Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 84, Issue 8
Displaying 1-22 of 22 articles from this issue
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  • Diagnosis of the Neck Lesions
    -Role of Fine Needle Aspiration Cytology-
    Hirosato Miyake, Masatoshi Horiuchi
    1991 Volume 84 Issue 8 Pages 1029-1037
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1029
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    Neck mass lesions of many etiologies: primary neoplastic disease, metastatic nodal disease, malignant lymphoma and even systemic infectious disease. Fine needle aspiration (FNA) biopsy is a safe and low cost technique, and is being used increasingly as a diagnostic work-up of outpatients with neck lesions. The accuracy of FNA depends on the primary site and histology. For nodal metastatic lesions of squamous cell carcinoma or benign diseases, the aspirated materials have a high rate of true positive diagnosis. The cytological diagnosis of malignant lymphoma and salivary gland malignancies is incorrect in about 30% of patients. When malignant lymphoma is suspected, open biopsy is recommended for pathological diagnosis and subgroup differentiation. FNA is not widely accepted for the diagnosis of lymphoma in lymph nodes. Immunohistochemical techniques for studying aspirates provide more accurate diagnosis for complicated cytology. Samples from cystic lesions are usually inadequate, may led to false negative diagnoses. Repeat aspiration or excisional biopsy is essential for the correct diagnosis of those lesions.
    FNA has a role in the initial evaluation of head and neck tumor and possible recurrence of previous tumor. False negative diagnoses in malignant diseases is a limitation of this technique. The combined clinical use of FNA and radiological imaging technique is recommended for the differential diagnosis of neck mass lesions.
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  • Epidermosis of the Tympanic Membrane
    [in Japanese], [in Japanese]
    1991 Volume 84 Issue 8 Pages 1038-1039
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1038
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  • Deafness in Patients with Mumps
    Shigeru Kikuchi, Takehiko Harada, Tatsuya Yamasoba, Masato Yagi
    1991 Volume 84 Issue 8 Pages 1041-1047
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1041
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    The clinical features of 12 patients with deafness due to mumps, including one with asymptomatic mumps, are reviewed. The diagnosis was made according to the criteria for diagnosis of mumps deafness determined by the Acute Profound Deafness Committee set up by the Ministry of Health and Welfare, Japan.
    1) The 12 patients were 5 to 25 years old (mean, 9.5).
    2) All 12 had unilateral total or profound sensorineural hearing loss.
    3) Hearing did not improve after treatment.
    4) Six patients complained of dizziness or vertigo. Eight patients were examined with the ice water caloric test; four showed a normal response and four no response.
    The patient with deafness due to asymptomatic mumps was a 5-year-old girl, who complained of dizziness and hearing loss in her left ear. Three days after the onset of deafness, she visited our hospital. Total sensorineural hearing loss on the left and right-beating nystagmus were noted. Her left ear showed no response to the ice water caloric test. Treatment with steroid medication did not improve her hearing. No swelling of the salivary glands was noted during the entire clinical course. Paired sera taken 3 days and 18 days after the onset of deafness showed a significant increase in antibody titer to mumps virus, confirming the diagnosis of asymptomatic mumps. The importance of serological tests in such a case is discussed.
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  • Vestibular Aqueduct Measured by Computed Radiography in Normal Persons and Patients with Meniere's Disease
    Taizo Takeda, Hiroaki Nakatani, Kenichi Kozakura, Akinobu Kakigi, Haru ...
    1991 Volume 84 Issue 8 Pages 1049-1058
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1049
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    Polytomography of the vestibular aqueduct by a new method of radiographic imaging, computed radiography (CR), was carried out in 30 normal subjects and 25 patients with Meniere's disease, 14 of whom had bilateral involvement.
    The vestibular aqueduct could be identified clearly not only in normal subjects but also in patients with Meniere's disease. Normal vestibular aqueducts were funnel-shaped or tubular, and the width of the external aperture was about 6.0mm. On the other hand, a hypoplastic vestibular aqueduct with a narrow external aperture was often observed in patients with Meniere's disease. Especially in the affected ear of patients with unilateral Meniere's disease, the external aperture was very narrow; its mean width was 2.2mm. In these cases, the most common radiographic configuration of the vestibular aqueduct was filiform. It was concluded that a hypoplastic vestibular aqueduct may be one of the etiologic factors in Meniere's disease.
