Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 86, Issue 7
Displaying 1-21 of 21 articles from this issue
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  • Respiratory Disorders during Sleep; Clinical Aspects and the Role of Otolaryngologists
    Kiyoshi Togawa, Soichiro Miyazaki, Koji Yamakawa, Yoshiaki Itasaka
    1993 Volume 86 Issue 7 Pages 929-939
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.929
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    Respiratory disorders during sleep, including sleep apnea syndrome and snoring, cause increased respiratory work and/or hypoventilation, which create various malign effects on cardio-respiratory functions and daytime activities.
    Among a variety of obstructive and non-obstructive causes, the most common is obstruction of the upper respiratory tract from the nose to the larynx. To diagnose the location and severity of sleep dyspnea, taking a careful history of the symptoms and signs, local and general physical findings, including fiberoptic endoscopy, X-ray films of the upper airway profile, cephalometry, and polysomnography should be performed. The parameters for polysomnography are EEG, EOG, EMG, ECG, SaO2, tcPOO2 and tcPCOO2, pressures in the mesopharynx and the esophagus, tidal volume, and heart rate.
    There are both conservative and surgical treatments. For patients with moderate obstruction, nasal CPAP, body weight reduction, medication as indicated, and mandibular prosthesis are used depending on the cause. For those with severe obstruction, intranasal surgery, adenotomy and tonsillectomy, uvulopalatopharyngoplastry (UPPP), median partial glossotomy, tracheotomy, etc. are indicated, again, depending on the cause. In order to achieve satisfactory results, it is important to pay close attention not to overlook obstructions other the ones already manifested.
    As upper airway surgeons, otolaryngologists must treat such patients properly by diagnosing precisely the sites and degrees of severity of the obstructions and providing the correct treatment, conservative and surgical, with multifactorial cooperation.
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  • Vestibular Neurectomy for Meniere's Disease
    [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1993 Volume 86 Issue 7 Pages 940-941
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.940
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  • Pyle's Disease with Visual and Hearing Loss; A Case Report
    Yasuhiko Sakikawa, Toru Kaneko, Kenjiro Yoshimi, Naohiko Watanabe, Yas ...
    1993 Volume 86 Issue 7 Pages 943-950
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.943
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    Craniometaphyseal dysplasia is a rare congenital disorder in which marked sclerosis and hypostosis of the craniofacial skeleton are associated with abnormal modeling of the metaphyses of the long bones. The disorder was first reported by Pyle in 1931 as “a case of unusual bone development”. Only a few cases have been reported in the literature. The present paper describes otolaryngological features observed in a case of Pyle's disease. An 8-year-old boy developed symptoms of progressive visual and hearing loss due to bony impingement on the cranial foramen and the Eustachian tube. Radiographic examinations showed marked sclerosis of the base of the skull and underdevelopment of the paranasal sinuses and mastoids. Although otolaryngological manifestations are rare, we need to keep this disease in mind in order to prevent hearing deterioration by surgical intervention at an early stage.
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  • Meniere's Disease; Diagnosis at the First Episode of Hearing Loss
    Yoshiyuki Kitaoku, Takashi Matsunaga, Ikuo Kitano, Kazuhiko Nario, Mas ...
    1993 Volume 86 Issue 7 Pages 951-956
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.951
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    Over a 10-year period, two patients with a diagnosis of sudden deafness without vertigo and 15 patients with a diagnosis of sudden deafness with vertigo at their first episode of hearing loss later developed definite Meniere's disease. These early Meniere's disease patients were compared with 133 patients with sudden deafness without vertigo, 71 patients with sudden deafness with vertigo, and 90 patients with definite Meniere's disease. Differences in the results of audiography, glycerol test, caloric test, and electrocochleography were assessed.
    There was a significant difference in an upsloping audiogram between patients who had sudden deafness with vertigo and those with definite Meniere's disease (chi-square test: p <0.05). The latter patients often had an upsloping audiogram, while the former patients had very little as a result of high grade hearing loss. Thus, a first attack of Meniere's disease can be suspected if a patient with sudden deafness and vertigo has an upsloping audiogram. There was less hearing loss in the early and definite Meniere's disease groups than in the sudden deafness patients.
