Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 91, Issue 11
Displaying 1-17 of 17 articles from this issue
  • Satoshi KITAHARA
    1998 Volume 91 Issue 11 Pages 1081-1087
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We administered an intracordal injection of silicone or fat to 114 cases with unilateral vocal cord paralysis between January 1983 and December 1997. The primary injection method was transcutaneous (100 cases). The injection material used in most cases was silicone, but in recent years fat has been injected instead. There was no difference in outcome related to injection procedures. Regarding injection technique, the three prerequisite conditions which resulted in a good post-operative voice were as follows: the position of the paralyzed vocal cord was close to the median line; atrophy of the vocal cord was less; and the two vocal cords did not differ in height. Recent progress in surgical techniques, as well as an increased incidence of cancer such as lung cancer and esophageal cancer, has resulted in an increase in the number of cases of laryngeal paralysis after surgical treatment of malignant tumors. Since reported human-adjuvant disease in conjuction with the use of silicone, alternatives to silicone have been in demand. The manipulation of fat however, remains difficult and we anticipate the development of an injection material which is more easily manipulated, non-absorbed, and which induces minimal tissue response.
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  • [in Japanese], [in Japanese]
    1998 Volume 91 Issue 11 Pages 1088-1089
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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  • Takae Sato, Chiori MATSUMTO, Ken KITAMURA, Hidenori YOKOTA, Takeshi FU ...
    1998 Volume 91 Issue 11 Pages 1091-1095
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We report a rare case with astrocytoma in the region of the bilateral cerebellopontine angle. The patient was a 33-year-old male who was diagnosed with neurofibromatosis 2 by clinical, audiovestibular and neuroradiological examination. However, the postoperative pathological diagnosis was consistent with fibrillary astrocytoma. Most gliomas in the posterior cranial fossa arise from the brainstem, and seldom originate in the vestibulocochlear nerve. Thus, we discuss the characteristics of glioma arising in the eighth cranial nerve and its association with neurofibromatosis 2.
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  • Masato NISHIMURA, Yuko KUGA, Akiko OKUYAMA, Tamotsu HARADA
    1998 Volume 91 Issue 11 Pages 1097-1101
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Prognostic factors in idiopathic sudden sensorineural hearing loss were analyzed statistically in 135 patients admitted to the Department of Otorhinolaryngology at Sumitomo Hospital between 1993 and 1996. Patients treated within 6 days after onset recovered significantly better than those treated 7 or more days after onset. The patients with hearing within 80 dBHL recovered significantly better than those over 80 dBHL. Moreover, the improvement rate was better in the low frequencies than in the high frequencies. Severity of vertigo was closely related to poor recovery of hearing loss in the group with hearing of less than 40 dBHL at onset, although this relationship was not evident in the group with hearing of more than 40 dBHL at onset. These results suggest that patients with acute endocochlear hydrops may be included in the group with vertigo and hearing of better than 40 dBHL at onset.
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  • Takeshi MORITA, Keisaku TABUCHI, Shinnichiro KITAJIRI
    1998 Volume 91 Issue 11 Pages 1103-1106
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Tick bites in the external auditory canal of humans are very rare. On July 14th 1997, a 65-year-old woman consulted our hospital, complaining of right tinnitus. She noted right tinnitus after walking around the coppice near her house two days before her visit to our hospital. Otolaryngological examination showed a hard tick bite on the anterior wall of right external auditory canal of the patient. Using local anesthesia, we made an incision around the bite site and removed the tick with connecting tissue. The tick body removed from the patient measured 4mm in length, 3mm in maximum width and 0.8mm in height. By acarological observation, the tick was identified as an adult female Haemaphysalis longicornis in the early stage of sucking blood. Ixodid hard tick bites are known to frequently communicate various kinds of microbial diseases to humans, including Japanese spotted fever, Q fever and Lyme disease. In cases of human tick bite, it is important to remove the tick completely and to identify the species in order to prevent these microbial diseases. We reported this rare case of a tick bite in the external auditory canal of a human as the 14th case in Japan.
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  • Allergic Rhinitis Using Acoustic Rhinometry
    Motofumi OHKI, Yukiko YOSHINO, Nobuo Usui
    1998 Volume 91 Issue 11 Pages 1107-1113
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The evaluation of nasal obstruction is important for the treatment of perennial allergic rhinitis. Although, nasal resistance induced by rhinomanometry is useful, several authors have reported that nasal resistance is not correlated with the sensation of nasal obstruction.
