Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 87, Issue 10
Displaying 1-21 of 21 articles from this issue
  • Hiro-omi TAKAHASHI
    1994 Volume 87 Issue 10 Pages 1309-1319
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Patients with T3 or T4 lesions of the larynx were given radiotherapy or radiochemotherapy. In 47 patients the vocal cords were fixed, the treatment restored vocal cord mobility in 35 of them. In 41 of the 55 patients treated, visual inspection showed disappearance of the tumor.
    If recurrence of a tumor was noted during the course of observation, salvage surgery was performed. Salvage surgery was not needed in 32 (68%) of the 55 patients.
    The 5-year survival rates were 78.6 & for T3 patients with glottic lesion, 68.8% for T3 with supraglottic lesions and 85.1% for with T4 supraglottic lesions. Salvage surgery was succesful in one patient with subglottic cancer (T3N0M0).
    These results indicate that radiotherapy or radiochemotherapy is effective in the treatment of T3 and T4 lesions of the larynx.
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  • [in Japanese]
    1994 Volume 87 Issue 10 Pages 1320-1321
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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  • Noritake WATANABE, Kazuhide YOSHIDA, Goro MOGI
    1994 Volume 87 Issue 10 Pages 1323-1327
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We treated a 54-year-old female with a high right jugular bulb combined with contralateral abnormal Intracranial venous circulation and discuss the pathogenesis of high jugular bulb. This patient had an episode of right myringoplasty in 1987, and in the course of that surgery, no abnormal mass was found in the middle ear cavity. Six years after surgery, a pulsating blue mass protruding from the hypotympanum was found by an otologist, and she was referred to our clinic with suspected glomus tumor. CT scan showed a mass protruding from the right jugular fossa. Internal carotid artery angiography on both sides revealed expansion and dilation of the right jugular bulb in the venous phase without any abnormality of the arterial system. In the venous phase of left internal carotid artery angiography, an obstruction of the ipsilateral intracranial venous system was observed from the bifurcation of the transverse sinus to the jugular vein. These findings suggest that the abnormality of intracranial venous circulation may result in the development of the high jugular bulb. Intracranial venous obstruction may cause an increase of the contralateral venous blood flow, and this increase of blood flow may result in expansion and protrusion of the jugular bulb into the hypotympanum.
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  • Fumio OHNO, Kunihiko SAKAMOTO, Masaru OHYAMA
    1994 Volume 87 Issue 10 Pages 1329-1335
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Middle ear pressure is thought to be an important factor in the pathogenesis of otitis media. It is well known that body position, type of breathing, and kind of inhaled gas influence middle ear pressure. There is an increase in middle ear pressure when general anesthesia is induced with a gas such as nitrous oxide. In this study, an attempt was made to answer the question as to whether the inhalation of non-anesthetic inert gas can increase middle ear pressure.
    Eight ears were selected: 4 atelectatic ears and 4 infantile ears. Helium-oxygen mixture gas (He 79%, O2 21%) or argon-oxygen mixture gas (Ar 79%, O2 21%) was administered via face mask for 120 minutes, and middle ear pressure was measured with tympanometry just before and during gas inhalation. The middle ear pressure changes during gas inhalation were compared with those during air respiration.
    The results were as follows;
    1. Middle ear pressure was increased by the inhalation of argon-oxygen mixture gas. However, no specific pressure change was noted in the middle ear during inhalation of helium-oxygen mixture gas.
    2. The difference in pressure in the middle ear during helium-oxygen inhalation and argon-oxygen inhalation might be due to the different solubility coeffients of the two inert gases.
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  • Shigeru ISHIKAWA
    1994 Volume 87 Issue 10 Pages 1337-1347
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Patulous eustachian tube (PET) is not an uncommon disease. Drugs are seldom used for PET treatment. The purpose of this study was not to evaluate the usefulness of the Chinese medicine “Kami-Kihi-To” for PET, but to call attention to the possibility of drug therapy for PET.
