Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 88, Issue 12
Displaying 1-24 of 24 articles from this issue
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  • Management of Bony Posterior External Ear Canal in the Tympanoplasty for Cholesteatoma
    [in Japanese]
    1995 Volume 88 Issue 12 Pages 1525
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1525
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese]
    1995 Volume 88 Issue 12 Pages 1526-1528
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1526
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  • [title in Japanese]
    [in Japanese]
    1995 Volume 88 Issue 12 Pages 1529-1532
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1529
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  • [title in Japanese]
    [in Japanese]
    1995 Volume 88 Issue 12 Pages 1532-1535
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1532
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese]
    1995 Volume 88 Issue 12 Pages 1536-1538
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1536
    JOURNAL FREE ACCESS
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  • Objective and Quantitative Evaluation of Redness of Laryngeal Mucosa
    [in Japanese], [in Japanese], [in Japanese]
    1995 Volume 88 Issue 12 Pages 1540-1541
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1540
    JOURNAL FREE ACCESS
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  • Suboccipital Approach for Removal of Small Acoustic Neuromas
    Yasutaka AIHARA, Tomokazu KAMIO, Kenta KUNIMOTO, Chiaki KUDO, Kazuo SU ...
    1995 Volume 88 Issue 12 Pages 1543-1550
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1543
    JOURNAL FREE ACCESS
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    Ten patients with confirmed acoustic neuroma were operated on with a suboccipital approach. The tumors were less than 20mm in diameter, and two of them were intracanalicular acoustic neuromas.
    Until now, this approach was used mainly by neurosurgeons for relatively large tumors, but we took the suboccipital approach for small neuromas, because this approach provides a wide view.
    The surgical team consists of a neurosurgeon, neurotologist, anesthesiologist and nursing personnel. The neurosurgeon makes the incision, performs the craniotomy, and exposes the tumor or the posterior aspect of the petrous bone as well as the VIIth and VIIIth cranial nerves in the cerebellopontine angle. The neurosurgeon debulks it and partially dissects it from the brain stem. Then, the neurotologist opens the internal auditory canal and removes the remainder of the tumor.
    Five of the 10 patients had serviceable hearing, and pre-operative hearing levels were preserved in 3 of the 5. Functional preservation of the facial nerve was possible in 8. There were no serious postoperative complications.
    Excision of a small neuroma shortly after diagnosis may offer the best chance of hearing preservation. The suboccipital approach may be advisable for the preservation of hearing and facial nerve function even if the neuroma is small.
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  • Prognosis of Sudden Deafness and Echo Patterns of Narrow-Band Evoked Otoacoustic Emissions
    Taizo TAKEDA, Akinobu KAKIGI, Hiroaki NAKATANI, Shouichi SAWADA, Haruo ...
    1995 Volume 88 Issue 12 Pages 1551-1560
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1551
    JOURNAL FREE ACCESS
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    Narrow-band evoked otoacoustic emissions (narrow-band EOAEs) from 40 normal ears and 75 ears with sudden deafness were studied to investigate the possibility of predicting the prognosis of sudden deafness. Narrow-band EOAEs from normal ears were composed mainly of two main echo trains, fast and slow components with different latencies and frequency distributions. These echo trains also differed in vulnerability. Slow components disappeared easily even in patients with moderate deafness of 30 to 50dB HL on the low tone average (for 0.125, 0.25, 0.5 and 1.0kHz). Fast components also decreased in amplitude or disappeared in patients with profound deafness exceeding 50dB HL. However, fast and/or slow components often persisted in the early stage of sudden deafness. The prognosis was relatively good when the fast or slow components were detected within one week of the onset of deafness, and hearing recovered almost completely in patients with both components. The prognosis was poor when fast or slow components were not yet detected 2 weeks after the onset of deafness. Improved hearing could be expected in patients with neither fast nor slow components.
