Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 88, Issue 10
Displaying 1-20 of 20 articles from this issue
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  • Aural Barotrauma
    Noriyuki YANAGITA, Tsutomu NAKASHIMA, Hiromi UEDA, Shigeji FUKUTA, Mak ...
    1995 Volume 88 Issue 10 Pages 1243-1252
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1243
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    It is known that sudden changes of atmospheric pressure can damage the acoustic organs. We have used hyperbaric oxygen therapy for patients with sudden deafness and Bell's palsy. During this therapy, barotrauma of the middle ear has been observed in some patients. However, it disappears spontaneously and no inner ear barotrauma has been observed. The prognosis is generally good in middle ear barotrauma.
    We treated 136 patients with inner ear barotrauma caused by diving, landing or taking off in an airplane, blowing the nose, blast injury, etc. Of these patients, only 27% had combined middle ear barotrauma. In the early stage, complete hearing recovery was expected in most cases. Of 16 patients, whom we treated with exploratory tympanotomy, rupture of the round window membrane was found in 5 and rupture of both the round and oval window membranes in 1.
    As to the cause of aural barotrauma, we speculated that the change of pressure directly affected the mucous membrane of the middle ear, but in inner ear barotrauma the change of pressure was transmitted to the inner ear through the labyrinthine window membranes, and had a strong effect on the endolymph, which damaged sensory hair cells. The results of experimental studies on guinea pigs confirmed this speculation.
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  • Technique of Laryngomicrosurgery
    [in Japanese]
    1995 Volume 88 Issue 10 Pages 1254-1255
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1254
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  • Neurotological Analysis of Traumatic Positional Vertigo; A Report of Three Cases
    Satoko ABE, Hiroaki ICHIJO, Manabu ICHINOHE, Hideichi SHINKAWA
    1995 Volume 88 Issue 10 Pages 1257-1262
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1257
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    Three patients with traumatic positional vertigo were neurotologically examined. The first and second patients were middle-aged females who had suffered head injuries in traffic accidents. The first patient had left total deafness, and the second patient had no cochlear symptoms. The third patient was a male worker who was injured by falling rocks and had right sensorineural hearing loss. In all the three patients, we found brisk rotatory nystagmus accompanied with vertigo in the head hanging position. The theory of free-floating particles in the posterior semicircular canal seems to explain the rotatory nystagmus and the gradual decrease in its intensity. On the basis of this theory, a canalith repositioning procedure (CRP) was performed in all three patients. It was effective in the second and third patients, but in the first patient positional nystagmus and vertigo were unchanged.
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  • Bilateral Simultaneous Facial Palsy
    Mitsuhiro MORI, Takashi HIRAMATSU, Takehiro KAIDA
    1995 Volume 88 Issue 10 Pages 1263-1268
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1263
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    Bilateral simultaneous facial palsy is rare. We encountered a 37-year-old male who presented with complete facial palsy on both sides within a 2-day interval (first the right side, then the left side 2 days later). There were no dysfunctions in the cranial nerves except for the 7th cranial nerve, and no abnormalities on ABR or MRI. This case was considered due to peripheral facial palsy. The results of all nerve excitability tests (NET) were within 6.0±0.5mA. Our tests did not indicate the cause of this disorder.
    We will report the course of recovery for both the right and left sides in this case. The rate of recovery has been assessed according to the facial score proposed by Yanagihara.
    In this case, recovery of the facial palsy began on the right side, one day before recovery on the left side began. Both right and left facial scores recovered to the same level 14 days after onset. The left side was completely cured by the 40th day, but the right side was not completely cured until the 5th month of treatment. As for the recovery of the three facial divisions (frontal, ocular, and oral division), the left side followed the same pattern throughout the course. In contrast, the right side followed a different course after the 3rd week.
    We suspect that these different courses of clinical recovery were caused by either a time-lag between the onset of the disorder and the initiation of treatment, or differences in the localization of the disorder, or both.
