Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 88, Issue 5
Displaying 1-20 of 20 articles from this issue
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  • Swallowing Function Test Based on Neural Mechanisms
    Takemoto SHIN, Toshiro UMEZAKI
    1995 Volume 88 Issue 5 Pages 553-559
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.553
    JOURNAL FREE ACCESS
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    In general, esophagography with a VTR system, electromyography and measurement of the pressure of the digestive tract are used for evaluation of the swallowing function. In previous reports a time lag in movement of the bolus was pointed out in many patients with dysphagia. However, a standardized time reference for this lag was not clarified in most cases.
    A new concept evaluating dysphagia is introduced in this study to clarify the pathophysiology of swallowing disorders. The movement of the bolus is referred to as a phase, and the time progress of the patterned output from the medullary swallowing center is referred to as a stage. It can, therefore, be considered that dysphagia occurs when the time lag between the phase and stage exceeds the physiologically permissible limits.
    The standard point of the phase and stage were determined separately from an analysis of the esophagogram with a VTR system in normal volunteers, and the time lag between the two points was measured in patients with dysphagia. We devised a new instrument to evaluate the swallowing function, which can record simultaneously the pressure of the oral cavity and pharynx and the air flow rate. These methods were useful for detecting the delay of the initiation of pharyngeal swallowing which is observed in patients with dysphagia caused by lesions of the corticobulbar tract.
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  • Congenital Cholesteatoma
    [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1995 Volume 88 Issue 5 Pages 560-561
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.560
    JOURNAL FREE ACCESS
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  • Intertest Reliability of Transtympanic Electrocochleography
    Masutoshi NISHIKAWA, Keiko NISHIKAWA
    1995 Volume 88 Issue 5 Pages 563-567
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.563
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    The intertest reliability of transtympanic electrocochleography (ECoG) was studied in 30 ears by measurements of the difference in amplitude and latency between the first and second tests. The interval between the initial test and the retest ranged from one week to 3.5 years.
    The summating potential (SP), action potential (AP), AP latency and -SP/AP ratio at high intensities (80 dBnHL) showed good test-retest correlations. The waveforms in the two tests had almost he same shapes.
    Therefore, the intertest reliability of ECoG is considered to be good.
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  • Sudden Deafness in Patients with Diabetes Mellitus
    Masato NISHIMURA, Takayuki SHIRAISHI, Masako OKUSA, Yumi NARAMURA, Shi ...
    1995 Volume 88 Issue 5 Pages 569-574
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.569
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    A clinical study of auditory acuity and outcome was carried out in 27 patients with diabetes mellitus and sudden deafness. Although it has been believed that deafness first causes inability to hear high frequency sounds, the patients in this study, whose sensorineural hearing loss in each ear was compared, tended to lose the hearing of mid frequency sounds (500Hz to 1kHz) in particular.
    A further study of the influence of diabetes mellitus on auditory acuity and the relationship between examination results and outcome showed the following: (1) patients with advanced diabetic retinopathy tended to have little improvement of auditory acuity, (2) patients with proteinuria had significantly less improvement in hearing than did those with no proteinuria, (3) patients with high serum HbA1c levels at the onset of deafness tended to have less improvement in hearing than did those with low levels, and (4) no correlation was noted between the duration of illness and the prognosis.
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  • Analysis of 21 Ears with Otoscierosis Treated with Stapedotomy 1989-1994
    Makoto MIURA, Haruo TAKAHASHI, Yasushi NAITO, Tadahiko SUGIMARU, Iwao ...
    1995 Volume 88 Issue 5 Pages 575-579
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.575
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    Seventeen patients (21 ears) with otosclerosis were treated with Stapedotomy between 1989 and 1994 in our clinic. The percentage of stapedotomy has increased from 1.6% of all ear surgery in 1989 to 10% in 1994. The average pre-operative air and bone conduction thresholds (0.5, 1, 2kHz) were 57.9dB and 33.2dB, respectively. In 13 (62%) of 21 ears, tympanograms were type A. In all ears, the stapedial reflex was absent. In 5 (36%) of 14 ears, computed tomography of the temporal bone showed demineralization at the fissula ante fenestram. The improvement of air and bone conduction thresholds after operation was 20.2 dB and 5.1 dB, respectively. Twelve ears (55%) showed a post-operative air-bone gap within 10 dB.
