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84 巻, 2 号
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―はじめに―金子 敏郎1991 年 84 巻 2 号 p. 131-132
発行日: 1991/02/01
公開日: 2011/11/04
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塩野 博己, 北原 伸郎, 飯沼 寿孝1991 年 84 巻 2 号 p. 132-137
発行日: 1991/02/01
公開日: 2011/11/04
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鈴木 晴彦1991 年 84 巻 2 号 p. 137-139
発行日: 1991/02/01
公開日: 2011/11/04
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原口 兼明, 大山 勝1991 年 84 巻 2 号 p. 139-142
発行日: 1991/02/01
公開日: 2011/11/04
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山下 敏夫1991 年 84 巻 2 号 p. 142-145
発行日: 1991/02/01
公開日: 2011/11/04
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亀井 民雄, 松井 伸一郎, 設楽 公一, 鎌田 英男, 安岡 義人, 城下 尚1991 年 84 巻 2 号 p. 146-147
発行日: 1991/02/01
公開日: 2011/11/04
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―段階手術所見からの検討―暁 清文, 比野平 恭之, 柳原 尚明1991 年 84 巻 2 号 p. 149-154
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーThe incidence and location of the posterior canal wall defect were studied in 175 ears of 167 patients who underwent planned two-stage tympanoplasty by the intact canal wall technique during the last ten years. Of the 84 ears with intact scutum, the bony defect was present in 14 ears at the first operation, and in 12 of these at the second operation. Ten ears developed bony defects between the first and second operations, although the canal wall had been primarily preserved. This was ascribed to atrophy of the posterior canal wall. Of the 91 ears with destruction of the scutum, bony defects other than of the scutum were present in 12 ears at both operations. Canal wall atrophy was present in 16 of the 91 ears. Canal wall defects were listed according to Weinberg's classification. In the canal wall atrophy group, Type A lesions (a round hole in the middle of the canal wall) were seen in 20 ears; Type B lesions (a semicircular defect in the interior wall) in 3 ears; Type C lesions (a semicircular defect in the exterior wall) in 3 ears. Type D lesions (bony destruction along the entire length of the posterior wall) were not seen.抄録全体を表示PDF形式でダウンロード (696K) -
飯野 ゆき子, 杉田 公一, 中井 淳仁, 安部 浩一, 増田 哲也, 鳥山 稔1991 年 84 巻 2 号 p. 155-162
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーSeven patients (8 ears) with acute otitis media associated with transient sensorineural hearing loss were studied. The patients were 21 to 63 years old and complained of hearing loss following typical symptoms of acute otitis media such as otalgia and otorrhea. All ears demonstrated mixed hearing loss and all showed complete recovery. The serum antibody titer against mycoplasma was elevated in only one patient-the one with bilateral disease. Serologic examination in the other patients showed neither viral infection, such as influenza type A or type B, nor mycoplasma infection. However, all the episodes were preceded by or accompanied by an upper respiratory infection, and bullous myringitis or serous otorrhea was observed in the ears. These clinical signs suggested the presence of unidentified viral infection. The site of the lesion producing the sensorineural hearing loss seemed to be the cochlea because of the absence of abnormal findings in the auditory brainstem response and of the severe hearing loss primarily at 8kHz.抄録全体を表示PDF形式でダウンロード (961K) -
青柳 満喜, 橋口 一弘, 吉田 昭男, 牧嶋 和見1991 年 84 巻 2 号 p. 163-168
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーWith the advent of antibiotics, severe complications of acute otitis media have decreased significantly. Bezold's abscess, which is a well known complication of acute otitis media, is an extremely rare disease in Japan.
We report a case of masked mastoiditis which later went on to Bezold's abscess. The patient was a 17-year-old male who was admitted to our department with complaints of pain and swelling of the right postauricular and right neck regions.
Physical examination on admission revealed intact tympanic membranes but there was slight tenderness in the right postauricular region. X-ray films showed radiopacity in the right mastoid region, and CT scan revealed a soft tissue density in the right mastoid air cells and abscess formation deep to the sternocleidomastoid muscle.
The patient was operated on under general anesthesia. The right neck was explored through an anterior skin incision, and an abscess was observed beneath the right sternocleidomastoid muscle. It was drained.
A radical mastoidectomy on the right ear revealed granulation tissue in the mastoid cavity and a defect in the mastoid cortex. No defect was observed in the facial canal or semicircular canals.
The postoperative course was uneventful. The patient was discharged 30 days after the operation.