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  • Prognosis of Otitis Media with Effusion Treated Mainly with Conservative Therapy
    Kazuhiko Hokunan, Tetsuji Wada, Takashi Ohsaki, Mitsuaki Takahashi
    1991 Volume 84 Issue 8 Pages 1059-1065
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1059
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    We reviewed 157 ears of 100 children with otitis media with effusion in order to clarify the effect of conservative therapy and the risk factors for chronicity. They were treated mainly with conservative therapy: administration of S-carboxymethylcysteine (S-CMC) and politzerization or catheterization of the eustachian tubes. Of the 100 children 66 (94 ears) had only conservative treatment. Of the 94 ears 78 (83%) were cured within 3 months. All ears were divided into two groups on the basis of the time required for recovery: Group I, ears cured within 6 months after the first visit; Group II, ears not cured within 6 months. The average age in Group II was lower than in Group I. Children in Group II complained less of ear symptoms at the first visit than did those in Group I. We conclude that younger age and lack of complaint may be considered to be risk factors for chronicity of otitis media with effusion.
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  • Refractory Otitis Media with Effusion in Relation to Eustachian Tube Dysfunction and Nasal Sinusitis
    Akihiko Fujita, Junji Sakakihara, Kyosuke Kurata, Iwao Honjo, Haruo Ta ...
    1991 Volume 84 Issue 8 Pages 1067-1070
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1067
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    Otitis media with effusion (OME) in children usually subsides spontaneously, but in some cases it is refractory. To find the factors which prevent recovery, we examined 69 patients (112 ears) aged 10 to 20 years who had persistent OME. As factors most closely related to the etiology of OME, eustachian tube function and the influence of paranasal sinusitis were examined.
    We found that the tubal ventilatory function of refractory cases was greatly disturbed, in 33% of those cases, the passive opening pressure of the tube was higher than normal, while 19 ears showed closing failure of the tube in the sniffing test. Paranasal sinusitis was found in 50% of the refractory cases, significantly lower than in younger children (aged 4 to 9 years) with OME.
    Thus, it may be concluded that tubal dysfunction caused by some organic abnormalities plays an important role in the etiology of refractory OME in adolescence.
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  • Recurrent Pleomorphic Adenoma of the External Auditory Canal; A Case Report
    Toshihiko Kamito, Mitsuaki Takahashi, Toshihide Adachi, Tokuji Unno
    1991 Volume 84 Issue 8 Pages 1071-1075
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1071
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    Parotid pleomorphic adenoma tends to recur after inadequate surgical treatment. A 57-year-old man had a recurrent pleomorphic adenoma of the left external auditory canal. The tumor was elastic hard and covered with intact auditory canal skin. A CT scan showed that the tumor was located from the posterior external auditory canal to the mastoid with bone destruction. After mastoidectomy, the tumor was removed “en bloc” with surrounding bone and skin. The histopathological diagnosis was “benign” pleomorphic adenoma. It was considered to be a recurrence of parotid tumor. Because 1) he had previously received surgical treatment twice for a parotid pleomorphic adenoma, 2) the tumor was located very close to the previous recurrent tumor. There has been no recurrence since our surgeries. We consider that it is important to control recurrent pleomorphic adenomas by adequate surgical treatment after obtaining the previous surgical records and pathological information.
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  • Antral Balloon Technic in the Treatment of Malar Bone Fracture
    Yoshio Yamawaki, Yutaka Harita, Hiroyuki Kitamura, Shohaku Oyagi, Atsu ...
    1991 Volume 84 Issue 8 Pages 1077-1083
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1077
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    A method for the reduction of malar bone fractures by the use of antral balloon technic is suggested.
    It seems to us that this method is a simple one without severe complications and is superior to other methods, especially for fractures of the maxillary sinus with many bone fragments.
    We demonstrate three typical cases of malar bone fracture treated by this method, and describe our goals and method of treatment of this fracuture.
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  • Persistent Hypernasal Speech after Pharyngeal Flap Operation; A Report of Two Gases
    Kazunori Mori, Michio Kawano, Iwao Honjo, Eiichi Fujimura
    1991 Volume 84 Issue 8 Pages 1085-1089
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1085
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    Two patients with cleft palate cases, who had persistent hypernasal speech after pharyngeal flap surgery, underwent repeated pharyngeal flap operation and achieved good velopharyngeal function.