    The glycerol test was positive in 27.3% of early Meniere's disease patients and in 53.3% of definite Meniere's disease patients. There was no significant difference between early Meniere's disease and the other diseases.
    Five of the six early Meniere's disease patients tested had an increased negative SP/AP ratio on electrocochleography, as did 67.3% of definite Meniere's disease patients. There was a significant difference between definite Meniere's disease patients and those who had sudden deafness with or without vertigo (chi-square test: p <0.05). Although there was no significant difference between early Meniere's disease patients and sudden deafness with vertigo, it seemed that electrocochleography was useful in distinguishing Meniere's disease from sudden deafness at the first episode of hearing loss.
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  • IgE Antibodies to Chamaecyparis Obtusa Pollen in Patients with Nasal Allergy
    Hirotaka Ito, Joh Nishimura, Motohiko Suzuki, Shinichiro Mamira, Kaoru ...
    1993 Volume 86 Issue 7 Pages 957-962
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.957
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    Specific IgE antibody titers to the pollen of Chamaecyparis obtusa (Cypress) and Japanese cedar were determined by CAP RAST in sera from 267 patients diagnosed as having allergic rhinitis at outpatient departments of several hospitals in Metropolitan Nagoya (Nagoya City University Hospital, Nagoya Higashi Municipal Hospital, Nagoya Midori Municipal Hospital, Meijo Hospital). The assay results were correlated with the patients' subjective symptoms, objective signs and skin tests.
    1) The CAP RAST assay yielded a positive rate of 50.6% for Chamaecyparis obtusa and 73.8% for Japanease cedar pollens.
    2) Results of CAP RAST inhibition test suggested that while Chamaecyparis obtusa and Japanese cedar have some common antigens, the former also has a certain unique antigen.
    3) A positive correlation was found between the results of intradermal Chamaecyparis obutusa skin test and those of CAP RAST.
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  • Intranasal Meningoencephalocele; A Case Report
    Yasuhiro Ozaki, Shin-ichi Okumura, Yasuo Mishiro, Yuji Miyawaki, Yuu I ...
    1993 Volume 86 Issue 7 Pages 963-970
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.963
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    A 48-year-old male with pachydermoperiostosis complained of right nasal obstruction. Rhinoscopy revealed a light grey polypoid mass in his right nasal cavity. This was biopsied. Cerebrospinal fluid (CSF) suddenly dripped from the remnant stump after the operation. The histological diagnosis was meningoencephalocele with no neoplasm. MRI showed fluid collection in his right nasofrontal duct from his right frontal sinus.
    We therefore diagnosed transfrontal meningoencephalocele of the right nasal cavity with CSF rhinorrhea. Continuous spinal drainage was done for six weeks, but the leakage continued. An extranasal approach was selected for repairing the CSF leakage. A bone defect was found in the posterior wall of the right frontal sinus. This defect was successfully covered with femoral fascia and muscle with the use of a fibrin sealant. His post operative condition was good.
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  • Recent Experiences with Four Patients with Rhinogenic Intracranial Complications
    Takumi Miura, Akira Mochida, Hideaki Motosugi, Hirokazu Tanigawa, Tosh ...
    1993 Volume 86 Issue 7 Pages 971-978
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.971
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    Case 1: A 21-year-old male had abscess of the brain and interhemispheric subdural area secondary to acute frontal sinusitis. Case 2: A 55-yera-old female had two brain abscesses. Case 3: A 15-year-old female had an epidural abscess secondary to acute frontal sinusitis. Case 4: A 15-year-old male had a subdural abscess. All 4 patients were treated successfully. The developpment of antibiotic therapy has reduced the incidence of rhinogenic intracranial complications, but 38 cases were reported in the past 10 years. Careful observation, prompt diagnosis and early treatment are very important.
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  • Granulocyte Colony-Stimulating Factor-Producing Spindle Cell Carcinoma of Maxillary Sinus
    Jun-ichi Yodo, Kiyonori Kuki, Tadahito Saito, Takao Samyukawa, Shinji ...