    There is no doubt that EOAEs are generated by the outer hair cells, which are among the most vulnerable tissues in the cochlea. Therefore, the loss or presence of EOAEs is thought to reflect the severity of the lesions in the cochlea and to be closely linked to the prognosis of sudden deafness. Generally, electrocochleography provide valuable information about the prognosis. In contrast, EOAE testing is a simple and non-invasive procedure, which is a potentially promising way to predict the prognosis of sudden deafness.
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  • Cochlear Implant Surgery in Patients with Inflammatory Lesions in the Middle Ear
    Tetsuo HIMI, Tomoko SHINTANI, Tomo YAMAGUCHI, Yasuaki HARABUCHI, Iwao ...
    1995 Volume 88 Issue 12 Pages 1561-1565
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1561
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    Treatment of patients with severe bilateral hearing loss by cochlear implants usually requires that there be no inflammation in the middle ear. We treated three patients in whom the electrophysical criteria for cochlear implant were fulfilled. However, there had middle ear infections. As a first step we performed a myringoplasty, a mastoidectomy with reconstruction of the posterior wall of the external canal and a mastoidectomy with insertion of a ventilation tube. Approximately one year after the first operation, a Cochlear implant was performed. There was no major complication due to the electrode insertion into the cochlea and the results of speech perception were not different from those in patients with normal middle ears. Therefore, it is considered that this twostage operation in patients with a middle ear infection makes it possible to do cochlear implants in some patients who it was previously thought to have contraindications.
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  • Acoustic Trauma Induced by Explosion of a Fire Cracker
    Yoshie INOUE, Yasuo TANAKA, Hiroaki NISHIDA, Miki MASEKI
    1995 Volume 88 Issue 12 Pages 1567-1570
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1567
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    Acoustic trauma in a 10 year-old girl is reported. A toy fire cracker which someone set for fun exploded near the right side of the head suddenly when the patient sat on a swing. Pure tone audiometry and Bekesy's audiometry indicated dip type hearing loss at 2kHz in the right ear and at 1kHz in the left ear. Evoked otoacoustic emissions measurement for 1kHz dip type hearing loss revealed an elevation of detection threshold more precisely than electrocochleography. Spontaneous otoacoustic emissions were found in the upper and lower range of the dip type hearing loss bilaterally.
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  • Prolonged Vertigo and Dizziness Treated with Kampo-Medicine
    Masaki TAJIMA, Jiro MUTOU, Hidetake SHIGA, Yoshinori MEZAWA
    1995 Volume 88 Issue 12 Pages 1571-1578
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1571
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    Prolonged vertigo and dizziness are good indications for Kampo treatment. An analytical study of the effect of Kampo-medicines on 30 patients with prolonged vertigo or dizziness was carried out, and the following results were obtained:
    1) Every male patient was successfully cured with “Sui” medicine*.
    2) Female patients more than about 70 years of age were also cured with “Sui” medicine.
    3) Female patients with menstrual disorders, or uterine and ovarian diseases were cured with a combination of “Sui” and “Ketsu” medicine**.
    4) Younger females with vertigo or dizziness at the time of menstruation were treated succesfully with “Ketsu” medicine only.
    5) Patients wtih psychosomatic symptoms in addition to vertigo or dizziness required “Ki” medicine*** in combination with “Sui” or “Ketsu” medicine.
    These results have contributed to finding the most effective Kampo-medicine for patients suffering from prolonged vertigo and/or dizziness.
    *“Sui” medicine: medicine for regulating body fluids.
    **“Ketsu” medicine: medicine for regulating blood and the water metabolism of the body.
    ***“Ki” medicine: medicine for regulating vital energy in the body.
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  • Traumatic Tympanic Membrane Perforation; A Clinical Study
    Keiji MORIYA, Masaaki HIYOSHI
    1995 Volume 88 Issue 12 Pages 1579-1585
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1579
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    This is a retrospective study of 95 patients, aged 0 to 82 years, with traumatic tympanic membrane perforation.
    1) The ratio of direct to indirect injuries was 1:2.
    2) Most injuries were in the anteroinferior quadrant.
    3) Infection was a complication in 33%.
    4) Most of the perforations closed with conservative therapy. However, if the injury cannot be expected to close in 1 month, surgical repair should be performed.
