Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 88, Issue 2
Displaying 1-21 of 21 articles from this issue
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  • Oncological Characteristics of Hypopharyngeal Carcinoma
    Yasushi MURAKAMI
    1995 Volume 88 Issue 2 Pages 133-146
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.133
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    Treatment results of hypopharyngeal carcinomas have been extremely poor in many institutes throughout the world, worse than those of other squamous carcinomas in the head and neck region.
    To determine whether the poor results are due to regional characteristics or biological behavior, the author analyzed a total of 341 hypopharyngeal carcinomas treated during the past 20 years, clinically, statistically and immunohistologically. The results are reported and carefully evaluated with suggestions for therapeutic improvement.
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  • Head and Neck Reconstruction with a Peroneal Flap
    [in Japanese], [in Japanese], [in Japanese]
    1995 Volume 88 Issue 2 Pages 148-149
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.148
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  • Cerebellar Infarction with Occlusion of the Right Vertebral Artery; A Case Report
    Kaori HIGUCHI, Masataka MURAKAMI, Yasuyuki NISHIYAMA, Yuko SAITO, Tosh ...
    1995 Volume 88 Issue 2 Pages 151-157
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.151
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    A 61-year old male complained of rotatory vertigo with hearing disturbance, nausea, and vomiting. Although the symptoms suggested peripheral vestibular dysfunction, a diagnosis of cerebellar infarction was made from the MRI findings. The patient first showed deviation toward the right while walking, secondary rotatory vertigo, nausea, vomiting, and spontaneous horizontal and rotatory nystagmus toward the left. The nystagmus changed to gaze nystagmus during the clinical course. Vertebral angiography showed occlusion of the right vertebral artery near the foramen magnum and collateral branches from the left vertebral artery. It is considered that circulatory insufficiency of the inner ear caused the vertigo attacks, but signs or symptoms of cerebellar dysfunction were not apparent because of the presence of collateral branches. We conclude that MRI and MRA are useful in the early diagnosis of cerebellar infarction.
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  • Effect of Contralateral Sound Stimulation on Human DP-OAE
    Jun TSUJI, Yasushi NAITO, Haruo TAKAHASHI, Iwao HONJO
    1995 Volume 88 Issue 2 Pages 159-163
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.159
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    Distortion products otoacoustic emissions (DP-OAE) were recorded in normal human subjects, and the effect on them of contralateral sound stimulation was examined. DP-OAE were suppressed up to 2.7dB by contralateral sound stimulation. To find out whether this suppression occurred via the cochlear efferent pathways, we examined a patient with vertigo and normal hearing before and after vestibular neurectomy. The suppression disappeared after vestibular neurectomy. These results suggest that DP-OAE is suppressed by contralateral sound stimulation via cochlear efferent pathways.
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  • Prediction of Speech Recognition after Cochlear Implant
    Yosaku SHIOMI, Haruo TAKAHASHI, Iwao HONJO, Yasushi NAITO, Juichi ITO
    1995 Volume 88 Issue 2 Pages 165-169
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.165
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    We investigated the relationships among preoperative promontory stimulation test results (threshold, dynamic range and gap detection), duration of profound deafness and postoperative vowel and consonant recognition scores. Twenty-eight profoundly deaf patients were implanted with the Cochlear corporation multielectrode implant programmed in the bipolar+1 mode. 6 months or more later they were re-examined. Only the dynamic range of preoperative promontory stimulation showed a significantly positive correlation with the vowel recognition score. And both vowel and consonant recognition scores tended to decrease with longer periods of profound deafness. To select or counsel patients, we must totally consider preoperative promontory stimulation results and the duration of profound deafness.