    Acoustic rhinometry was introduced by Hilberg et. al. (1989) to assess the geometry of nasal cavity. The method, based on sound reflection analysis provides an estimate of the cross-sectional area of the nasal cavity as a function of the distance from the nostril. Recently, acoustic rhinometry has become popular in our country. The aim of this study was to evaluate changes in the nasal mucosa of patients with perennial allergic rhinitis and in normal subjects and to investigate the benefits of acoustic rhinometry.
    Ten normal subjects and 10 patients with perennial allergic rhinitis were measured by acoustic rhinometry before and after administration of a topical decongestant using an acoustic rhinometer (RHIN2100 SRE co. Denmark). Changes in the nasal volume (0.8-4.0cm) (0-7.0cm) and cross-sectional area (c-notch) were greater in patients than in normal subjects. However, the nasal volume and cross-sectional area in patients with perennial allergic rhinitis were the same as in normal subjects.
    These results suggest that the nasal mucosa of patients with perennial allergic rhinitis is more swollen than that of normal subjects. Moreover, measurements of nasal volume and nasal cross-sectional area are able to define the structure of the nasal cavity. These values can be utilized to evaluate baseline values and improvements when medications are administered.
    In conclusion, acoustic rhinometry is potentially useful for evaluating nasal physiology, especially in cases of allergic rhinitis.
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  • Shin TAKEI, Junichi YODA, Mihoko JINNIN, Yumi KAGAWA, Kazuma YAMAUCHI, ...
    1998 Volume 91 Issue 11 Pages 1115-1120
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We report a case of mucoepidermoid carcinoma in the nasopharynx. A woman, aged 59, who suffered from chronic otitis media with effusion was referred to our department due to a mass lesion on the Rosenmuller's fossa. The mass lesion was pathologically diagnosed as a mucoepidermoid carcinoma. CT and MRI scans showed a well bordered round shadow which was limited to the orifice of the left eustachian tube, without invasion of the skull base.
    As the patient did not agree to surgical treatment, we selected radiotherapy using a gamma knife for treatment of the nasopharyngeal tumor. The tumor responded well to gamma knife treatment and disappeared with 30Gy irradiation (Edge dose). The patient has shown no recurrence of the tumor for a year and 6 months after treatment. Gamma knife radiotherapy may be one potential treatment strategy for intractable lesions of the head and neck such as mucoepidermoid carcinoma in the nasopharynx.
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  • Tatsuyuki FUKUSHIMA, Nobuo TAKAGI, Hirotsune OHNISHI, Toshiaki SHIBATA ...
    1998 Volume 91 Issue 11 Pages 1121-1126
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Eight cases of medial blowout fracture underwent endoscopic surgery by a transnasal approach, and the cause of double vision was investigated by analyzing CT and operative findings. The medial blowout fractures were classified into three groups by CT findings; comminuted fracture type, adhesion fracture type and trapped door fracture type. The fractures were also classified into three groups on the basis of operative findings: strangulated type, adhesive type and obstruction of sinus type. Each group delineated on the basis of operative findings corresponded to a CT findings group: comminuted fracture type and strangulated type, adhesion fracture type and adhesive type, trapped door fracture type and obstruction of sinus type. The grade of double vision was the most serious with the comminuted fracture type, followed by the adhesion fracture type and trapped door fracture type. These results suggest that the cause and grade of double vision can be determined before surgery using CT findings, and this information may help in the operation for double vision. Since endoscopic surgery for medial blowout fracture is not complicated, the trapped door fracture type as well as the comminuted type of fracture were considered to be indicative of surgery.
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  • Yasuo OGAWA, Harushiro Sato, Hiroyuki FUJITA, Koji OTSUKA, Susumu ARAK ...
    1998 Volume 91 Issue 11 Pages 1127-1135
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Fifty-three patients (38 males and 15 females) with paranasal sinus cysts which were accompanied by orbital symptoms were treated in our hospital from May 1985 through May 1995. The average patient age was 48.3 years. Of 53 patients, 42 had undergone primary surgery for chronic sinusitis. The patients were classified into 4 groups according to the location of the cystic lesions, as follows: (1) maxillary, or maxillary-ethmoidal type: 15 cases. (2) frontal, or frontalfrontethmoidal type: 17 cases. (3) frontethmoidal type: 10 cases. (4) spheno-postethmoidal type: 11 cases. The common orbital symptoms were exophthalmos (19 cases), orbital pain (17 cases), periocular swelling (12 cases), lacrimation (12 cases), diplopia (11 cases) and visual disturbance (8 cases). The eight patients with visual disturbances were further analyzed.
