Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 89, Issue 11
Displaying 1-20 of 20 articles from this issue
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  • The Role of Temporal Information in Speech Perception
    Hisayoshi KOJIMA, Kazuhiko SHOJI
    1996 Volume 89 Issue 11 Pages 1297-1305
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1297
    JOURNAL FREE ACCESS
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    Previous studies have revealed that sound stimuli are transformed into two kinds of information in the cochlea: frequency information and temporal information. In speech perception, the important role of temporal information has been well recognized. Although many investigators have examined temporal firing patterns of the cochlea nerve in anesthetized animals, few have studied human cochlea because of the limitations of electrophysiological techniques. In this paper, a train of continuously detected compound action potentials (CAPs) was examined and used as an indicator of temporal information. CAPs are believed to represent synchronized firings of auditory nerve fibers and can be obtained easily in human.
    Sound perception mechanisms, which aggressively included missing fundamentals and speech sounds, were reviewed and elucidated from the standpoint of CAP production. It is suggested that better understanding of temporal information will provide valuable information for improving hearing aids and cochlea implants.
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  • A Case Report of Laryngeal Neurofibroma
    [in Japanese], [in Japanese], [in Japanese]
    1996 Volume 89 Issue 11 Pages 1306-1307
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1306
    JOURNAL FREE ACCESS
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  • Two Cases of Wernicke's Encephalopathy Caused by an Intravenous Solution without Vit. B1
    Keizo ARAKAWA, Mayumi OKADA, Hiroaki OHTA, Masahiko OGASAWARA, Toshimo ...
    1996 Volume 89 Issue 11 Pages 1309-1317
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1309
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    We report here 2 cases of Wernicke's encephalopathy following the use of an intravenous solution that did not contain any Vit. B1.
    Case 1 was a 69-year-old woman who had undergone an operation for an early stage gastric cancer, and had received an intravenous solution deficient in Vit. B1. Thirty-three days after the operation, symptoms such as dizziness, nystagmus, disorientation and dyspnea were observed.
    A brain MRI showed a high intensity signal in the periaqueductal area, and Wernicke's encephalopathy was suspected. An ENG test revealed lateral gaze nystagmus, and Caloric testing was negative bilaterally.
    Case 2 was a 23-year-old man who had suffered from Crohn's disease for the past 4 years. He also received the intravenous solution without Vit. B1 due to an ileus which had occurred. Twentyseven days after the onset of the IVH, he developed dizziness, nystagmus, gait disturbances, disturbances of short term memory and ataxia. A brain MRI showed a high intensity signal in the periaqueductal area. An ENG test showed lateral gaze nystagmus, and Caloric testing was negative bilaterally. He was therefore suspected with Wernicke's encephalopathy.
    The incidence of Wernicke's encephalopathy following treatment with a solution that does not contain Vit. B1 seems to be increasing MRI findings and neuro-otological signs are useful for an early diagnosis of Wernicke's encephalopathy.
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  • Two Cases of Psychogenic Hearing Loss Combined with Aphonia
    Hitoshi Satoh, Hajime OHTAKI, Toshiyuki FUJISAKI, Yuichi Nakano
    1996 Volume 89 Issue 11 Pages 1319-1322
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1319
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    Two cases of psychogenic hearing loss combined with psychogenic aphonia are reported.
    Case one was a 15-year-old female with psychogenic hearing loss that appeared just before taking a high school entrance examination. After she passed the examination, the complaint of hearing loss was reduced. Three years later she suddenly suffered from psychogenic aphonia prior to taking a college entrance examination. The aphonia also diminished after she passed the examination. Both the hearing loss and aphonia were attributed to the stress caused by the entrance examinations.
    Case two was a 26-year-old female who suddenly suffered from profound hearing loss and aphonia simultaneously. The conditions were brought on apparently by a psychogenic reaction to a stressful relationship with her mother-in-law.
