Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 87, Issue 11
Displaying 1-21 of 21 articles from this issue
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  • Recent Trends in Multimodal Treatment for Carcinoma of Maxillary Sinus
    Mamoru MORITA, Mamoru MIYATA
    1994 Volume 87 Issue 11 Pages 1459-1468
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1459
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    To avoid postoperative cosmetic and functional disabilities, treatment plans combining surgery, radiotherapy and regional chemotherapy were introduced for the treatment of maxillary sinus cancer in 1964. Since then, various refinements of multimodal treatment have been developed at several institution. In Japan, recent data indicate an average five-year survival rate exceeding 50%. However, preservation of function and figure, i. e. preservation of the hard palate and the eye, may not be achieved in most patients.
    The details of the multimodal treatment plans, such as the dose of radiation or the extent of surgery, differ considerably among various institutions. The quality of life of the survivors is strongly affected by the type of treatment. Currently, in most institutions the patient receives more than 50 Gy of radiation, followed by total maxillectomy. Although surgery plays an important role in multimodal treatment, total maxillectomy, which requires resection of the hard palate, is not always necessary. Preservation of the eye is an important consideration, however, a radiation dose in excess of 50 Gy results in the loss of vision.
    To improve the survivors' quality of life, various institutions have introduced changes in multimodal treatments for this type of cancer. For example, our treatment plan consists of a low irradiation dose of 24 Gy, combined with six fluorouracil intra-arterial infusions followed by piecemeal resection of the tumor, with the objective of preserving the eye and the hard palate. Although only 37 patients have been treated with this method, the five-year survival rate, as estimated by the Kaplan and Meier method, is 79%.
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  • Clinical Application of Positron CT in Head and Neck Tumors
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1994 Volume 87 Issue 11 Pages 1470-1471
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1470
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  • Bilateral Gradenigo's Syndrome; A Case Report
    Naohito HATO, Seiji KAWAKITA, Naoaki YANAGIHARA, Hiroshi ARITOMO, Shok ...
    1994 Volume 87 Issue 11 Pages 1473-1479
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1473
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    Gradenigo's syndrome was diagnosed in a 5-year-old male with bilateral acute otitis media, paralysis of both abducens nerves and bilateral irritation of the trigeminal nerves. After myringotomy and administration of antibiotics, his tympanic membrance became normal, and the bilateral trigeminal nerve irritation disappeared, but residual mastoiditis was revealed by X-ray examination. Right extended mastoidectomy was performed including removal of the bony sinus plate on Mar. 2, 1990. Although bilateral abducens palsy improved immediately, serological findings and double vision deteriorated again 10 days after the operation. Reexploration was done on Mar. 16, 1990. Residual inflammatory changes in the petrous apex were eradicated, especially around the lateral sinus and anterior to the superior semicircular canal through the petrous apex. An extradural abscess was found at the petrous apex. The left trigeminal nerve irritation and the left abducens paralysis was attributed to the right petrositis because bilateral abducens nerve function recovered completely after the second operation on the right temporal bone. Since extradural abscess at the petrous apex is difficult to diagnose preoperatively and has been reported in many patients with Gradenigo's syndrome, it must be kept in mind in the diagnosis and the treatment of Gradenigo's syndrome. Twelve cases of Gradenigo's syndrome reported in Japan from 1960 to 1992 were reviewed. Acute otitis media was the cause in five, all children. In three of them abducens paralysis appeared within one week after onset of the acute otitis media. Mortality of Gradenigo's syndrome is still 10%, similar to that of brain abscess associated with otitis media.
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  • Neurotological Findings in a Patient with Clivus Meningioma
    Nobuyuki FUJIMOTO
    1994 Volume 87 Issue 11 Pages 1481-1488
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1481
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    A 51-year-old female presented with bilateral high-pitched tinnitus of approximately 6 years' duration, during which period she had visited several otolaryngologists without relief. Examination revealed a mild left hearing loss but was otherwise normal. The patient subsequently related a 3-year history of staggering gait with a tendency to fall to the left and difficulty with intentional movements and numbness of her left hand, all of which were transient, episodic and reversible. These episodes strongly suggested an intracranial lesion rather than a peripheral inner ear disorder, necessitating a more detailed neurotologic examination. The patient had a normal Romberg test and slight imbalance to the left side on Mann's test. Routine position testing exhibited vertical nystagmus through Frenzel's spectacles. Electronystagmography revealed saccadic pursuit, recorded with CETT (Circular Eye Tracking Test), and an inhibited left OKP (Optokinetic Pattern test). These neurotological findings suggested pathologic changes in the left posterior cranial fossa. Computed tomography and magnetic resonance studies showed a large, spherical space-oc-cupying lesion in the posterior cranial fossa. The final diagnosis of clivus meningioma was made during cranialsurgery. This case illustrates the importance of a careful detailed history and neurotological examinations if suggested by the history.