    1993 Volume 86 Issue 7 Pages 979-986
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.979
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    Spindle cell carcinoma is a relatively rare tumor occurring usually in the upper respiratory and/or digestive tract, and less frequently in the maxillary sinus. Recently we treated a patient with spindle cell carcinoma of maxillary sinus.
    The patient was a 65-year-old male. The initial pathologic diagnosis was well-differentiated squamous cell carcinoma.
    He received immunochemotherapy (balloon-occluded arterial infusion of CDDP and recombinant interleukin-2) as a neoadjuvant, followed by radiation. The tumor was partially reduced in size, but total regression was not achieved. The residual tumor was surgically removed, and postoperative irradiation was applied to a total dose of 60 Gy.
    Six months later, however, the tumor reappeared and grew rapidly. Definitive surgical treatment was performed. Pathologic examination revealed that the recurrent tumor consisted of carcinoma and sarcomatous, spindle cell compartments. Differential diagnosis included carcinosarcoma, malignant fibrous histiocytoma, and spindle cell carcinoma. Immunohistochemical techniques were used to distinguish between epithelial and mesenchymal properties in a sarcomatoid area. Keratin was found in sarcomatoid parts, so the tumor was diagnosed as spindle cell carcinoma.
    The spindle cell carcinoma reappeared within 3 months and leukocytosis in the peripheral blood paralleled tumor growth. A tumor cell line (OKK-HK) was established from this spindle cell carcinoma. Granulocyte colony-stimulating factor (G-C SF) was detected (1255 pg/ml) in the supernatant of cultures of this cell line.
    This spindle cell carcinoma responded well to the local administration of WPG (biological response modifier). However, the patient died of respiratory failure.
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  • Lymphangioma with Macroglossia; A Case Report
    Tomoaki Nakano, Michinari Muraoka, Satoki Wakami, Yoshiaki Nakai
    1993 Volume 86 Issue 7 Pages 987-991
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.987
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    Lymphangioma is relatively rare in the oral cavity. Diffuse lymphangioma of the tongue causes macroglossia.
    We treated a 1-year-old girl with a diagnosis of tongue lymphangioma. Local injections of bleomycin were performed three times without effect. So partial glossectomy by Egyedi and Obwegeser's method was performed to reduce the size of the tongue.
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  • Adenoid Cystic Carcinoma of Sublingual Gland; A Case Report
    Shigeru Hirato, Hiroyuki Kitamura, Koji Miyata, Ken-ichi Kaneko, Ryo A ...
    1993 Volume 86 Issue 7 Pages 993-996
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.993
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    Malignant tumors of the sublingual gland are uncommon. We report here a case of adenoid cystic carcinoma of the sublingual gland.
    A 36-year-old woman was refered to our hospital with a swelling of the floor of the mouth on the left side. MRI showed a tumor of the left sublingual gland. Fine needle aspiration biopsy (FNA) revealed adenoid cystic carcinoma. Resection of the left oral floor and left submandibular neck dissection were performed, and 50 Gy post operative irradia-tion was given.
    MRI and FNA were very useful in the diagnosis of the sublingual tumor.
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  • Small Cell Carcinoma of the Parotid Gland; A Case Report
    Jun-ichi Unehara, Masatoshi Horiuchi, Hirosato Miyake
    1993 Volume 86 Issue 7 Pages 997-1001
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.997
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    Small cell carcinoma is an extremely rare tumor in the parotid gland. An 82-year-old man visited the Department of Otorhinolaryngology of Tokai University Hospital with a mass in the left parotid region. Fine needle aspiration biopsy was performed, and a preoperative diagnosis was made of malignant parotid tumor. Subtotal resection of the left parotid gland and radical neck dissection were performed.
    Pathological examination confirmed the diagnosis of small cell carcinoma, and neuroendocrine granules were demonstrated by electronmicroscopy.