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  • Stapes Surgery during Past 19 Years
    Hiromi UEDA, Noriyuki YANAGITA, Hideto NIWA
    1995 Volume 88 Issue 2 Pages 171-176
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.171
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    Since 1975 stapedectomy (SDE) has been performed in 34 ears and stapedotomy (STO) in 75 ears. STO with Teflon wire piston prosthesis has been done frequent since 1989. We retrospectively selected 3 groups in chronological order and compared the results of closure of the air-bone gap. The group operated on after 1989 had significantly better results (closure of the air-bone gap to within 10dB) than the other groups. SDE with wire loop prosthesis and STO with Teflon piston (diameter 0.3mm) prosthesis were less successful than STO with Teflon wire piston (diameter 0.6mm). STO with Teflon wire piston prosthesis after 1989 led to significantly better results than before 1989. The better results during the last period can be attributed to improvements of operative techniques in addition to the choice of STO with Teflon wire piston prosthesis.
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  • Early Prediction of Facial Nerve Recovery after Surgery for Acoustic Neuroma
    Masanori ASAI, Yasushi SASAKI, Shingo MURAKAMI, Naoaki YANAGIHARA
    1995 Volume 88 Issue 2 Pages 177-182
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.177
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    Intraoperative evoked EMG response, facial grading score, nerve excitability test (NET) and electroneuronography (ENoG) were used for early prediction of facial nerve recovery after acoustic neuroma surgery in 33 patients with normal preoperative facial nerve function. Facial movements were scored with Yanagihara's 40 point regional grading system, and NET and ENoG were performed every week after surgery until discharge from the hospital.
    The absence of an intraoperative facial nerve evoked response was a predictor of poor recovery of the facial nerve; however, the presence of the response did not always mean a good prognosis. The regional grading score was found to be a good prognostic indicator for facial nerve recovery. In patients whose score remained over 20 points during the postoperative month, facial function recovered fully within three months. On the other hand, poor recovery could be predicted in patients with scores lower than 8 points during the postoperative month. The NET and ENoG were very useful in predicting facial nerve recovery, especially in those with scores of 10 to 20 points in the grading system. Normal NET results or those showing mild denervation predicted full recovery within three months and moderate denervation in the NET also pointed to a good prognosis. However, NET results or ENoG showing severe denervation predicted poor recovery of the facial nerve, although the details could not be predicted.
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  • Familial Branchio-Oto-Renal Syndrome
    Satoshi IWASAKI, Yuuichi KANOU, Tomoyuki HOSHINO, Kunihiro MIZUTA
    1995 Volume 88 Issue 2 Pages 183-188
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.183
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    The branchio-oto-renal syndrome (BORS) is an autosomal dominant disorder with branchial anomalies: preauricular pits and branchial fistulas, hearing loss and renal anomalies.
    We treated a daughter and her father with BORS. The 23-year-old female had bilateral hearing loss, bilateral cervical fistulae, bilateral preauricular pits, hypoplasia of the left auricle and atresia of the left external meatus. Target CT revealed Mondini type hypoplasia, an enlarged vestibule and a partial defect of the horizontal semicircular canal. Her IVP showed a diverticulum of a calyx on the left side and hypoplasia of the right kidney.
    Her father also had bilateral profound hearing loss, right preauricular pits, atresia of the left external meatus and a malformed left auricle.
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  • Diagnosis and Surgical Treatment of Cerebrospinal Fluid Rhinorrhea
    Masamitsu HYODO, Eiji YUMOTO, Katsuya SAEKI, Jyoji HORIUCHI, Naoaki YA ...
    1995 Volume 88 Issue 2 Pages 189-194
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.189
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    Cerebrospinal fluid (CSF) rhinorrhea is potentially serious because it may lead to recurrent meningitis. Therefore, early diagnosis and appropriate treatment of CSF rhinorrhea are required.
    We treated 13 patients with CSF rhinorrhea during the past 15 years. Four of them had meningitis. All 13 were successfully treated surgically with a rhinological approach in 12 and an intracranial approach in one. On the basis of our experience, RI counts of intranasal pledgets and detection of tau-transf errin in the nasal discharge were helpful in the diagnosis of CSF rhinorrhea. A coronal CT scan was useful in the determination of the precise location of the fistula.
