Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 86, Issue 12
Displaying 1-20 of 20 articles from this issue
  • Kiyotaka Murata
    1993 Volume 86 Issue 12 Pages 1673-1682
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The recent advancement of CT and MRI diagnostic techniques has enabled detection of small tumors existing in the middle fossa, temporal bone and infratemporal region. This has encouraged otologists to major in surgeries of the whole temporal bone, surrounding cerebellopontine angle, internal acoustic meatus, middle fossa and infratemporal regions. This study was designed to demonstrate how successfully lesions at these sites may be managed by otosurgeons. Access to the sites of lesions in our skull base surgery was achieved by transmastoid approach, by subtotal resection of the temporal bone, by translabyrinthine approach or transtemporal middle fossa approach, by transtemporal supralabyrinthine approach to the geniculate ganglion and adjacent regions, by approach through the temporal bone to retro-and parapharyngeal spaces beneath the temporal bone and by combination of infra-and extratemporal bone approach.
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  • [in Japanese], [in Japanese], [in Japanese]
    1993 Volume 86 Issue 12 Pages 1684-1685
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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  • Atsushi Hatano, Ryusuke Saito, Yoshifumi Uno, Manabu Maeta, Makoto Kan ...
    1993 Volume 86 Issue 12 Pages 1687-1695
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The longterm results of tympanoplasty were analyzed in 53 ears of children aged 4 to 15 years with chronic otitis media.
    A canal-up type I tympanoplasty was employed to 34 ears with non-cholesteatomatous chronic otitis (25 granulating otitis and 9 adhesive otitis). The rate of primary graft take (success rate of closing perforation) was 91% and the hearing results were satisfactory. The overall success rates were similar among all age groups. Consequently, tympanoplasty can be recommended in children of all ages, including preschool age.
    Regarding initial surgery in 15 ears with cholesteatoma, an extensive cholesteatoma filling the entire air-cell area was found in 5 ears (33%) and cholesteatoma spreading into the middle ear cleft was found in 11 ears (73%).
    Despite a large number of cases with active and rapidly growing cholesteatoma, complications from cholesteatoma in children were relatively low. In our series, only one case developed a complication due to wide exposure of the facial nerve.
    Thirteen cases with cholesteatoma extending into the attic or mastoid were treated by canal wall down procedures with canal reconstruction or mastoid obliteration. Six cases with cholesteatoma restricted to the middle ear space were treated with canal wall up procedures. At the latest follow-up ranging 4 to 52 months (average 24.5 months) after surgery, all cases were dry and maintained good anatomic results without recurrence. From these results, surgical procedures for cholesteatoma in children should be selected according to the extent of the lesion as in adults.
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  • -New Recording Methods-
    Hiroaki Nakatani, Taizo Takeda, Haru Saito
    1993 Volume 86 Issue 12 Pages 1697-1705
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Antidromic facial nerve response is considered to be an indicator of nerve damage within the temporal bone in the earliest stage of facial paralysis. However, it is difficult to obtain the nerve response clinically because its small Potential with short latency can easily be interfered by initial stimulus artifacts and compound muscle action potentials.
    In this study, we investigated several recording methods such as polarity of stimulus, method of stimulation, type and site of recording electrode and elimination of compound muscle action potentials to obtain a clear and analyzable response. Initial stimulus artifacts could be reduced by using pairs of pulses with alternating polarity and by stimulation via the parotid duct. A needle electrode for the active electrode and recording in the tympanic cavity improved the SIN ratio of the nerve response. Subtracting the response recorded at a lateral site of the external auditory canal from that obtained at a more medial site eliminated compound muscle action potentials. We conclude that these methods are necessary to identify the nerve response and make possible the use of this test in the early diagnosis of facial paralysis.
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  • Yasuko Kaneda, Yasushi Naito, Akira Takagi
    1993 Volume 86 Issue 12 Pages 1707-1714
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A case of relapsing polychondritis (RP) is reported. A 44-year-old male with rubor in the bilateral auricles, congested bulbar conjunctivae, vertigo, and left hearing impairment was treated with prednisolone, high-dose pulse methylprednisolone, and cyclosporin A (CsA) . C orticosteroid therapy alone could not prevent flare-up of the symptoms when dose was decreased. Combining corticosteroids with CsA improved the symptoms significantly, and steroids were successfuly reduced to a maintenance dose.
