Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 86, Issue 6
Displaying 1-21 of 21 articles from this issue
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  • Otitis Media with Effusion in Children
    [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1993 Volume 86 Issue 6 Pages 771-781
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.771
    JOURNAL FREE ACCESS
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  • Color Doppler Guided Matas' Test
    [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1993 Volume 86 Issue 6 Pages 782-783
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.782
    JOURNAL FREE ACCESS
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  • Neuro-Otological Disturbance in HTLV-1 Associated Myelopathy
    Ryosei Minoda, Kengo Uno
    1993 Volume 86 Issue 6 Pages 785-789
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.785
    JOURNAL FREE ACCESS
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    HTLV-1 associated myelopathy (HAM) is considered to be caused by Human T-lymphotrophic Virus Type 1 (HTLV-1), and is characteraized by slow progressive spastic paraparesis. Although sphincteric and sensory disturbances are observed as other major symptoms, disturbances of eye movement and hearing loss occur in some patients as minor symptoms. In order to clarify the neuro-otological abnormalities, we perfomed pure tone audiometry, auditory brainstem responses, and equilibrium tests in 12 patients. Eleven of them showed sensorineural hearing loss and one patient showed mixed hearing loss. On the auditory brainstem responses, 8 patients showed increases of I-III interpeak latency, and 5 patients showed increases of I-V interpeak latency. On positioning nystagmus tests, 1 patient showed rotatory nystagmus. On the eye tracking tests, 2 patients showed superimposed saccadic eye movements on sinusoidal curve and 2 other patients showed ataxic eye movements. On the caloric test, 1 patient showed unilateral CP. These facts suggest not only involvement of the spinal cord but also involvement of the brainstem, as reported previously.
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  • MRI in G erebellopontine Angle Tumors
    Yukiko Iida, Mutsuo Naito, Norihiko Asahina, Masaki Kato, Yoshito Okam ...
    1993 Volume 86 Issue 6 Pages 791-798
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.791
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    We report 12 cases of tumors the cerebellopontine angle demonstrated by magnetic resonance imaging (MRI). T1-, T2-, and T2*-weighted imaging and gadoliniumdiethylenetriamine pentaacetic acid (Gd-DTPA) contrast medium radiography were carried out with a superconducting-type MR apparatus with a static magnetic field of 1.5 tesula. The tumor images were demonstrated by signals of lower intensity than those of the white matter of the brain in T1-weighted images, and by slightly higher-intensity signals in T2-and T2*-weighted images, but were very strongly depicted with Gd-DTPA. It was sometimes possible to identify the nerve from which the tumor developed, depending on the direction of the MRI, but it was necessary to select the imaging conditions carefully in order to avoid false negatives. We know of past cases of such tumors that have been treated as sudden deafness or other conditions.
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  • Unilateral Psychogenic Hearing Loss in Childhood; A Report of Two Cases
    Shigeki Akita, Tsuyoshi Okawa, Keiko Ito, Keisuke Mizuta, Toshimi Koji ...
    1993 Volume 86 Issue 6 Pages 799-805
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.799
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    We treated two 8-year-old females with psychogenic hearing loss of sudden onset. Both audiograms showed unilateral sensorineural hearing loss and no saucer audiogram. However, their auditory brainstem responses and stapedial reflexes were normal. The second patient also had psychogenic stricture of her visual field. The contradiction between subjective audiometry and objective measurements suggested psychogenic hearing loss. The external cause was a friend's shouting in her ear in the first case, and a thunderstorm in the second case. Both patients were treated with psychotherapy, and their hearing levels were restored to normal. The stricture of the visual field in the second case was also improved.
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  • Functional Hearing Loss Induced by Vertigo; A Case Report
    Misao Tsubokawa, Toshihito Tsubokawa, Yachiyo Tominaga, Toshio Otsubo, ...
    1993 Volume 86 Issue 6 Pages 807-813
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.807
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    We report a case of functional hearing loss induced by vertigo. It was difficult to diagnose it correctly because of accompanying vertigo, suspected of being due to vestibular neuritis.