    In 6 out of the 8 patients, visual acuity returned to the expected level after surgery. The following conclusions were obtained from an analysis of the clinical features.
    (1) Improvement of visual acuity was expected when the preoperative visual acuity remained measurable and surgery was performed within 3 months from the onset of visual disturbances.
    (2) In case of severe visual disturbance postoperative prognosis was satisfactory when the light sense was still present and the optic disc had not atrophied.
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  • Yoshie HORIBE, Noriyuki FUKUSHIMA, Shitau HIRATA, Rika OSADA, Koji YAZ ...
    1998 Volume 91 Issue 11 Pages 1137-1142
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Aggressive fibromatosis is a rare tumor, especially in the head and neck region. Although its pathological findings are benign, clinical findings are malignant, which indicate locally expansive growth and bony destruction. We report a case of aggressive fibromatosis which involved the right paranasal sinuses.
    A 40-year-old male was hospitalized due to increasing nasal obstruction, right cheek swelling and repeated nasal bleeding. CT scan and MR images showed that the large mass mainly involved the right maxillary sinus, eroded the walls of the sinus and invaded the right orbita, the nasal cavity, the ethmoid sinus, the sphenoid sinus, the inf ratemporal f ossa and the pterygomaxillary space. An excisional biopsy was performed, and the pathological diagnosis was aggressive fibromatosis. Therefore chemotherapy and radiation therapy were performed, but both were ineffective. Finally, total extirpation of the tumor was carried out, and no recurrence has been revealed over the 15 months after the operation.
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  • Masakazu MIYAGISHIMA, Kensei NAITO, Tatsuyoshi OKADA, Katsuhiko KOMORI ...
    1998 Volume 91 Issue 11 Pages 1143-1147
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Carcinosarcomas of the nose and the paranasal sinus are moderately rare. We experienced the rare case of a 30-year-old man with left photopsia. CT and MRI findings showed a large tumorous lesion occupying his right nasal cavity and ethomoidal sinus, which had invaded the anterior cranial fossa.
    Microscopic examination of the biopsy specimen from his nasal cavity revealed a poorly differentiated squamous cell carcinoma. Chemo-and radiotherapy were performed on the nasal and sinus carcinoma, however, the patient died 9 months later.
    A final pathological examination of the specimen after death showed a carcinosarcoma, which was comprised of both a squamous cell carcinoma and a rhabdomyosarcoma.
    The sixteen cases of carcinosarcoma of the nose and the paranasal sinus reported in Japan, including our case, were reviewed in this paper
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  • Tsutomu UEDA, Eiji Sato, Makoto SHIRANE
    1998 Volume 91 Issue 11 Pages 1149-1151
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Diphtheria is one of the infectious diseases which physicians are obligated to report. For several decades, the number of patients reported to have diphtheria in Japan has been less than 10 per year. Recently we treated a case of pharyngeal diphtheria. A 24 year old male consulted our hospital complaining of pharyngeal pain. His palatine tonsils were covered with a thick grayishwhite menbrane, which bled easily when this white membrane was removed. Metachromatic granules stained by the Neisser method were recognized in the swab of his palatine tonsil. These findings suggested a diagnosis of pharyngeal diphtheria.
    The patient was treated immediately with antitoxin and piperacillin sodium. He recovered completely 30 days after admisson without any sequelae and the white pseudomembrane on his palatine tonsils was extinguished. Most importantly, when a patient is suspected of suffering from diphtheria, the therapy should be carried out immediately.
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  • Akimitsu KAWAI, Takeshi AKISADA, Tsuyoshi YOSHIHIRO, Shigeo HIRAI, Mas ...
    1998 Volume 91 Issue 11 Pages 1153-1156
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The occurrence of retropharyngeal abscess in children has decreased due to antibiotic therapy. We report a case of retropharyngeal abscess in a 1-year and 2-month-old boy. The patient complained of rhinorrhea and snoozing for 3 weeks without severe symptoms such as pyrexia and dyspnea. The soft tissue X-ray film of the neck and CT findings suggested a retropharyngeal abscess. We performed emergent transoral drainage under general anesthesia. After surgery, cefpirome sulfate was administered intravenously. Bacteriological examination of a specimen of pus revealed β-streptococcus haemolyticus A. The patient was discharged without any complications on the 13th hospital day. The importance of the early diagnosis and treatment of this disease was discussed.