    In both cases, the threshold of auditory brain stem evoked response was normal while the threshold of pure tone audiogram indicated profound sensorineural hearing loss. The phonolaryngogram was useful for diagnosis and evaluation of voice disturbance.
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  • Positive Summating Potential in Electrocochleograms
    Masutoshi NISHIKAWA, Keiko NISHIKAWA
    1996 Volume 89 Issue 11 Pages 1323-1329
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1323
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    Electrocochleograms (ECoG) obtained by the promontory recording technique using a needle electrode were recorded from 215 ears of patients affected by Meniere's disease and other conditions in order to evaluate the clinical significance of summating potential (SP) polarity.
    The patients with positive SP waveforms tended to have better ECoG waveform responses than those without positive SP waveforms.
    The incidence of positive SP waveforms recorded from patients with Meniere's disease was higher than that from patients with other conditions.
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  • Transient Hearing Loss after Dural Puncture; A Case Report
    Hideki TAKEGOSHI, Tetsuo SENBA, Satoshi ASANUMA
    1996 Volume 89 Issue 11 Pages 1331-1337
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1331
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    We report a case of temporary decrease in bilateral hearing after a lumbar puncture. A 46-year-old female underwent extradural anesthesia for vaginal hysterotomy. During administration of the extradural anesthesia between lumbar vertebra No. 4 and 5 using a 17-gauge needle, the dura mater was damaged, resulting in leakage of cerebrospinal fluid. Lumbar puncture was then performed between lumbar vertebra No. 3 and 4 and the operation was performed. On the following day, the patient complained of bilateral hearing loss, headache, and tinnitus. The audiometry showed a hearing loss of 20-50dB mainly in the low frequency range. The patient was treated with lactated Ringer's injection and vitamin B12. An audiogram on the seventh postoperative day showed improvement. Normal hearing returned 4 weeks later. Seven months later, the patient underwent spinal anesthesia again for fracture dislocation of the left ankle. A 25-gauge needle was used for this anesthesia. She did not complain of headache and hearing loss, but minor hearing deficits were found by audiometry. We speculate that the hearing loss could be due to endolymphatic hydrops resulting from perilymphatic hypotonia due to loss of CSF.
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  • Epidemiological Study of Nasal Allergies in Medical Students
    Atsushi Matsubara, Keiichi IKENO, Takeshi FUJITA, Shigetoshi FUJITA, Y ...
    1996 Volume 89 Issue 11 Pages 1339-1345
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1339
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    The prevalence and factors relating to the appearance of nasal allergies were investigated, in a group of 351 medical students. The prevalence of nasal allergies in the 351 students was 39.6%. About 56% of the students were sensitized by some inhalation antigen. The primary antigens among the students who had grown up in Aomori Prefecture were house dust, mites and orchard grass.
    It was suggested that the appearance of nasal allergies is nearly always due to the presence of both environmental and hereditary factors.
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  • Indications for and Limitations of Endoscopic Endonasal Surgery for Postoperative Maxillary Cysts
    Takuo IKEDA, Takehisa Saito, Takechiyo YAMADA, Eiko IWAKI, Yoko KONO, ...
    1996 Volume 89 Issue 11 Pages 1347-1352
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1347
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    Recently, endoscopic endonasal surgery has been widely used in the treatment of chronic sinusitis, with good results reported by many investigators. Endoscopic endonasal surgery is a technique available not only for chronic sinusitis but also for post-operative maxillary cysts. In this report, the indications for and limitations of endoscopic endonasal surgery for postoperative maxillary cysts are discussed based on experience gained from treating 14 cysts in our department.
    The indications for endonasal endoscopic surgery include cysts in close contact with the lateral wall of the inferior meatus, and those cysts that can be widely opened to the middle nasal meatus.
    The following cases could not be treated by endonasal endoscopic surgery:
    1) cysts that were localized in areas distant from the nasal cavity,
    2) cysts in which the lateral wall of the inferior nasal meatus was bony and very thickened,
    3) cysts that could not be sufficiently opened to the middle nasal meatus.
