Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 89, Issue 7
Displaying 1-19 of 19 articles from this issue
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  • Mechanisms of the Development of Nasal Hyperreactivity in Nasal Allergy
    Akiyoshi KKONNO, Nobuhisa TERADA, Tsutomu NUMATA, Toyoyuki HANAZAWA, H ...
    1996 Volume 89 Issue 7 Pages 773-783
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.773
    JOURNAL FREE ACCESS
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    Nasal hyperreactivity in nasal allergy conditions is closely related to allergic inflammation, particularly to infiltration by activated eosinophils in the nasal mucosa, observed 4 to 10 hours after a single antigenic challenge. Repeated antigenic challenge in subjects with nasal allergy enhanced nasal hyperreactivity. On the other hand, various therapies including topical steroids, immunotherapy and antiallergic drugs inhibited the infiltration of eosinophils and basophilic cells in the nasal mucosa, and thus inhibited nasal hyperreactivity. The characteristic features of the nasal mucosa in subjects with nasal allergy were: (1) morphological and functional changes of the nasal epithelium which facilitated the sensory excitation of the nasal reflexes to various stimuli; (2) depressed sympathetic and enhanced parasympathetic activity of the nasal mucosa, with correspond-ing changes in the density of autonomic nerve receptors; (3) enhanced expression of histamine H1 receptor mRNA in the nasal epithelium; and (4) changes in the number and volume of effector organs in the nasal mucosa. Receptor antagonists of leukotrienes and thromboxane A2 could also effectively depress the reactivity of the nasal mucosa to histamine. The direct and indirect effects of these chemical mediators, together with each patient's constitutional predisposition, were also considered to have an effect on enhanced nasal hyper-reactivity.
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  • Cases with Transverse Fracture of the Temporal Bone
    [in Japanese], [in Japanese]
    1996 Volume 89 Issue 7 Pages 784-785
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.784
    JOURNAL FREE ACCESS
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  • Two Cases of Large Cerebellopontine Angle Tumors with Normal Pure-Tone Hearing
    Shiro AKAHANI, Noriaki Takeda, Ichiko TAKEMOTO, Izumi KOIZUKA, Takeshi ...
    1996 Volume 89 Issue 7 Pages 787-793
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.787
    JOURNAL FREE ACCESS
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    Two patients with large cerebellopontine (CP) angle tumors and normal pure-tone hearing levels are reported. Case 1, a 49-year-old woman, first experienced hearing distortion in her left ear. Case 2, a 45-year-old woman, first experienced numbness at the tip of her tongue, and then noted hearing loss in the left ear. However, their pure-tone audiograms were normal. In both cases, the Bekesy audiogram showed a type III tracing for the left ear, and the results of auditory brainstem response (ABR) testing were abnormal. A CT scan and a MR imaging demonstrated a CP angle tumor of 6×4 cm size in Case 1, and of 3.5×3 cm size in Case 2. The former was a surgically confirmed CP angle meningioma, and the latter was a surgically suspected facial nerve neuroma. These cases emphasize the fact that a large CP angle tumor can be present without affec-ting pure-tone hearing sensitivity. The clinician must be aware that a subjective hearing impair-ment may be the only clues to the presence of a CP angle tumor. ABR is a valuable procedure for detecting CP angles tumors in patients with normal pure-tone hearing.
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  • Bilateral Acoustic Neurinoma; A Case Report
    Eiji Takahashi, Yatsuji Ito, Keisuke MIZUTA, Kenichi ANDO, Hideo MIYAT ...
    1996 Volume 89 Issue 7 Pages 795-799
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.795
    JOURNAL FREE ACCESS
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    A 64-year-old woman was affected with sudden bilateral hearing loss. She initially visited us complaining of right-sided accordingly hearing loss, which was diagnosed as right sudden deafness, and treated. Thereafter she indicated that vertigo, with right tinnitus, had increased. She was subsequently diagnosed with Meniere's disease. Thereafter she visited us complaining of left-sided hearing loss. After numerous clinical visits and extensive examinations, including MRI, she was diagnosed as having a bilateral acoustic tumor, although she didn't have the cafe-au-lait spots, induration under the skin, or small nodules of the iris and juvenile cataractas that are characteristic of Recklinghausen's disease. As her symptoms were atypical and the course of her disease was unusual for patient affected with an acoustic tumor in consideration of her age, we didn't recommend surgery. Presently she uses a hearing aid in the left ear.
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  • Correlation of Electrocochleographic Data and Hearing Loss
    Masutoshi NISHIKAWA, Keiko NISHIKAWA
    1996 Volume 89 Issue 7 Pages 801-807
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.801
    JOURNAL FREE ACCESS
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    Transtympanic electrocochleography (ECoG) with clicks and tone-bursts at a frequency of 1000 Hz was performed in 155 patients (160 ears) who visited JA Yamaguchi Shuto General Hospital. Action potentials (AP), negative summating potentials (—SP) and cochlear microphonics (CM) were examined.
