Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 84, Issue 9
Displaying 1-24 of 24 articles from this issue
  • Shinsuke Ito
    1991 Volume 84 Issue 9 Pages 1193-1198
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    It is generally accepted that the medial vestibulospinal tract originates in the medial vestibular nucleus, which is supplied from the semicircular canals. In animal studies of these pathways it descends only to the upper thoracic levels of the cord. In humans, however, there is some indirect evidence to support the concept that impulses from the semicircular canals reach the lumbosacral cord and influence lower as well as upper extremity activity. After unilateral horizontal duct stimulation with cold water, four-legged animals show deviation of the upper half of the body to the stimulated side. Under the same conditions, humans lose ipsilateral lower limb extensor tonus and tend to fall to the same side. It is logical to assume that the horizontal canal plays a role not only in passive but also in voluntary movements. Our observations demonstrate that the horizontal canal functions during circular walking so that the trunk is skillfully turned by the legs. In animals, the forelegs steer the body while the hindlegs advance it. However, in humans, the lower extremities perform both of these functions. The structure of the foot is wellsuited for these functions.
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  • [in Japanese], [in Japanese], [in Japanese]
    1991 Volume 84 Issue 9 Pages 1200-1201
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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  • Kyoko Ogawa, Masahiro Mori, Noriyuki Yanagita
    1991 Volume 84 Issue 9 Pages 1203-1208
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Hyperbaric oxigen (HBO) is employed to treat cerebral infarction, spinal disorders, obstruction of the central retinal artery and some other diseases.
    The authors investigated secretory otitis media as a complication of HBO.
    From November 1, 1987, to March 31, 1990, 96 patients had ten or more HBO treatments at Kariya General Hospital.
    Before the first HBO procedure, all patients were examined and tympanometry, and their level of consciousness was recorded. There were 180 ears without secretory otitis media or chronic otitis media.
    HBO-induced secretory otitis media developed in 56 of the 180 ears (31.1%). In patients with the A type of tympanogram (121 ears) HBO-induced secretory otitis media occurre in 24.8% and in those with the B or C type (37 ears), the incidence was 46.0%.
    The difference is significant (P<0.05). We also correlated of the incidence of HBO-induced secretory otitis media with the level of consiousness. In patients with normal consciousness (121 ears), the incidence was 24.8% and in those with disturbed consciousness (59 ears), it was 44.1%, significant difference (P<0.01).
    Our investigation indicates that the type of tympanogram and the level of consciousness are important predictors of HBO-induced secretory otitis media.
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  • Yasushi Matsumoto, Yuji Kawamura, Naoaki Yanagihara, Masanori Sadamoto ...
    1991 Volume 84 Issue 9 Pages 1209-1215
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Magnetic resonance imaging (MRI) was carried out in 27 patients with Bell's palsy. T1-weighted spin-echo images (TR500/TE25-34) were taken before and after the intravenous administration of Gd-DTPA (0.1mmol/kg) with 0.5T superconductive MRI. There was significant enhancement at the geniculate ganglion and the horizontal segment of the involved facial nerve in 22 patients (81.5%) and at the vertical segment in 20 (74.1%). Enhancement at the meatal fundus was seen in only 4 patients (14.9%) and at the labyrinthine segment in 8 (29.6%). These results corroborate other evidence that the geniculate ganglion is involved most frequently in Bell's palsy. In addition, the enhancement of the proximal portion, i. e. the meatal fundus and the labyrinthine segment of the nerve, although not common, noted in this study may be important in the diagnosis and treatment of Bell's palsy.
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  • Yoshifumi Uno, Ryusuke Saito, Kazunori Nishizaki, Hisako Matsuoka, Mak ...
