Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 89, Issue 4
Displaying 1-24 of 24 articles from this issue
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  • Surgical Complications in Otorhinolaryngology
    [in Japanese]
    1996 Volume 89 Issue 4 Pages 407-408
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.407
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese]
    1996 Volume 89 Issue 4 Pages 408-411
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.408
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese]
    1996 Volume 89 Issue 4 Pages 411-414
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.411
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese]
    1996 Volume 89 Issue 4 Pages 414-417
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.414
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1996 Volume 89 Issue 4 Pages 417-420
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.417
    JOURNAL FREE ACCESS
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  • A Case Report of Dermoid Cyst in Supra-Orbital Part
    [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1996 Volume 89 Issue 4 Pages 422-423
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.422
    JOURNAL FREE ACCESS
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  • Ossicular Disruption with Post-Traumatic Hearing Loss
    Nobuya FUJITA, Kaori ANDO, Takashi UEDA, Toshiaki YAMANAKA, Kazuhiro O ...
    1996 Volume 89 Issue 4 Pages 425-427
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.425
    JOURNAL FREE ACCESS
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    Seven patients with post-traumatic ossicular disruption are described. Average hearing impairment for the 7 patients was 45.9dB. An exploratory tympanotomy was carried out in all patients.
    During surgery, discontinuity was found in the incudostapedial (IS) joint in 4 patients, in the malleoincudal (MI) joint in 1 patient, and in both the IS and MI joint in 2 patients.
    The discontinuity was reconstructed by type III tympanoplasty in 6 patients. Four of the total 7 patients were transposed and the incus body was trimmed. The other 2 patients were PORP. Hearing impairment averaged 13.1dB after tympanoplasty.
    Cases of conductive deafness are occasionally encountered, in which it is difficult to confirm the presence of pathological lesions by conventional hearing and imaging tests, necessitating exploratory surgery. It is possible to improve hearing impairment significantly in many of these cases by performing a tympanoplasty. Therefore, in patients with similar lesions after head trauma, aggressive treatment is recommended with prerequisite informed consent.
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  • Gunshot Injury of the Left Temporal Bone; A Case Report
    Yutaka NAKANISHI, Eiji TAKEUCHI, Hiroya KITANO, Yoshirou YAZAWA, Kazut ...
    1996 Volume 89 Issue 4 Pages 429-433
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.429
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    We treated a 20-year-old man with a blind bullet wound of the left temporal bone and perforating bullet wounds of the right temporal legion, the right upper arm and right femur.
    Following physical examination, X-P, and CT, a bullet was detected in the left temporal bone. However, other wounds did not contain bullets. Emergency surgery was performed. The bullet was suspected to have entered through the posterior part of the mastoid tip, pass through the mastoid cavity and stopped at the tympanum. The facial canal was partially broken at the vertical portion, however the facial nerve was not damaged. The bullet was removed after resecting the posterior external auditory canal. Tympanoplasty type i combined with external canal wall drilling-down technique was performed.
    The patient showed left facial palsy after surgery. However, this gradually improved. The postoperative course in his left ear was good without infection, although the patient was deaf in that ear.
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  • The Effects of Submucous Turbinotomy on Allergic Rhinitis
    Shigehito MORI, Hitoshi Saito, Yasumasa TOKUDA, Yasuyuki TASAKA, Mitsu ...
    1996 Volume 89 Issue 4 Pages 435-441
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.435
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    The effects of submucous turbinotomy were investigated in 45 patients with perennial nasal allergies caused by house dust, who were resistant to treatment with various medications. Subjectively, all of the patients had reduced nasal obstruction and more than 90% of the patients showed a decrease in both sneezing and rhinorrhea for one year postoperatively. Objectively, the mean nasal airflow value increased significantly. Furthermore, the nasal provocating reaction to specific antigens was weakened in 93.5% of patients.
    These results suggest that submucous turbinotomy is a useful surgical treatment for severe nasal allergy, as evidenced by the improvements in not only the nasal airflow but also the nasal allergic reaction.
