Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 91, Issue 12
Displaying 1-19 of 19 articles from this issue
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  • Postantibiotic Effect of Antibacterial Agents
    Mikiko TAKAYAMA, Tetsuo ISHII
    1998 Volume 91 Issue 12 Pages 1183-1189
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1183
    JOURNAL FREE ACCESS
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    Many different types of antibacterial agents have been developed and used clinically. Efficacy is evaluated on the basis of the antibacterial activity of the agent, the concentration reached in infected tissues, and the frequence and type of side effects. However, with the recent increases in resistant bacteria and compromised hosts, it has become necessary to devise administration methods that obtain maximum effects with the minimum dosage of antibacterial agents.
    For administration of the most appropriate antibacterial agents, it is necessary to study both the pharmacodynamics, (i. e., the interaction between drug and microorganism) and the pharmacokinetics, (i. e., the behavior of the drug in the body).
    The usefulness of the postantibiotic effect (PAE), a pharmacodynamic parameter, was evaluated in patients with otorrhea and chronic otitis media.
    PAE is defined as an inhibitory effect on the growth of microorganisms which persists after brief contact with the antibacterial agent. In the present study, Levofloxacin (LVFX), a quinoline that has a PAE, was tested. The subjects were 42 patients who were divided into three groups: a 400mg b. i. d group (n=14), a 200mg daily group (n=13), and a 200mg b. i. d. group (n=15).
    Good clinical efficacy (including both markedly effective and effective cases) was obtained in the 400mg b. i. d group and the 200mg daily group.
    The bacteriological efficacy as shown by the bacterial eradication was highest in the 400mg b. i. d group, followed by the 200mg daily group and the 200mg b. i. d group.
    Antibiotic usefulness was higher in the 400mg b. i. d group and the 200mg daily group. It was concluded that, when quinolones are administered, consideration should be given to the PAE and to increasing the dose given each time when appropriate.
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  • Parry-Romberg Syndrome
    [in Japanese], [in Japanese], [in Japanese]
    1998 Volume 91 Issue 12 Pages 1190-1191
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1190
    JOURNAL FREE ACCESS
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  • The Vertical Component of Caloric Nystagmus in Patients with Meniere's Disease
    Manami TAKAMATSU, Sei KITAJIMA, Kasumi ISHI-I, Naomi KAWACHI, Yoshiko ...
    1998 Volume 91 Issue 12 Pages 1193-1199
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1193
    JOURNAL FREE ACCESS
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    The vertical caloric nystagmus in 20 normal subjects and 35 Meniere's disease was recorded using ENG and an infra-red video camera in the spine position. Calolic stimulation was performed by irrigation of the outer ear canal with 5 ml water of 20°C with the animal in a side position with the irrigated ear up.
    The upward vertical component of nystagmus was recorded in all of the normal subjects. The maximum slow-phase velocity of the vertical component was 0.26 times higher than horizontal component. The difference in CP% between the right and left ear was less than 20% in both the horizontal and vertical components in all of the normal subjects. We estimated accurate recording of caloric nystagmus was in 35 out of 72 Meniere's disease patients, exchanging 21 patients also have vertical spontan nystagmus. A total of 34 out of 35 patients have up beating vertical caloric components. The CP% of the right and left ear varied widely in horizontal components. In contrast, the differences in CP% of the vertical component were less than 20%. These findings suggest that the damaged lesions of the inner ear of Meniere's patients are not uniformly distributed it in the three semicircular canals of Meniere's patients. Thus, it is important to measure not only horizontal but also vertical components.
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  • Efficacy of the Canalith Repositioning Method for Treatment of Benign Paroxysmal Positional Vertigo
    Mamoru FUJII, Ikuo INOKUCHI, Nobuaki AYADA, Nobuhiko KIMURA, Tomoo ONO ...
    1998 Volume 91 Issue 12 Pages 1201-1206
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1201
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    Canalith repositioning methods have been designed to release free floating canalith from the posterior semicircular canal back into the utricle to treat benign paroxysmal positional vertigo (BPPV). Treatment by Semont's liveratory maneuver, one of these methods, was compared to treatment by medication only.