    1) Click-evoked AP detection thresholds and tone-burst-evoked CM detection thresholds were cor-related with pure tone thresholds at frequencies of 1000 Hz and 4000 Hz, and with average pure tone hearing levels in the frequency range of 500-4000 Hz. Click-evoked AP detection thresholds correlated well with pure tone thresholds at a frequency of 4000 Hz (correlation coefficient: 0.800).
    2) Click-evoked AP detection thresholds in patients with high-frequency hearing loss were higher than those in patients with low-frequency hearing loss.
    Click-evoked AP amplitudes in patients with high-frequency hearing loss were lower than those in patients with low-freuency hearing loss. There were significant differences in click-evoked AP thresholds and AP amplitudes between patients with high-frequency and low-frequency hearing loss. Click-evoked AP thus appeared to be related to high-frequency hearing loss.
    3) There were significant differences in average pure tone hearing levels in the frequency range of 500-4000 Hz, pure tone thresholds at frequencies of 1000 and 4000 Hz, click-evoked AP detection thresholds and amplitudes, and tone-burst-evoked CM detection thresholds between patients with and without a delayed response following CM.
    Patients with a delayed response following CM thus appeared to have better hearing levels and better ECoG waveform responses than did those without a delayed response following CM.
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  • Traumatic Fracture of the Stapes Footplate; A Case Report
    Taisuke Kobayashi, Kiyofumi GYO, Eiji YUMOTO
    1996 Volume 89 Issue 7 Pages 809-813
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.809
    JOURNAL FREE ACCESS
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    A 16-year-old boy was referred to Ehime University Hospital with suspicion of ossicular chain dislocation three days after accidental trauma to his right ear caused by an earpick. He experienced hearing loss and tinnitus immediately after the ear injury. Two hours later, he experienced vertigo with nausea. Otoscopic examination revealed that the long process of the incus had penetrated the tympanic membrane. A pure tone audiogram revealed a mixed hearing loss with an average air conduction threshold of 56 dB. Neither spontaneous nor positional nystagmus was noted. Results of a fistula test were negative. During surgery, fractures of the stapes were noted at the anterior crus and footplate, although perilymphatic leakage was not found. After removal of the fragmented stapes and the dislocated incus, a teflon wire piston was placed on the oval window following coverage with a fascial graft. The wire was fixed to the malleus handle. Postoperatively, dizziness disappeared and the hearing improved to 26 dB.
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  • Intraparotid Facial Nerve Schwannoma; Report of Two Cases
    Hidetoshi HARAGUCHI, Norihiko ISHIKAWA, Hitoshi HENTONA, Taro SUGIMOTO ...
    1996 Volume 89 Issue 7 Pages 815-821
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.815
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    Two cases of intraparotid facial nerve schwannoma are presented. Case 1 was a 38-year-old female who complained of a slowly growing tumor under her left ear. She had had an open biopsy at another hospital about two years earlier ; the tumor was diagnosed histologically as schwannoma. Surgical excision was performed, and the tumor was diagnosed as a schwannoma originating from the buccal branch of the facial nerve. Case 2 was a 74-year-old female who complained of a slowly growing tumor under her left ear. The tumor was accompanied by slight pain, and left facial palsy was noted. Surgical excision was performed under a preoperative diagnosis of malignant parotid gland tumor. However, the tumor was found to be a schwannoma originating from the main trunk of the facial nerve, the upper part of the tumor was growing into the stylomastoid foramen.
    Intraparotid facial nerve schwannoma is rare, and in Japan, only 26 cases have been reported to date.
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  • Adenocarcinoma in the Nasal Cavity; A Case Report
    Yoshihiko ISHIZU
    1996 Volume 89 Issue 7 Pages 823-826
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.823
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    Adenocarcinoma of the nasal cavity is a rare malignant tumor. A 48-year-old man was referred to our hospital with swelling and pain of the nasal root. An easily bleeding tumor was found in the left nasal cavity, presumably arising from the nasal septum. The nasal bone was destroyed and subcutaneous invasion was suspected from the CT scan.
    Pathological examination of the tumor confirmed the diagnosis of adenocarcinoma. The tumor was removed with the skin of the nasal root, part of the nasal bone and nasal septum. He was given chemotherapy 3 times (CAP therapy: CDDP, THP-adriamycin, cyclo-phosphamide). The defect of the external nose was reconstructed with a midline forehead flap after 3 months.