    An 8-year-old-boy came to the hospital complaining of severe vertigo. There was spontaneous nysatgmus to the left side and sensorineural hearing loss of the right side on puretone audiometory. The caloric response was diminished on the same side. We diagnosed sudden deafness with vertigo or labyrinthitis on the right side and started treatment. During treatment, a contradiction between his behavior and his hearing capacity was noticed, and the ABR test and stapedial reflex showed normal reactions. We finally diagnosed this case as functional hearing loss induced by vertigo. His hearing loss recovered when the vertigo disappeared.
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  • Laser Surgery for Perennial Nasal Allergy
    -3rd Report; Its Mechanism-
    Shigeki Kawamura, Nobuo Kubo, Tomoshige Fukutake, Toshio Yamashita, Ta ...
    1993 Volume 86 Issue 6 Pages 815-821
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.815
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    The long-term effects of CO2 laser surgery for nasal allergy were described previously. The mechanism was then investigated by antigen provocation tests. Rhinomanometry and laser doppler velocimetry were performed during provocation tests before and two months after surgery. The ECP (eosinophil cationic protein) content of the nasal lavage fluid was also measured. The amount of ECP was significantly decreased after surgery in each patient, especially in those with a very good response to surgery. Nasal airway resistance was not altered by the surgery; however, its response to antigen provocation was significantly lessened. Nasal blood flow in patients with nasal allergy was less than that in normal subject, but the difference was decreased by laser treatment. These result suggest that laser surgery is effective for nasal allergy via the following mechanism: laser injure vaporizes the nasal mucosa to a limited depth producing secondarily a permanent scared layer. This scar persists for as long as 5 years, preventing allergic reactions and inhibiting the release of chemical mediators. The elimination of superficial capillaries and surrounding connective tissue prevents mucosal edema. This surgery affects the resistant vessel layer and not the capacitant vessel layer. Therefore laser surgery seems to be functional and minimum surgery for nasal allergy.
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  • Comparison of Nasal Disease in Patients with Congenital Velopharyngeal Insufficiency and with Cleft Palate
    Yasuyuki Ishikawa, Ryoichi Amitani
    1993 Volume 86 Issue 6 Pages 823-827
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.823
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    Congenital velopharyngeal insufficiency (CVPI) is characterized by a disorder of the velopharynx similar to that observed in cleft palate without an overt or submucous cleft. We investigated nasal disease in 62 patients with congenital velopharyngeal insufficiency and compared the findings with those in cleft palate patients and normal subjects.
    The incidence of sinusitis in CVPI patients (46.8%) was similar to that in cleft palate patients (44.4%)-markedly higher than in normal subjects (<10%). The incidence of septal deviation was low (25.8%), and total nasal resistance was almost normal in CVPI patients. In contrast, in patients with cleft palate, septal deviation was common, and total nasal resistance was significantly higher than that in CVPI. The saccharin test was performed to evaluate nasal mucociliary clearance, and the ciliary beating frequency (CBF) of ciliated cells from the septal mucosa was also examined, since nasal mucociliary dysfunction was assumed to be one of the causes of sinusitis in cleft palate patients. In CVPI patients, the saccharin time and CBF values were normal. Further investigation is needed to evaluate the cause of the high incidence of nasal sinusitis in patients with CVPI.
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  • Metastatic Renal Cell Carcinoma in a Paranasal Sinus; A Case Report
    Akira Kodama, Kazutomo Kitajima, Ken-ichi Kataoka, Yutaka Nakaishi
    1993 Volume 86 Issue 6 Pages 829-833
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.829
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    A tumor in the right ethmoid sinus was found in a 71-year-old male with recurrent severe epistaxis. Endonasal biopsy was performed with severe bleeding, and the tumor proved to be metastatic from a renal cell carcinoma. Kidney tumor metastases to the nose and paranasal sinuses are not rare according to the urological literature. Thus, in patients with severe epistaxis if malignant tumor is suspected, we should remember the possibility of metastases from the kidney. Since some metastatic tumors develop many years after nephrectomy for renal cell carcinoma, long term careful follow-up examinations are essential.
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  • Ranula; Diagnosis and Treatment
    Ryo Asato, Hiroyuki Kitamura, Shin-ichi Takagita, Keisaku Tabuchi, Kou ...