    Histopathologically, the superficial layer of the submucosa of the turbinate was occupied by fibrous tissues, and the vessels, nasal glands and eosinophils infiltration almost disappeared. These changes were considered to weaken the allergic reaction, and to block both the venous plexus and the secretion of rhinorrhea.
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  • A Case of Extramedullary Plasmacytoma in the Nasal Septum
    Takayuki NAKAGAWA, Toshinobu SHIGETA, Tadayoshi TAKASHIMA, Tsunemasa A ...
    1996 Volume 89 Issue 4 Pages 443-447
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.443
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    Extramedullary plasmacytoma, a rare type of plasmacytoma, can often be diagnosed only by histological examinations.
    Recently, we encountered a case of extramedullary plasmacytoma originating in the nasal septum, which was diagnosed by immunohistochemical examination. The tumor was identified as IgG-κ type by the enzyme-labeled antibody technique. The tumor total removed with an Nd-YAG laser and post operative irradiation was performed. No signs of local recurrence or multiple myeloma have been recognized during the follow-up period.
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  • Repair of a Medial Orbital Wall Fracture in the Ethmoid Sinus Using a Balloon Catheter
    Mitsuru IGARASHI, Myojyo KANAJI, Shinji SUZUKI, Akihiko FUJITA
    1996 Volume 89 Issue 4 Pages 449-453
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.449
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    A patient with a broad medial orbital blowout fracture was treated surgically by the balloon catheter technique.
    After repair of the medial orbital wall through a transorbital approach with an external incision, a balloon catheter was inserted into the anterior and posterior ethmoid sinus by the endonasal approach to repair the medial orbital wall of the blowout fracture. The catheter was left in for nineteen days. Satisfactory results were obtained.
    The balloon catheter technique is quite simple and useful in the repair of fractures of the medial orbital wall.
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  • Large Mucocele of Frontal Sinus Treated with Craniosurgery; A Case Report
    Nobuhiro HAKUBA, Tadahiko SAIKI, Kazuhiko Takeda, Masamitsu HYODO
    1996 Volume 89 Issue 4 Pages 455-460
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.455
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    A 30-year-old male complained of nasal obstruction and left upper eyelid swelling. CT scan and MRI revealed a huge mucocele of the left frontal sinus extending into the left orbit and lateral to the left anterior cranial fossa. Severe paranasal sinusitis was also present. Under general anesthesia, a huge mucocele and severe paranasal sinusitis were operated on by craniosurgery through a coronal incision and by endoscopic endonasal sinus surgery respectively. All the paranasal sinuses were packed with polyps, and bone destruction was evident in the left frontal bone and upper wall of the left orbit. The mucocele was removed easily from the dura mata. Dead spaces were packed with fascia and fatty tissue from the femur and with temporal muscle. The patient recovered uneventful by and continues to be well at present.
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  • A Case of Extramedullary Plasmacytoma of the Maxilla with the Expression of Cytokeratin
    Hideaki SUZUKI, Ryo ICHINOHASAMA, Naoki INAMURA, Tomonori TAKASAKA
    1996 Volume 89 Issue 4 Pages 461-469
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.461
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    We report a case of extramedullary plasmacytoma of the maxilla, which was difficult to diagnose definitively by conventional histopathology because of the presence of epithelial antigens.
    A 62-year-old male with a 7-month-history of unilateral epiphora and nasal obstruction followed by swelling of his left cheek is presented. Physical findings, CT scanning and MRI imaging revealed a maxillary tumor, T4N0M0. Blood test, serum and urine protein analyses and bone marrow examination showed no abnormality. No other systemic lesion was found in X-rays and 67Ga- and 99mTc-scintigrams. Exploratory resection was performed, and the tumor was pathologically diagnosed as an undifferentiated carcinoma on the basis of its morphological features and positive immunohistochemical examination for epithelial markers such as cytokeratin and epithelial membrane antigen (EMA). The patient received preoperative local irradiation of 40Gy, and underwent total maxillectomy followed by irradiation of 50Gy and administration of cisplatin and 5-fluorouracil.