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  • Salivary Gland Choristoma of the Middle Ear; A Case Report
    Shinichi SAI, Hirobumi KUMAZAWA, Tadashi IWANO, Shyugo SHIRAISHI, Tosh ...
    1995 Volume 88 Issue 5 Pages 581-585
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.581
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    A salivary gland choristoma was formed in the middle ear of a patient with old temporal bone fracture. A 41-year-old female complained of loss of hearing in the right ear and a floating feeling of one month's duration. The right external auditory canal and ear drum appeared normal, but conductive hearing loss was noted. CT scan showed fracture lines in the temporal bone and low density shadows in the middle ear and mastoid. We thought that the hearing loss was due to a conductive disorder caused by the fracture, anomaly of the ossicles or otosclerosis, so we operated on the middle ear through a right post-auricular incision. A fracture line was seen extending to the middle ear, which was filled with clear secretion and two round masses close to the ear drum. Parts of the ossicles had dissapeared, so we reconstructed the conduction system of the middle ear, using the incus in a collumellization operation. Pathological examination of the masses showed a salivary gland choristoma in the middle ear. Our experience shows that it is important for clinicians to keep in mind that salivary gland choristoma can causes conductive hearing loss and facial palsy.
    We must be careful to avoid facial nerve injury when treating choristoma or other masses in the middle ear.
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  • Otitis Media and Facial Paralysis Caused by Adult T-cell Leukemia
    A Case Report
    Mitsuhiro HASEGAWA, Minoru IKEDA, Sohei ENDO, Yoshiharu WATANABE, Hiro ...
    1995 Volume 88 Issue 5 Pages 587-590
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.587
    JOURNAL FREE ACCESS
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    A 61-year-old male developed left otitis media and left peripheral facial nerve paralysis. One month later right otitis media and right peripheral facial nerve paralysis occurred. ATL cells were found in the peripheral blood, and anti-ATL associated antigen was demonstrated by the serological examination. The cerebrospinal fluid contained ATL cells, but no ATL cells were found in the granulation tissue removed from the middle ear cavity.
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  • Benign Tumors of 116 Patients in Auricle and External Canal
    A Study
    Michinari MURAOKA, Tetsuhiro HYOUDO, Satoki WAKAMI, Yoshiaki NAKAI
    1995 Volume 88 Issue 5 Pages 591-595
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.591
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    During the past 15 years, we have treated 116 patients (67 males and 49 females) with benign tumor in the auricle and external canal. The tumor was in the auricle in 57 patients, in the external canal in 24, in the ear lobe in 20, in the concha in 9, in the preauricular area in 6. Pathological examination showed epidermoid cyst in 58 patients, and pigmented nevus in 12. A few patients had hemangioma simplex, strawberry mark, senile keratoma, seborrheic keratoma, sebaceous nevus, papilloma, enchondroma, fibroneuroma, cyst or keloid. All 116 tumors were resected. When we operate on these tumors, we must consider the anatomy of the auricle and external canal and use techniques of plastic surgery.
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  • Laser Turbinate Surgery for Allergic Rhinitis and Hypertrophic Rhinitis
    Takashi HIRAMATSU, Mitsuhiro MORI, Hikari KOIZUMI, Takehiro KAIDA, Mot ...
    1995 Volume 88 Issue 5 Pages 597-604
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.597
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    Using a contact Nd-YAG laser, we vaporized the pathological inferior turbinates of 24 patients with perennial allergic rhinitis and hypertrophic rhinitis resistant to medical treatment. The patients were 18 males and 6 females, aged 4.67 years. This operation was performed as one day out patient surgery in 20 of the 24 patients. About two weeks after the treatment, 18 out of 22 patients no longer needed anti-allergic or any other drugs. One month after the treatment, 13 out of 17 patients were in no need of any drugs. One patient had been under treatment for nine months. We conclude that contact Nd-YAG laser surgery is useful for the treatment of turbinate dysfunction in patients with perennial allergic rhinitis and hypertrophic rhinitis resistant to medical treatment.