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  • Nasal and Paranasal Tuberculosis; A Report of Two Cases
    Hiroaki MAENO, Kazuo KUMOI, Kaoru KOIKE
    1995 Volume 88 Issue 10 Pages 1269-1277
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1269
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    Primary or secondary nasal tuberculosis is rare and it is virtually a forgotten disease entity among ENT practitioners. We report here two cases of nasal tuberculosis. One was due to secondary tuberculosis in a 19-year-old female who presented with symptoms suggestive of right maxillary sinusitis. Chest X-ray showed active pulmonary tuberculosis and bacteriology also showed growth of Mycobacterium tuberculosis. The other was a case of primary nasal tuberculosis in a 60-year-old woman who presented with a granulomatous lesion in the bilateral aspects of the nasal septum masquerading as nasal midline necrosis. Although no acid fast bacilli were identified in the nasal biopsy, septum or nasal swab, and systemic examination showed no evidence of tuberculosis, diagnosis was made on histological examination. The implications of nasal and paranasal tuberculosis are discussed.
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  • Analysis of the Relation between Daily Airborne Cedar Pollen Counts and Meteorologic Factors with Type III Quantification
    Shigehito MORI, Hitoshi SAITO, Toshihisa ITO, Mizue SEKI
    1995 Volume 88 Issue 10 Pages 1279-1285
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1279
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    We analyzed data related to daily cedar pollen counts and meteorological factors for 53 days during the pollinosis season in 1991 and 35 days in 1993 using type III quantification, a concept of multivariant analysis, which makes it possible to ascertain plural relations among factors.
    The results obtained were as follows:
    1) Large amounts of pollen grain are typically scatterd on fine, cold days with a north wind during cedar pollinosis season. However, when large amounts of pollen were scattered on the previous day, many pollen grains will remain airborne even on a rainy day.
    2) On cold, rainy days with a west or south wind, the number of grains will be typically lower.
    3) The airborne pollen count is not affected much by the higher daily temperature.
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  • Evaluation of Mucosal Tolerability by DDS through Nasal Mucosa Assessment in Case of Elcatonin
    Shoji MATSUNE, Masahiko YOSHITSUGU, Yutaka HANAMURE, Masaru OHYAMA
    1995 Volume 88 Issue 10 Pages 1287-1293
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1287
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    Mucosal tolerability of a nasal spray containing elcatonin and absorption enhancer was assessed both in vitro and in vivo; (1) using the cultured human ciliated cells obtained during sinusitis surgery, results were analyzed under a differential interference microscope combined with a high speed video system, (2) using 9 healthy volunteers, the degree of local symptomatic irritation was evaluated, and the time course of the effect on mucociliary transport and rhinomanometry and plasma concentration of elcatonin and absorption enhancer after administration was determined. According to an analysis based on cell culture, nasal spray directly damage ciliated cells to an extent similar to other drugs already in clinical use. The trial on volunteers showed no harmful effects except for a slight stinging sensation and nasal discharge for a few minutes immediately after administration. Based on these results, the harmful effect of this nasal spray on the nasal mucosa seemed to be no greater than that of drugs commonly given intranasal administration currently in clinical use.
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  • Endonasal Maxilloethmoidal Sinus Surgery
    Yoshiaki TSUTA
    1995 Volume 88 Issue 10 Pages 1295-1301
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1295
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    We developed a new endonasal procedure (transsubmucosal maxilloethmoidal sinus surgery through the inferior turbinate) for chronic sinusitis and present the theoretical ground as well as an outline of the procedure. This technique yielded satisfactory results with a good postoperative clinical progress and no complications. Results were evaluated after one year by classifying changes in the maxillary sinus into 5 types. Better pneumatization was seen in cases where the mucosal membrane of the maxillary sinus was kept intact, whereas various changes occurred in cases where the mucosal membrane of the maxillary sinus was resected. On immunohistological investigation, immunological staining of the mucosal membrane of the inferior turbinate and the mucosal membrane around the natural ostia was conducted using monoclonal mouse anti-human mast cell tryptase (Daco-Mast Cell, AA1). Cases were divided by the presence or absence of allergy involvement, but no significant difference was found. It may be concluded from these results that this new procedure is useful for chronic sinusitis irrespective of the presence or absence of allergy involvement.