    For a surgical treatment, a rhinological approach with minimal morbidity was indicated in most patients. Key points of the operation are: 1) careful observation of the fistula under an operating microscope or a rigid nasal endoscope, 2) water-tight closure of the fistula with fibrin glue and two or three layers of autogenous fascia, 3) intra-and postoperative CSF drainage to prevent an increase of intracranial pressure.
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  • Enterobacter cloacae Infection of Nasal Cavity; A Case Report
    Masafumi NAKAGAWA, Shinya SOHMA, Hisao MURAKATA
    1995 Volume 88 Issue 2 Pages 195-200
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.195
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    Enterobacter cloacae infection of the nasal cavity is very rare. A 65-year-old woman visited our hospital complaining of left epistaxis and nasal obstruction. Anterior rhinoscopy showed a black necrotic mass in the left nasal cavity, and a malignant tumor was suspected. The histopathological diagnosis of a biopsy specimen was necrotic tissue with bacterial colonies and no tumor cell. Bacteriological examination of the necrotic mass showed Enterobacter cloacae. So the diagnosis was Enterobacter cloacae granuloma. Piperacillin was given by intravenous infusion. The mass grew smaller and was removed from the nasal cavity.
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  • Olfactory Neuroblastoma with Cardiac Metastasis; A Case Report
    Hironari SHIMIZU, Jun-ichi ISHITOYA, Minoru TORIYAMA
    1995 Volume 88 Issue 2 Pages 201-206
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.201
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    A 35-year-old Korean woman visited our hospital complaining of right nasal discharge and recurrent epistaxis. The intranasal examination showed a telangiectatic polyp on the right, and polypectomy was carried out. Immunohistochemical studies of the polyp showed neuroblastoma. She underwent preoperative irradiation (Liniac 40.5 Gy), Denker's operation and boost radiotherapy (Co60 18 Gy, Remote-Afterloading System), and the tumor was well controlled locally. However, she died of cardiac metastasis one year later.
    Immunohistochemical examinations with NSE (neuron specific enolase), S-100 protein and vimentin were found to be useful in the diagnosis of olfactory neuroblastoma.
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  • Postirradiation Ethmoid Sinus Sarcoma with Intracranial Extention; A Case Report
    Hideki TAKEGOSHI, Ken-ichi NIBU, Tadashi TANAKA, Toshiyoshi TANAKA, Ke ...
    1995 Volume 88 Issue 2 Pages 207-211
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.207
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    A 16-year-old female developed sarcoma in the anterior skull base approximately 15 years after irradiation for bilateral retinoblastoma.
    At the age of 1.5 years, the right eye of this patient was enucleated and she received 6300 rails through two portals for retinoblastoma. When she was three years old, her left eye was enucleated because of retinobalstoma, and cobalt 60 was implanted in her left orbit.
    The patient remained disease-free for 15 years until a mass developed on the right side of her nose. Computed tomography scans demonstrated a tumor involving the ethmoidal sinuses, nasal cavities and epipharyngeal space. She underwent anterior craniofacial resection through a frontal craniotomy and complete rhinotomy. The tumor was removed totally and diagnosed histopathologically as sarcoma.
    The association between bilateral retinoblastoma and the development of secondary, nonocular tumors has been emphasized in recent years. This association is thought to occur as a consequence of irradiation therapy. Recently, molecular genetic techniques have made great progress and the retinoblastoma gene (RB) has been isolated as a human tumor suppressor gene. Secondary tumors have been shown to lose RB function. Patients with bilateral retinoblastoma always have an abnormal gene.
    After irradiation treatment for bilateral retinoblastoma, it is advisable to pay attention to the possibility of a secondary malignant tumor which can be radiation-induced and hereditary.
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  • Soft Palate Injury Caused by the Fireworks; A Report of Two Cases
    Masaki FURUKAWA, Madoka K FURUKAWA, Hideki MATSUDA, Mamoru TSUKUDA, Ma ...