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  • Frontal Sinusitis and Abscess
    Shin-ichi HAGINOMOR, Kazuo MAKIMOTO, Takashi ITO, Sumiko NAKAKOJI, Osa ...
    1995 Volume 88 Issue 5 Pages 605-611
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.605
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    A 27-year-old male complaining of anterior frontal swelling and pain was sent to our hospital for further examination and treatment. Examinations, including X-ray, CTscan, MRI, led to a diagnosis of frontal sinusitis with bone defect of the anterior wall and a fistula between the frontal sinus and the skin. After radical maxilloethmoidectomy, an extranasal frontal sinus operation employing a coronal incision was performed under general anesthesia. A bone defect was found in the medio-superior portion of the left frontal sinus. The defect connected with the fistula to the frontal skin as an extension of the frontal sinus lesion. After complete removal of the inner wall lesions in the frontal sinus and nasofrontal duct, the latter was plugged with autogenous iliac bone grafts. Then autogenous abdominal fat was implanted into the frontal sinus. The anterior wall of the frontal sinus was reconstructed with an iliac bone graft. During the 34 months since surgery, he has had no recurrent infection and no cosmetic or functional problem. In conclusion, frontal sinus surgery via a coronal incision approach is feasible when a wide surgical field with direct visualization of the frontal sinus is required, and it can produce satisfactory results.
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  • Cystic Diseases in Submandibular Region
    A Report of Three Cases
    Keijiro FUKAZAWA, Ayako SUGII, Ryoji SASAKI, Minoru HAGA
    1995 Volume 88 Issue 5 Pages 613-617
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.613
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    We report two cases of plunging ranula and one of dermoid cyst of the submandibular region. A 30-year-old female presented with a painless swelling in the right submandibular region. A clinical diagnosis of plunging ranula was made, and the patient underwent surgical excision. The cyst was extirpated with the sublingual and submandibular glands. The other plunging ranula was in a 46-year-old female. The cyst was extirpated with the left submandibular gland through a surgical incision in the left submandibular region. There has been no recurrence in either case.
    A 17-year-old female presented with a swelling in the left submandibular region. CT and echography revealed a large cyst in the floor of the left side of the mouth. Under general anesthesia, the cyst was removed surgically. The histopathological diagnosis was dermoid cyst.
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  • A Case of Tonsillar Condyloma Acuminatum
    Shuichi WATANABE, Susumu TOMINAGA, Hajime OGURA, Kunihiro FUKUSHIMA, Y ...
    1995 Volume 88 Issue 5 Pages 619-622
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.619
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    Tonsillar condyloma acuminatum (CA) was diagnosed in a 21-year-old man. Historical data showed that he had had oro-genital contact with four sex partners during the previous two years. Human papillomavirus type 6 was detected in the DNA isolated from the CA by Southern blot hybridization.
    Historical data of the patient together with the detection of the infectious agent suggests strongly that the tonsillar CA was a consequence of sexual transmission of the virus. This is the first report of oropharyngeal CA in which HPV type 6 has been identified in Japan.
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  • Malignant Fibrous Histiocytoma in the Hypopharynx
    A Case Report
    Masataka MURAKAMI, Yuko AKIYAMA, Gou TEI, Takashi SHINOMIYA
    1995 Volume 88 Issue 5 Pages 623-628
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.623
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    Malignant fibrous histiocytoma (MFH) is uncommon in the head and neck region. We report a case of MFH in the hypopharynx. A 71-year-old woman complained of dyspnea and dysphagia. Emergency tracheotomy was performed because the posterior wall of the hypopharynx was occupied by a tumor obstructing the supraglottis. Histologic examination showed MFH. In consideration of her quality of life, a radical excision was not performed.
    She was treated with cisplatin and radiation and then underwent laryngo microsurgery with CO2 Laser to evaporate the necrotic tissue in the hypopharynx. There has been no evidence of recurrence for 6 months after surgery. The results of immunohistological tests for MFH are described.
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  • Laryngeal Palsy as the Initial Symptom of Zoster Sine Herpete
    A Case Report
    Mitsuhiko NAKAHIRA, Hiroaki NAKATANI, Haruo SAITO, Kazuyuki TASHIMA, S ...