    Nineteen months after the surgery, the patient manifested a tumor in the thyroid region with high serum gamma-globulin and IgG levels. In addition, IgG-kappa-type myeloma protein was detected by immunoelectrophoresis of the serum. The patient underwent subtotal thyroidectomy. Although the tumor cells of the surgical specimen still exhibited epithelial markers, electron microscopic observation, immunohistochemical examination and Southern blot analysis demonstrated rough endoplasmic reticulum-rich cytoplasm, kappa (+) lambda (-) of Ig light chain and rearranged bands of Ig heavy chain, which are characteristic of plasmacytoma. The tumor was, consequently, diagnosed as extramedullary plasmacytoma. Serum gamma-globulin and IgG levels returned to the normal range 4 months after the second surgery.
    In conclusion, we emphasize that plasmacytoma may express epithelial antigens, and thus the importance of multiple supplementary methods to diagnose this neoplasm.
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  • Benign Recurrent Tumors of the Parotid Gland
    Yoshiyuki TANIGAITO, Hirokazu YOSHIDA, Hiroaki SHIMIZU, Satoru FUKAMI
    1996 Volume 89 Issue 4 Pages 471-477
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.471
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    Seven cases of benign recurrent parotid gland tumors (male: 1, female: 6) were studied clinically. The average age of the six patients with pleomorphic adenoma was 41.5 and one patient with adenolymphoma was 75 years old. The average age of patients with pleomorphic adenoma at initial surgery was 29.7 and that of those with adenolymphoma was 65. Patients with pleomorphic adenoma received initial surgical therapy while they were much younger than other patients without recurrent pleomorphic adenoma. The period between initial surgery and the tumor recurrence ranged from 4 to 13 years. Most patients did not visit the hospitals immediately despite noticing the recurrent tumors and few patients visited the hospitals where they received the initial surgical therapy. None of the patients had any local pain or facial nerve paralysis. Surgical excision was carried out. Pathologically, two cases had single recurrent tumor and the other cases had multiple recurrent tumors. Many recurrent tumors of pleomorphic adenoma were type 1 or 2 on Seifert's classification of pleomorphic adenoma. Type 2 tumors surrounded by adipose tissues had no tumor capsule. The patient with adenolymphoma developed two tumors and it was unclear whether these tumors were recurrent tumors or regrowth of residual tumors. Post surgically, three patients showed facial nerve paralysis including transient cases. In six patients who received the atypical surgery initially, it was possible to locate the facial nerve at the main trunk but some cases required resection of the nerve branch. In one case who underwent standard initial surgery, the increase in fibrous tissues was remarkable and safe preservation of the whole facial nerve was very difficult. It was suggested that in the initial surgical therapy, the physician must resect the tumor sufficiently and then maintain records of the pathological data and the surgical findings (especially a map of the facial nerve) for a long time, considering the potential for recurrence.
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  • MR Findings of Pleomorphic Adenomas in the Parotid Glands
    Koshi IKEDA, Hiroshi IWAI, Tsutomu KATOH, Koichi TOMODA, Toshio YAMASH ...
    1996 Volume 89 Issue 4 Pages 479-484
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.479
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    We surveyed MRI (magnetic resonance images) of 105 parotid tumors including 51 Pleomorphic adenomas and assessed the usefulness of MR findings in differentiating pleomorphic adenomas from other benign tumors and malignant tumors.
    It was reported that pleomorphic adenomas show a low signal intensity on T1-weighted images, a high signal intensity on T2-weighted images, and well-defined margins with an inhomogeneous internal structure on MRI. In our results, low signal intensity on T1-weighted images, well-defined margins, and an inhomogeneous internal structure were essential findings for the diagnosis of pleomorphic adenomas in MRI. However, these features were often shown in other benign and malignant tumors. High signal intensity on T2-weighted images was an essential finding for diagnosis of pleomorphic adenomas and showed relatively high specificity to pleomorphic adenoma when compared with other parotid tumors.
    Although rim formation around the tumor and lobulated contour as MR features of pleomorphic adenomas were not observed frequently on MRI of pleomorphic adenomas, these did show a high specificity for those tumors, indicating that these features are useful for differential diagnosis of pleomorphic adenomas from other benign and malignant tumors.
    Histopathological study indicated that rim formation around the tumor and lobulated contour observed in MRI corresponded to capsule formation and lobulated growth of pleomorphic adenomas, respectively.