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  • Lingual Thyroid with Marked Calcification; A Case Report
    Akira Kodama, Kaoru Uchida, Hiroshi Ozawa, Ken-ichi Kataoka
    1993 Volume 86 Issue 7 Pages 1003-1007
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1003
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    A 47-year-old female was admitted to our department because of a sensation of foreign body in the throat. After various medical examinations, partial resection of the lingual thyroid was initially planned. However, the tumor was extremely hard and impossible to resect, so total removal of the tumor was performed. The histological diagnosis was “thyroid tissue with hyalinized and calcified stroma without malignancy”. Even an extensive search of the literature failed to uncover a case similar to ours.
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  • Neurilemmoma of the Base of the Tongue; A Case Report
    Nobuya Fujiki, Mitsuharu Nonomura, Yasunori Konishi
    1993 Volume 86 Issue 7 Pages 1009-1012
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1009
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    Neurilemmoma at the base of tongue is relatively rare.
    A 28-year-old female with a tumor at the base of her tongue visited our clinic in February, 1992.
    Under general anesthesia by oral intubation, the tumor was completely removed extracapsularly through the oral approach. The histopathological diagnosis was Antoni type A neurilemmoma.
    She has no lingual paralysis or taste loss after the operation, so the origin of the neurilemmoma could not be identified.
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  • Evaluation of Hoarseness by Prediction Error of LPC Method
    Tomoyuki Haji, Keizo Tate, Hideyuki Kataoka, Nobuya Fujiki
    1993 Volume 86 Issue 7 Pages 1013-1018
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1013
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    A new method was developed for the quantitative evaluation of hoarseness with the use of a personal computer.
    The prediction error (residual signal) of voice samples was obtained by a linear predictive coding (LPC) method. The differential of the error was processed statistically by applying the Rayleigh distribution. Then, the coefficient of the probability density function was calculated and used as a parameter for the degree of hoarseness.
    This method was applied to 42 normal and 55 abnormal voice samples, and it was proved to be useful for the quantitative evaluation of hoarseness. It was also useful for the objective evaluation of voice improvement after phonosurgery.
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  • 10 MHz High-Resolution Sonography with Low-Attenuation Ultrasonic Acoustic Coupler
    Yuji Kano, Hiroyuki Kakuta, Hitoshi Hiratsuka
    1993 Volume 86 Issue 7 Pages 1019-1024
    Published: July 01, 1993
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1019
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    The usefulness of 10 MHz high-resolution sonography for superficial lesions of the head and neck was studied, and direct probe scanning was compared with probe scanning with a low-attenuating ultrasonic acoustic coupler. 1) As the acoustic coupler was soft enough to be attached to the skin, we could get a full image of the scanned area. 2) Since the acoustic coupler made the marginal image of the skin clearer, better images of the content and the margin of subcutaneous lesions could be obtained. 3) The ultrasonic acoustic coupler was so fragile, however, that we could not use it in many cases.
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  • Delayed Response Following Cochlear Microphonics
    -Its Characteristics and Analysis-
    TAKEDA Takeda, Akinobu Kakigi, Tomoyuki Haji, Haruo Saito, Yoshiki Aoy ...
    1993 Volume 86 Issue 7 Pages 1025-1032
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1025
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    Cochlear microphonics (CM) and delayed response following CM (DRCM) were investigated in 10 guinea pigs. The acoustic stimuli used were 1 kHz and 4 kHz tone pips. DRCM could be detected in all animals with a threshold less than 35 dB pe SPL in cochlear action potential (AP), but decreased or became undetectable at AP thresholds over 40 dB pe SPL. The input-output curves of DRCM revealed typical nonlinear properties and showed the saturation phenomenon at fairly low sound intensity around 60 dB pe SPL, compared to the sound level at which CM is saturated. Thus, CM and DRCM could be separated by a modification of Probst's method, taking into account their different input-output functions. DRCM differed from CM by being independent of the frequency of acoustic stimulation, although it was dependent on the phase. DRCM seemed to contain relatively low frequency ranges, 0.5 to 2.0 kHz. Therefore, DRCM evoked by 4 kHz tone pips could be separated easily from CM by high-cut filtering. The waveform of DRCM, separated by a modification of Probst's method, was quite similar to that separated by high-cut filtering. Thus, DRCM is thought to be a different evoked potential from CM.