    Since their original pharyngeal flaps were narrow and situated inferiorly, it was thought that they prevented the normal upward movement of the velum. The original flap was resected and a new high-attached superior-based pharyngeal flap was made by Owsley's method and good results were achieved in both patients. It was thought that those who have restricted palatal elevation due to a narrow and low-attached pharyngeal flap may need resection of the original flap and a second high-attached pharyngeal flap operation.
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  • Erysipelas in a Patient with Acute Pharyngo-Laryngitis and Nephritis
    Shinsuke Ueda, Hiroaki Shimosaka, Ichiro Nakano, Hiroo Katamachi
    1991 Volume 84 Issue 8 Pages 1091-1096
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1091
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    A 57-year-old man was admitted to our hospital because of sore throat, hoarseness and hematuria. His pharynx and larynx were very red and his vocal cords were swollen. On the second day after admission, a red rash of the trunk and neck developed suddenly.
    These symptoms and signs subsided after intravenous injections of flomoxef sodium (2g×6 days), but fever (37.0°C-37.7°C) and painful swelling of neck skin persisted. So injections of sultamicillin tosilate (1g×4 days) and dexamethasone were started, and these symptoms disappeared completely. Transient renal dysfunction, hematuria and proteinuria disappeared ten days after admission.
    The laboratory data and clinical course of this patient suggest that latent chronic nephritis was aggravated by erysipelas.
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  • DNA Evaluation for Human Papilloma Virus Infection in Adult Laryngeal Papilloma
    Rinya Sugita, Tohru Ogiwara, Katsuhiko Fukamoto, Kouki Nakaigawa, Kazu ...
    1991 Volume 84 Issue 8 Pages 1097-1103
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1097
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    Tissues from patients with adult-onset type laryngeal papilloma were examined for the presence of human papillomavirus (HPV).
    The presence of HPV DNA was determined by in situ hybridization with biotin-labelled HPV DNA probes and by dot blot hybridization with 32P-labelled HPV DNA probes.
    Two cases of adult-onset type multiple laryngeal papilloma were positive for HPV-6, but a case of single laryngeal papilloma was negative for HPV.
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  • Asynchronous Quadruple Carcinoma, Including Laryngeal Carcinoma; A Case Report
    Akihiko Kato, Yukimitsu Takahashi, Kunio Yanohara, Yasuo Sakakura
    1991 Volume 84 Issue 8 Pages 1105-1109
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1105
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    The patient was a 62-year-old male with the complaint of hoarseness. He had had partial cystectomy for carcinoma of the bladder 8 years earlier and resection of a basal cell carcinoma of the left auricle 2 years earlier.
    Laryngeal carcinoma was diagnosed (T2N0M0), and he was treated with irradiation (60Gy). During the course of irradiation for the laryngeal carcinoma, a general examination revealed that he had liver carcinoma.
    After the irradiation, a left lobectomy of the liver was performed for hepatocelluler carcinoma. He is alive and well without any evidence of disease 15 months after partial hepatectomy.
    In this case the serum was positive for anti HTLV-I (ATLA) antibodies.
    It was suggested that HTLV-I might be involved in the development of these 4 malignancies.
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  • Ovarian Carcinoma Metastasis to the Thyroid Gland
    Tadahiko Sugimaru, Kazuhiko Shoji, Hideyuki Fukushima
    1991 Volume 84 Issue 8 Pages 1111-1117
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1111
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    A 73-year-old woman complained of hoarseness for 4 months. Clinical examination showed a diffuse thyroid goiter (6.0×4.5cm) and bilateral vocal cord palsy. Open biopsies showed adenocarcinoma. However, immunohistochemical study showed that the origin was not the thyroid gland. Further examination of the lungs, breasts, stomach, and colon showed no evidence of tumor. Although she had severe renal failure, bilateral total thyroidectomy was carried out. She died of a renal failure 42 days after the operation. Ovarian endometorial carcinoma with metastasis to the thyroid gland was found on postmortem examination. The immunohistochemical examination is important for the diagnosis of metastatic thyroid carcinoma.
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  • Clinical Evaluation of Recurrence after Initial Surgical Therapy for Differentiated Thyroid Carcinoma
    Hideyuki Fukushima, Mitsuharu Nonomura, Kazuhiko Shoji, Iwao Honjo
    1991 Volume 84 Issue 8 Pages 1119-1125
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1119
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    From 1980 to 1989, 225 patients had initial surgical therapy for differentiated thyroid carcinoma in our department. In this series, 21 patients had clinical recurrences in the neck and 20 patients had lymph node metastasis which were mainly outside the region of the neck dissection; one of these also had local recurrence.