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  • Burkitt's Lymphoma of the Parapharyngeal Space; A Case Report
    Ken ISHIJIMA, Mitsuharu NONOMURA, Tatsuo KIKUGAWA
    1996 Volume 89 Issue 4 Pages 485-488
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.485
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    Although most tumors in the parapharyngeal space are benign, a few malignant tumors have been reported. Malignant lymphomas are very rare, and Burkitt's lymphoma in the parapharyngeal space has been reported only once in the world literature. Here we describe a patient with Burkitt's lymphoma of the parapharyngeal space.
    A 63-year-old male visited us because of a rapidly increasing mass at the angle of his mandible. MRI showed a large tumor occupying the parapharyngeal space. The FNA report was probable malignant tumor but perhaps not malignant lymphoma. We suspected carcinoma of the parapharyngeal space and resected it through a neck incision. Histological examination showed Burkitt's lymphoma, and the patient was referred to the department of hematology in our hospital.
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  • Resection of Vocal Fold Polyps and Nodules with a Flexible Fiberscope
    Kazunori MORI, Machiko FUJITA, Takao KANBE, Minoru HIRANO
    1996 Volume 89 Issue 4 Pages 489-493
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.489
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    Although endolaryngeal microsurgery is now regarded as the optimal method to remove small lesions of the larynx, resection of these lesions with a flexible fiberscope under local anesthesia is easy and can be performed in outpatients. The purpose of this study is to investigate the surgical results and indications for this technique.
    One hundred and forty-eight patients with vocal fold polyps or nodules underwent resection of these lesions by this technique. Aerodynamic and acoustical evaluation of the pre- and postoperative patients' voice showed marked improvement after surgery. Postoperatively ninety-five per cent of these patients recognized a subjective improvement of their voice. No complications were found. However, some patients required postoperative voice therapy.
    Although this technique is thought to be safe and easy, the vocal fold nodule, which looks round and hard and has a smooth surface, should be treated by endolaryngeal microsurgery under general anesthesia.
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  • Two Cases with Metastatic Cervical Lymph Nodes from Nasopharyngeal Carcinoma Simultaneously Showing Tuberculous Caseosa
    Takuji KANEKO, Ichiro AKAO, Hiroya IWATAKE, Isao KATO, Masayuki TAKAGI
    1996 Volume 89 Issue 4 Pages 495-499
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.495
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    We had encountered two men, 51-year and 35-year-old, with nasopharngeal carcinoma. These patients showed nasopharyngeal tumor and metastatic lymph nodes in the neck. After chemotherapy followed by radiation, bilateral neck dissection was performed under general anesthesia.
    Poorly differentiated carcinoma was diagnosed histologically in both patients, however, resected of neck lymph nodes showed caseating granuloma suggesting tuberculous. Thus, it was suggested that tuberculous lymph nodes might be caused by decreased immunological competence due to nasopharyngeal carcinoma.
    There have been few cases with lymphadenitis which have demonstrated both cancer cells and tuberculous caseosa.
    We discuss the mechanism based on previous reports.
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  • Lateral Aberrant Thyroid Tumor; A Case Report
    Kouichirou ASANO, Keisuke MIZUTA, Yatsuji ITOU, Tomoo SUZUKI, Hideo MI ...
    1996 Volume 89 Issue 4 Pages 501-504
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.501
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    A 53-year-old female complained of a growth in the left side of the neck. A tumor was found at the carotid triangle. It was elastic soft and measured approximately 3.0×3.2cm in size. Ultrasound scan confirmed the mass, which was well demarcated, solid, and with a complex echotexture. CT scans revealed that the tumor was located inside the sternocleidomastoid muscle and showed partly high-density-area suggestive of calcification.
    The tumor was removed en bloc and showed no connection to the thyroid. The macroscopic appearance more closely resembled thyroid tissue than cervical lymph node. Pathohistologically, it was normal thyroid tissue with thyroid follicles of varying sizes. There was no evidence of malignancy.
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  • Cervical Thymic Cyst
    Masahiro YANAGIDA, Hiroshi IWAI, Jun KITA, Masayuki MINAMINO, Hiroki I ...