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  • Acute Hearing Loss, 6000 Hz-dip Type; A Case Report
    Tadashi ISHIMARU, Makoto SAKUMOTO, Ikuo NAGAYAMA, Mitsuru FURUKAWA
    1994 Volume 87 Issue 11 Pages 1489-1494
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1489
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    We usually use 6 frequencies, 250, 500, 1000, 2000, 4000 and 8000 Hz, in conventional pure tone audiometry. When these 6 points do not show hearing loss, our clinical diagnosis is no hearing loss. If the hearing loss is not located in the clinical 6 frequencies, we cannot detect it.
    The authors diagnosed 6000 Hz-dip type acute hearing loss in a 43-year-old male with tinnitus. We measured the hearing levels at 6 frequencies and found no hearing loss. The pitch of his tinnitus was 6000 Hz, so we measured the hearing levels at 4 other frequencies (800, 1500, 3000 and 6000 Hz) and detected a 6000 Hz-dip.
    Steroid treatment cured both the tinnitus and the 6000 Hz-dip hearing loss.
    When hearing loss occurs at a frequency other than the conventional pure tone audiometric frequencies, a mistaken diagnosis of no hearing loss is made. If the patient complains of tinnitus, the clinician should investigate the pitch and measure the hearing level near the frequency of the tinnitus. This is a useful method of discovering narrow diptype acute hearing loss.
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  • Paroxysmal Positional Vertigo in a Patient with an Ischemic Brain Stem Lesion Detected by MRI
    Koji YUEN, Hiroko SUGIHARA, Shuichi WATANABE, Yu MASUDA
    1994 Volume 87 Issue 11 Pages 1495-1500
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1495
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    A 64-year-old woman had a 15-year history of intermittent vertigo when her head was in the lateral position. The vertigo disappeared in a week with medication, but recently the intervals between the vertigo attacks have become shorter. This time she complained that the positional vertigo had continued for over a month. The vertigo was not accomplained by tinnitus or hearing loss. The patient had hypertension for two years and has taken an anti-hypertension drug. In addition, hyperlipidemia was detected several years ago. She showed positional nystagmus of the direction changing type directed towards the upper ear in the lateral head position. Her nystagmus has a latent period and is continuous. Habituation with test repetition was not seen. The caroric test induced excessive nystagmus, and visual suppression was poor. These otoneurological findings suggest that inhibition of the vestibulo-occular system by the cereellum was not functioning well. MRI showed a small ischemic lesion in her brain stem as a pontine high signal (T2 high intensity, T1 normal).
    Bruns first described paroxysmal positional nystagmus which was due to disorders of the central nervous system. Kornhuber reported that this form of nystagmus is related to the inhibitory role of the cerebellum. Sakata called it “paroxysmal positional vertigo of the malignant type. (MPPV)” These reports described the nodulus and the cerebellar tonsils as the sites of lesions which induced the symptom. The lesion detected by MRI in our case differed from previously reported lesions. Sakata also suggested that a disorder in the vestibulo-cerebellum pathway might cause the symptoms. In this case, paroxysmal positional vertigo arose from a disorder of the inhibitory system of the cerebellum.
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  • Pathophysiology of Peripheral Positional Vertigo
    Hiroaki ICHIJO, Mika SASAKI, Satoko ABE, Manabu ICHINOHE, Masafumi HOS ...
    1994 Volume 87 Issue 11 Pages 1501-1508
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1501
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    Using infrared CCD camera and electronystagmography, we analyzed positional nystagmus in 33 patients with peripheral positional vertigo.