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  • Evaluation of Pharyngeal Sensation in Patients with Abnormal Sensation in the Throat
    Yoshihisa Tsuta
    1993 Volume 86 Issue 7 Pages 1033-1043
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1033
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    With the presumption that patients with abnormal sensation in the throat have a local abnormality in the pharynx or some sensory dysfunction, we tested the subjective threshold with EGM (electro gustmeter) and objective sensation with SEP (somatosensory evoked potential).
    1) The subjective test of the posterior pharyngeal wall revealed significantly greater perception in the patients than in normal controls.
    2) The subjective test in the glossopharyngeal region revealed similar results.
    3) A two point discrimination test in the glosspharyngeal region revealed a significant decrease in the 10 dB range above the threshold in the patients.
    4) No significant difference was noted between the patients and the controls in the SEP obtained by electrical stimulation of the glossopharyngeal region.
    These results suggest a disturbance of pharyngeal peripheral sensation in patients with abnormal sensation in the throat. Thus, it appears that the mechanism of onset of sensation in the throat is similar to that of tinnitus and of phantom limb sensation.
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  • Adjuvant Chemotherapy with UFT for Head and Neck Cancer
    Mamoru Miyagichi, Shun-ichi Sakai, Yasuo Koike, Tatsuya Ishida, Haruo ...
    1993 Volume 86 Issue 7 Pages 1045-1051
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1045
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    Patients with head and neck cancer, especially squamous cell carcinoma, were divided into a UFT treated group (195 patients) and a contorol group (234 patients) after radical therapy. No difference was observed between the two groups.
    Next we selected 155 pairs of patient from the two groups. The pairs had the same primary site and the same grade of disease.
    UFT was shown to prolong the disease free period after radical therapy for squamous cell carcinoma of the mouth.
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  • Empirical Therapy with FMOX for Otolaryngological Infections
    Shingo Murakami, Naoaki Yanagihara, Koshiro Nakamura, [in Japanese], [ ...
    1993 Volume 86 Issue 7 Pages 1053-1059
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1053
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    The empirical use of FMOX was evaluated in 210 patients with bacterial infections in the otorhinolaryngological field. As a general rule, FMOX 2 or 4 g in adult and 60-150 mg/kg in children was administrated intravenously twice a day. The clinical effectiveness was evaluated by the doctor in charge as excellent, effective, slightly effective or ineffectve. The clinical efficacy was defined as the number of patients excellent or effective responses. The clinical efficacy could be analyzed and in 191 patients and the side effects in
    210 patients.
    1. The overall clinical efficacy rate was 90.1%; 80.0% in otitis media, 91.7% in paranasal sinusitis, 94.4% in tonsillitis and 91.7% in pharyngitis and laryngitis.
    2. The rate of bacterial elimination was 76.2% in 130 patients with positive cultures.
    3. Side effects were observed in 8 patients (3.3%) but they were transient ; one had vomiting and the others mild hepatic or renal dysfunction.
    We conclude that FMOX is reliable as an empirical treatment of otorhinolaryngological infections.
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  • Enteruede as an Elemental Diet for Patients with Head and Neck Cancers
    Motoyuki Hashiba, Shunkichi Baba, Isato Tsuge, Yasuhiro Ito, Takashi K ...
    1993 Volume 86 Issue 7 Pages 1061-1070
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1061
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    Twenty eight patients were given an elemental diet (Enterued®) containing small peptides through a nasal feeding tube. Oral alimentation was difficult for these patients because of head and neck cancer itself or the therapy, surgery and/or irradiation. In 23 of the patients (82.1%) the nutritional status was improved. Diarrhea occurred as a side effect in 5 of them (17.9%), 3 of whom stopped using Enterued®. The speed of administration should be carefully controlled to prevent diarrehea.
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  • Nasal Allergy and Infiltrating Cells
    [in Japanese]
    1993 Volume 86 Issue 7 Pages 1072-1073
    Published: July 01, 1993
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.86.1072
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