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  • Malignant Melanoma of the Nasal Cavity; A Case Report
    Kenichi KATAOKA, Akira KODAMA, Kaoru UCHIDA
    1996 Volume 89 Issue 7 Pages 827-831
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.827
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    A 31-year-old female with nasal obstruction as her chief complaint was diagnosed histopathologically to have undifferentiated carcinoma with its origin on the right side of the nasal septum. Chemotherapy (CDDP, PEP, VDS, UFT) and radiation therapy was instituted but with no success. Then, surgical resection of the tumor was performed, malignant melanoma was diagnosed. Postoperative chemotherapy with DAVP (DTIC, ACNU, PEP, VCR) was instituted but she died of lung and brain metastasis. Immunohistochemical examination of the initial biopsy specimen confirmed the diagnosis of amelanotic melanoma.
    We conclude that immunohistochemical examination (S-100, HMB-45) is useful in diagnosing amelanotic melanoma.
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  • Intracranial Infection as a Complication of Paranasal Sinusitis; A Case Report
    Koichi SUGIHARA, Hiroyuki OIKI, Kiyotaka MURATA
    1996 Volume 89 Issue 7 Pages 833-838
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.833
    JOURNAL FREE ACCESS
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    Intracranial complications of nasal infection have decreased, and the death rate has also fallen because of the development of antibiotics and CT scanning. However, some recent reports show that intracranial complications of nasal infections are increasing in number.
    Our patient, a 15-year-old male, had a high fever and severe headache, and 3 days later he started vomiting. He was admitted and examined immediately. Physical examination and serologic tests showed bacterial meningitis, and CT scans showed frontal sinusitis and subdural abscess. Broadspectrum antibiotics were administered, but his symptoms were not reduced, so frontal sinus surgery was performed. Mucosal inflammation and suppurative discharge were found. Eleven days later the intracranial abscess was drained. After few weeks his condition had improved, and he was discharged without any complications.
    Previous reports and our case suggest that there is a high incidence of intracranial complications of nasal infection in young males. Therefore, in young male patients with paranasal sinusitis, immediate diagnosis and treatment are necessary if intracranial complications are suspected.
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  • Accessory Parotid Gland Tumor; A Case Report
    Hiromitsu Saito, Hiroyuki FUJITA, Tomoyuki YOSHIDA, Fumihisa HIRAIDE
    1996 Volume 89 Issue 7 Pages 839-844
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.839
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    We have recently treated a patient with an accessory parotid gland tumor. The diagnosis was made by sialography, sialo-CT and MRI. Sialography seemed to be the most useful examination in the diagnosis of this malignant tumor, because it could demonstrate the tangential accessory duct which appeared to be separate from the main parotid gland and duct.
    We could respect the tumor without the difficulty of dye injecton into Stenon's duct. In addi-tion, we describe the clinicopathlogical features of previous five patients with accessory parotid tumor (three malignant, two benign) treated in our hospital.
    We could recognize the tangential accessory duct in all five patients during the operation.
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  • Treatment Results for Stage I and Stage II Laryngeal Carcinoma
    Sanson HAN, Hiroyuki KITAMURA, Shin-ichi TAKAGITA, Ryo ASATO, Yuka IWA ...
    1996 Volume 89 Issue 7 Pages 845-847
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.845
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    Combined therapy, using a Nd-YAG laser and irradiation, for the treatment of stage I and stage II laryngeal carcinoma has been applied at our facility since June of 1990. A total of 18 cases of stage I and 12 cases of stage II laryngeal carcinoma were investigated retrospectively. Among these 30 cases there were 3 cases of stage II supraglottic cancer, 26 cases of glottic cancer (stage I: 17 cases, stage II: 9 cases), and one of stage I subglottic cancer.
    Preservation rate of the larynx in stage I and stage II laryngeal carcinoma patients has been poor in the past. In the present series of patients, however, the larynx was preserved in 100% of the stage I patients and in 58.3% of the stage II patients. Though these results represent a substantial improvement over the previous preservation rate, preservation of the larynx in stage II patients remained similar to that in other reports.
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  • Deep Neck Abscess in Children; Two Cases Report
    Makoto HANADA, Shigehiro OHWAKI, Akira KODAMA, Kazutomo KITAJIMA
    1996 Volume 89 Issue 7 Pages 849-854
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.849
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    Two cases of deep neck abscess in children are reported. Case 1, in a one-year-old female, was caused by acute upper respiratory tract infection. Case 2, in a 9-year-old female, who had been experiencing bone marrow suppression due to chemotherapy for the treatment of acute myelocytic
    leukemia, was caused by rubella. Both cases were treated by surgical drainage under general anesthesia and the subsequent clinical course was good.
    Deep neck abscess is rarer in children than in adults. As such, the characteristics of this type of abscess in children are discussed in this paper.