    Seven of 10 patients (70%) treated with the liveratory maneuver showed improvement within a week. Conversely, only 1 of 10 patients (10%) showed improvement within a week when treated with medication only.
    Accordingly canalith repositioning should be the first choice of treatment for BPPV.
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  • A Case Report of Neurothekeoma in the Temple
    Susumu MARUYAMA, Itaru YAMAMITI, Motooki YASUNO
    1998 Volume 91 Issue 12 Pages 1207-1212
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1207
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    Neurothekeoma is a rare benign tumor, sometimes localized in the dermis and subcutis of the head and neck region or the shoulders.
    An 11-year-old female complained of temporal swelling. Histopathological examination of a biopsy specimen suggested neurothekeoma. Because of severe bleeding and the high risk of damaging the facial nerve, incomplete excision was performed. Up to ten months after the operation, no increase in the size of the residual tumor was detected.
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  • Surgical Treatment for Perennial Nasal Allergy
    -Endoscopic Surgery with COZ Laser-
    Kiminori Sato, Tadashi NAKASHIMA
    1998 Volume 91 Issue 12 Pages 1213-1217
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1213
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    Surgical treatment was performed in 10 cases of perennial nasal allergy, in which conservative treatment had no effect. Surgical methods employed included vaporization of the entire surface of the inferior turbinate with a defocused carbon dioxide laser beam, submucosal inferior turbinotomy and septum plasty. A rigid endoscope and thin pipe guide handpiece were used in the surgical procedure. Six months after this surgery, all of the patients had excellent or good results.
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  • Pleomorphic Adenoma Arising from the Nasal Septum; A Case Report
    Takafumi YOSHIDA, Hideki MATSUDA, Toshiyuki KOTATSU, Hayashi INABA, Ta ...
    1998 Volume 91 Issue 12 Pages 1219-1229
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1219
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    A 69 year-old female complained of left nasal bleeding. A tumor had arisen from the left nasal septums, and had obstructed the left nasal cavity. The tumor was removed with endoscopic surgery, and the pathological diagnosis was a pleomorphic adenoma. The cellularity of this tumor was richer than the salivary glands. A literature review revealed 70 cases, including the present case, of the pleomorphic adenoma arising from the nasal cavity in Japan. However, few immunohistochemical studies on this type of tumor have been reported. On our immunohistochemical examination, the solid area was immunoreactive for keratin, actin, vimentin and glial fibrillary acidic protein (GFAP). The luminal cells in the tubulo-ductal structure were immuno-positive for keratin, carcinoembryonic antigen and epithelial membrane antigen, whereas the outer cells in this area were immuno-positive for actin. The myxoid area was immunoreactive for keratin, vimentin, GFAP and 5-100 protein, and the chondroid area was immuno-positive for keratin, actin, vimentin and S-100 protein. These results are somewhat different from those reported for pleomorphic adenomas in the salivary glands. The variable immunohistochemical nature of pleomorphic adenomas in the nasal cavity may reflect the variety of biological behaviours of this tumor.
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  • Epipharyngeal Tuberculosis Accompanied by Middle Ear Tuberculosis
    Chiaki MAKIISHI, Chihiro HATTA, Keijirou FUKAZAWA, SATOMI SATOMI, Masa ...
    1998 Volume 91 Issue 12 Pages 1231-1235
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1231
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    A case of epipharyngeal tuberculosis with middle ear tuberculosis is reported. A 4lyear-old female complained of left otorrhea and left facial nerve palsy. Examination of the epipharynx revealed a granular mass. A biopsy from the epipharynx showed only inflammatory changes. A smear of ear discharge and post nasal discharge showed no positive results. To facilitate diagnosis and to reduce the inflammation, we performed an exploratory tympanotomy and biopsy of the epipharynx under general anesthesia. The pathological findings were consistent with Mycobacterium tuberculosis infection. Anti-tuberculosis chemotherapy was performed for one year and the epipharynx granuloma disappeared and the facial nerve palsy was reduced. The present case suggests that it can be difficult to diagnose tuberculosis and that it is very important to consider tuberculosis in cases of intractable inflammation of the head and neck region.
