Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 92, Issue 10
Displaying 1-19 of 19 articles from this issue
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  • Functional Anatomy and Plasticity of the Auditory Cortex
    Yasushi NAITO
    1999 Volume 92 Issue 10 Pages 1027-1039
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1027
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    Because it is very difficult to directly record neuronal activities in the human brain, the function of the auditory cortex has been investigated primarily in experimental animals using pure tones and some complex sound stimuli. However, recent advances in brain imaging have made it possible to analyze the functional anatomy of the auditory cortex in human subjects. In addition, many recent reports on the primate auditory cortex deal with communication sound processing. Thus, medical and biological approaches in this field are coming close to each other, thereby developing a new field of research. This article reviews recent reports, including ours, on functional anatomy and plasticity of the auditory cortex in both human and monkey brains. PET (positron emission tomography) studies on pre- and postlingually deafened cochlear implant users have brought about many new findings not only on developmental plasticity but also on adult plasticity of the human auditory cortex. Human results of the central processing of speech obtained through PET, MEG (magneto-encephalogram), and fMRI (functional magnetic resonance imaging) were re-evaluated from a biological viewpoint based on animal experiments. Biological approaches in the research on the human auditory cortex may shed new light on the understanding of the function and plasticity of our hearing and spoken language processing.
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  • Reconstruction following Resection of Oral Cancer
    [in Japanese]
    1999 Volume 92 Issue 10 Pages 1040-1041
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1040
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  • Otogenic Intracranial Complication
    -A Case of Cerebral Abscess-
    Mayumi OHNO, Masaharu ISHIKAWA, Takuya YAMAKAWA, Ichiro ANDO, Shotaro ...
    1999 Volume 92 Issue 10 Pages 1043-1047
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1043
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    A case of an otogenic intracranial complication secondary to cholesteatoma is reported. A 25-year-old male was admitted to our hospital for headache and otorrhea due to acute mastoiditis and meningitis. Six days after mastoidectomy, CT showed a cerebral abscess in the occipital lobe. The abscess was surgically drained by a neurosurgeon. Two weeks after the drainage, removal of cholesteatoma was performed. Six months later, the patient is doing well.
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  • Sudden Deafness with Further Progression of Hearing Loss
    Norikuni KASUYA, Mikio SUZUKI, Tsuyoshi KITANISHI, Hiroya KITANO, Yosh ...
    1999 Volume 92 Issue 10 Pages 1049-1057
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1049
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    We analyzed 14 patients who showed a further progression of hearing loss after an initial examination of 214 patients with sudden deafness. They were divided into 2 groups based on the type of hearing loss progression. Group I consisted of six patients who displayed a rapid progression after increased hearing loss had begun. Group II consisted of eight patients who showed transient hearing improvement before an increase in hearing loss. The clinical features of the 14 patients were from a earlier visit to the clinics experiencing dizziness and/or vertigo with less recovery of hearing loss than the other patients. However, more than 60% of the 14 patients showed complete recovery or a marked hearing improvement. The predominant type of hearing loss was high tone loss at the initial audiological assessment in both groups. The flat type hearing loss was usually noted at the time when the patients experienced their greatest hearing loss. Although the details of the etiology of hearing loss progression remain unclear, group I was thought to be the slow type sudden deafness, whereas the deterioration of hearing loss in group II may be due to a circulatory disturbance of the inner ear.
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  • Clinical Application of Three-Dimensional CT of the Auditory Ossicles
    Toshishige KIDO
    1999 Volume 92 Issue 10 Pages 1059-1062
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1059
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    This study was performed to evaluate the usefulness of three-dimensional (3D) helical CT imaging of the ossicles. High quality 3D images could be obtained in normal ear and diseased ears of cases of ossicular abnormality and chronic otitis media. But, the very thin structures of stapes, such as the stapedial crura and foot plate, could not be represented. Preoperative diagnostic findings of ossicles in diseased ears through 3D images corresponded with their surgical observations. As a result, this study showed that 3D images of the ossicles by helical CT can offer detailed diagnosis and are clinically useful.
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  • Argon Plasma Surgery of the Inferior Nasal Turbinates
    Keijiro FUKAZAWA, Hiroshi OGASAWARA, Megumi FUJII, Seiichi TOMOFUJI, M ...