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  • Shiro Yoshimura
    1993 Volume 86 Issue 12 Pages 1715-1721
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Alnus sieboldiana (alder) was thickly planted against floods or after land development at the base of Mt. Rokko. This investigation of 272 patients with spring hay fever due to Japanese cedar or alnus sieboldiana showed a correlation between the positive rate of the radioallergosorbent test to alder and alder pollen counts. Seventy three patients with alnus sieboldiana pollen allergy answered a questionnaire about food hypersensitivity. Hypersensitivity to apples was reported by twenty-two per cent of the patients. All of the 7 applehypersensitive patients had positive IgE antibodies to apples.
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  • -Evaluation of Nasal Symptoms-
    Eiji Yumoto, Seiji Kawakita, Masamitsu Hyodo, Koshiro Nakamura
    1993 Volume 86 Issue 12 Pages 1723-1731
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Between December 1986 and February 1991, endonasal sinus surgery under endoscopic guidance was performed on 95 patients with chronic paranasal sinusitis. Forty-six of the 95 patients were followed for more than one year, ranging from 12 to 53 months with an average of 26 months. Each patients rated the severity of nasal symptoms on admission to the hospital and during the latest visit after one year follow-up. Rating was based on a 4-point scale (O: normal, 1: slight, 2: moderate, 3: severe). Nasal symptoms checked include 1) times blowing nose per day, 2) difficulty in blowing nose, 3) amount of choanal discharge, 4) difficulty in expelling choanal discharge, 5) nasal obstruction, 6) disturbance in the sense of smells, and 7) headache. The number of patients with grade 2 or 3 nasal obstruction and headache decreased to 4-6% of the total. On the other hand, more than 20% still complained of choanal discharge or hyposmia. Nasal obstruction was relieved in 88.4% of the patients who had complained of it while choanal discharge was relieved in only 65.9%. Other symptoms were relieved in over 70% of the patients. Greater improvement in each symptom on long-term follow-up occurred when the preoperative degree was more severe. Choanal discharge appeared in four patients and worsened in two patients. The nose became slightly stuffy in one patient.
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  • Osamu Oshima, Akihito Watanabe
    1993 Volume 86 Issue 12 Pages 1733-1738
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The formation of plunging ranula is related to extravasation of salivary secretions and source of the extravasation seems to be sublingual gland.
    However it is difficult for supplemental methods of exploration, such as computed tomography, echography, etc. to reveal the source and existence of plunging ranulas. Therefore, we used magnetic resonance imaging (MRI) examination.
    In two cases of plunging ranula, we suspected that the source was the sublingual gland and that the lesions extended from the sublingual region to the cervical region through the posterior edge of mylohyoid muscle on MRI. The sublingual gland was removed through the mouth. No dissection of the cervical ramifications associated with the ranula was undertaken, and these disappeared once the source of the extravasating saliva was removed.
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  • Yoshinobu Ogawa, Takashi Matsunaga, Hiroshi Miyahara, Yasuteru Yamanka ...
    1993 Volume 86 Issue 12 Pages 1739-1745
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Adenoid cystic carcinoma of the larynx is very rare. Less than 0.25 per cent of all laryngeal carcinomas are adenoid cystic tumors, and only seventeen cases have been reported in the Japanese literature. In this paper, a case of adenoid cystic carcinoma originating in the supraglottic area of the larynx is reported.
    A 56-year-old woman complained of cough and hoarseness of two months duration. Indirect laryngoscopic examination revealed a smooth mass involving the left false cord and arytenoid area. The pathology report was compatible with adenoid cystic carcinoma. The patient underwent total laryngectomy and left neck dissection. She has remained well for the last two years with no evidence of recurrence or metastases.
    We examined the resected specimens histologically by whole organ serial sectioning and discuss the evaluation, treatment, clinical course and prognosis of adenoid cystic carcinoma of the larynx.
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  • Yuji Nakamaru, Keiji Iizuka, Akihiro Honma, Yutaka Yoshida
    1993 Volume 86 Issue 12 Pages 1747-1751
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 72-year-old woman had noted left submandibular swelling for 7 years. On examination a 5 × 5 cm smooth, hard, fixed, painless mass was palpable in the left submandibular area. CT scan showed a circumscribed, isodense mass near the bifurcation of the carotid artery. Extirpation of the tumor was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia. The postoperative course was good, and the patient remains free of disease more than 5 months after surgery.
    Intravascular papillary endothelial hyperplasia is characterized by intravascular endothelial proliferation that resembles angiosarcoma. This disease seems to be the result of a peculiar process of thrombus undergoing organization. The prognosis is good, and the treatment is usually total extirpation of the tumor.