    1993 Volume 86 Issue 6 Pages 835-838
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.835
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    From 1968 to 1990, 30 patients with ranula were treated in our department: 9 men and 21 women aged 5 to 55 years (mean age 29.1 years).
    There were 20 sublingual (66.7%), 5 sublingual-submandibular (16.7%) and 5 submandibular types (16.7%). It is hard to diagnose ranula of the submandibular type, but CT scans are useful.
    Four patients had recurrences after the first surgery, because of imcomplete excision of the sublingual gland. It is important to remove the sublingual gland completely.
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  • Metastasis from Pancreatic Carcinoma to Palatine and Lingual Tonsils; A Case Report
    Akimitsu Kawai, Yozo Orita, Hidekazu Yamamoto, Takeshi Akisada, Junshi ...
    1993 Volume 86 Issue 6 Pages 839-845
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.839
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    Metastatic tumors to the head and neck from distant primary tumors are rare. Very few cases of metastatic tonsillar tumor have been reported in the literature, and most of them originated in the lung, kidney, skin, or stomach. We treated a patient with pancreatic cancer which had metastasized to the palatine and lingual tonsils. A 57-year-old male complained of sore throat and a feeling of foreign body in the pharynx after treatment for a lung tumor. The right palatine and lingual tonsils were coated with a dirty furlike covering. Biopsy showed an undifferentiated carcinoma. The tumor disappeared completely after radiation treatment, but he developed liver damage and obstructive jaundice caused by para-aortic lymph node swelling. Jaundice disappeared after PTCD (percutaneous transhepatic cholangio drainage) and radiation to the abdomen, but he died 2 months later of peritonitis carcinomatosa. Autopsy revealed primary pancreatic undifferentiated carcinoma which had metastasized to the lung and tonsils.
    As far as we are aware, this is the first report in Japan of metastasis to the tonsils from a primary pancreatic tumor. The clinical aspects of metastatic tonsillar tumor and a possible mechanism of the metastatic processes are discussed.
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  • Schwannoma of the Larynx; A Case Report
    Mayumi Komori, Shigenobu Iwata, Kazuo Sakurai, Ryuichi Kato, Kenji Tak ...
    1993 Volume 86 Issue 6 Pages 847-850
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.847
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    Neurogenic neoplasm of the larynx is not common, and only 48 cases have been reported in the Japanese literature. The authors treated a 53-year-old man with schwannoma in the larynx. The tumor was located on the inside of the right arytenoid fold. When the mass was extirpated endoscopically, two fine nerve fibers were seen connected with the mass. These fibers were thought to be internal branches of the right superior laryngeal nerve. It was concluded that this tumor was derived from the superior laryngeal nerve. The 49 cases of laryngeal neurogenic tumor reported in Japan are analyzed statistically.
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  • Clival Chordoma; A Case Report
    Hiromichi Shirato, Keisuke Mizuta, Toshimi Kojima, Tomoo Suzuki, Hideo ...
    1993 Volume 86 Issue 6 Pages 851-859
    Published: June 01, 1993
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.851
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    A giant chordoma originating in the clivus was found in a 26-year old female. At 13 years of age she had had polyneuritis after chickenpox, and a tumor of the nasopharynx was found coincidentally, but a definitive pathological diagnosis was not made even after repeated examinations in our clinic.
    In March, 1991 at 26 years of age, she visited our clinic again with a complaint of bilateral nasal obstruction. A giant cystic tumor was found in the nasopharynx, and she was admitted. Pathological examination in tissues obtained from a second operation revealed chordoma. The origin was considered to be the clivus because of its location on plain skull films, CT and MRI. The tumor had destroyed the apex of the pyramidal bone and invaded the intracranial space, showing severe kinking of the ponto-medullary junction of the brainstem. The tumor was partially removed by a transoral, and transpharyngeal approach and retromastoid craniectomy. The pathological diagnosis was typical chordoma, but it was considered to be unusual because the patient had not had symptoms of cranial nerve disturbance for 13 years.
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  • Multiple Hemangiomas in the Head and Neck Diagnosed by Diagnostic Imaging; A Case Report
    Masaki Furukawa, Kiminao Ooishi, Madoka K. Furukawa, Toyokazu Yoshida, ...