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  • The Coronal CT of the Paranasal Sinuses in the Postoperative Maxillary Cyst
    Atsuko IKEDA, Motohisa IKEDA, Atsushi KOMATSUZAKI
    1995 Volume 88 Issue 10 Pages 1303-1309
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1303
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    We classified patients with paranasal sinus disease into 3 categories, those with or without a history of previous Caldwell-Luc procedure according to clinical diagnosis. Class A: postoperative maxillary cysts in 22 patients. Class B: paranasal sinusitis in 21 patients who had undergone Caldwell-Luc surgery. Class C: paranasal sinusitis in 62 patients who had not undergone paranasal sinus surgery.
    This study evaluated the ethmoid, frontal and sphenoid sinuses in these 3 classes of patients on coronal CT scan. High density areas in the ethmoid sinuses were observed in 25.0% of class A, 80.0% of class B, and 82.1% of class C; in the frontal sinuses in 19.0% of class A, 73.7% of class B, and 73.3% of class C; in the sphenoid sinuses in 18.2% of class A, 57.1% of class B, and 51.6% of class C. As a result, the prevalence of high density areas in the ethmoid, frontal and sphenoid sinuses in patients (class A) with postoperative maxillary cysts was significantly lower than those in patients (classes B and C) with paranasal sinusitis. The authors speculated that postoperative maxillary cysts arise in cases that had few or lightly inflammatory changes of the ethmoid, frontal and sphenoid sinuses.
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  • A Clinical Study of 160 Cases with Major Salivary Gland Tumors
    Takehiro HANADA, Tsutomu MATSUZAKI, Katsunori FUKUDA, Hiroshi TSURUMAR ...
    1995 Volume 88 Issue 10 Pages 1311-1317
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1311
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    Between October 1979 and September 1994, 160 cases of major salivary gland tumors were treated surgically in the Department of Otolaryngology, Kagoshima University. Of 160 tumors, 145 arose from the parotid gland, 15 tumors arose from the submandibular gland but no tumors arose from the sublingual gland. Tumors were classified according to the classifications of the World Health Organization. Incidence, gender, age, pathological diagnosis, symptoms, effectiveness of preoperative examinations were studied and discussed. Among 160 tumors, the number of adenolymphoma in the parotid gland were higher than previous reports. Also a rare case of myoepithelioma associated with adenoid cystic carcinoma in the same parotid gland is reported.
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  • Measuring Salivary Flow Function by 99mTc-Scintigraphy
    Hiroyuki OIKI, Etsuo YAMAMOTO, Masaki OHMURA, Megumu HINO, Katsuji IKE ...
    1995 Volume 88 Issue 10 Pages 1319-1328
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1319
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    In a series of 115 subjects with various oral symptoms, salivary flow function was evaluated quantitatively by 99mTc-pertechnetate scintigraphy. For data processing, four regions of interest (ROI) were drawn over the parotid and submandibular glands. A time-activity curve was plotted for each ROI. The uptake rate and the secretion rate expressed as a percentage, were obtained from data that were subtracted by an additional ROI over the front used as background. Rates were calculated from a sample of the dose solution scanned under identical conditions, with the peak of the curve at rest and the bottom of the curve at stimuli.
    The uptake rates in the parotid and submandibular glands were equal. The number of cases showing that the secretion rate of the parotid gland was higher than that of the submandibular gland was three times the number of cases in which the secretion rate was higher in the submandibular gland. The uptake rate and the secretion rate of the parotid gland decreased gradually with age, but in the submandibular gland, neither rate changed with age. The uptake rate and the secretion rate in Sjögren's syndrome was significantly lower than those of other cases. In a significant number of cases, the side with a higher uptake rate in the parotid gland also showed a higher rate in the submandibular gland on the same side. This appears to suggest that a phase of salivary flow of the unilateral parotid gland synchronized with that of the ipsilateral submandibular gland.
    Our method of analysing salivary flow function appeared not only to show the same dynamics of salivary flow as previous reports showed, but also demonstrates the details of salivary flow dynamics.