    1995 Volume 88 Issue 5 Pages 629-634
    Published: May 01, 1995
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.629
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    We report a rare case of zoster sine herpete with left laryngeal palsy followed by facial palsy. The patient was a 67-year-old male who complained of hoarseness and dysphagia. Fiberscopic examination revealed left laryngeal palsy and swelling of the left arytenoid region. Hypopharyngeal cancer was suspected. Seven days after the onset of laryngeal palsy, the left face was paralyzed. There was no eruption on the pinna. Serological tests revealed a significant rise of varicella-zoster virus (VZV) antibody. The patient was treated with intravenous acyclovir, steroid and mannitol. He recovered completely from both paralyses within 2 months. We suggest that VZV infection should be ruled out in cases of laryngeal palsy.
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  • Usefulness of MRI in the Diagnosis of Bronchial Foreign Body
    A Case Report
    Nobuo OHTA, Kunio ARAI, Jiro HARADA
    1995 Volume 88 Issue 5 Pages 635-637
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.635
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    Diagnosis of a radiolucent foreign body in the lower airway is not always easy. Holzknecht's sign in conventional radiography has been considered one of the most useful procedures, but various newer procedures, including tomography, bronchography, xerotomography, xeroradiography, digital radiography, CT and MRI scintigraphy are being used to provide a more precise diagnosis of foreign body in the lower airway.
    MRI (T1 weighted image) was used in the examination of a patient with a bronchial foreign body and provided a precise diagnosis of a plastic foreign body in the lower airway.
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  • Compound Action Potentials in the Guinea-Pig Cochlea Evoked by Speech Sounds
    Tomoko OKUMURA, Shogo SHINOHARA, Shigeru HIRANO, Hisayoshi KOJIMA, Kaz ...
    1995 Volume 88 Issue 5 Pages 639-644
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.639
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    Compound action potentials (CAPS), synchronized potentials by firings of many fibers in the auditory nerve, are thought to represent temporal information related to sound coding in the cochlea. In the present study, CAPs in nine guinea-pig cochleae evoked by speech sounds were examined by electrocochleography. CAPS were evoked at (1) onset of voiceless stop consonants [p], [k], [t], and voiced stops [b] in every cases, (2) onsets of voiced stops [d], [g] in some cases and (3) onset of semi vowels [w] in some cases. CAPs were not observed at other consonants or semi vowel [y], and seldom observed at the onset of vowels in consonant-vowel syllables.
    It is concluded that some inf ormations which are important for speech recognition such as the onset of stop consonants is coded as temporal information, synchronized firing of auditory nerve fibers, in the cochlea.
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  • Clinical Study of Ternelin® Therapy and Ternelin® and Hydergine® Therapy for Tinnitus
    Yoshiyuki Kitaoku, Takashi Matsunaga, Hiroyuki Kitamura, [in Japanese] ...
    1995 Volume 88 Issue 5 Pages 645-656
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.645
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    Patients with tinnitus were treated with Ternelin® (tizanidine hydrochloride) alone or in combination with Hydergine® (dihydroergotoxine mesylate). The following results were obtained.
    1) When overall improvement was assessed at the end of the dosing period, 36% of the 136 patients who received Ternelin and Hydergine® (the combined therapy group) showed moderate or marked improvement, while 61.8% of the patients in this group showed slight, moderate or marked improvement. The combined therapy was rated as moderately or highly useful in 35.3% and slightly to highly useful in 61% of all cases.
    2) Of the 24 patients who received Ternelin alone (the solo therapy group), 25% showed moderate or marked improvement, and 66.7% showed slight, moderate or marked improvement. Solo therapy was rated as moderately or highly useful in 25% and slightly to highly useful in 66.7%.
    3) of the 153 patients who received combined therapy (including 17 patients who were only included in the safety assessment), 9 developed adverse reactions (3 cases of drowsiness, and one each of orthostatic syncope, hypotonia, dizziness, gastric pain, constipation and oral thirst). None of the patients given Ternelin® alone showed any adverse reactions.