    1993 Volume 86 Issue 6 Pages 861-868
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.861
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    Multiple hemangiomas in the head and neck is relatively uncommon and the preoperative diagnosis is difficult. A 25-year-old female was referred to our clinic in January 1990, because of swelling of the left cheek for 3 years.
    Several mass lesions in the head and neck were detected by diagnostic imaging and she was diagnosed as having multiple hemangiomas.
    A mass in the anterior region of the neck was resected. The pathological diagnosis was cavernous hemangioma.
    The usefulness of diagnostic imaging is discussed. MRI was especially useful in detecting multiple hemangiomas because all the mass lesions had high signal intensity on T2-weighted images.
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  • Cervical and Mediastinal Emphysema Caused by Vocal Exercises
    Mutsumi Kuga, Minoru Ikeda, Yasuhiro Tagaya, Hidehisa Nalazatp, Yoshih ...
    1993 Volume 86 Issue 6 Pages 869-873
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.869
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    The author recently treated a patient with cervical and mediastinal emphysema caused by excessive vocal exercise. The 26-year-old male had had similar swelling of the neck two years earlier also during vocal exercise. For four days he had let it take its own course, and the swelling had disappeared. The vocal exercise, which he carries out as a form of selftraining, is done in such a way as to produce high pressure in the abdomen. This time, he had been continuing the vocal exercise for three hours when swelling of the neck occurred. A CT scan indicated swelling of the face, neck and mediastinum. Part of the rear wall on the right side of the trachea was observed to be thin, and this site was assumed to be the origin of the emphysema. Good rest and antibiotics to prevent infection resulted in disappearance of the swelling in approximately one week.
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  • Accuracy and Reliability of Three-Dimensional Surface Reconstruction Measurement
    Chikashi Mizukami, Etsuo Yamamoto, Masaki Ohmura, Hiroyuki Oiki, Jun T ...
    1993 Volume 86 Issue 6 Pages 875-879
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.875
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    We are using a new three-dimensional (3-D) surface reconstruction system to measure the temporal bones. This system offers the advantage of observation of the external aperture of the vestibular aqueduct and the porus acusticus internus in living subjects. However, its accuracy has not been confirmed. To investigate the accuracy of this new system, we measured the length of an in situ ceramic ossicular replacement prosthesis (CORP) of known length of 6.0mm using 3-D surface reconstruction, conventional plain X-ray and polytomography. The CORP was scanned in the axial, sagittal and oblique directions. The mean measured length obtained with the 3-D surface reconstruction images was 5.94±0.21 on vertical scans, 5.91±0.27 on horizontal scans, and 6.01±0.25 on oblique scans. There were no significant differences among the measured lengths obtained in the three directions. Therefore, this 3-D surface reconstruction measurement system is considered to be reliable.
    Conversely, the mean measured length obtained by plain X-ray was 7.98±0.20, and by polytomography it was 7.94±0.23. These conventional methods have the inherent disadvantage of magnification of size which consequently requires correction.
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  • Quantitative Analysis of Rabbit Facial Nerve Fibers
    Jyu Nin
    1993 Volume 86 Issue 6 Pages 881-884
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.881
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    Recovery of the orbicularis oculi muscle is often slower than that of the orbicularis oris muscle in patients with idiopathic facial nerve palsy. This difference is considered to depend on anatomical or physiological differences of these muscles and their innervating nerve fibers, but there has been little discussion of this problem.
    Myelinated nerve fibers innervating the orbicularis oris and the orbicularis oculi muscles, from the buccal branch and zygomatic branch of a rabbit were analyzed quantitatively. After complete dissection of the facial nerve, the nerve branch to be taken as a sample was decided with the use of electrostimulation. Cross sections of the nerve were examined microscopically, and magnified photographs (×500) were studied with an image analyzer. Histograms showed larger fibers in the zygomatic branch than in the buccal branch. The mean value and standard deviation of diameter of nerve fibers in the zygomatic branch and buccal branch were 10.6±2.7μm and 7.6±2.7μm, respectively a statistically significant difference.