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  • Gas Producing Infection in the Neck; A Case Report
    Yoshihiko ISHIZU
    1995 Volume 88 Issue 10 Pages 1329-1334
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1329
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    A 55-year-old woman was hospitalized because of swelling in the neck and dyspnea. She had been treated unsuccessfully with antibiotics for several days. Since gas producing abscess in the deep neck and airway obstruction were radiographically demonstrated, she had an emergent tracheotomy. Foul pus was discharged between the thyroid cartilage and hypopharyngeal constrictor muscle, the surface of the muscle was necrotic. She was treated with antibiotics and transcanular oxygen. A few days after, another abscess was found in the right parotid region and she was treated by an incision which allowed washing with oxydol. This therapy was effective and she recovered completely.
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  • Advantages of Using a Skin Stapler in Head and Neck Surgery
    Yuji IMATE, Shiro ENDO, Michihiko OGATA, Kouji HASUIKE, Masahiro TAKAH ...
    1995 Volume 88 Issue 10 Pages 1335-1339
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1335
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    In 12 cases of head and neck surgery, use of a disposable skin stapler (Proximate®; Ethicon) was compared with nylon sutures with respect to time required for wound closure and the cosmetic result. Time required for closure was reduced by 90% using the stapling device, and cosmetic appearance was satisfactory compared to that with nylon sutures. With regard to safety, we found that the staples were not exposed into the subcutaneous space when subcuticular suture was performed. It was concluded that stapling is satisfactory in head and neck surgery with regard to safety and cosmetic results.
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  • Hyperthyroidism after Subtotal Thyroidectomy for Graves' Disease
    Keisaku TABUCHI, Kazuhiko SHOJI, Hisayoshi KOJIMA, Hiroyuki KITAMURA, ...
    1995 Volume 88 Issue 10 Pages 1341-1345
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1341
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    Postoperative recurrent hyperthyroidism was studied in 25 out of 171 patients who underwent subtotal thyroidectomy for Graves' disease. Mean weight of the remnant thyroid tissue was 6.5±0.9 grams and mean follow-up time was 31.8±16.2 postoperative months. Fifteen (60%) of the patients needed antithyroid drugs after recurrence, but the doses of the drugs were small in most patients. Of the 15 patients, 5 (33%) entered remission due to antithyroid drugs. The appropriate weight of remnant thyroid is thought to be 6 grams, but it should be less than 6 grams in children and the patients who are resistant to antithyroid drugs before surgery. As the status of thyroid function may change over long periods, long-term follow-up is needed.
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  • Schwannoma of Cervical Vagus Nerve; A Report of Three Cases
    Takahide KOUMURA, Masahiro MORI, Akihiro TERADA, Hisashi YOKOI, Shigen ...
    1995 Volume 88 Issue 10 Pages 1347-1352
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1347
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    We recently encountered 3 cases of schwannoma of the cervical vagus nerve in the parapharyngeal space. Diagnosis was based on CT, MRI, angiography as well as clinical symptoms.
    The tumor was removed by cervical approach in all cases, and one case was treated by midline mandibulotomy.
    In two of three cases, the tumor was removed together with the vagus nerve. We performed intracapusular removal of the tumor in the remains. Hoarseness occurred after surgery in all cases. We followed all patients postoperativery, and performed phonosurgery in one patient with persistent hoarseness. After surgery, hoarseness disappeared almost completely.
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  • Measuring the Inner Ear Impedance of Dogs Using a Newly Developed Ceramic Device
    Hidemitsu SATO
    1995 Volume 88 Issue 10 Pages 1353-1359
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1353
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    Inner ear impedance was measured in 17 ears of 13 dogs using a newly developed device with piezoelectric ceramic elements. The device was composed of two elements, one for activation of the stapes and the other for recording vibrations of the former element in the form of an electric output, which varies in accordance with the magnitude of the inner ear impedance.
    Under general anesthesia, the animal was fixed in a prone position and the middle ear was exposed. Then, the malleus and incus were carefully removed and the measuring device was positioned on the head of the stapes. Average impedances in 10 ears were 3.99M ohm at 1kHz, 4.43M ohm at 2kHz and 13.05M ohm at 4kHz. Experimental rupture or closure of the round window did not cause significant change in inner ear impedance values. However, fixation of the stapes increased the values in the frequency range between 1 and 6kHz up to a peak of 36.54M ohm.