    The diagnosis of PET is made from its symptoms and abnormal tympanic membrane movement during hyperventilation detected with impedance audiometry.
    “Kami-Kihi-To” was administered to 88 patients, and 66 of whom questioned subjective symptoms, and 24 of whom were evaluated objectively by impedance audiometry. Complete relief was achieved in 36 patients (54.5%) treated with “Kami-Kihi-To”, and 14 patients (21.2%) obtained partial relief. There was objective evidence of complete improvement of tympanic membrane movement in eight patients (33.3%), and partial improvement in nine patients (37.5%). Side effect were noted in three patients (4.5%).
    These results suggest that drug therapy for PET is possible.
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  • Toshihiro SUZUKI, Masaya UCHIDA, Susumu NAKAE
    1994 Volume 87 Issue 10 Pages 1349-1353
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 56-year-old female visited our clinic with a complaint of intermittent otorrhea of the left ear. The posterior canal wall was retracted by a bony defect. A CT scan showed destructive changes and soft tissue in the posterior canal wall. A diagnosis of external auditory canal cholesteatoma was made. After surgical removal of the cholesteatoma, the bony margins were smoothed, and the bony defect was filled with temporal bone putty and covered with a homograft of cartilage and temporal fascia. There has been no evidence of recurrence.
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  • Keiko NISHIKAWA, Masutoshi NISHIKAWA
    1994 Volume 87 Issue 10 Pages 1355-1362
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The amount of Japanese cedar and cypress pollen has been measured every spring for 10 years at JA Yamaguchi Shuto General Hospital. The total counts of cedar and cypress pollen and the day pollen scattering began have differed depending on the year.
    The relationship among pollen counts, meteorological factors and biophenomenological factors was investigated.
    A correlation was noted between the day pollen scattering began and the mean air temperature in January, February and August.
    No correlation was found between the total pollen counts and meteorological factors such as mean air temperature, maximum air temperature and sunshine duration in January, February, July and August.
    A correlation was evident between the day pollen scattering began and the day Japanese apricot trees came into bloom.
    No correlation was observed between the day pollen scattering began and biophenomenological factors such as the first day of singing of Japanese skylarks, the first day the large brown cicadas are heard and the day that cranes fly away from Yashiro.
    These findings suggest that forecasting cedar and cypress pollen scattering is not easy even when meteorological and biophenomenological factors are recorded.
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  • Sanson HAN, Hisayoshi KOJIMA, Kazuhiko SHOJI, Shin-ichi TAKAGITA, Myoj ...
    1994 Volume 87 Issue 10 Pages 1363-1367
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Olfactory neuroblastoma is an uncommon malignant tumor of neural crest origin arising from the olfactory epithelium. It was originally described by Berger in 1924, and since then many cases have been reported. But in Japan the disease is uncommon, and it is difficult to diagnose.
    We recently treated a 42-year-old male with olfactory neuroblastoma invading the skull base. We performed cranio-facial surgery after radiation and chemotherapy. There has been no recurrence of the tumor more than 10 months after surgery.
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  • Yoshitaka OKAMOTO, Norio SARASHINA, Zensei MATSUZAKI, Kiyoshi TOGAWA, ...
    1994 Volume 87 Issue 10 Pages 1369-1377
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Disagreement remains concerning the proper treatment of patients with indirect optic nerve injury.
    This report summarizes the diagnosis and treatment of 13 patients who were examined with high-resolution computed tomography and reviews the literature on this rare injury.
    Several pathogenic mechanisms, including edema, compression and ischemia of the optic nerve, seem to be involved, although the natural history of traumatic optic neuropathy is not clear.
    The time from injury to treatment, the level of consciousness at the time of injury and the presence of optic canal fracture do not correlate well with the recovery or nonrecovery of vision.