Acute otitis media is cured easily with antibiotics. However, when antibiotics therapy is incomplete, acute otitis media develops without evident symptoms and severe complications sometimes occur. We stress in this paper the careful use of antibiotics in treating acute otitis media.抄録全体を表示PDF形式でダウンロード (4864K) -
斉藤 稚里, 渡辺 周一, 内藤 好宏, 増田 游1991 年 84 巻 2 号 p. 169-174
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーA 63-year-old man had suffered from increasing bilateral conductive hearing loss, left facial nerve palsy and a vestibular disturbance. Proliferative granular lesions were found in the gingiva, the external canal and the middle ear cavity on both sides. Histopathological studies revealed pemphigus vegetans, and the clinical course during and after steroid therapy suggested the Hallopeau type of this disease. It has been reported that phemphigus vegetans is a rare disease which occurs in the mucosa of the oral cavity or the moist regions of the skin. Moreover, no case with ear problems has been reported.
This paper emphasizes the importance of recognizing this rare disease in the E. N. T. area. The pathogenesis of the ear-associated problem is also discussed.抄録全体を表示PDF形式でダウンロード (5004K) -
武安 陽子, 加藤 明理, 伊藤 浩一, 金沢 博俊, 湯浅 貴文, 臼井 信郎1991 年 84 巻 2 号 p. 175-180
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーUsing the asthograph, we investigated the effect of ketotifen on the hyperresponsiveness of the nasal mucosa in 12 patients with allergic rhinitis.
Ketotifen was administered (2mg a day in two doses) for eight weeks.
Inhalation tests of methacholine through the nose were performed with the asthograph before and after the course of medication, and eosinophil counts were recorded.
i) There was no significant change in initial nasal respiratory resistance (Rrs. N. cont).
ii) Hypersensitivity of the nasal mucosa reflected by Dmin decreased significantly after eight weeks of treatment.
iii) Nasal reactivity reflected by Sd. N did not change significantly during treatment.
iv) Eosinophil counts in nasal secretions and blood did not change significantly.抄録全体を表示PDF形式でダウンロード (536K) -
横山 道明, 硲田 猛真, 新井 宏紀, 榎本 雅夫1991 年 84 巻 2 号 p. 181-186
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーSynchronous reconstruction of the defect of the face and hard palate afterr maxillectomy was performed with free myocutaneous flaps. A 58-year-old male and a 65-year-old male were treated for maxillary cancer (T4N0) with total maxillectomy and resection of facial skin (include the orbital contents in the latter case). The defects were reconstructed synchronously with two types of free myocutaneous flap: rectus abdominis (the former case), latissimus dorsi (the latter case). They were able to eat two weeks after surgery and did not suffer from speech disturbance. The greatest advantage of using free myocutaneous flaps for such reconstruction is the availability of enough muscle to fill the dead space and sufficient skin and the chief disadvantage is the risk of herniation after removal of the rectus abdominis.抄録全体を表示PDF形式でダウンロード (4594K) -
木村 正, 岸本 誠司, 鎮西 邦彦, 齋藤 春雄1991 年 84 巻 2 号 p. 187-192
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーAlthough several complications are encountered after cleft palate operation, airway obstruction due to massive tongue edema is rarely reported. However, this complication may be life threatening, and the definite etiology remains unclear. We recently treated two patients with massive tongue edema, which developed shortly after cleft palate operation. The management of this complication is described and the pertinent literature is reviewed. We conclude that during cleft palate operations, the oropharyngeal cavity including the tongue must be thoroughly examined before extubation, and if any sign of tongue edema exists, the tube should be left in place for a while to maintain the airway.抄録全体を表示PDF形式でダウンロード (3595K) -
渡邉 昭仁, 野平久 仁彦, 畔田 貢, 由良 晋也, 白戸 勝, 金井 直樹1991 年 84 巻 2 号 p. 193-196
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーA 40-year-old woman complained of a painless mass in the left side of the floor of the mouth. A 2×2cm round, smooth, nontender mass was palpable on the left side of the floor of the mouth; it was fixed to the symphysis of the mandible. No cervical lymph nodes were palpable. T2-weighted MRI scan of the tumor showed smooth margins and a heterogeneous signal. A contrast-enhanced CT scan showed a slightly enhanced mass lesion. Radionuclide scanning with 67Ga showed a hot tumor. Radiography revealed a malignant tumor originating in a minor salivary gland or a sublingual gland. Microscopic examination of the tumor showed adenocarcinoma.
Radical neck dissection was combined with resection of the left side of the floor of the mouth and of the internal margin of the mandible. The surgical defect was reconstructed with a rectus abdominis musculocutaneous flap.