    1996 Volume 89 Issue 4 Pages 505-509
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.505
    JOURNAL FREE ACCESS
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    A case of cervical thymic cyst is presented, and the literature is reviewed. A 25-year-old-female was found to have a frontal neck mass. At surgery, the thyroid gland was found to be normal, but displaced by a cystic mass. The cyst was lobulated and contain clear fluid. It was removed from the carotid laterally and from the trachea medially.
    Thymic cysts are unusual neck masses that may occur along the embryologic pathway of migration of the thymus. The mass produces few symptoms, but can sometimes cause air way obstruction. Treatment consists of excision of the cyst and prognosis is usually good. This entity should be included in the differential diagnosis of neck masses.
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  • Diagnosis of Tortuosity of Common Carotid Artery by MRA
    Tomohiro MAKOSHI, Hiro-omi Takahashi, Toyota ISHII, Shinichi FURUSAWA
    1996 Volume 89 Issue 4 Pages 511-514
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.511
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    Tortuosity of the common carotid artery is not a rare disease. Diagnosis of the disease is usually made by digital subtraction angiography (DSA). However, the examination for the diagnosis should have few effects on the body because the disease often involves seniors who can easily develop complications such as hypertension. We reported two cases in which magnetic resonance angiography (MRA) and ultrasonography were useful in establishing diagnosis. These examinations are also preferable because of their simplicity and minor impact on the body.
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  • Gas Exchange in Middle Ear through the Mucosa
    Makito TANABE, Haruo Takahashi, Iwao HONJO
    1996 Volume 89 Issue 4 Pages 515-518
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.515
    JOURNAL FREE ACCESS
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    Ventilation of the middle ear is of two types: 1) ventilation via the eustachian tube and 2) ventilation via the middle ear mucosa. Ventilation via the middle ear mucosa is performed by gas exchange between the middle ear and the blood. The gas composition of the middle ear differs from that of air and resembles that of venous blood. The gas composition and the pressure of the middle ear may be affected by the gas composition of blood and the condition of the middle ear mucosa. When there is a difference in partial pressure between the middle ear and the blood, gas diffuses through the mucosa to equalize the partial pressures. Gas exchange in the middle ear through the mucosa is due to diffusion which depends on the difference in partial pressure. It is not known whether gas exchange between the middle ear and the blood occurs only by gas diffusion between the middle ear and blood and depends on differences of partial pressure.
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  • Evaluation of Temporal Resolution with Electrocochleograms and Auditory Evoked Brainstem Responses
    Shogo SHINOHARA, Kazuhiko SHOJI, Hisayoshi KOJIMA, Koji MIYATA, Shiger ...
    1996 Volume 89 Issue 4 Pages 519-523
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.519
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    Temporal resolution is an important factor in auditory processing, especially in speech recognition. A psychoacoustic gap detection test has been divised to evaluate it in humans.
    We designed an electrophysiological gap test using electrocochleograms (ECochGs) and auditory evoked brainstem responses (ABRs) to clarify the region in which the gap detection threshold is decided in the auditory pathway. ECochGs and ABRs were elicited simultaneously by a probe tone (4kHz, 85 dBSPL, 2msec duration, tone burst) with a preceding masker tone (4kHz, 85dBSPL, 50 msec duration, tone burst) in 16 subjects with normal hearing. As two tone intervals (gaps) were shortened from 10 msec by 2 msec steps, the amplitudes of the action potential (AP) in ECochGs and wave V in ABRs decreased and became undetectable. The thresholds for AP detection which are regarded as gap detection thresholds in the cochlea ranged from 2 to 6 msec with an average of 4.0 msec, while the thresholds for wave V detection, thresholds in the inferior colliculus, had the same range with an average of 4.4 msec, which is similar to the results of the psychoacoustic gap test introduced by Shailer and Moore in 1989. We conclude that a gap detection threshold is present in the peripheral auditory system in normal listeners.
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  • Treatment of Postoperative Complications in the Congenital Aural Atresia
    [in Japanese], [in Japanese]
    1996 Volume 89 Issue 4 Pages 524-525
    Published: April 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.524
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