    The improvement of visual acuity was not always better in patients treated surgically than in those treated conservatively. Immediate operation after the injury did not assure a good prognosis.
    Our observations suggest that the first choice of treatment for optic nerve injury is the administration of a high dose of a steroid, unless visual acuity grows worse. If vision fails to improve within a week, one should consider decompression by an intracranial or transethmoidal approach depending on the site of the fracture.
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  • Mutsumi KUGA, Akihiro IKUI, Norihisa HAMADA, Kenichi WATANABE, Hideo O ...
    1994 Volume 87 Issue 10 Pages 1379-1382
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We recently treated a patient with a penetrating gun shot wound from the posterior part of the left ear to the left maxillary sinus. The patient was a 35-year-old male who had been injured by a bullet entering behind his left ear. X-ray films and CT scans of the paranasal sinuses at the time of the initial examination showed a bullet in the frontal part of the left maxillary sinus. Intracranial damage was not suspected. Treatment was carried out on the same day. The wound behind the left ear was opened, and a Caldwell-Luc operation was performed. The bullet was removed from inside the left maxillary sinus. The patient had slight difficulty in movement of the articulus mandibularis. No abnormality of the cranial nerves, including the facial nerve, was observed, and the patient's recovery after the operation was good.
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  • Masato YOKOYAMA, Mitsuya SUZUKI, Yasunaga SARAI, Ken-ichi NIBU
    1994 Volume 87 Issue 10 Pages 1383-1387
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We reviewed our 11-year experience with 96 patients treated for salivary gland tumors originating in the parotid gland (72 patients, 75%), submandibular gland (11 patients, 11%), and minor salivary glands (13 patients, 14%). The most common histology was pleomorphic adenoma, 57% of the total (77% of the benign tumors). The distribution of patients according to the histology and the site of origin are summarized.
    Survival in patients with malignant tumors differed significantly according to the histological grade and clinical stage. Postoperative irradiation was useful in the local control of tumors with a high grade of malignancy and suspicion of microscopic residual disease. Chemotherapy for unresectable or recurrent carcinomas had a poor response rate (33%) and short response duration (8 to 12 weeks).
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  • Hiroyuki OIKI, Etsuo YAMAMOTO, Masaki OHMURA, Chikashi MIZUKAMI, Tetsu ...
    1994 Volume 87 Issue 10 Pages 1389-1394
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    One hundred and thirteen parotid tumors were excised in our hospital from May 1987 to December 1993. Pleomorphic adenoma was the most common tumor (41%), followed by adenolymphoma (Warthin's tumor; 25%). Of the 130 tumors, 18 (14%) were malignant: two mucoepidermoid tumors, one adenoid cystic carcinoma, 11 adenocarcinomas, one undifferentiated carcinoma and three malignant lymphomas. The percentage of Warthin's tumors was much higher than in previous reports and it was the most frequent tumor in males. The recent increase of Warthin's tumors may be due to changes in the age distribution of the population and to advances in medicine.
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  • Shinichi ISHIMOTO, Mitsuya SUZUKI, Masato YOKOYAMA
    1994 Volume 87 Issue 10 Pages 1395-1400
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    A 58-year-old woman complained of a foreign body sensation and slight dyspnea when lying on her left side. Laryngoscopic examination revealed a dark purple mass in the right aryepiglottic fold of the larynx.
    Fiberoscopy and CT and MR examinations led to a clinical diagnosis of probable a hemangioma of the larynx.
    Our surgical approach was suprahyoid pharyngotomy and tumor resection. Since it was very difficult to distinguish blood vessels from lymphatic vessels entering the tumor, we used a transmission electromicroscope (TEM) for our pathological examination.
    The final diagnosis was cavernous lymphangioma.