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  • A Case Report of Maxillary Tuberculosis
    Masashi IMANAKA, Yuzo YAMANOTO, Hiroshi TAKENAKA
    1998 Volume 91 Issue 12 Pages 1237-1241
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1237
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    Paranasal tuberculosis is a rare disease and only 26 cases have been reported in the Japanese literature. We describe a case of secondary maxillary tuberculosis.
    The patient was a 72 year-old female who complained of right nasal discharge and bloody sputum. A CT-scan showed that the right maxillary sinus was diffusely cloudy and had the legion with enhancement effect. The patient had been hospitalized previously for treatment of pulmonary tuberculosis 50 years ago. However there has been no evidence of recrudescence since then. Open biopsy of the maxillary sinus was performed and rapid histopathological examination did not reveal a malignant tumor, Caldwell-Luc surgery, in addition to ethmoidectomy and sphenoidostomy were performed successively. The mucous membrane of the maxillary sinus had some polypoidly thickened lesion and a grayish lesion. The mucous membrane and content of the maxillary sinus were examined by Ziehl-Neelsen's staining and no acid fast bacilli were identified. The diagnosis was made on the basis of histopathological findings which revealed some epithelomd cells under the mucosal epithelium and Langhans giant cells. Detection of Mycobacterium tuberculosis using PCR methods revealed sputum to be negative and the nasal discharge to be positive. We recognized that she did not harbour M. tuberculosis now, but that chemotherapy was necessary. After the operation, isoniazid, ethambutol and rifampicin were administered. Detection of M. tuberculosis using PCR methods was performed 40 days later and the nasal discharge was negative. No recurrence has been noted since she was released from the hospital. Hence PCR methods was able to detect M. tuberculosis rapidly and precisely, it was useful in determining the therapeutic plan and judging therapeutic effects.
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  • Occult Tonsil Carcinomas; Diagnostic Implications of a Tonsillectomy for Head and Neck Malignancies of Unknown Origin
    Yuichiro HONJYO, Yoichiro TOMIYAMA, Jun-ichi YOSHIDA, Kenji MITANI
    1998 Volume 91 Issue 12 Pages 1243-1246
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1243
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    We report the case of an occult tonsil carcinoma diagnosed only after a tonsillectomy. A 55 year-old man with upper and midjugular lymph node metastases from an unknown primary tumor was referred to our hospital for treament. The search for the primary tumor required panendoscopy of the upper aerodigestive tract, with biopsies of suspicious lesions at the level of nasopharynx and tonsils, which yielded no detectable primary site. The patient then underwent an ipsilateral radical neck dissection and tonsillectomy. Subsequent histopathologic examination of the whole tonsil specimen revealed an occult tonsil carcinoma in one of the crypts.
    We conclude that an ipsilateral tonsillectomy is the only reliable screening method to rule out an occult malignancy of the tonsil, and should be performed in patients with upper or mid jugular lymph node metastases due to an unknown primary tumor.
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  • Palatine Tonsillar Metastasis from a Small Cell Carcinoma of the Lung
    Akihito WATANABE, Akihiro KATAYAMA, Kenji OKAYASU
    1998 Volume 91 Issue 12 Pages 1247-1251
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1247
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    Metastasis of a tumor to the tonsil is a rare event and moreover, prognosis is typically poor. Here, we will report a case with good prognosis where a palatine tonsillar tumor which had metastasized from a small cell carcinoma of the lung was surgically excised followed by the neck dissection.
    A 70-year-old male had been in our hospital for treatment of lung carcinoma. Following a history of pharyngalgia for one month, he was sent to our division for examination. A tumor mass which was partially ulcerated, was revealed in the superior region of the left palatine tonsil. Tumefied submandibular lymph nodes were palpable. A histopathological examination of biopsy material taken from the left palatine tonsil resulted in the diagnosis of a small cell carcinoma. Since the primary tumor seemed to have been removed successfully and metastasis was not observed except in the palatine tonsil, the patient was treated by radical excision of the tumor, followed by the neck dissection. After surgery the patient underwent two courses of a combination chemotherapy with CDDP + VP 16 + MMC, and subsequently left the hospital.