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  • Surgical Management of Pediatric Sinusitis
    Tsutomu NONOYAMA, Yuichi MAJIMA, Shinya KAWAGUCHI, Jun SHINOGI, Tomohi ...
    1996 Volume 89 Issue 11 Pages 1353-1358
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1353
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    From January 1990 to June 1995, nasal and/or sinus surgery was performed on 21 children with chronic sinusitis. There were 9 males and 12 females aged 5 to 15 years, with an average age of 11.3 years. Ten children received a polypotomy alone, and functional endoscopic sinus surgery was performed on 13 patients. Three patients underwent a Caldwell-Luc operation. The follow-up information was gathered by questionnaires mailed to all 21 patients and all of the patients replied. The mean follow up period was 32 months. Before the surgery, nasal obstruction was the most predominant symptom and rhinorrhea was the second. Of the 21 patients, 18 patients (85.7%) had complete resolution of their symptoms, and when questioned as to whether their surgical therapy had been successful, 16 patients (76.2%) recorded positively.
    In 9 of the patients, we performed rhinoscopic and X-ray examinations 28 months after the operation. Endoscopic sinus surgery was performed on 5 patients (8 diseased sides), and a polypotomy was performed on 4 patients (6 diseased sides). In this study, we found that endoscopic sinus surgery was more effective than the polypotomy. We conclude that endoscopic sinus surgery is effective in the treatment of chronic sinusitis in children.
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  • Myoepithelioma of the Paranasal Sinus; A Case Report
    Ichiro TATEYA, Tadahiko SUGIMARU, Nobuya FUJIKI, Kyosuke KURATA
    1996 Volume 89 Issue 11 Pages 1359-1364
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1359
    JOURNAL FREE ACCESS
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    Myoepithelioma is a rare lesion which has been reported mainly in the salivary glands. In the nasal cavity and paranasal sinuses, its occurrence is exceedingly rare and, to our knowledge, only 5 cases have been reported. We recently treated a 31-year-old female with myoepithelioma of the ethmoid sinus who presented with swallowing disturbance because of a rapidly expanding choanal polyp. We performed a Caldwell-Luc operation and found the tumor expanding into the ethmoid sinus. For diagnosis, immunohistochemical examination was effective in addition to H-E staining.
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  • Clinical Investigation of Peritonsillar Abscesses
    Joji Kobayashi, Tadahiko SAIKI, Kazuhiko Takeda, Hideo JOKO
    1996 Volume 89 Issue 11 Pages 1365-1369
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1365
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    The authors investigated the clinical course of 49 patients with peritonsillar abscesses treated at Uwajima City Hospital between January 1983 and December 1995. The cohort consisted of 36 males and 13 females, aged 15 to 68 (mean age, 37.2 years old). Along with administration of antibiotics, removal of the abscess was performed by needle aspiration in 25 cases, and incision for drainage in 24 cases, respectively. There were no statistical differences in clinical stage and course between the group under 40 years old and the group over 40 years old. There was also no difference between the group treated with needle aspiration and the group treated with incision, except for the length of hospital stay healing time. Interval tonsillectomy was carried out in 10 cases. Recurrence of the peritonsillar abscess occurred in only one case. Therefore, we recommend needle aspiration as the first choice for treatment of peritonsillar abscesses. In cases of peritonsillar abscess with no past history of habitual angina, tonsillectomy is not indicated because recurrence of peritonsillar abscesses is rare.
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  • A Case of Malignant Lymphoma of the Larynx
    Hiroko KAWARAI, Shuichi WATANABE, Sachiyo YAMAMOTO, Kunihiro FUKUSHIMA ...
    1996 Volume 89 Issue 11 Pages 1371-1375
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1371
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    A case of malignant lymphoma of the larynx in a 55-year-old male is reported with a review of the literature. Patient's chief complaint was an abnormal feeling in his larynx. Laryngoscopy revealed a tumor in the right aryepiglottic fold. Biopsy showed B cell type non-Hodgkin's malignant lymphoma. The clinical stage of this patient was IE. He was treated with chemotherapy (CHOP) and radiation therapy (30Gy). The tumor was well controlled, and no recurrence was noted one year and eight months after discharge.