    1) Patients were classified into three categories: (a) lateral type: horizontal nystagmus occurs in lateral position; (b) sagittal type: rotatory nystagmus occurs in head-hanging position (so-called benign paroxysmal positional vertigo); and (c) mixed type.
    2) Vertigo and nystagmus began with a few seconds latency after the head was tilted, briefly increased to a maximum, and then gradually decreased.
    3) In all types, the number of female patients was greater than that of male patients.
    4) In the lateral type, the mean period from the onset to the disappearance of vertigo was about 3 weeks. However, in those with the sagittal type or mixed type it was much longer.
    5) The intensity of positional nystagmus was influenced by the direction of gravity in all types.
    The free-floating particles theory seems to be able to explain the latency of the nystagmus, the gradual decrease in its intensity, and recurrence of the vertigo. Lateral type lesions are thought to be in the lateral semicircular canal, and sagittal type lesions perhaps in the posterior semicircular canal; mixed type lesios are thought to be in both.
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  • Postoperative Aeration of the Tympanic Cavity in Relation to Eustachian Tube Function
    Akihiko FUJITA, Kyosuke KURATA, Shin-ichi TAKAGITA, Haruo TAKAHASHI, N ...
    1994 Volume 87 Issue 11 Pages 1509-1513
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1509
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    One of the purposes of tympanoplasty is the creation of an aerated middle ear cavity, and the ventilatory function of the eustachian tube should play an important role in the attainment of this goal. In this study, the relation between the results of tympanoplasty and tubal function is discussed with the computed tomographic evaluation of postoperative middle ear aeration following canal down tympanoplasty.
    On the bases of the results of the modified inflation test, 24 patients (22 ears with cholesteatoma, 2 with atelectasis) were divided into two groups: 14 ears with fair tubal function and 10 ears with poor tubal function. CT studies were performed 6 months to 1 year after the surgical procedure, with 1.0 mm contiguous sections in the semi-axial projection. Middle ear aeration was classified into 4 grades according to the CT findings. The fair tubal function group showed significantly better postoperative aeration than the poor tubal function group. In addition, in the former group the prognosis for postoperative hearing was satisfactory.
    Eustachian tube function correlated well with the results of tympanoplasty, suggesting that tubal function plays an important role in the prognosis after ear surgery.
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  • A New Treatment for Severe Epistaxis
    Hitoshi HENTONA, Masahiko SUZUKI, Atsushi KOMATSUZAKI, Hideki MURAOKA, ...
    1994 Volume 87 Issue 11 Pages 1515-1523
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1515
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    Patients with severe bleeding from the upper and posterior portions of the nasal cavity are generally treated by Bellocq tamponade, balloon tamponade or surgery, i, e, embolization or ligation of the artery. These procedures cause local pain, headache and nasal obstruction. We tried a new method of treatment in 31 patients with severe epistaxis using oxy-cellulose cotton. The bleeding was controlled adequately in 29 patients, some of whom had been treated by Bellocq tamponade in other hospitals and pleased to be free of the discomfort of their previous experiences.
    This new method is summarized as follows:
    1) It is mandatory to recognize the bleeding point, because oxy-cellulose cotton is to be packed at only one bleeding point in the nasal cavity. 2) Oxy-cellulose cotton is divided into small fragments, because the space around the bleeding point is usually narrow and deep within the nose. A piece of the divided contton is dipped in epinephrine or lidocaine solution before use because dry cotton sticks easily to normal nasal mucosa.
    3) Referred pain is felt in the ear when the cotton is packed on the lateral wall of the inferior meatus, and in the forehead when it is packed in the meatus olfactorius. 4) This treatment never interferes with other treatments for severe epistaxis, and combined procedures with ribbon gauze, Bellocq tamponade, balloon tamponade, etc, can be used when needed.
    5) Inserted cotton does not need to be removed, because it is absorbed in a few days.
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  • Ossifying Fibroma with Severe Nasal Hemorrhage; A Case Report
    Hirofumi NISHIZONO, Shinya MATSUNAGA, Ichiro MORIYAMA, Fumio OHNO, Shi ...
    1994 Volume 87 Issue 11 Pages 1525-1529
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1525
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    Ossifying fibroma is an uncommon fibro-osseous tumor, usually found in the maxilla or mandible. It has been reported that is difficulte to differentiate this tumor from fibrous dysplasia clinically and histopathologically.