    Twenty two months after surgery the patient remains stable without a relapse.
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  • Laryngomicrosurgery Using aVideo-Endoscopic System with a Video-Laryngoscope
    Michitoshi OHNO
    1998 Volume 91 Issue 12 Pages 1253-1257
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1253
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    Laryngomicrosurgery has been performed under an endoscopic video-monitoring system (“the endoscopic method”) since November 1996 at our department. This method using the Slimline type of Video-Laryngoscope (KARL STORZ, Model III) was compared with “the conventional method” using a microscope. The endoscope was connected to a TV-system to visualize the surgical field on a large monitor screen.
    (1) Instruments and surgeon's position: An expensive and large microscope, which was required for surgery with the “the conventional method”, was unnecessary for surgery with “the endoscopic method”. As a result, the surgeon could easily insert, handle and fix the instruments in a comfortable position.
    (2) Surgical field: “The endoscopic method” facilitated excellent visualization and recording of the entire surgical field including the instruments, while “the conventional method” suffers from two kinds of visual field defects and insufficient luminous energy resulted in poor recordings of the surgical field.
    (3) Laryngeal extension: The vertical outer diameter of the Video-Laryngoscope is greater than that of the conventional smaller laryngoscope. Therefore, laryngeal extension may be more difficult during surgery using “the endoscopic method”.
    “The endoscopic method” had advantages over “the conventional method” based on (1) and (2) above. I expect that the disadvantage mentioned in (3) will be easily overcome by reducing the vertical outer diameter of the Video-Laryngoscope.
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  • Cervical Ganglioneuroblastoma; A Case Report
    Norio YAMAMOTO, Hiroyuki KITAMURA, Shin-ichi TAKAGITA, Sanson HAN, Tos ...
    1998 Volume 91 Issue 12 Pages 1259-1263
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1259
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    Ganglioneuroblastoma is composed of both ganglion and neuroblast cells and is a subset of neuroblastoma, which is one of the most popular malignant tumors of children. This type of tumor typically originates from the abdomen and rarely from the neck. We report a case of cervical ganglioneuroblastoma in this article.
    A 9 year-old girl was presented as having an elastic hard tumor in the left side of her neck. The tumor located behind the bifurcation of the common carotid artery and no blood flow was detected by either ultrasonic study or magnetic resonance imaging. We performed extirpation of the tumor as a neurinoma, and carried out an additional neck dissection after the tumor was diagnosed as a ganglioneuroblastoma by pathologic study of a frozen section of the tumor. Its origin was thought to be the cervical sympathetic trunk.
    Complete surgical resection is sufficient treatment for cervical ganglioneuroblastoma in children because it can be detected earlier than abdominal tumors and because radiation therapy and chemotherapy have serious side effects on children.
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  • Subcutaneous Xanthogranuloma of the Neck; A Case Report
    Masaharu TOKURIKI, Hideaki TSUZUKI, Sigeharu FUJIEDA, Toshio OHTSUBO, ...
    1998 Volume 91 Issue 12 Pages 1265-1269
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1265
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    A 68-year-old man with the chief complaint of swelling on the left side of the neck due to a subcutaneous xanthogranuloma is reported. As he was initially suspected to have a malignant tumor, we performed an open biopsy. Histological examination after surgical removal of the tumor led to a diagnosis of xanthogranuloma. Xanthogranuloma is a relatively rare tumor in the head and neck region, and although xanthogranuloma is classified as benign, caution should be taken in its follow-up, because it may recur or present as a malignant tumor from a pathological viewpoint.
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  • Statistical Analyses of Esophageal and Bronchial Foreign Bodies
    Kazuya KIKUCHI, Yasuaki HARABUCHI, Makoto HAMAMOTO, Hideaki SHIRASAKI, ...