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  • Fuyuki ENOMOTO, Ichirou ANDOU, Eiko NAKAZAWA, Akihiko KANOU, Makiko KI ...
    1998 Volume 91 Issue 11 Pages 1157-1162
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    We experienced a patient who first visited the Department of Otolaryngology with the chief complaint of tonsillitis, with subsequent eruption during the observation period. On the basis of these findings, a diagnosis of Sweet's disease was made. The patient was a 28-year-old female who complained chiefly of pharyngalgia and fever. Antibiotic therapy, which was indicated in accordance with the diagnosis of tonsillitis was ineffective in relieving the symptoms. A skin biopsy was performed because of complications including painful nodular skin lesions, arthalgia and swelling of the joints. The skin biopsy results facilitated a definitive diagnosis of Sweet's disease. The patient's expression of adhesion molecules associated with peripheral neutrophils was within the normal range. We regarded the causative factor as a hypersensitive reaction due to tonsillitis, and conducted a tonsillectomy.
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  • Makoto Ito, Takaki MIWA, Mitsuru FURUKAWA
    1998 Volume 91 Issue 11 Pages 1163-1172
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    Albino rats were tested for their ability to localize sounds in space and for their reflex head orientation to auditory stimulation before and after a micro knife transection of the commissure of Probst. The animals were trained to approach a sound source on a two choice test apparatus in order to obtain a water reward. The minimum audible angles were then determined for midline (left vs. right) sound localization using the method of descending limits to define the thresholds for auditory spatial acuity. The commissure of Probst was then transected through its midline decussation with a micro knife inserted into the brain according to stereotaxic coordinates. Following a postoperative recovery period of at least one week, the rats were retrained and again tested for sound localization. After completing the sound localization tests, the animals were tested for reflex head orientation with a single burst of 70dB (SPL) broad-band noise. In most cases, the lesions were within 200-300 microns of the midline, and damage at locations lateral to the knifecut was very slight. The condition of the damaged fibers was confirmed by both anterograde and retrograde tract tracing methods. After a complete transection of the commissure of Probst, the number of cell bodies in the dorsal nucleus of the lateral lemniscus (DNLL) was greatly reduced. Most of the contralaterally projecting neurons in the DNLL underwent retrograde degeneration. Complete transection of the commissure of Probst resulted in elevated behavioral thresholds for midline sound localization. The minimum audible angles were elevated, and reflex head movements towards the sound source were abolished in most animals with extensive lesions. These results suggest that the Commissure of Probst fibers, including the crossed projections from the DNLL, play a role in auditory spatial perception, especially in the ability to discriminate small auditory angles. These projections also appear to play an important role in the reflex pathway for auditory head orientation.
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  • Masao MITSUI, Kentaro OCHI, Takuji KANEKO, Isao KATO
    1998 Volume 91 Issue 11 Pages 1173-1176
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
    The usefulness of a nasal dilator (Breathe RightTM) for otorhinolaryngologic disorders was reported previously. The purpose of this paper was to evaluate the usefulness of the Breathe RightTM apparatus especially for pharyngo-laryngeal lesions. Subjects who had usrd the Breathe RightTM during the night for at least 2 weeks were selected. Eighteen patients including 5 patients who had chronic pharyngo-laryngitis and 13 patients who had abnormal pharyngo-laryngeal sensation were investigated.
    All patients received of rhinomanometry measurements. The P (1.0) cmH2O values on pressure flow curves were evaluated. All except two patients showed a decrease in nasal resistance. These changes were significant.
    Eighty percent of chronic pharyngo-laryngitis cases and 62% of abnormal pharyngo-laryngeal sensation cases were improved using the Breathe RightTM dilator. The overall effectiveness rate of treatment using Breathe RightTM for pharyngo-laryngeal lesions was 67%.
    It can be concluded from our results that the application of the Breathe RightTM dilator is useful for pharyngo-laryngeal lesions in some cases.
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  • [in Japanese]
    1998 Volume 91 Issue 11 Pages 1178-1179
    Published: November 01, 1998
    Released on J-STAGE: November 04, 2011
    JOURNAL FREE ACCESS
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