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  • Biocompatibility of Hydroxyapatite and Tricalciumphosphate Composite
    Yoshio YAMAWAKI, Yoshihiko NISHIMURA, Yoshihisa SUZUKI, Masaki SAWADA
    1995 Volume 88 Issue 10 Pages 1361-1366
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1361
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    Twelve white adult rabbits weighing 3000-4000 grams were used in this study. They were anesthethized with i. v. sodium pentobarbital.
    In one group, non-intracranially penetrating bone defects (about 5.0×5.0×1.5mm) were made in the frontal bone bilaterally. Hydroxyapatite and tricalciumphosphate composite (HTC) plugs of the same shape and size as the defects were inserted and covered with pedicled periosteum, free periosteum, or soft tissue only. Specimens of tissue were collected for histopathological examination 3 months later. The specimens were cut into 10μm thick sections and stained with hematoxylin and eosion for light microscopic studies.
    In the second group, HTC plugs of the same size (about 5.0×5.0×1.5mm) were placed on the frontal bone (onlay grafting) and covered as in the first experiment and examined in the same way.
    Macroscopic and microscopic examinations revealed firm contact between bone and HTC in all of the first group (bone defect group) and in the bones covered by pedicle periosteum in the second group. Firm contact between periosteum and HTC was observed in both groups. No infection or foreign body reaction occured. Three monthes later no invasion of osteoblasts from bone to composite was observed.
    Our results suggest that HTC has excellent and reliable biocompatibility with bone and periosteum.
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  • Drug Therapy for Dizziness Associated with Autonomic Imbalance
    Atsushi SHINKAWA, Makoto SAKAI
    1995 Volume 88 Issue 10 Pages 1367-1373
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1367
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    Alprazolam, a minor tranquilizer used to treat idiopathic dizziness was studied clinically. Thirty-one patients with dizziness who had no spontaneous nystagmus were administered Alprazolam orally at 1.2mg/day, divided into three fractions for more than 4 weeks. TMI (Toho Medical Index) was examined before the treatment in 30 patients.
    Clinical efficacy was excellent in 10, good in 7, fair in 9 and not useful in 5. The overall efficacy rate was 54.9%. In 12 patients who scored grade III and IV on TMI which showed the degree of autonomic imbalance, the efficacy rate was 75.0%. However, in 18 patients who scored grade I and II on TMI which showed no or minimal autonomic imbalance, the efficacy rate was 38.9%. No adverse effects were observed except for one case of sleepiness.
    These results suggest that Alprazolam is a useful minor tranquilizer for the treatment of dizziness associated with autonomic imbalance.
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  • Influence of Otic Solution on Mucociliary Function in the Tubotympanum
    Yoshhharo OHASHI, Yoshiharu OHNO, Yoshikazu SUGIURA, Hideki OKAMOTO, H ...
    1995 Volume 88 Issue 10 Pages 1375-1379
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1375
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    The influence of three kinds of otic solution, NY-198 (Lomefloxacin), OFLX, and CMX on the mucociliary system of the tubotympanum in the guinea pig was examined. Culture medium RPMI 1640 was used as control solution in this study. The following results were obtained.
    1. The otic solution, NY-198 did not injure the ciliary activity of cultured eustachian tube mucosa.
    2. Intratympanic injection of the otic solution, NY-198 did not injure the ciliary activity or the mucociliary clearance in the tubotympanum in the guinea pig.
    3. The other otic solutions, OFLX and CMX did not show any dramatic pathological effect on the mucociliary system of the tubotympanum. However, their effects were more prominent than those of the NY-198 solution.
    In conclusion, the study showed that NY-198 otic solution had no pathological effects on the mucociliary system of the tubotympanum, and that NY-198 is an extremely safe otic solution for the treatment of bacterial otitis media.
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  • How to Present Morphological Pictures
    [in Japanese]
    1995 Volume 88 Issue 10 Pages 1380-1381
    Published: October 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1380
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