    1991 Volume 84 Issue 9 Pages 1217-1223
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 33 year-old woman complained of slowly progressive left facial palsy and a tumor in the external auditory meatus. The tumor had destroyed the mastoid process and the inferior wall of the external auditory meatus, and extended to the posterior fossa dura and to the deep skull base anterior to the styloid process. A review of the Japanese literature since 1937 revealed 20 cases of facial nerve neurinoma originating from the vertical portion of the Fallopain canal. The common clinical presentation and symptoms in most cases were progressive facial palsy and tumor in the external auditory canal. We would like to emphasize that facial nerve neurinoma in the temporal bone is not as rare as has been commonly believed and that patients with facial nerve palsy, especially if it increases gradually over weeks and months, should be examined completely in order to find it in the early stages.
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  • -Effect of Preoperative Angiographic Embolization, Blunt Dissection and Twisting the Stem of the Tumor-
    Yoshiaki Iguchi, Tetsuya Shitara, Hiroomi Takahashi, Makito Okamoto, K ...
    1991 Volume 84 Issue 9 Pages 1225-1231
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Angiofibroma of the nasopharynx is almost always, but not exclusively, is seen in adolescent males. These lesions are histologically benign, but regarded as malignant tumors clinically because of severe nosebleeds and progressive growth in the nasopharynx.
    Two patients with juvenile nasopharyngeal angiofibroma are described in this paper. Preoperative angiographic embolization and total removal of the tumor by twisting the stem was successfully performed in both cases.
    The effect of preoperative embolization of the perfusing artery of the tumor through angiography and surgical therapy are discussed in comparison with the other patients treated in our hospital.
    Blunt dissection and twisting off the tumor are effective if the tumor has a stem. Embolization of the perfusing artery is considered to be necessary before surgical removal when the tumor has a wide base, in which case removal of the tumor by twisting the stem is not possible.
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  • Ken-ichi Inakami, Akira Ogawa, Hideyuki Onuma, Hidehiko Ishikawa
    1991 Volume 84 Issue 9 Pages 1233-1239
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 54-year-old man was referred to the Self-Defense Forces Central Hospital for evaluation of nasal obstruction, a nonhealing ulcer of the hard palate, severe headache and spiking fever. A necrotic and hemorrhagic tumor was found in the nasal cavity. The original biopsy revealed a dense cellular infiltrate to the submucosa in which mononuclear cells predominated. Chest roentgengram, ECG, clinical examination, serology and urinalysis were all within normal limits. The diagnosis was lethal midline granuloma. Radiotherepy was administered in a dose of 5000 rads to the involved areas, and predonisolone, cyclophosphamide, 6-MP and vinclistine were given. The treatment was effective, localized lesion was controlled, and the necrosis disappeared. Two months later, painful soft tissue swellings appeared in his thigh, scapula and hip. A biopsy of the hip lesion showed atypical mononuclear cells infiltrating the subcutaneous area and muscle layers. Serum CPK rose markedly and rapidly. Three weeks later the patient died of respiratory failure. This lethal midline granuloma was a systemic and progressive type, and the nasal involvement was the first manifestation of the disease.
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  • Shin-ichi Saito, Jiro Hozawa, Hideichi Shinkawa, Keiji Fukuoka, Tetsuy ...
    1991 Volume 84 Issue 9 Pages 1241-1247
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Three cases of maxillofacial trauma could be more precisely diagnosed by three dimensional computed tomography, which showed stereotaxically the extent and course of the fracture-line. The stereotaxic investigation of pre- and post- operative X-ray images, not only improves the effectiveness of surgery, but also makes possible a more exact evalution of what reconstructive procedure can be performed.
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  • Shinsei Nishihara, Eiji Yumoto, Hiroshi Okamura, Naoaki Yanagihara
    1991 Volume 84 Issue 9 Pages 1249-1253
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 48-year-old man was referred to us complaining of a copious clear watery discharge from his left nostril, that had started 8 weeks earlier. Tomographic studies revealed a mass in the left frontal sinus. A radioisotope was introduced into the subarachnoid space by lumbar puncture, and 3 hours later the radioactivity of pledgets in the left nasal cavity was significantly greater than in the right nasal cavity. Cerebrospinal fluid rhinorrhea through the left frontal sinus was therefore diagnosed. An extranasal approach was selected for repairing the cerebrospinal fluid leakage. The polypoid tissue in the left frontal sinus was removed. There were two bony defects in the posterior wall of this sinus. These defects were successfully closed by fascia lata with the use of a fibrin sealant, and continuous spinal drainage was done pre- and post- operatively. The postoperative course was uneventful. Histological diagnosis of the tissue removed from the frontal sinus was menigoencephalocele.