    The incidence of recurrence was higher in the patients with JN0, especially without neck dissection. The incidence of recurrence was higher in the patients with t4 treated with total lobectomy.
    We conclude that prophylactic neck dissection around the thyroid is required in patients without lymph node metastasis. Total lobectomy is indicated for patients with t1 and t2.
    We would select total thyroidectoy for patients with t3 and t4.
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  • Psychosomatic Condition and Personality of Patients with Head and Neck Malignancies Evaluated before and after Treatment
    Mikikazu Yamagiwa, Teruhiko Harada, Masahiko Kubo, Ryo Amesara, Yasuo ...
    1991 Volume 84 Issue 8 Pages 1127-1131
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1127
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    We used the Cornell Medical Index Health Questionnaire (CMI) and the Maudsley Personality Inventory (MPI) to collect medical and psychological data from 35 males (42-78 years of age; average 62.5) and 15 females (20-76 years of age; average 54.7) with malignant head and neck tumors immediately before hospitalization for treatment of the tumors at Mie University Hospital and just before discharge from the hospital. There were 10 nose and paranasal, 8 oral, 8 pharyngeal, 14 laryngeal, 6 thyroid gland tumors and 4 others. The period of hospitalization was 1 to 13 months, average 3.3 months.
    1) Somatic and psychological complaints registered on the CMI were significantly lower after treatment (p<0.05 and p<0.01, respectively, in the paired Wilcoxon test).
    2) There were no changes in the patients' depressive and autonomic dysfunctioning scores evaluated by the CMI during the treatment period.
    3) Analysis of the MPI revealed that the patients became slightly more introverted and significantly (p<0.01) less neurotic during the treatment period. However, the Lie scale score in the MPI was slightly higher after treatment, suggesting that patients tended to answer the questions more dishonestly after treatment in order to indicate greater improvement than had actually been achieved.
    We conclude from the results that treatment of head and neck tumors, although it is sometimes painful and function-destructive, does lead to psychosomatic improvement as long as discharge from the hospital is possible.
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  • Respiration Patterns of Snorers
    Soichi Motoyama, Yuki Fujiwara, Takashi Yamazaki, Tatsuya Sadaoka, Nor ...
    1991 Volume 84 Issue 8 Pages 1133-1145
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1133
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    The flow rate and flow volume of nasal and oral respirations of snorers were measured separately under three conditions: awake, a sleep without snoring, and a sleep with snoring.
    1. Respiration with the mouth open was scarcely observed when the patients were awake, but when they were sleeping with or without snoring, almost all patients respired with the mouth open. However, even when they were snoring with the mouth open, the flow volume through the nose was higher than through the mouth.
    2. The wave form of the flow rate showed gentle curves when the patients were awake or a sleep without snoring. On the other hand, when the patients were snoring, the curves showed various fluctuations.
    3. The flow volume tended to be lower during sleep without snoring than when awake, and decreased further during snoring.
    4. When the oral and nasal flow rates during snoring were compared, the rate was almost the same in inspiration and expiration in one group, but different in another group.
    5. The respiratory rate was maximum in sleep with snoring and minimum when awake.
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  • Application of Optic Fiber Guide CO2 Laser
    Tomio Terazono, Wataru Oshima, Shinya Kihira, Miho Nakao, Eisuke Takeg ...
    1991 Volume 84 Issue 8 Pages 1147-1151
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1147
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    The application of optic fiber guide CO2 laser device to diseases of the nasal cavity, epipharynx and oral cavity is described. The probe of this device is 2.3mm in diameter and is made of argentum halide. The maximum output is 10 watts. It enables us to perform the CO2 laser surgery under optic fiber guide for the first time. It is expected to be applied more extensively because of its compactness and its ease of use even for outpatients.
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  • Adenoid Cystic Carcinoma; A Review of Recent Findings
    Yuzo Yamamoto, Tetsuro Saka, Hiroaki Takahashi
    1991 Volume 84 Issue 8 Pages 1153-1166
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1153
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    We reviewed the recent findings of adenoid cystic carcinoma: clinical characteristics, histological features, prognosis, differential diagnosis and therapy. Nextly, to determine whether and how the histological features of the tumor varied during its natural history, we examined all the available histological slides from the same patient. We also investigated the origin of the tumor and the degree of differentiation immunohistochemically, and we estimated its proliferative activity by analyzing the nuclear DNA content.