    15-year-old female had severe nasal hemorrhage. CT scans revealed a large and well-circumscribed hard mass with low dencity areas in maxillary and ethmoid sinuses. Biopsy of the tumor showed cavernous hemangioma, but the histological examination on the surgically removed tumor was revealed ossifying fibroma.
    The maxillary artery, which was suspected to be a feeding artery, was successfully embolized with small pieces of Gelfoam. The clinical, radiological, and pathological characteristics of the disease are discussed, the literature is reviewed.
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  • Sonography for Pleomorphic Adenoma of the Salivary Gland
    -Comparison of 10 MHz and 7.5 MHz Probes-
    Yuji KANO, Hiroyuki KAKUTA, Hitoshi HIRATSUKA
    1994 Volume 87 Issue 11 Pages 1531-1536
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1531
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    Pleomorphic adenomas of the salivary gland were studied with 10 MHz high-resolution sonography. Direct probe scanning at 10 MHz was compared with 7.5 MHz probe sonography with direct probe scanning, and with probe scanning with a water bag and with a gel conductor. 1) The margins, internal echogenicities of the adenoma and vascular images surrounding the tumor were more clearly delineated with 10 MHz direct probe scanning than with 7.5 MHz sonography with direct probe scanning or probe scanning with a gel conductor. 2) The margins and internal echogenicities of the adenoma were as clearly demonstrated by 10 MHz probe scanning as by 7.5 MHz probe scanning with a water bag.
    Calcifications (small areas of high echogenicity) in the adenoma and vascular images surrounding the tumors were clearer with 10 MHz direct probe scanning than with 7.5 MHz probe scanning with a water bag.
    Ultrasonography with a 10 MHz probe proved to be useful in the assessment of pleomorphic adenoma of the salivary gland.
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  • Improvement of Psoriasis Vulgaris after Tonsillectomy
    Makoto HAMAMOTO, Akikatsu KATAURA, Yasushi KUKUMINATO, Hiroshi TSUBOTA ...
    1994 Volume 87 Issue 11 Pages 1537-1541
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1537
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    Psoriasis vulgaris is a chronic refractory disease. Various treatments have been tried, but each of them has its merits and demerits. In order to evaluate the effect of tonsillectomy in patients with psoriasis vulgaris, we operated on 35 patients with tonsillectomy and observed the course of psoriasis. Preoperatively we did the tonsillar provocation test and the tonsillar nigation test and investigated the relation between the tonsillar tests and improvement of the skin eruption.
    Improvement of their psoriasis was observed in about half of patients. Psoriasis was improved especially in younger females.
    These results suggest that tonsillectomy is very effective for certain patients with recalcitrant psoriasis, if we select them carefully.
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  • Retropharyngeal Abscess in Adults; A Case Report and Review of the Literature
    Susumu SATO, Masanori SAKAGUCHI, Kiichiro TAGUCHI
    1994 Volume 87 Issue 11 Pages 1543-1547
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1543
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    A 47-year-old man complained of dyspnea after a traffic accident. He was found to have a retropharyngeal abscess.
    We review 35 case of retropharyngeal abscess reported in Japan between 1986 and 1992, 9 patients were below 3 years of age, and 16 were over 20 years of age.
    The causes were infection in 7, tuberculosis in 4 and presumably related to diabetes in 4. However, there was no report of post-traumatic origin.
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  • Laryngeal Amyloidosis; Clinical Study of Two Cases
    Mikio SUZUKI, Kazutomo KITAJIMA, Yoshiro YAZAWA, Aoi OUNAKA, Kazunari ...
    1994 Volume 87 Issue 11 Pages 1549-1556
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1549
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    Laryngeal amyloidosis is a rare disorder that is usually localized. We treated two patients with laryngeal amyloidosis and reviewed the clinical features of 86 cases of laryngeal amyloidosis reported in Japan. A 47-year-old male (case 1) and a 69-year-old male (case 2) complained of hoarseness. We found a tumor in the supraglottic region in case 1 and in the supraglottic to glottic region in case 2. Surgical resection with a laryngofissure was performed in each patient. Hoarseness was relieved in both patients. Since case 2 also had glottic cancer (squamous cell carcinoma), irradiation therapy with 60 gy of Co60 was administered after surgical resection. The most frequent symptom in the 86 cases reported in Japan was hoarseness, and the commonly affected sites were in the supraglottic and glottic regions. Patients must be treated by laryngofissure if the larynx is widely affected by amyloidosis as in our patients.