    These findings suggest that the delay in recovery of the paralyzed orbicularis oculi muscle might be due to the difference in diameter of the zygomatic and buccal branch nerve fibers.
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  • Ibudilast for Dizziness; A Clinical Study of 27 Patients
    Makoto Ohki, Yo Kimura, Ryoji Kanayama, Takashi Okuyama, Yoshio Koike
    1993 Volume 86 Issue 6 Pages 885-894
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.885
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    Ibudilast is a cerebral vasodilator. Its therapeutic effect and safety were studied in 27 patients with dizziness due to cerebro-vascular insufficiency. The patients were given a 10mg capsule of ibudilast 3 times a day for over 8 weeks.
    In 22 out of 26 patients (84.6%) subjective symptoms disappeared, and objective signs were reduced in 12 out of 13 (92.3%). In 23 of the 27 patients (85.2%) there was over all improvement. No severe clinical side effects were noted.
    The results suggest that ibudilast is a clinically useful drug for the treatment of dizziness due to cerebro-vascular insufficiency.
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  • Azeptin®'s Efficacy in Patients with Otitis Media with Effusion
    Isuzu Kawabata, Yasuya Nomura, Kyozo Kikuchi, [in Japanese], [in Japan ...
    1993 Volume 86 Issue 6 Pages 895-909
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.895
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    The usefulness of the anti allergic agent Azeptin® was evaluated in 182 patients with otitis media with effusion. Azeptin® was administered in a dose of 2 mg twice daily for 4 to 8 weeks patients over 6 years of age and in a dose of 1mg to those under 5 years of age.
    The efficacy of Azeptin® was determined by evaluating the response to treatment of subjective symptoms such as tinnitus, hearing impairment, and feeling of ear, blockage tympanic findings and hearing acuity.
    The final general improvement rate was 39.5% for good to excellent responses and 65.0% for fair to excellent responses.
    Notably improved were hearing impairment, feeling of ear blockage and appearance the tympanic membrane and reduced fluid retention.
    Side effects were experienced by 2.2% of the patients: drowsiness, gastric discomfort, vomiting and a bitter aftertaste (1 case each).
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  • Bacteriological, Pharmacokinetic and Clinical Studies on Banan® tab in Otorhinolaryngological Infections
    Jun-ichi Yoda, Toshihide Tabata, Kiyonori Kuki, Yasuhiro Hayashi, Dais ...
    1993 Volume 86 Issue 6 Pages 911-925
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.911
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    Bacteriological, pharmacokinetic and clinical studies on Banantab (cefpodoxime proxetil, CPDX-PR), a new oral cephalosporin derivative, were conducted in 235 patients with otorhinolaryngological infections.
    1) A dose of 100mg of CPDX-PR was administered after meals twice daily for 3-16 days. The clinical efficacy rate was 93.3% in acute otitis media (15 cases), 80.4% in acute exacerbation of chronic otitis media (46 cases), 84.2% in acute sinusitis (19 cases), 70.5% in acute exacerbation of chronic sinusitis (44 cases), 81.5% in acute tonsillitis (27 cases), 71.4% in acute exacerbation of chronic tonsillitis (7 cases), 87.0% in acute pharyngolaryngitis (54 cases), 58.3% in acute exacerbation of chronic pharyngolaryngitis (12 cases), and 90.0% in acute otitis externa (10 cases).
    2) In bacteriological studies, 134 strains of causative organisms were isolated from 117 patients. The bacteriological eradication rate was 84.3%.
    3) As to adverse effects, abdominal pain and nausea were observed in one case each. Elevation of GOT and GPT was noted in one patient.
    4) Drug concentrations in serum, palatine tonsil, and maxillary sinus mucosa were measured after oral administration of 200mg during fasting. Tissue concentrations of CPDX two hours after administration of the serum level were 27.0±12.8% (mean±S. D.) in palatine tonsils and 63.8±15.1% in maxillary sinus mucosa.
    Our results show that CPDX-PR is useful in otorhinolaryngological infections.
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  • Office Management of Draining Ears with Tympanic Membrane Perforation
    [in Japanese]
    1993 Volume 86 Issue 6 Pages 926-927
    Published: June 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.926
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