    1) Adenoid cystic carcinoma is a common malignant tumor which arises usually in salivary glands, especially a minor salivary gland, and occasionally in a nasal or paranasal cavity or external auditory canal. It is characterized by insidious invasion, by proneness to perineural infiltration and by a mixture of several histological patterns in the same tumor. It often metastasizes to the lung hematogenously and occasionally invades the brain directly.
    2) The dominant histological pattern shifts from the tubular type through the cribriform and trabecular types to the solid type during the clinical course.
    3) Tumor cells stained positively for both the acinar-ductal cell line (lactoferrin, lysozyme, secretory component, CEA, amylase, keratin) and the myoepithelial cell line (actin, myosin and S-100 protein).
    4) The mean incidence of over 4.5 C polyploid cells in the regions with the dominant pattern in each tumor was lowest in that with the cribriform pattern, higher in trabecular pattern areas and highest in solid pattern areas. These results show that proliferative activity is lowest in the cribriform, highest in the solid, and intermediate in the trabecular pattern areas.
    The results of the present study may be of value in predicting the histological transformation of the tumor, estimating its prognosis and determining therapy.
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  • Distribution of Methamphetamine in the Cochlea
    Shigeyo Nagase, Masahiro Mukaida, Fumihisa Hiraide, Hiromitsu Saito, S ...
    1991 Volume 84 Issue 8 Pages 1167-1172
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1167
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    Methamphetamine activates catecholaminergic neurons and releases noradrenalin from their nerve endings in the central nervous system. Many reports have described the distribution of methamphetamine in the central nervous system after systemic administration. However, there have been only a few studies on the effect of this drug on peripheral organs, and known dealing with the inner ear.
    The authors used immunohistochemical methods to investigate the effect of methamphetamine on the pheripheral auditory system. Methamphetamine was administered to guinea pigs via intraperitoneal injection. The distribution of methamphetamine in the cochlea was studied by light microscopy following its immunohistochemical staining, and the methamphetamine concentration in the serum was also measured.
    1. Histochemical examination revealed that methamphetamine was present in the hair cells of the organ of Corti, spiral ligament and spiral ganglion cells 30 minutes after administration.
    2. The drug concentration in the serum rose rapidly, and then dropped in a logarithmic way with time until it became nearly horinzontal after 6 hours.
    The results suggest that methamphetamine penetrated the blood-labyrinth barrier (BLB) and then reached the organ of Corti, although some methamphetamine took a route to the inner ear via the cerebrospinal fluid. The pharmacological effect of methamphetamine on the cochlea was excitation of the sensory cells, the afferent nerve fibers connecting to them, and the spiral ganglion cells.
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  • Clinical Study on Tizanidine Hydrochloride (Ternelin®) Therapy of Tinnitus Patients with Shoulder Stiffness
    Takayuki Shiraishi, Takeshi Kubo, Toru Matsunaga, Kazuhiko Sugimoto, H ...
    1991 Volume 84 Issue 8 Pages 1173-1178
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1173
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    The clinical effects of tizanidine hydrochloride (Ternelin®) were investigated in 62 patients (84 ears), 20 males and 42 females, with tinnitus and shoulder stiffness or headache. Tizanidine (3mg a day) was given orally. The usefulness of the drug for tinnitus was evaluated after 2-7 weeks of administration. The rate of effectiveness on tinnitus was 71.0% and that on stiff shoulder was 56.5%. Both tinnitus and stiff shoulder were reduced, but there was no significant corelation between the two complaints (Spearman's analysis). Side effects of the drug were noted in 5 patients (7.2%).
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  • Early Seasonal Treatment of Japanese Cedar Pollinosis with Topical Glucocorticosteroids
    Fumikazu Mizukoshi, Hiroshi Takenaka, Kenji Dejima, Kenji Saito, Ryo K ...
    1991 Volume 84 Issue 8 Pages 1179-1188
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1179
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    The effects of early seasonal administration of topical glucocorticosteroids for Japanese cedar pollinosis were examined. In a group that received the drug one week prior to the onset of the season, nasal symptoms were significantly suppressed in the early period of the season. When treatment was started at the onset of the season, the same effects were achieved but commenced one week later. In both groups, nasal congestion was greatly alleviated.
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  • Diagnosis and Treatment of Thyroid Gland Masses
    [in Japanese]
    1991 Volume 84 Issue 8 Pages 1190-1191
    Published: August 01, 1991
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.84.1190
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