Postoperative evaluation of mastication and articulation was good. The patient had no evidence of recurrence one year after surgery.抄録全体を表示PDF形式でダウンロード (3768K) -
掌本 圭吾, 斎藤 裕子, 高木 伸夫, 安田範夫 範夫, 久育 男, 村上 泰1991 年 84 巻 2 号 p. 197-202
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーA 19-old female with a large cavernous hemangioma located in the right lateral wall of the oropharynx between the superior pole of the palatine tonsil and the vallecula was removed surgically after embolization. The procedure consisted of a horizontal skin incision of the upper neck, mandibular bone dissection and obliteration of the defect with a pedicled sternomastoid muscle. The defect in the cavity was well epithelized 6 weeks postoperatively with minimal scar contraction.抄録全体を表示PDF形式でダウンロード (4910K) -
寺薗 富朗, 大島 渉, 中尾 美穂, 紀平 晋也, 河田 了, 大川 和春, 高田 憲1991 年 84 巻 2 号 p. 203-207
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーAn unusual case of pleomorphic adenoma of the epiglottis is described. A 71-year-old female complained of dysphagia. Laryngoscopy revealed a tumor located on the laryngeal side of the epiglottis. The tumor was excised successfully by laser treatment under laryngomicroscopy. The extirpated tumor was 1.5cm in diameter, the cut surface was solid and light yellow, and the microscopic diagnosis was pleomorphic adenoma. This is one of three cases of pleomorphic adenoma of the epiglottis to have been reported in Japan.抄録全体を表示PDF形式でダウンロード (1979K) -
川島 理, 富沢 克夫, 安岡 義人, 亀井 民雄1991 年 84 巻 2 号 p. 209-216
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーIn 20 cases of laryngeal carcinoma, the pre-operative computerized tomography (CT) films were correlated with the macroscopic appearance of specimens obtained at the time of surgery. A correct diagnosis of cartilage destruction was made by preoperative CT in 75% of cases in which the thyroid cartilage was involved and in about 79% of those with either arytenoid or cricoid cartilage involvement. A comparison between the pathological findings and the pre-operative CT findings in 9 cases of laryngeal carcinoma with destruction of the thyroid cartilage revealed several pathological changes which may lead to an incorrect CT diagnosis. These changes include microscopic infiltration; destruction of cartilage at the anterior commisure; tumor advance to sites of ossification, especially infiltration into ossifying cartilage located between two areas of non-ossifying cartilage; and infiltration of the tumor within the cartilage with preservation of the perichondrium.抄録全体を表示PDF形式でダウンロード (5630K) -
任 書熹, 久 育男, 豊田 健司, 園田 隆郎, 宇野 敏行, 八木 正人, 村上 泰1991 年 84 巻 2 号 p. 217-223
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーWe reviewed the clinical records of 266 patients with recurrent laryngeal nerve paralysis examined at our department between 1978 and 1987, one hundred and fifty three males and 113 females. The highest incidence was found in those over 50 years of age. The lesion was unilateral in 244 patients (right in 54 and left in 190) and bilateral in 22. The paralytic vocal fold was fixed in the paramedian position in the majority of patients. The etiologic causes were frequently thyroid tumor, lung cancer, esophageal cancer and idiopathic paralysis. The incidence of paralysis due to malignant tumors increased with age. In the young age group paralysis due to heart surgery was frequent. A very high rate of recovery was observed in patients with paralysis due to endotracheal incubation.抄録全体を表示PDF形式でダウンロード (721K) -
大谷 真喜子, 山下 敏夫, 天野 一, 原田 成信, 熊澤 忠躬1991 年 84 巻 2 号 p. 225-230
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーIsolated vestibular hair cells are thought to be a very useful tool for the study of vestibular function. However, very little work has been done yet, especially in mammalian species. In 1989 Valat et al first described a technique for the isolation of vestibular hair cells from guinea pigs. We used their technique and studied the morphology of isolated vestibular hair cells.