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  • Yoshihiko ISHIZU
    1994 Volume 87 Issue 10 Pages 1401-1403
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    An 84-year-old male complained of hoarseness and dyspnea. Laryngeal fiberscopy revealed a peduncular tumor on the right vocal cord. To prevent choking from the tumor, we extirpated it with laryngeal forceps. The tumor was diagnosed histologically as pseudosarcomatous squamous cell carcinoma, and no residual tumor tissue remained. He and his family rejected further treatment because of his pulmonary emphysema. Because the tumor is reported to have poor radiosensitivity, he has been followed with observation only, and there has been no recurrence.
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  • Shin-ichi Takagita, Koichi Omori, Myojo Kanaji, Kazuhiko Shiji, Hisayo ...
    1994 Volume 87 Issue 10 Pages 1405-1411
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    It used to be said that solitary thyroid nodules are more likely to be malignant than multinodular goiters. This concept was based on physical examinations. However, with advances in ultrasonography many multiple nodular goiters are being detected. So, it has become more difficult to diagnose multiple nodular goiter accurately as benign or malignant. We studied the findings of ultrasonography, fine needle aspiration biopsy (FNA), and postoperative histopathological examination of 197 nodules in 61 patients with multiple nodular goiters operated on in the past three years.
    One or more malignant nodules were found in 44 patients (72.1%).
    The sensitivity for malignancy of FNA was 67.6% and the specificity was 91.7%. Of the FNA positive group 90.9% proved to be malignant and of the FNA negative group 50.0% proved to be benign on histopathological examination after surgery.
    The finding of calcification on ultrasonography was significantly correlated with malignancy (p<0.01), sensitivity was 84.1% and specificity was 64.7%. Of the goiters with calcification 86% proved to be malignant and of those without calcification 61.1% proved to be benign on histopathological examination.
    It is concluded that the diagnosis of multinodular goiter is more accurate when both FNA and ultrasonography are used. Multiple nodular goiters of class I or II without calcification are considered to be benign, and multiple nodular goiters of class III, IV, or V and those of class I, II with calcification are considered to be malignant. With these standards, 86% of the goiters provisionally diagnosed as malignant proved to be malignant, and 90.9% of those considered to be benign proved to be benign on histopathological examination after operation.
    Therefore, goiters with class I or II of FNA findings and no calcification on ultrasonography can be observed as benign, if they are small. Other goiters should be operated on, because they may be malignant.
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  • Masaharu SUDO, Masahiro TANABE, Masahiro ISHIKAWA, Michitaka IWANAGA, ...
    1994 Volume 87 Issue 10 Pages 1413-1417
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Six patients were treated surgically for parathyroid adenoma. All were female with an age range of 40 to 77 years. Two patients were suffering from bone disease, one patient from renal lithiasis and two from symptoms due to hypercalcemia. The total serum calcium ranged from 10.2 to 10.8mg/dL (normal 8.2-10.0mg/dL). Parathormone levels ranged from 56-156pg/ml (normal 10-60pg/ml). Real-time ultrasonography, CT, MRI and Tl-Tc subtraction scintigraphy were performed. Ultrasonography and Tl-Tc scintigraphy revealed parathyroid tumors in five patients, but CT and MRI showed tumors in only two. We performed unilateral neck exploration in five patients. In the sixth patient exploration had to be extended to the contralateral side. Unilateral parathyroidectomies were performed in all six patients. There were no postoperative complications other than hypocalcemia. The serum calcium levels returned to normal in five patients. One patients had permanent hypocalcemia.
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  • Katsuhiko FUKAMOTO, Masafumi NAKAGAWA, Naoyuki KONO
    1994 Volume 87 Issue 10 Pages 1419-1426
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    From 1987 through 1994, 337 patients with malignant tumors visited our department; 147 of them had a cervical masses, which could have been diagnosed as a metasis from an unknown primary tumor. In order to determine the usefulness of roentgenologic diagnosis, we investigated the process by which the primary tumor was confirmed.
