cinematographic or stroboscopic images have been obtained from the supraglottic area, but the vibratory mode of the lower surface of the vocal fold remains unclear. We observed vocal fold vibrations from the infraglottic as well as the supraglottic areas with high-speed cinematography and found that:
    1) Traveling waves moved upward from the mucosal upheaval or inside it. That is, the mucosal upheaval vibrated with an earlier phase than any other portion of the vocal fold.
    2) In the closing phase, the lower lip became a free edge and moved upward. After contract of the lower lips of both sides in the midline, lower lip became the upper lip and moved upward. At the time of contact, the reflection wave, identified as the lower lip from the infraglottic image, retracted laterally rapidly.
    3) At the end of the opening phase, the lower lip of the next cycle began to move medially.
    4) The mucous membrane outside of the mucosal upheaval did not virbrate actively.
    5) On the basis of these findings, we tried to diagram the frontal sections of the vibrating vocal fold in different phases.
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  • Ryuji Kiyota, Koji Ajisaka, Yasuo Iwabuchi, Kenzo Murano, Kaneaki Hara ...
    1991 Volume 84 Issue 1 Pages 113-120
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The therapeutic effect of Tofisopam was studied in 30 patients with vertigo, dizziness and/or tinnitus. They were given oral Tofisopam 150mg daily (50mg three times a day), and the severity of their complaints was recorded before and two or four weeks after the start of treatment.
    The medication was effective in 63.2% of the patients with vertigo and/or dizziness, and in 66.7% of the patients with tinnitus. Psychological analysis (T. M. I.) showed a significantly better response in patients with autonomic dysfunction complaints than in those with neurosis. Significant improvement was also noted in patients with tinnitus, the frequency of which was under 2kHz.
    These results indicate that Tofisopam is useful in the treatment of selected patients with neurootological diseases such as vertigo, dizziness and tinnitus.
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  • Kazuyo Yura, Takafumi Kawahara, Asako Koshimune, Yasuki Watanabe, Mamo ...
    1991 Volume 84 Issue 1 Pages 121-127
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The effect of lysozyme (Leftose°) on bleeding during tonsillectomy and adenoidectomy was investigated in children. Leftose° was administered for one week before and two weeks after the operation in 31 of 60 patients in whom tonsillectomy or adenotonsillectomy was performed.
    1) The blood loss during surgery was not significantly different between Leftose°-treated patients and the others.
    2) Blood coagulation tests before and after Leftose° administration showed no significant difference, but the bleeding time and partial prothrombine time decreased slightly in administration of Leftose°.
    3) No side effects of Leftose° administration were noted.
    Leftose° had no major effect on bleeding during tonsillectomy and adenoidectomy although it had a slight influence on blood coagulation.
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  • [in Japanese]
    1991 Volume 84 Issue 1 Pages 128-129
    Published: January 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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