    1998 Volume 91 Issue 12 Pages 1271-1275
    Published: December 01, 1998
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1271
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    Over 5 year period from 1991 to 1995, seventy-two patients with foreign bodies in the esophagus (n=62) and bronchus (n=10) were treated in our clinic. Most of the patients with esophageal foreign bodies were in their sixties and patients ≤3 years. The most common esophageal foreign body was a fish bone (37%), followed by a press-through-pack (PTP; 15 cases), and coins (6 cases). Twenty-seven of 28 fish bone or PTP foreign bodies were located in the first narrow part of the esophagus; while 9 of 15 coin or meat foreign bodies were located in other regions. Rigid esophagoscopy was used in about 70% of patients with fish bones, PTP or meat; electronic fiberscopy was used in about 25% of the patients. A balloon-tip catheter was useful in 3 of 6 patients with coins. Esophagotomy was performed in only 2 cases with fish bones. The number of cases with PTP was increased markedly in the present study as compared with our reports in 1950-1989. Patients with bronchial foreign bodies were most commonly 1 year of age (5 cases). Of 10 bronchial foreign bodies, 5 were peanuts and 3 were dental materials. Foreign bodies were found in the left main bronchus of 6 patients and in the right of 4. All bronchial foreign bodies were removed with bronchoscopy under general anesthesia. An educational campaign is needed to decrease the number of patients with esophageal and bronchial foreign bodies.
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  • A Case of Internal Jugular Vein Phiebectasia
    Makoto Ito, Hiromi OOKA, Takaki MIWA, Mitsuru FURUKAWA
    1998 Volume 91 Issue 12 Pages 1277-1281
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1277
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    Ectasia of the jugular system is unusual in children. We present here a pediatric case with internal jugular vein phlebectasia, and an adult case with a venous aneurysm. These two ectasias were observed as nonpulsatile, elongated or round neck masses that enlarges with the Valsalva maneuver or speaking. Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and angiography have all been used in the diagnosis of ectasia. However, CT with a contrast agent make it possible to obtain a clear diagnosis, and allows the detection of thrombus formation.
    In our adult case, a thrombus in the aneurysm was suggested. After CT with a contrast agent, angiography was useful to detect the thrombosis and its connection with the internal jugular vein. Surgical resection of the jugular aneurysm was undertaken to avoid the risk of embolization in this case. In our pediatric case, the phlebectasia has been examined regularly because the lesion was stable in size, and there was no thrombus formation. We recommend surgical resection only if the lesion forms a thrombus, increases in size, or causes cosmetic deformity.
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  • Fine Needle Aspiration Biopsy of Head and Neck Lesions; Review of 461 cases
    Keiichi KIHARA, Manabu NAKANOBOH, Tsuyoshi MATSUNAGA, Hiroshi MORIKAWA ...
    1998 Volume 91 Issue 12 Pages 1283-1287
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1283
    JOURNAL FREE ACCESS
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    Ectasia of the jugular system is unusual in children. We present here a pediatric case with internal jugular vein phlebectasia, and an adult case with a venous aneurysm. These two ectasias were observed as nonpulsatile, elongated or round neck masses that enlarges with the Valsalva maneuver or speaking. Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and angiography have all been used in the diagnosis of ectasia. However, CT with a contrast agent make it possible to obtain a clear diagnosis, and allows the detection of thrombus formation.
    In our adult case, a thrombus in the aneurysm was suggested. After CT with a contrast agent, angiography was useful to detect the thrombosis and its connection with the internal jugular vein. Surgical resection of the jugular aneurysm was undertaken to avoid the risk of embolization in this case. In our pediatric case, the phlebectasia has been examined regularly because the lesion was stable in size, and there was no thrombus formation. We recommend surgical resection only if the lesion forms a thrombus, increases in size, or causes cosmetic deformity.
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  • Surgical Treatment for Bilateral Vocal Fold Fixation at Midline of The Glottis
    [in Japanese]
    1998 Volume 91 Issue 12 Pages 1288-1289
    Published: December 01, 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.1288
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  • Erratum to : Clinical Effect of Harmonic-M® on Postoperative Head and Neck Tumors
    1998 Volume 91 Issue 12 Pages e1
    Published: 1998
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.91.12_e1
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