    1995 Volume 88 Issue 2 Pages 213-218
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.213
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    Case 1: A 24-year-old drunken male held a firecracker in his mouth and lit it. The firecracker exploded, in contact with the center of the soft palate immediately and lacerated soft palate. The surgery was performed to repair the injured soft palate.
    Case 2: A 25-year-old drunken male held a lighted firecracker in his mouth and burned his soft palate. He recovered with conservative therapy.
    Velopharyngeal function after treatment was good in both cases.
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  • Laryngeal Carcinoma with Mediastinal Lesions; A Report of 3 Cases
    Masaaki KASHIWAMURA, Kazuyuki YAMADA, Shigeki HIYAMA, Satoshi FUKUDA, ...
    1995 Volume 88 Issue 2 Pages 219-224
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.219
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    Mediastinal metastasis of or invasion by laryngeal carcinoma is not common. If it is not found in the early stage and treated, it causes miserable symptoms such as tracheal stenosis or intratrachal hemorrhage. We treated three patients with laryngeal carcinoma with mediastinal metastasis or invasion. The primary lesion was subglottic in two and glottic in one. The clinical course and some examination results suggested that two patients had metastases and one had direct invasion.
    We concluded that patients with laryngeal cancer, especially subglottic, should be examined for mediastinal, as well as cervical lymphnode metastasis, as soon as possible. We otolaryngologists should be able to find mediastinal lesions early using examinations such as CT scans.
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  • Leiomyoma of the Neck; A Case Report
    Makoto HANADA, Kazutomo KITAJIMA
    1995 Volume 88 Issue 2 Pages 225-229
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.225
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    A 49-year-old male had a painless right anterolateral cervical mass. It was suspected of being a benign tumor from CT and FNA findings. It was removed under general anesthesia. Histological examination revealed a solid leiomyoma. No recurrence has been noted for about 2 years since the operation. Leiomyoma of the neck, except in the pharynx, larynx or skin, is very rare. Its characteristics and origin are discussed.
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  • Parathyroid Carcinoma with Recurrent Laryngeal Nerve Paralysis; A Case Report
    Mamoru SAKAMOTO, Mani KITANI, Yoshimaro ISHIKAWA
    1995 Volume 88 Issue 2 Pages 231-235
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.231
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    A 46-year-old man complained only of hoarseness. Right recurrent laryngeal nerve paralysis was seen, but neck tumor was not palpable, 201T1 subtraction 99mTc scanning and parathyroid hormon (PTH-c) were within normal limits. From Echo, CT and MRI etc, parathyroid tumor was suspected. En block dissection of the tumor was performed.
    At histopathological examination, recurrent laryngeal nerve had atrophic change under pressure of tumor, not infiltrated. The individual tumor cells had poorly atypia and rarely showed mitoses, but blood vessel invasion was found at a part. So parathyroid carcinoma was diagnosed.
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  • Anti-Tumor Effect of Chinese Herbal Medicine “Sheng-Jin-Jie-Du-Yin” on a Human Maxillary Cancer Cell Line
    Yutaka OGAWA, Kazuyoshi FUJII, Hiroshi TAMAI
    1995 Volume 88 Issue 2 Pages 237-249
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.237
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    We evaluated the anti-tumor effect of the herbal medicine, Sheng-Jin-Jie-Du-Yin, on a human maxillary cancer cell line transplanted into nude mice.
    This herb consists of 16 crude drugs developed in China. We found it to be effective in inhibiting the cancer transplanted into animals. The two crude drugs, solanum lyratum herb and oldenlandia herb, in Sheng-Jin-Jie-Du-Yin accounted for the anti-tumor effect.
    The anti-tumor effect of solanum lyratum herb was noted when it was combined with radiotherapy, while oldenlandia herb was effective in the inhibition of tumor growth when given alone or in combination with radiotherapy.
    We measured the NK activities in nude mouse spleen cells and concluded that the anti-tumor effect of oldenlandia herb is related to an immune mechanism.