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  • Immunohistochemical Study of Thyroid Cancer
    Shinya OHASHI, Fumihisa HIRAIDE, Tomoyuki YOSHIDA, Hidenori MARUOKA, H ...
    1994 Volume 87 Issue 11 Pages 1557-1562
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1557
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    To demonstrate the immunohistochemical properties of thyroid cancer, we used antithyroglobulin antibody staining and anti-PCNA antibody staining in a studies of six patients (two males and four females), four with undifferentiated thyroid cancer and two with papillary carcinoma of the thyroid who were treated at Tokyo Medical College Hospital. One of the patients with undifferentiated cancer also had papillary carcinoma. Observations were carried out separately of cells from undifferentiated and papillary carcinoma sites.
    The evaluation method was a qualitative examination of anti-thyroglobulin antibody staining and anti-PCNA antibody staining of 1, 000 cancer cells. All the cells showing uniform staining of the nucleus were considered to be labeled cells. The percentage of positive staining was calculated.
    All of the undifferentiated cancers were negative for anti-thyroglobulin antibody staining, whereas all of the papillary carcinomas were positive.
    The rate of positive anti-PCNA antibody staining was 10.8-35.5% in the undifferen-tiated cancers and 1.2-2.8% in the papillary carcinomas. A clear difference in anti-PCNA antibody staining was thus found between these two types of thyroid cancer.
    Undifferentiated cancer of the thyroid is a comparatively rare disease. In the present study, also, the number was small, and it was thus impossible to demonstrate clearly a statistically significant correlation between the results of immunohistochemical staining and the outcome. However, undifferentiated cancer and papillary carcinoma showed definite characteristic patterns of staining which corresponded with the differences in their outcome and presumably with their degrees of malignancy.
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  • Two-Year Statistical Analysis of 1, 055 Snoring Patients
    Kimiaki KATORI, Shoji TAKAYASU, Sanae KATORI
    1994 Volume 87 Issue 11 Pages 1563-1572
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1563
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    During a two-year period 1, 055 snoring patients (613 males aged 3 to 82 years and 442 females aged 4 to 80 years) were seen in our snore clinic. Examinations in both our outpatient and inpatient clinics were by appointment only.
    Patients wishing to be admitted (166) were examined for sleep apnea syndrome and were treated if it was present. Of the 122 patients who were observed with an apnea monitor for two consecutive nights 71 (58.2%) had an apnea index of 5 or more (range, 5.0 to 65.5). The apnea indexes determined on two consecutive nights were consistent in 87.9% of the patients.
    Nasal patency of 90% or more for both expiration and inhalation was present in only 121 (19.2%) of 631 patients, and patency of 60% or less for both expiration and inhalation was present in 230 patients (36.5%).
    In measurements of loudness of snoring the group with a median value of 50 dB (range 47.5 to 52.5 dB) was the largest, followed in order by the 55 dB group and the 45 dB. The mean loudness of snoring was 49.2 dB.
    Home therapy with “Skainar Steam II ®” applied 30-90 minutes before going to bed caused satisfactory improvement in 317 (90.1%) of 352 patients who answered the follow up questionnaire.
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  • Residual Disinfector on Endoscope after Disinfection
    Takatsugu ITABASHI, Rika NAKAGAWA, Masato FUJIMORI
    1994 Volume 87 Issue 11 Pages 1573-1578
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1573
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    In 1993 we described a newly designed disinfector for flexible laryngeal fiberoptic endoscopes which used glutaral solution and running water. The endoscope was first dipped in glutaral solution and then washed thoroughly in the washer with running water. Because of its coagulative effect on protein, glutaral solution should not be applied directly to the mucosa.
    In this study we tried to investigate if the glutaral solution was detectable on the surface of the endoscopes after washing. The detection of the glutaral solution was carried out using a color comparaison method with fuchsin.
    In all 60 trials of testing after 3 minutes or less of washing by the washer, no glutaral solution was detected on the surface of the endoscopes which had been dipped in the solution. However, in tests of old endoscopes with rough surfaces caused by extream usage, over 2 ppm of glutaral solution was detectable after 2 minutes of washing.