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  • Moutatsu Go, Tatsuyuki Banno, Meiho Nakayama, Kazumi Yamada, Isao Taki ...
    1991 Volume 84 Issue 9 Pages 1255-1258
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 33-year-old male with left paranasal sinusitis was treated by antral puncture at another clinic. The puncture needle broke, and part of it remained in the left maxillary sinus. On the same day we removed the broken needle from the antrum by C aldwell-Luc antrotomy. We examined the broken needle by X-ray and electron microscopy and found that the break was due to metal corrosion.
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  • Yasuyuki Ohira, Kimitaka Kaga, Keiyu Uebo, Akira Kodama
    1991 Volume 84 Issue 9 Pages 1259-1265
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We studied the pathology of 25 temporal bones of 15 patients with maxillary sinus carcinoma. Nine of them (60%) showed temporal bone invasion from maxillary sinus carcinoma. Of 14 temporal bones on the same side as the maxillary sinus carcinoma, eight (57%) showed carcinomatous invasion. Of 11 temporal bones on the contralateral side, three (27%) showed carcinomatous invasion.
    Of 10 bilateral temporal bones removed from patients with maxillary sinus carcinoma, bilateral carcinomatous invasion was observed in two (20%). The most common site of carcinomatous invasion was the petrous portion.
    The main routes of carcinomatous invasion of the temporal bone from maxillary sinus carcinoma were as follows: 1) via invasive destruction of the posterior wall of the maxillary sinus, the base of the skull, and the temporal bone; 2) via destruction of the ethmoid and sphenoid sinuses, the base of the skull, and the temporal bone; 3) the fallopian canal; and 4) the carotid canal. Invasion was frequently by routes 1 and 2 but in only one case each was invasion by routes 3 and 4.
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  • Yumi Fujiwara, Masanori Aoki, Kazuyuki Kawaguchi, Masaya Takumida, Kat ...
    1991 Volume 84 Issue 9 Pages 1267-1272
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A galvanic current may be caused in the oral cavity when two or more dissimilar metallic repair materials are present, and it is well known among dentists that severe pain, called “galvanic pain”, may result. We report two cases of glossitis thought to have been caused by oral galvanism. We measured the galvanic current in patients with glossitis and found significantly larger electric currents in the patients than in controls. We suspect that oral galvanism is the cause of glossitis when the conditions are as follows: 1) Anemia, medications, mechanical stimulation by dental repair, zinc deficiency, etc. have been ruled out; 2) Currents greater than five micro-amperes are demonstrated.
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  • Kazunori Mori, Michio Kawano, Iwao Honjo, Eiichi Fujimura
    1991 Volume 84 Issue 9 Pages 1273-1277
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 51-year-old man developed velopharyngeal insufficiency after palatine tonsillectomy. His preoperative velopharyngeal function was normal and he had none of the features of C alnan's triad that suggest submucous cleft palate or congenital velopharyngeal insufficiency.
    His velopharyngeal insufficiency was thought to be induced by adhesions between the lingual base and the anterior faucial pillars and cicatrication of the anterior faucial pillars. His velopharyngeal insufficiency was almost completely cured by resection of these scar tissues and covering the raw surface with a local buccal membrane flap.
    Velopharyngeal insufficiency induced by palatine tonsillectomy is very rare, but it is a possible complication of palatine tonsillectomy and must be taken into account.
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  • Yasuhiro Manabe, Tomitaka Kubo, Shinya Wakui, Sachio Yoshida, Hitoshi ...