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  • Hearing Results of Modified Type IV Tympanoplasty
    Yoshihumi UNO
    1995 Volume 88 Issue 12 Pages 1587-1594
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1587
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    Hearing was tested in 26 ears with destroyed shapes superstructure 1-12 months after ossicular reconstruction and tympanoplasty. Audiograms were recorded not only at speech frequencies but at all seven frequencies from 125 to 8000Hz. Five bone autograf is (preserved ossicles), 19 cartilage autografts and two hydroxyapatite ossicular prostheses (Apaceram-T®) were used as columellae.
    1. Overall success rates according to the criteria of Clinical Otology Japan (1987) were 47.6% at 6 months and 55.6% at 12 months after surgery.
    2. Postoperative hearing gains were obtained at all frequencies except 8000Hz, and hearing improvement was greater at low and middle frequencies.
    3. Hearing improvement still fluctuated until 12 months after surgery at both low and high frequencies. Therefore, the evaluation of postopeartive hearing after modified type IV tympanoplasty should be done about 12 months after surgery.
    4. Hearing improvement in modified type IV tympanoplasty may be due more to regrowth of normal mucosa in the middle ear cavity than to the materials and procedures used in ossiculoplasty.
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  • Extirpation of Epipharyngeal Cyst with KTP/532 Laser; A Report of Two Cases
    Hiroyuki DAIDO, Yukio KATORI, Katsuhisa IKEDA, Naoki INAMURA, Hideaki ...
    1995 Volume 88 Issue 12 Pages 1595-1598
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1595
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    Epipharyngeal cysts were removed by KTP/532 laser from a 54-year-old male and a 68-year-old male. The chief complaint of both patients was a sensation of a foreign body on the epipharynx. MRI revealed a lateral cyst on the right wall of the epipharynx in both patients. Each cyst had a smooth surface and a high intensity signal in T2 weighted pulse sequences. The symptoms totally disappeared, and no recurrence of cysts had been observed for 3 months and more after treatment. The application of KTP/532 laser extirpation to epipharyngeal cysts caused little bleeding and no obvious complications.
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  • Toxic Shock Syndrome after Endoscopic Sinus Surgery; A Case Report
    Shinsei NISHIHARA, Eiji YUMOTO
    1995 Volume 88 Issue 12 Pages 1599-1603
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1599
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    A rare case of toxic shock syndrome (TSS) following nasal surgery is reported. Endoscopic sinus surgery was performed on a 32-year-old man with a diagnosis of chronic sinusitis. Nasal packing was removed four days after surgery. The following day, sudden onset of nausea, vomiting, abdominal pain, sore throat and fever were noted. His temperature rose to 40°C accompanied by hypotension with systolic blood pressure being 60mmHg. Diffuse erythroderma appeared on the trunk with petechiae on the thighs. His condition recovered rapidly after administration of immune globulin. Nasal culture grew methicillin-resistant Staphylococcus aureus. Management of TSS is presented along with a review of the literature. Otolaryngologists should be aware of the manifestations of TSS after nasal surgery.
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  • Therapy for Malignant Tumors of Paranasal Sinuses
    Hiroyuki YONEKAWA, Akihiro HONMA, Keiji IIZUKA
    1995 Volume 88 Issue 12 Pages 1605-1611
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1605
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    From 1985 to 1994, 36 patients with paranasal sinus carcinoma were treated with chemotherapy, radiotherapy and extensive maxillectomy and primary reconstruction at the Department of Otorhinolaryngology, Kushiro City General Hospital. Four cancers arose from an ethmoid sinus and 32 from a maxillary sinus. Of the maxillary sinus malignant tumors, six presented with T2 lesions, 13 with T3, and 10 with T4; seven had nodal disease.
    1) Patients with far-advanced cancer received only palliative care. The 5-year survival rate of the other 30 was 69.5%. In the 21 with squamous cell carcinoma, the survival rate was 77.1%.
    2) Adjuvant therapy could be completed in 22 patients, and their survival rate was 79.2%.