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  • Yoshimi Miyajima, Shinzo Tanaka, Keiichi Chiziwa
    1993 Volume 86 Issue 12 Pages 1753-1756
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A rare case of thrombophlebitis of the external jugular vein is reported. The patient was a 66-year-old male and complained of cervicodynia of the right side and lockjaw. Swelling and redness were observed on the right side of his neck. Despite treatment with antibiotics cervicodynia and lockjaw worsened. On C T scan, the wall of the right extra jugular vein was thickened and circulation in the vein was obstructed. Resection of the right extra jugular vein was performed and the symptoms disapeared immediately after surgery. The resected vein had a thick wall containing a thrombus. The patient has remains well any evidence of disease 6 months following treatment.
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  • Koichi Oki, Kohei Wada, Yuzo Yamamoto, Kazuo Makimoto, Hiroaki Takahas ...
    1993 Volume 86 Issue 12 Pages 1757-1762
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Actinomycosis is a chronic purulent granulomatous disease caused by actinomyces, an organism which is often present in man. Patients with a chronic clinical course have been on the increase in recent years, and differentiating this disease from tumor is often necessary when the mass is in facial and cervical regions other than the oral cavity and jaw. We report two cases of actinomycosis in the face and neck.
    Case 1: A 54-year-old man complained of a swelling in the anterior part of the neck. A mass 65 × 70 mm with redness of the skin was noted at his first visit. The mass was of platelike consistency with a smooth surface closely adherent to the surrounding tissue. The tuberculin test was negative. A malignant tumor was considered, so percutaneous needle biopsy was performed, but no significant abnormality was found. Antibiotics were given by drip infusion, and the mass disintegrated. Yellow viscous pus containing light gray granules was discharged to form a fistula.
    Case 2: A 40-year-old man developed a swelling in the left cheek. A ping pong ball-sized mass of plate-like consistency with redness was noticed at his first visit. A fistula formed in the oral cavity on the left, and pus was discharged from it. Plain CT revealed an isodense lesion in the left cheek, with no connection to the maxillary sinus.
    Actinomyces is anaerobic, so it was not detected by culture in either case. Histopathological examinations of actinomycotic granules was useful in the diagnosis.
    The treatment consists mainly of drainage by incision of the lesion and administration of antibiotics, especially penicillin.
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  • -A Case Report and Cytogenetic Study-
    Shogo Shinohara, Nobuya Yagi, Shin-ichi Sato, Hatsue Nakao, Tetsuya Og ...
    1993 Volume 86 Issue 12 Pages 1763-1768
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A Case of carotid body tumor in the left submandibular region of a 54-year-old woman is reported. Because a hot area was recognized on CT scan between the internal and the external carotid artery, carotid angiography was performed, which showed the existence of a hypervascular tumor.
    Based on a diagnosis of carotid body tumor, surgery was performed under hypotensive general anesthesia. The tumor (3 cm × 3 cm) was resected without injuring any of the main vessels or cranial nerves except the external carotid artery.
    The specimen was examined histologically and the preoperative diagnosis was confirmed. However, chromosomal disorder (anti-oncogene) as suggested in the hereditary cases of carotid body tumor found in retinoblastoma, was not detected.
    Further studies are expected to clarify the cytogenetic mechanism.
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  • Shigeru Hirano, Hiroyuki Kitamura, Koji Miyata, Ken-ichi Kaneko, Ryo A ...
    1993 Volume 86 Issue 12 Pages 1769-1773
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Therapeutic results for 46 patients with distant metastases of head and neck cancers other than thyroid cancer, treated at Tenri hospital from 1975 to 1992, were evaluated. Of 57 sites of metastases studied, 30 were in the lung, 11 the liver and 11 the bone. Chemotherapy, radiotherapy and surgery were performed singly or in combination and the results for each site of metastases was analysed. For lung metastases, radiotherapy or surgery, if possible, is considered effective in improving the prognosis. The prognosis for liver metastases was quite poor, but transarterial infusion into the hapatic artery was expected to prolong the survival period. Radiotherapy for bone metastases was quite effective, while chemotherapy had little effect. Active therapy for distant metastases was expected to improve the quality of life.
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  • Kiyohiro Ffujino, Juichi Ito, Yoshiko Shiomi, Tatsuyoshi Saiga, Tomita ...