    The diagnosis was malignant lymphoma in 43 of the 147 cases. In 80 were the primary origin was determined by anamnesis and local examinations, and in 19 by diagnostic imaging. Two other patients were diagnosed as branchial cancer by postoperative histological examination. Finally, three patients were shown to have metastatic cancer from an unknown primary tumor.
    In diagnostic imaging, the usefulness of CT was confirmed, but MRI also gave helpful information in two patients with epipharyngeal cancer, two of the cancer of base of the tongue, and one with thyroid gland cancer.
    The three cervical metastatic cancers from an unknown primary site were all in males, and their cervical lesions were presented in the suprahyoid area; the histology was squamous cell carcinoma.
    We investigated the role of MRI in the serch for the primary site of metastatic cervical tumor. It has been assumed that the percentage of cancers of unknown primary origin is decreasing, since MRI and CT can find primary lesions of cervical metastases, but there was no definite decrease in this study. If oral floor cancer could be proved by histological examination in the first patient with cancer from unknown origin in this study, the percentage of cancers of unknown primary origin might be reduced.
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  • Takako OYA
    1994 Volume 87 Issue 10 Pages 1427-1436
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Morphological changes were induced in vestibular ganglion cells by gentamicin or labyrinthectomy and examined by transmission electron microscopy. Gentamicin (250mg/kg) was administered via the carotid artery.
    By 24 hours after the injection, the vestibular sensory cilia had almost disappeared. Seven days after the injection, no significant change was observed in the vestibular sensory cilia. However, the number of neurofilaments in the vestibular ganglion cells was increased, and the endoplasmic reticulum had been transformed morphologically to polysomes.
    Cytochemical stains showed that acid phosphatese (ACPase) activity and cytochrome oxidase activity had decreased.
    On the other hand, 7 days after labyrinthectomy, no significant change was observed in the vestibular ganglion cells either morphologically or cytochemically. After one month, however, vacuoles had formed and cytochrome oxidase activity was decreased.
    These results suggest that the early effect of gentamicin on the vestibular ganglion cells is reversible and may be due to direct action of gentamicin. This early change is followed by irreversible retrograde action which finally leads to cell degeneration.
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  • Masashi KATO, Taku HATTORI, Mayumi KITAMURA, Reiko BEPPU, Noriyuki YAN ...
    1994 Volume 87 Issue 10 Pages 1437-1440
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    In this objective evaluation of the efficacy of prophylactic treatment for Japanese cedar pollinosis during natural allergen exposure, oxatomide (60mg/day, per os) was administered during the spring of 1993. The prophylactic treatment group (n=10) received the medication from Jan. 11. The no treatment group (n=10) did not receive the medication. Total subjective symptom scores, blood eosinophil counts and the level of albumin in nasal secretions were examined and compared in two groups on Mar 12.
    Three parameters in the prophylactic treatment group were lower than those in the no treatment group. The differences in subjective symptoms and blood eosinophil counts were significant. The effect of prophylactic treatment can be evaluated objectively.
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  • Tamotsu HARADA, Yoshiaki KAWASAKI, Toru MATSUNAGA
    1994 Volume 87 Issue 10 Pages 1441-1455
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    In patients receiving radical surgery for chronic paranasal sinusitis, we compared the hemostatic effects of Opthalm K® (carbazochrome 10mg, phytonadion 5mg and ascorbic acid 100mg), with that of combinations of any two of the three ingredients in a double-blind controlled trial. The study involved a total of 219 patients from 13 institutions, and the medications were compared in 211 patients after 8 had been withdrown because of ineligibility. The overall efficacy of the drugs was assessed on the basis of the decrease in bleeding time, and the reduction of intra-operative and of post-operative blood loss. The overall usefulness was judged from the overall efficacy plus the overall safety. Both of the efficacy and the usefulness of Opthalm K® were superior to those of the products combining only two of the three ingredients.
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  • [in Japanese]
    1994 Volume 87 Issue 10 Pages 1456-1457
    Published: October 01, 1994
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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