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  • Multiple Extramedullary Plasmacytoma Arising in the Head and Neck Region; A Case Report
    Sanson HAN, Hiroyuki KITAMURA, Shin-ichi TAKAGITA, Ryo ASATO, Yuka IWA ...
    1996 Volume 89 Issue 11 Pages 1377-1381
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1377
    JOURNAL FREE ACCESS
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    Extramedullary plasmacytoma is a rare disease, which arises most commonly in the head and neck. We have recently treated a 34-year-old male with multiple occurences of extramedullary plasmacytoma originating in the epipharynx, posterior pharyngeal wall, tonsils and larynx. Histopathologic studies revealed to be a IgG-κ producing plasmacytoma.
    It has been reported that radiation therapy is the most effective treatment for extramedullary plasmacytoma, but surgical therapy was useful in this radio-resistant case.
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  • Multiple Primary Cancers of the Head and Neck
    Eiji Takahashi, Tomoo SUZUKI, Yatsuji Ito, Keisuke MIZUTA, Shinji SAKU ...
    1996 Volume 89 Issue 11 Pages 1383-1388
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1383
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    Multiple primary cancers of the head and neck cancers are not rare. From 1983 to 1993, we have experienced 29 cases of multiple primary cancers in the Department of Otorhinolaryngology at the Gifu University School of Medicine. The cancers involved the maxillary region in 1 case (1.2%), nasal cavity in 1 case (5.9%), oral cavity in 4 cases (5.5%), epipharynx in 1 case (2.5%), mesopharynx in 1 case (4.2%), hypopharynx in 4 cases (6.9%), larynx in 15 cases (7.6%) and other regions in 2 cases (5.9%). Males accounted for the majority of the cases (26 of 29). The proportion of patients aged 50 to 70 years was high, and the average age was 63.0. Histologically, combinations with squamous cell carcinomas were the most common type (17 of 19). Eight cases were patients diagnosed with a second cancer upon entering our hospital. In 7 cases, the second cancer was not diagnosed until 5-10 years after the first cancer was diagnosed. These observations suggest that we must follow patients for long periods. Also, to avoid overlooking concealed cancer in the multicentric zone, upper gastro intestinal endoscopy, and chest X-ray should be used to screen patients with head and neck cancers.
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  • Foreign Bodies of Dental Origin in the Airway and Gastrointestinal Tract
    Morito KAMADA, Kaoru SHIMAZU, Masatoshi NISHIO, Ichiro MORIMOTO, Manab ...
    1996 Volume 89 Issue 11 Pages 1389-1394
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1389
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    We treated 109 cases of foreign bodies of dental origin in the airway and gastrointestinal tract in our hospital during the 8 years from 1987 to 1994. A statistical analysis was performed on 109 cases, and the results were as follows:
    1. Of the 109 cases, 60 were males and 49 were females; 71 patients (65.1%) were over 40 years old.
    2. Eleven cases involved foreign bodies in the airway and 98 cases involved foreign bodies in the gastrointestinal tract.
    3. In both the airway and the gastrointestinal tract, crown restorations were the most common foreign objects, followed by dental instruments.
    4. Gastrointestinal foreign bodies were ejected by defecation in all but 2 cases. In cases of spontaneous ejection, ejection occured within 4 days after misswallowing in 81.2% of patients.
    5. The accidents occured during dental treatment in 92 cases (84.4%) and while eating in 17 cases (15.6%).
    We stress the importance of making models of dentures and crown restorations that are misswallowed before removal.