    In conclusion, when the disinfector which we had designed was applied for the disinfection of endoscopes, less than 2 ppm of glutaral solution (which is thought to be safe for human skin) remained on the surface after 3 minutes of washing, as long as the endoscope had not been damaged by excessive use.
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  • Voice Changes after Thyroid Surgery
    -Superior Laryngeal Nerve and Vocal Range-
    Keisaku TABUCHI
    1994 Volume 87 Issue 11 Pages 1579-1589
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1579
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    Vocal range was assessed in 228 patients before and after thyroid surgery. The lowest physiological tones were not changed by surgery. When external branches of the superior laryngeal nerves (ESLNs) were identified and preserved, the highest physiological tones (HPTs) were decreased more than 4 semitones in 18 (14%) of the patients 1 week after the surgery (average decrease was 1.4 semitones). When ESLNs were injured unilaterally, HPTs were decreased more than 4 semitones in 16 (84%) of the patients 1 week after the surgery (average decrease was 9.3 semitones), but 4 (36%) of the patients recovered in 2-10 (average 5.6) months. When ESLNs were injured bilaterally, HPTs were decreased in all 3 patients (average decrease was 14.3 semitones) and none of them recovered. Electromyography of the cricothyroid muscles showed that the mechanism of recovery of the vocal range is not reinnervation of the injured ESLNs but compensation by other laryngeal muscles.
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  • Roxithromycin in the Treatment of Japanese Cedar Pollen-Induced Allergic Rhinitis
    Hideki OKAMOTO, Yoshihiro OHASHI, Yoshiharu OHNO, Yoshikazu SUGIURA, H ...
    1994 Volume 87 Issue 11 Pages 1591-1599
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1591
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    The clinical effectiveness of roxithromycin (RXM), a new semisynthetic macrolide, in the treatment of allergic rhinitis was evaluated. Thirty-one patients who were treated in our outpatient clinic for Japanese cedar pollen-induced allergic rhinitis were selected for this clinical trial. They were treated with 150 mg/day of RXM in addition to the same medication they had received in the 1992 pollen season. RXM was administered from the 1993 pre-season until the end of May, 1993. The clinical efficacy of RXM was evaluated by a comparison of the nasal symptoms in 1992 season with those seen in 1993.
    1. The respective improvement rates for sneezing attacks, nasal hypersecretion, and nasal congestion were 53.3%, 50%, and 50%.
    2. Improvement and slight improvement rates according to Okuda' a criteria for general improvement were 45.2% and 58.1%, respectively.
    3. Improvement and slight improvement rates judged from questionnaires about general improvement were 45.2% and 58.1%, respectively.
    4. RXM administration superimposed on specific immunotherapy contributed significantly to clinical relief of nasal symptoms during the pollen season (improvement: 58.8%; slight improvement: 76.5%).
    5. RXM administration superimposed on nonspecific anti-allergic treatment had little effect on nasal symptoms during the season (improvement: 28.6%; slight improvement: 35.7%).
    6. Side effects were noted in 2 patients; slight upper abdominal discomfort.
    Our clinical study suggests that RXM is effective in the treatment of Japanese cedar pollen-induced allergic rhinitis. An additional suggestion is that RXM may enhance the mechanism by which specific immunotherapy alleviates nasal symptoms.
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  • Effect of Azelastine on Allergic Rhinitis
    Ryo AMESARA, Sawako MASUDA, Setsuo NAKAMOTO, Setsuo NAKAMOTO, Yasuo SA ...
    1994 Volume 87 Issue 11 Pages 1601-1607
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1601
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    Three hundred and twenty eight patients with allergic rhinitis were treated with Azelastine chloride. Nasal symptoms were improved in 77.7% of those allergic to Japanese cedar pollen, in 89.1% of those with housedust allergy, and in 87.3% of those allergy to both Japanese cedar pollen and housedust. The clinical effects were examined for at least two weeks after the initial administration. Side effects were seen in 2.2% of the patients. These data indicate that Azelastine is a good medicine for the treatment of allergic rhinitis.
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  • Perilymphatic Fistula
    [in Japanese]
    1994 Volume 87 Issue 11 Pages 1608-1609
    Published: November 01, 1994
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.87.1608
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