    3) In 14 patients with squamous cell carcinoma, adjuvant therapy could be completed, and all survived.
    Especially for maxillary sinus squamous cell carcinoma, local control is directly linked with improvement of the 5-year disease-free survival rate. The success of the en-bloc operation in multidisciplinary therapy is an important factor in their prognosis.
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  • Chondroma of the Tongue; A Case Report
    Toru KITAGAKI, Shunkichi BABA
    1995 Volume 88 Issue 12 Pages 1613-1615
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1613
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    Chondroma is a benign tumor of cartilage that very rarely occurs in the tongue, usually on the lateral border and dorsum. 42-year-old man was treated for chondroma of the central surface of the tongue. A review of the literature is presented and two definite theories (the metaplastic theory, the embryonic remnants theory) have been proposed for the histogenesis of chondroma of the tongue. The metaplastic theory postulates that the tumor derives from pluripotential mesenchymal cells. The embryonal theory postulates that the tumor originates from remnants of displaced fetal cartilaginous tissue.
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  • Laryngotracheal Stenosis in Infancy and Childhood
    Mitsuhiko NAKAHIRA, Seiji KISHIMOTO, Haruo SAITO, Tomoyuki HAJI
    1995 Volume 88 Issue 12 Pages 1617-1623
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1617
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    This paper describes the safe management of laryngotracheal stenosis in infancy and childhood. We treated 10 such patients over a 12 year period at the Kochi Medical School Hospital: 4 with congenital stenosis, 4 immature neonates on ventilators and 2 others on ventilators (one viral croup and one drowning). In 6 of these 10 patients (4 immature cases and 2 others), the stenosis was a result of prolonged intubation.
    With 7 patients the initial treatment was the application of a T-tube stent. Of these 7 patients, 2 of the treatments were successful, one patient died and the other four patients were treated using the trough method.
    With a total of 6 patients (including the 4 patients who initially had T-tube stents), the trough method was employed. Of these 6 patients, 5 of the treatments were successful: of these, 4 patients had composite auricular free grafts performed and one did not require it.
    During the treatments, 3 patients died, the causes of death were not related to the treatments.
    Two died of tracheomalacia and one of leukemia.
    Although it took an average of 28 months to complete, we recommend the trough method with the use of composite auricular free grafts as the safest and most reliable laryngotracheal reconstruction for infants and children due to the low success rate of initial using T-tube stents.
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  • The Values and Complications of Aspiration Biopsy Cytology
    Ichiro ANDO, Akira ARAI, Michitaka WATANABE, Akihiko KANO
    1995 Volume 88 Issue 12 Pages 1625-1632
    Published: December 01, 1995
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1625
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    Over the past 9 years, we studied 1090 cases of ABC (aspiration biopsy cytology) and 258 cases of malignant tumor. There were 3 false positive cases (1.2%) and 6 cases (2.3%) of histological misdiagnosis. Although we have not experienced fatal complications yet, we have recognized tuberuculous change in the needle tract after postoperative histology as a case of lymphoadenitis tuberuculosa.
    A search of the literature has revealed 4 cases of needle tract seeding after large needle biopsy and a case of embolism in the cerebral artery after ABC of head and neck lesions. Fatal complications of ABC were reported in 7 cases.
    Although the incidence of complication after ABC is not obvious, fatal complications of ABC are very rare in comparison with large needle biopsy and we consider that ABC is a safe method of clinical diagnosis.
    ABC imposes less burden on patients and differentiation of benign from malignant and identification of the presumable histological type are possible. Therefore, we conclude that ABC can be applied clinically in oto-rhino-laryngology.
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  • Review of Foreign Bodies in Soya
    Taiichi SAITOU, Akihito WATANABE, Tomotaka TOMIYAMA, Satoshi NONAKA, K ...
    1995 Volume 88 Issue 12 Pages 1633-1639
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1633
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    Between 1991 and 1993, 230 patients visited Wakkanai Municipal Hospital because of foreign bodies in the nasal cavity, external auditory canal or pharynx, and between 1984 and 1993, 35 patients because of foreign bodies in the esophagus or upper respiratory tract.