    1993 Volume 86 Issue 12 Pages 1775-1778
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 51-year-old woman complained of a submental mass with a red papule which arose probably after she was scratched by a kitten. Since antibiotic therapy for three weeks was not effective, the lesion was extirpated surgically. Histopathological examination showed granulomatous lymphadenitis. Bacilli were seen in Warthin-Starry stained specimens. The clinical course and histopathological findings led to a diagnosis of cat scratch disease.
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  • Ototaka Kaki
    1993 Volume 86 Issue 12 Pages 1779-1790
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The ultrastructures of the specialized cells in the ampulla were compared in chicks and guinea pigs. All the chick dark cells in the crista ampullaris were columnar in shape and had stereocilia on their apical surfaces. Many pinocytic vesicles containing dense substance were observed in the apical cytoplasm of the dark cells. The light cells, especially in the upper region of the eminentia cruciata, contained much expanded rough endoplasmic reticulum, which was filled with moderately electron dense material. These structures resembled those of the supporting cells in the sensory epithelium which participate in the formation of the cupula. The ultrastructures of the transitional cells of guinea pigs corresponded closely to those of the light cells. The tubulo-cisternal endoplasmic reticulum (TER) was present in all the specialized cells of both chicks and guinea pigs. The TER in the light cells was more developed than that in the dark cells. The ultrastructures of the cells of the planum semilunatum were not significantly different in the two animal species. It is concluded that morphologically the specialized cells of both chicks and guinea pigs consist of light cells, dark cells and cells of the planum semilunatum.
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  • Hirofumi Kihara
    1993 Volume 86 Issue 12 Pages 1791-1798
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The larynx plays a role in regulating air flow and pressure in the lower airway, and it is considered that there is a certain adjusting mechanism by which impulses are sent from the center through receptors in the periphery. The activity of the internal laryngeal muscles, a component of the larynx is, however, still poorly defined without an established theory, excepted for the posterior cricoarytenoid muscle.
    Several studies related to the activity of the human cricothyroid muscle during sleep have recentry been reported. Ten adults in good health aged 36 to 61 years and 20 patients with obstructive sleep apnea syndrome (OSAS) aged 24 to 61 years were examined. In the healthy adults, the activity of the cricothyroid muscle was studied during sleep. In patients with OSAS, the activity of the cricothyroid muscle was studied during sleep while OSAS was developing and while they were inspiring pure oxigen.
    In healthy adults, slight activity of the cricothyroid muscle was observed during inspiration. In OSAS patients, the activity of the cricothyroid muscle was stepped up by the appearance of OSAS and its activity was also observed during expirating, whereas the activity of the cricothyroid muscle was reduced by the inspiration of pure oxygen when OSAS was recognized.
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  • Kimiaki Katori, Shoji Takayasu, Sanae Katori, Sanae Katori, Yukiyoshi ...
    1993 Volume 86 Issue 12 Pages 1799-1810
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    In a pilot study to investigate the clinical effect of Celeport® on tinnitus, we administered 3 tablets per day (150 mg in 3 divided doses after meals) for longer than 8 weeks to 45 patients (53 ears) with sensorineural tinnitus.
    Celeport® was effective in 64.4% of the patients, a much higher rate of effectiveness than that of any other drug. Improvement was observed in all age groups.
    The efficacy of Celeport® was also suggested by the following: (1) in all 45 patients, improvement of the hearing level at 1 kHz and/or 2 kHz accompanied the reduction of tinnitus at the same pitch; (2) the intensity of tinnitus was reduced after Celeport® administration in 10 patients who had received an antianxiety medication or a tranquilizer, although there was no reduction of symptoms; (3) there was no significant difference in the effectiveness of this drug in these 10 patients and in the other 35 patients who received only Celeport®. We conclude that Celeport® may be a very useful remedy for sensorineural tinnitus.
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  • Nobuo Ohta, Shigeru Fukase, Kazutoshi Inakura, Ken Sakata, Takeshi Bep ...
    1993 Volume 86 Issue 12 Pages 1811-1821
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Ketotifen was administered to 49 patients with allergic rhinitis and to determine its effectiveness, serum and nasal fluid concentrations of eosinophil cationic protein (ECP) were analyzed. Ketotifen was effective for nasal symptoms and also decreased the number of eosinophils and the level of ECP in sera and nasal fluids of patients with allergic rhinitis. Side effects were not reported in present study.
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  • [in Japanese]
    1993 Volume 86 Issue 12 Pages 1822-1823
    Published: December 01, 1993
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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