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  • Rhabdomyosarcoma of the Cranial Fossa; A Case Report
    Kenji OKAMI
    1996 Volume 89 Issue 7 Pages 855-859
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.855
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    A 17-year-old male presented with progressive cranial nerve palsy. CT and MRI revealed a large tumor in the right cranial fossa with bone destruction. Radiation therapy was performed but only a temporary partial remission was obtained. After a 3-month hospitalization he died of respiratory failure due to lung metastasis. Autopsy revealed metastase in the lung, pleura, and adrenal gland. The pathological diagnosis was rhabdomyosarcoma.
    The difficulty of pathological diagnosis and the importance of early diagnosis and treatment are emphasized.
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  • Intra-Arterial Infusion Neoadjuvant Chemotherapy with Combination CDDP (or CBDCA) and 5-FU for Head and Neck Cancer
    Shin-ichi Sato, Syogo SHINOHARA, Tetsuya OGATA, Yasuko FUJIMOTO, Makot ...
    1996 Volume 89 Issue 7 Pages 861-865
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.861
    JOURNAL FREE ACCESS
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    Twenty-three patients with cancer of the oral cavity, oropharynx or maxillary sinus were treated with a combination of cisplatin (or carboplatin) and 5-fluorouracil given by intra-arterial and systemic infusion as neoadjuvant chemotherapy chiefly in preparation for surgery.
    There were 11(47.8%) complete and 9 (39.1%) partial responses. The overall response rate was 87.0%. The pathological complete response rate was 39.1% (9). Nineteen patients have shown no signs of recurrence 11-54 months after the initiation of therapy.
    These studies show that the regimen of intra-arterial infusion with cisplatin (or carboplatin) and 5-fluorouracil as neoadjuvant chemotherapy is highly effective for head and neck cancer.
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  • Spatiotemporal Observations of the Auditory System with a Multichannel Optical Recording
    -A Review of the Literature-
    Kiyohiro FUJINO, Iwao HONJO
    1996 Volume 89 Issue 7 Pages 867-879
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.867
    JOURNAL FREE ACCESS
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    Multichannel optical recording is a powerful method for clarifying the mechanisms underlying the complicated neural networks, because it can monitor multiple points of the nervous system simultaneously with fine spatiotemporal resolution. Many original findings have been discovered, particularly in the visual cortex, by using voltage-sensitive dyes or by recording intrinsic signals. Studies of the auditory system are relatively rare, but the dynamic characteristics of the auditory system can be revealed gradually with this method.
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  • Reliability Measures for Tinnitus Examination
    Katsuhiko TAMAKI
    1996 Volume 89 Issue 7 Pages 881-893
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.881
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    Many reports have addressed the use of the pitch match test and the loudness balance test in patients with tinnitus, but little has been reported regarding the reliability of these tests. We developed a reliability assessment method for facilitating the evaluation of patients with tinnitus. The reliability of the pitch match test and loudness balance test for tinnitus was examined using differences in pitch judgement between band noises and pure tones, and using the pitch test and loudness test of the Seashore measures for musical talents.
    In experiment 1, the pitch match test was performed in normal subjects using the XAB method for various frequencies of band noises and pure tones. In experiment 2, the pitch test and in experiment 3, the loudness test, of the Seashore measures for musical talents were performed in normal subjects. The subjects were divided into two groups based on the results of each experiment. One had good ability while the other had poor ability in differentiating test tones. Standards for judging the reliability of these tests in each experiment were then established by comparing the data from the two groups. A reliability judging method was subsequently developed using a combination of the standards obtained for these three experiments. These reliability tests were compared with test-retest result in the audiological examination, and the reliability test proved useful.
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  • Clinical Effects of Low-dose Clarithromycin (CAM) Therapy for Chronic Tonsillitis
    Hayato MISAWA, Toshinori IWAGAKI
    1996 Volume 89 Issue 7 Pages 895-902
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.895
    JOURNAL FREE ACCESS
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    This study was carried out to determine the clinical effects of low-dose clarithromycin (CAM) therapy for the treatment of chronic tonsillitis. Forty-two patients were assigned randomly to two groups : 200 mg of CAM per day (test group) and 400 mg per day (control group) for 4 to 8 weeks. The final overall effectiveness rates inclusive of excellent or good efficacy were 64% for the test group, and 55% for the control group, respectively. No statistical differences were noted in terms of subjective or objective efficacy between two groups. No side effects were observed in the control group, whereas mild upset stomach appeared in one case in the test group. Low-dose application of CAM was thus proved to be as effective as standard application.
    It was speculated that the efficacy of low-dose CAM therapy is mainly attributable to the immunomodulatory effects of 14-membered macrolides. These results suggested that low-dose administration of CAM can be useful for the treatment of chronic tonsillitis.
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  • Basic Idea for the Identification of ABR
    [in Japanese]
    1996 Volume 89 Issue 7 Pages 904-905
    Published: July 01, 1996
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.89.904
    JOURNAL FREE ACCESS
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