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  • Ethyl Loflazepate in the Treatment of Tinnitus
    Hidekazu TANAKA, Atsushi KOMATSUZAKI, Norihiko ISHIKAWA, Tohru OHGAKI, ...
    1995 Volume 88 Issue 2 Pages 251-256
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.251
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    Ethyl loflazepate (Meilax®) was administered orally to 91 patients suffering from tinnitus, 58 with tinnitus and sensorineural hearing loss, 27 with tinnitus without hearing loss, and 6 with tinnitus accompanied by sudden deafness. The clinical severity of tinnitus was evaluated every two weeks in terms of loudness, continuity and annoyance. Medication was rate of as effective in 27.5%, moderately effevtive in 33%, slightly effective in 17.6% and not effective in 21.8% at the end of treatment. Effectiveness depend on the duration of treatment. Patients treated for a relatively long period showed greater clinical improvement. Two patients complained of sleepiness as a side effect. It was concluded that ethyl loflazepate is effective in reducing severity of tinnitus.
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  • Treatment of Tinnitus with LipoPGE1
    Takao SAMUKAWA, Noboru YAMANAKA, Keiji FUJIHARA, Takaaki KIMURA, Junic ...
    1995 Volume 88 Issue 2 Pages 257-261
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.257
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    Severe tinnitus in 32 patients wtih senile deafness was treated with Lipoprostaglandin E1 10μg i. v. once a week. The tinnitus score was significantly decreased from 10 to 3.9±2.4. Slight to marked improvement was recorded in 90.6% of the patients. Early treatment, within 4 weeks of the onset of tinnitus, was more effective than later treatment. There were 4 patterns of improvement. No severe side effect was observed.
    The results of this study suggest that Lipoprostaglandin E1 is very useful in the treatment of tinnitus.
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  • Emedastine Difumarate in Treatment of Perennial Nasal Allergy; An Acoustic Study
    Mikikazu YAMAGIWA, Kenichiro FUJITA
    1995 Volume 88 Issue 2 Pages 263-269
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.263
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    Emedastine difumarate is a new anti-allergic agent which has been reported to be highly effective for allergy-induced nasal obstruction
    We evaluated the efficacy of the agent (Remicut® 2mg, 2 capsules/day) taken for more than 2 weeks by 10 patients (7 males and 3 females aged 34.2±8.7 years) with perennial nasal allergy. We used a 100mm linear visual analogue scale (VAS) in the subjective measurement of the nasal sensation of airflow. Objective measurement was done with acoustic rhinometry, a newly developed technic which provides an accurate estimate of the cross-sectional area of the nasal cavity in relation to the distance from the nasal entrance and, by integration, the nasal cavity volume. For the statistical study the paired t test was used.
    1) The mean±standard error (SE) of the VAS score was 28.0±7.9 before medication, 27.1±8.5 at one week, 25.3±7.6 at two weeks and 31.6±6.9 one week after the end of medication. There were no significant differences.
    2) The mean±SE of the right+left minimum cross-sectional area of the nose was a) 0.68±0.10cm2 before medication, b) 0.75±0.10cm2 at one week, c) 0.79±0.10cm2 at two weeks and d) 0.75±0.10cm2 one week after the end of medication. The difference between a) and b) c) is significant (p<0.005).
    3) The mean±SE of the right+left nasal cavity volume was a) 13.8±1.4cm3 before medication, b) 15.9±1.3cm3 at one week, c) 16.2±1.2cm3 at two weeks and d) 13.8±1.1cm3 one week after the end of medication. The difference between a) and b) c) is significant (p<0.01).
    The present acoustic study shows that emedastine difumarate reduces allergy-induced nasal obstruction. However, the subjective sensation of nasal airflow was not significantly improved as shown by the VAS study.
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  • Retro-Labyrinthine Disorders of the Vestibular System
    [in Japanese]
    1995 Volume 88 Issue 2 Pages 270-271
    Published: February 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.270
    JOURNAL FREE ACCESS
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