    1991 Volume 84 Issue 9 Pages 1279-1282
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Fibrin sealant was used in tonsillectomy, mainly to prevent postoperative bleeding, in 54 patients. Postoperative bleeding was not observed in any of the patients treated only by electric coagulation with fibrin sealant. Postoperative slough disappeared earlier when sealant was used. Reduction of postoperative pain was not clear. This material had a tendency to prevent postoperative fever. Operation time was shortened by its strong hemostatic effect.
    We concluded that this sealant was useful in tonsillectomy.
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  • Asako Koshimune, Takafumi Kawahara, Mamoru Miyaguchi, Shun-ichi Sakai
    1991 Volume 84 Issue 9 Pages 1283-1287
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Veloplasty was performed for two patients with micrognathia and difficulty in opening the mouth. They complained of heavy snoring and obstructive sleep apnea. The micrognathia of the patients was congenital in one and acquired in the other. Although they had had operations of the temporomandibular joint, they could open the mouth only one finger breadth between the teeth. Because of the difficulty in opening the mouth, veloplasty was done instead of uvulopalatopharyngoplasty, with complete relief of snoring and obstructive sleep apnea syndrome.
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  • Mamoru Sakamoto, Nobuhiko Araki, Akira Ogawa, Yoshimaro Ishikawa
    1991 Volume 84 Issue 9 Pages 1289-1294
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A case of childhood adenosquamous carcinoma of the thyroid gland is reported. Among the malignant tumors of the thyroid gland, squamous cell carcinoma is seen in only about 100 and no case in childhood has been reported in Japan.
    Our patient was a 15-year-old female who underwent total thyroidectomy and received radioiodine therapy. Carcinoma recurred in the right neck two years later. Conservative radical neck dissection was performed. Six years after the first operation, she is alive.
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  • Masako Yokota, Katsunari Yane, Reiko Kashiwagi, Hiroshi Miyahara, Taka ...
    1991 Volume 84 Issue 9 Pages 1295-1300
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Case 1 was a 69-year-old male, who suffered from remittent fever and cervical lymph node swelling after total laryngectomy. Case 2 was an 18-year-old female, who had had left cervical tenderness and remittent fever for one month. Biopsies in cervical lymph nodes showed massive necrotic lesions which consisted of proliferations of small lymphocytes and nuclear debris in some macrophages without neutrophile infiltration. The infections were resistant to antibiotics. Neck dissection in case 1 and steroid treatment in case 2 brought about cure.
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  • Soichi Motoyama, Yuki Fujiwara, Tatsuya Sadaoka, Noriya Kakitsuba, Hir ...
    1991 Volume 84 Issue 9 Pages 1301-1314
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We attempted to identify the sound source of snoring only by analyzing snoring sounds. Snoring sounds were tape-recorded at home and brought to the hospital by the patients, and with a sound spectrograph and a signal processor we analyzed the results and compared them with those of patients whose sources of snoring were confirmed fiberscopically.
    1. Patients whose fundamental frequency (FF) was fairly regular, the FFs ranged from 15 Hz to 300Hz, usually under 170Hz.
    2. In some cases, the FF changed in a single snore. A decrease of FF was observed more often than a increase.
    3. The pitch perturbation quotients of ordinary snoring sounds were larger than those of vocal fold vibrations.
    4. Among the sound sources confirmed fiberscopically, the great majority were vibrations of the soft palate, the FFs ranging from 20 Hz to 200 Hz. The few other sound sources of snoring comfirmed were: vocal folds (210 to 300Hz), the arytenoids (130 to 340Hz), the epiglottis (45 to 90Hz), and the tongue base (40 to 50HZ).
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  • -A Questionnaire Survey of 145 Drivers of Long Distance Transport Trucks-
    Atsushi Kawano, Hideki Yamaguchi, Sotaro Funasaka
    1991 Volume 84 Issue 9 Pages 1315-1324
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The drivers of long distance transport trucks exposed to infrasound vibration (about 115dBA). We studied the effects of infrasound with a questionnaire survey of long distance transport trucks. The questions dealt with general fatigue, yawning, sleepiness, vertigo, tinnitus, headache, sensation of being stifled, hearing impairment, abdominal symptoms and hypertension.