Vestibular hair cells were isolated from the macula sacculi, macula utriculi and cristae ampullaris of guinea pigs by enzymatic and mechanical dissociation. These isolated cells were classified into three types: flask-shaped cells, rod-shaped cells and round cells. The flask-shaped cells, which had a flask-shaped cell body, so-called neck, cuticular plate, sensory hairs and sometimes the remains of a nerve calyx, were obtained more readily from cristae ampullaris than from other vestibular sensory organs. The rod-shaped or round cells, which had a rod-shaped or round cell body without a neck, were often isolated from the macula sacculi and macula utriculi. The histological findings of the vestibular hair cells suggested that the flask-shaped cells are type I cells and that the rod-shaped cells are type II cells, while the round cells might be damaged type I or type II cells.抄録全体を表示PDF形式でダウンロード (3115K) -
―予報―新井 寧子, 飯田 直美, 鈴木 淳一, Volker Henn1991 年 84 巻 2 号 p. 231-238
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーCaloric nystagmus of 18 normal subjects and 10 monkeys were compared three dimensionally. Eye movements in darkness were recorded by an electronystagmography (ENG) in humans and magnetic search coils in eight rhesus monkeys. In some of the humans and also in two japanese monkeys, eye movements were observed under infra-red video monitoring. Caloric stimuli were applied by irrigating the external ear canal with 20°C water in the ear up position; then the head position was changed to the supine or to the prone position. The first phase of caloric nystagmus had three dimensional components except the torsional component in the supine position in humans; i.e. the horizontal component beat away from the side of irrigation in the supine position, and toward the side of irrigation in the prone position. The torsional component was counterclockwise with right ear irrigation and clockwise with left ear irrigation in both the supine and prone positions; the vertical component was up beating in the prone position and down beating in the supine in both the right and left ear irrigations. The torsional second phase of caloric nystagmus in monkeys was very active and lasted quite long in both the supine and the prone positions. In the side position, torsional nystagmus was markedly suppressed and strong vertical nystagmus appaered. In humans, almost no second phase of caloric nystagmus was recorded in the supine or prone positions, while weak but definite horizontal nystagmus was recorded in every subjects in the sitting position. These findings of the second phase of caloric nystagmus strongly suggested that the second phase of caloric nystagmus appeared in the earth horizontal plane, where no otolithic control exists.抄録全体を表示PDF形式でダウンロード (1057K) -
守田 雅弘, 久保 武, 酒井 俊一1991 年 84 巻 2 号 p. 239-244
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーEperisone H-Cl, which has been found to improve cerebral circulation and to act as a muscle relaxant, was used to treat 30 patients complaining of vertigo. The rate of effectiveness for vertebro-basilar insufficiency (13 patients) was 92.3%, and that for Meniere's disease (13 patients) was 76.9%. Eperisone was relatively effective for moderately intense vertigo, with the onset within 3 months. Rotating, floating and motion sensations decreased in most patients. On the other hand, the rates of effectiveness for hearing loss and tinnitus were low.
In patients with peripheral vertigo, the overall effectiveness of Eperisone was significantly greater in those whose shoulder muscle pain was alleviated than in those whose shoulder pain persisted. This suggests that the muscle relaxant effect of Eperisone plays an important role in the treatment of peripheral vertigo, including Meniere's disease.抄録全体を表示PDF形式でダウンロード (768K) -
羽柴 基之, 向井 研, 馬場 駿吉1991 年 84 巻 2 号 p. 245-257
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーGilostazol not only suppresses platelet aggregation but also increses blood flow in the brain. To determine whether it is useful in patients with vertigo due to circulatory disorders in both the peripheral and the central vestibular system, we investigated its clinical effect in 19 patients with vertigo, who were over 40 years of age and whose vertigo was considerd to be caused by circulatory disturbances. A dose of 200mg/day was administrated for 4 or 8 weeks.
1. The overall rate of improvement was 78% after 4 weeks and 85% after 8 weeks of treatment.
2. Fifteen of the 19 patients (79%) complained of a slight headache during the first week of treatment. Seven of them recovered soon without treatment. The other eight recovered when the drug's dose was reduced by 50% or when an analgesic was administered.抄録全体を表示PDF形式でダウンロード (1342K) -
―口蓋形成術における臨床的検討―楠本 健司, 一色 信彦, 澤田 正樹, 鈴木 茂彦, 平良 達三, 野瀬 謙介, 平本 道昭1991 年 84 巻 2 号 p. 259-265
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーThe push back operation was performed as the first palatoplasty in 51 patients with cleft palate. During surgery a microcrystalline collagen hemostatic agent (MCH) was used in 23 (MCH group). The other 28 served as controls.
Good hemostasis was obtained with MCH. It was very useful in 4 patients, useful in 15, and indefinite in 4. There were no differences in the duration of infusion or fever between the MCH group and the control group.
In the MCH group there was no postoperative fever and no side effects.
In some cases MCH was applied to the open wound, and wound healing was accelerated.抄録全体を表示PDF形式でダウンロード (4018K) -
海野 徳二1991 年 84 巻 2 号 p. 266-267
発行日: 1991/02/01
公開日: 2011/11/04
ジャーナル フリーPDF形式でダウンロード (211K)
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