    Of the 265 patients, 110 had a foreign body in the pharynx, 73 in the external auditory canal, 47 in the nasal cavity, 24 in the esophagus, and 11 in the upper respiratory tract.
    The most common foreign bodies were fish bones in the pharynx or esophagus, cotton balls in the external auditory canal, and BB bullets in the nasal cavity.
    Two patients had accidentally inhaled pieces of crab shells into the trachea. Since they were hollow cylinders, they did not cause suffocation. They could not be removed in one piece because the spines of the shells were stuck in the lining of the trachea so they had to be crushed and the fragments removed.
    The incidence of foreign body cases in Soya was calculated to be 8 to 10 per ten thousand people per year.
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  • Reduction of Aminoglycoside Ototoxicity by Piperacillin in Guinea Pigs
    Mikio SUZUKI, Yoshiro YAZAWA, Hiroya KITANO, Hiroshi MATSUOKA, Kazutom ...
    1995 Volume 88 Issue 12 Pages 1641-1646
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1641
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    The protective effect of piperacillin (PIPC) against ototoxicity induced by aminoglycoside was investigated in guinea pigs.
    In 13 animals, 0.1ml (4mg) per day of gentamicin solution was instilled into the left tympanic cavity on day 1 and day 4. The right ears of all animals were untreated. The PIPC treatment group, consisting of 7 animals, received an injection of PIPC solution (300mg/kg) intramuscularly from day 1 to day 5 while the control group, consisting of 6 animals, did not. Auditory brainstem response (ABR) in these animals was measured on day 1, day 4 and day 6.
    Significant changes were found in the hearing threshold of right ears in the PIPC treatment and the control groups. The increase in hearing threshold at day 4 and day 6 was significantly smaller in the PIPC treatment group (mean value: 22dB and 27dB, respectively) than in the control group (68dB and 88dB, respectively). The results of ABR in the present study indicate that PIPC has the potential to reduce aminoglycoside ototoxicity.
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  • Effects of Tonsillectomy on Articulation
    Yohji HORI
    1995 Volume 88 Issue 12 Pages 1647-1653
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1647
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    Changes in the articulation of 5 Japanese vowels after tonsillectomy were investigated using formants as indicators. Data from 40 patients were analyzed and those from 10 healthy volunteers were used as control. The comparison of formant frequencies before surgery and those 1 month after surgery revealed that F1, F2 and F4 remained within the range of intra-individual fluctuations in many cases. F3, however, exceedingly decreased in many cases, and the decrease was particularly marked for /o/. No evident change was observed as to the formant bandwidth. The larger the tonsill, the greater the changes in formant frequency.
    Using Mackenzie's classification, evaluations were unsatisfactory. Observing the postoperative changes over time, it was suggested that the altered vocal tract compensated slowly using surrounding tissues.
    From the acoustic evaluation, the changes in articulation due to surgery were considered negligible in clinical practice, although the problem for professional vocalists cannot be disregarded.
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  • Nasal Spray Treatment for Allergic Rhinitis in Children
    Atsuhito MORISHITA, Chikako KISHIOKA
    1995 Volume 88 Issue 12 Pages 1655-1663
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1655
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    The efficacy, safety and usefulness of ketotifen nasal spray was investigated in 20 children with mainly serous allergic rhinitis. Many of them had complications of atopic dermatitis and/or bronchial asthma, and had not responded to previous treatment. In this study, ketotifen nasal spray (0.05mg/puff) was given 2-4 times daily (0.2-0.4mg/day) for 4 weeks or longer. The percent efficacy and usefulness of ketotifen nasal spray were 55.0% and 55.0%, respectively, and clinical signs were considerably improved. Regarding the safety, there were no patients showing adverse reactions. These results showed that ketotifen nasal spray is a very effective and safe treatment for allergic rhinitis in children.
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  • Dysplasia of the Inner Ear
    [in Japanese]
    1995 Volume 88 Issue 12 Pages 1664-1665
    Published: December 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.1664
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