    4) The percentage of cases showing marked or moderate improvement was higher in the combined therapy group than in the solo therapy group, although this difference was not significant. In the ombined therapy group, the reduction in tinnitus peaked 2 to 4 weeks afterr the start of treatment. In the solo therapy group, the number of patients responding to the drug increased gradually with time, and more time was needed to obtain maximal effects than that in the combined therapy group.
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  • Clinical Efficacy of Oxatomide on Japanese Cedar Pollinosis
    -Results of Kanagawa Multicenter Study for 3 Years-
    Atsushi SHINKAWA, Hirosato MIYAKE, Makoto SAKAI, Isamu TAKEYAMA, Tetsu ...
    1995 Volume 88 Issue 5 Pages 657-670
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.657
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    We investigated the airborne pollen count of Japanese cedar and Hinoki cypress in Kanagawa prefecture for 3 years between 1991 and 1993, and evaluated the preventive and therapeutic effects as well as the clinical efficacy of oxatomide monotherapy in patients with cedar pollinosis during the 3 years.
    Total airborne pollen counts in 1991 and 1993, according to the data in Isehara City, were almost the same, 4888 and 3199, respectively, which were relatively high values. In 1992, however, pollen count was as low as 875, one forth to one fifth of the levels in the other years.
    The clinical efficacy of oxatomide was evaluated with regard to preventive and therapeutic effects. The study populations consisted of 98 patients for preventive effect and 51 for therapeutic effect in 1991, 91 and 34 in 1992, and 76 and 55 in 1993. A preventive effect was found early in the pollen season, in 80.6% in 1991, 79.8% in 1992 and 74.2% in 1993; in mid-season, in 69.1%, 72.3% and 61.9%; and late in the season, in 85.5%, 81.9% and 64.3%. A therapeutic effect early in the season was obtained in 52.2%, 50.0% and 66.7%; in mid-season, in 63.0%, 66.7% and 57.1%; and late in the season, in 83.3%, 73.3%, 59.6% in the respective years. The overall rate of adverse reactions for the 3 years was 3.9% (22/560 patients), most of which were transient sleepiness.
    These findings reconfirm the preventive and therapeutic efficacy and safety of oxatomide for cedar pollinosis.
    Furthermore, investigation using a symptom diary suggested that some cedar pollinosis patients developed symptoms before the first day of pollen season, and that onset of the symptoms could be significantly delayed by starting oxatomide treatment more than 2 weeks before the beginning of airborne pollen season.
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  • Tofisopam for Abnormal Sensation in the Throat
    A Clinical Evaluation
    Mikikazu Yamagiwa, Kenichiro Fujita
    1995 Volume 88 Issue 5 Pages 671-684
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.671
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    Tofisopam, a derivative of 2, 3-benzodiazepines, is reported to improve various symptoms, in particular somatic ones, caused by dysfunction of the autonomic nervous system. Autonomic nerve dysfunctton could also be the cause of abnormal sensation in the throat, such as a choking lump or itching.
    We administered tofisopam, Grandaxin Tablet® 50 (3 tablets/day after meals), for 2 weeks to 115 patients with abnormal sensation in the throat.
    The therapeutic effect of the medication was evaluated at the end of the first and second week of administration and one week after the termination of the treatment. It was considered to be markedly effective when the abnormal sensation improved subjectively 80% or more, effective if there was 50%-80% improvement, slightly effective at 20%-50% and not effective if improvement was less than 20%.
    In 2 of the 115 patients side effects (abdominal pain or chest pain) were so overwhelming that the medication had to be suspended.
    In the remaining 113 patients the medication was markedly effective in 25.7% and effective in 35.4% at the end of the first week; the corresponding figures were 31.9% and 43.4% at the end of the second week, and 39.8% and 36.3% one week after the termination of the medication. These results show the fairly rapid and long lasting effect of tofisopam. Tofisopam was more effective than traditional Chinese medicine or minor tranquilizers in patients with autonomic nerve dysfunction.
    The results indicate that tofisopam is effective in the therapy of abnormal sensation in the throat.
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  • Bioethics
    [in Japanese]
    1995 Volume 88 Issue 5 Pages 686-687
    Published: May 01, 1995
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.88.686
    JOURNAL FREE ACCESS
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