    We analyzed statistically the incidence of each symptom in relation to exposure to infrasound, the duration of work, the hours of driving and the hours of rest.
    The results were not statistical by significant. Exposure to about 115dBA of infrasound has no effect on humans.
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  • Shuichi Odahara
    1991 Volume 84 Issue 9 Pages 1325-1332
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Electromyograms of both gastrocnemius muscles were recorded in 22 normal adults during circular walking under two conditions: with no caloric stimulation and immediately after irrigation of the right auditory canal with 20°C water for 20 seconds while the horizontal semicircular canal was in the vertical position. The subject was asked to walk at higher speed than usual with eyes closed in a circle 2 meters in diameter.
    With no caloric stimulation, the activity of the gastrocnemius muscle was greater on the right side than on the left side during circular walking to the left and vice versa during circular walking to the right. Nystagmus towards the same side as the direction of the turning was simulataneously recorded by electronystagmography. Following irrigation of the right auditory canal the muscle activity was greater on the left side than on the right side during turning to the left, but no consistent difference in muscle activity was observed during turning to the right. Furthermore, the subject always complained of difficulty in walking to the stimulated side.
    The results indicate that an ampullopetal lymphatic flow in the semicircular canal caused by circular walking increases the antigravity muscle tonus of the ipsilateral leg. This facilitates the ipsilateral leg to support the body weight which shifts to the inner side of circular walking.
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  • Kazuo Matsui, Michihiko Nozue, Atsuro Seki, Hirofumi Morita, Koji Kami ...
    1991 Volume 84 Issue 9 Pages 1333-1338
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Included in the present study are 65 patients with sudden deafness treated with Solu-Medrol® starting within two weeks of the onset in our university hospital and seven related hospitals Nov. 1987-Dec. 1989.
    The dose of Solu-Medrole was initially 500mg and it was gradually diminished there after. Audiometry was repeated until the results were stabilized.
    The results were 34% complete recovery, 21% definite improvement, 25% slight improvement, 20% no improvement.
    These results are similar to those reported for other therapies. The outstanding difference is the better results in patients with hearing loss of more than 91dB; 92% of them improved more than 10dB in the averaged pure tone hearing.
    It is concluded that Solu-Medrole is useful for the treatment of sudden deafness, especially for severe cases of more than 91dB loss.
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  • Kiyofumi Gyo, Yoshinari Hirata, Toyohiro Shibahara, Kazunor Okamoto
    1991 Volume 84 Issue 9 Pages 1339-1344
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The clinical efficacy of Cefixime (CFIX) was evaluated in the treatment of otitis media. CFIX was administered orally to 35 patients with acute otitis media and to 12 patients with acute exacerbation of chronic otitis media.
    A favorable clinical response was seen in 30 of the 35 patients in the former group (efficacy rate, 85.7%) and in 8 out of the 12 patients in the latter (66.7%).
    Diarrhea occurred in 2 patients, but it ceased after discontinuation of the treatment.
    This study indicates that CFIX is a drug of first choice in the treatment of acute otitis media.
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  • Masuo Yamagishi, Satoshi Hasegawa, Hideo Nakamura, Yuichi Nakano, Kazu ...
    1991 Volume 84 Issue 9 Pages 1345-1353
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Azelastine was administered to 36 patients with grass pollinosis (timothy and orchard grass) for prevention and treatment.
    In the patients who started before the beginning of the pollen season, azelastine was very effective, and the rate of prevention of nasal and ocular symptoms of allergy was over 90%. When azelastine treatment was initiated after the onset of allergic symptoms the rate of improvement was not so high.
    Side effects appeared in only 3 patients (8.3%), mainly somnolence.
    These results indicate that azelastine therapy before the beginning of the pollen season is a useful method to prevent the symptoms of grass pollinosis.
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  • [in Japanese]
    1991 Volume 84 Issue 9 Pages 1354-1355
    Published: September 01, 1991
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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