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  • Current Advances in Rhinomanometry
    Kensei NAITO, Shigenobu IWATA
    1996 Volume 89 Issue 11 Pages 1395-1400
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1395
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    At the present, the most reasonable method of determining nasal patency is nasal resistance at point of ΔP100Pa or point of peak flow calculated from an equation R=0.78 (ΔP/V)1.33 or time-averaged nasal resistance measured by active posterior rhinomanometry with a full face capsule or a headout plethysmograph. While employing active anterior rhinomanometry, bilateral nasal resistance at point of peak flow should be estimated from the modified equation of Ohm's law for parallel resistors: T=0.96[R×L/(R+L)]0.92. In Japan, nasal resistance calculated from an equation R=ΔP/V at the point of ΔP100Pa using nozzle active anterior rhinomanometry may be appropriate for clinical use. Ten minutes while at rest in the sitting position is long enough for measuring nasal resistance.
    Peak flow index and nasal airflow acceleration are useful indicators of nasal breathing for objective evaluation of nasal patency.
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  • Brain Activity in the Motor Speech Areas and the Auditory Areas during Vocalization
    Demonstrated by Positron Emission Tomography
    Shigeru HIRANO, Hisayoshi KOJIMA, Yasushi NAITO, Iwao HONJO, Yoko KAMO ...
    1996 Volume 89 Issue 11 Pages 1401-1406
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1401
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    To reveal the interaction between the motor speech areas and the auditory areas during vocalization, brain activity during reading tasks was examined using Positron Emission Tomography (PET). The regional cerebral blood flow (rcBF) of six normal subjects was measured at rest, while reading everyday sentences silently, and while reading aloud. Regions of interest (ROIs) were set on the primary auditory area, the auditory association area, Broca's area, the motor area, the supplementary motor area (SMA) and the cerebellum. We subtracted rcBF data in ROIs during resting from those during each reading task, and evaluated the areas in which rcBF increased during each task. During silent reading, Broca's area, the SMA, and the cerebellum were activated bilaterally. During reading aloud, the primary auditory area, Broca's area, the motor area, the SMA, and the cerebellum were activated bilaterally, but the auditory association areas were not activated, even though the subjects heard their own voice. These results suggest that the activity of the auditory association area is suppressed when vocalizing everyday sentences. They also show a reasonable interaction between the motor speech areas and the auditory areas during vocalization.
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  • Clinical Evaluation of Administration of Midodrine in Patients with Orthostatic Dysregulation
    Hisayo NAKAYAMA, Shun-ichi IMAMURA, Izuru NOZAWA, Kaori HASHIMOTO, Yos ...
    1996 Volume 89 Issue 11 Pages 1407-1413
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1407
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    The effectiveness of midodrine administration for the treatment of dizziness in patients with orthostatic dysregulation (OD) was investigated. Midodrine (4mg/day) was administered for 8 weeks to 42 patients with dizziness who were confirmed to have orthostatic dysregulation based on a questionnaire. The patients were subdivided into 3 groups on the basis of blood pressure and Schellong test results. Twenty patients had low systolic pressure, less than 100mmHg at rest in the supine position, twelve patients had orthostatic hypotension, and the other ten patients were diagnosed to have orthostatic dysregulation without low systolic pressure or orthostatic hypotension.
    The effects of the drug were evaluated objectively on the basis of improvement in the Schellong test results, and subjectively on the basis of the patient's perception of symptoms as described in the OD questionnaire results at 4 and 8 weeks after midodrine administration. In general, the symptoms tended to decrease after treatment in most of the patients. In patients with hypotension or orthostatic hypotension, in particular, excellent improvement was achieved. Improvement occurred not only in the patients symptoms, but also in low blood pressure at bed rest and Schellong test results. These observations suggest that administration of midodrine was efficacious in the treatment of dizziness in patients with orthostatic dysregulation as a probable consequence of poor cir culatory function due to autonomic imbalance.
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  • Observation of Scattering Number of Japanese Cedar Pollens as Clinician
    [in Japanese]
    1996 Volume 89 Issue 11 Pages 1414-1415
    Published: November 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.1414
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  • Erratum to : Recent Studies on Head-Shaking Nystagmus
    1996 Volume 89 Issue 11 Pages e1
    Published: 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.11_e1
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