    1999 Volume 92 Issue 10 Pages 1063-1069
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1063
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    Argon plasma surgery was performed in 19 cases of perennial nasal allergy, nine cases of hypertrophic rhinitis and six cases of chronic sinusitis with aspirin-induced asthma. Argon plasma coagulation is a new modality of electrosurgery and a special mode of high-frequency surgery. This method is characteristic in that the high-frequency electric current is conducted to the tissue via ionized argon (argon plasma). It can be used not only for hemostasis but also for thermal devitalization of the tissue. Coagulation and desiccation of the tissue develops, resulting in a shrinking effect. Using a rigid endoscope, the probe, from which argon gas was blown out, was inserted into the nasal cavity. The surface of the inferior turbinate was coagulated with the argon plasma beam.
    Two months after the surgery, the nasal breathing improved in 100% of 19 patients with perennial nasal allergy, and nasal discharge in 56.3% of the patients. In addition, 88.9% of nine patients with hypertrophy of the inferior turbinate showed improved nasal breathing. The surgical technique and advantages of argon plasma coagulation are discussed.
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  • Incidence of Penicillin Resistant Streptococcus Pneumoniae in a Nursery School
    Makoto Ito, Akiko SHIRAI, Akiko TATSUMI, Tomokazu YOSHIZAKI, Toshiro N ...
    1999 Volume 92 Issue 10 Pages 1071-1079
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1071
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    In order to investigate the bacteriologic and clinical interpretation of the flora of the nasopharynx from children (n=31) and the staff (n=15) in a nursery school, penicillin resistance (Pcr) of Streptococcus pneumoniae was examined. Chief bacteria from children were S. pneumoniae (27 strains, 87%), Haemophilus influenzae (27 strains, 87%) and Moraxella catarrhalis (24 strains, 80%). Of the 27 strains of S. pneumoniae, 23 strains (85%) were identified as a Pcr S. pneumoniae. Two children had recurrent episodes of acute otitis media, but no children showed the conditions of acute otitis media on the medical examination day. From these data, prevalence of Pcr S. pneumoniae is very high in young children in nursery school in Japan.
    On the other hand, chief bacteria from the staff were H. influenzae (8 strains, 47%) and M. catarrhalis (2 strains, 12%). S. pneumoniae was not detected in these healthy adults.
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  • A Case of Rhinogenic Meningitis with Unconsciousness
    Masaru KAWASAKI, Hideo Nakamura, Yutaka HIGUCHI, Hiromi KONDOH, Masafu ...
    1999 Volume 92 Issue 10 Pages 1081-1086
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1081
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    Rhnnogenic meningitis is a rare complication with a relatively high morbidity rate. Recently, a case of rhinogenic spontaneous meningitis with unconsciousness was reported. The patient was a 22-year-old male who exhibited headaches, high fever and right eyelid swelling. Unconsciousness and meningeal signs developed the night of admission. Spinal fluid analysis showed a high cell count. He was diagnosed as having rhinogenic meningitis. Chemotherapy and spinal drainage were carefully conducted. Following an improvement of the intracranial complications, a right Caldwell-Luc operation, a right external frontoethmoidectomy and left endoscopic sinus surgery were carried out. However, no bony defects were recognized in any sinus. The intracranial complications were considered to be caused by a bacterial infection via the venous system. Nasal operation should be carried out according to the state of intracranial complications and the general condition of the patient.
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  • A Case of Rhinogenic Intracranial Complications
    Shintaro Satoh, Seiji TAKAGI, Kuniyoshi TSUDA, Takemoto SHIN
    1999 Volume 92 Issue 10 Pages 1087-1095
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1087
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    A case of meningoencephalitis and subdural abscess originating from the paranasal sinusitis was reported. A 12-year-old boy developed a high fever, severe headache, hemiplegia and unconsciousness following a common cold.
    Physical examination and laboratory examination showed bacterial meningitis. CT and MRI demonstrated frontal sinusitis, meningoencephalitis and subdural abscess. He was treated surgically with the transfrontal approach (Killian's method) under general anesthesia. Large doses of broad-spectrum antibiotics were administered intravenously before and after surgery. He was discharged without any complication after a few weeks.
    For the management of this disease, close monitoring with MRI revealed important intracranial and sinus findings. We successfully treated meningoencephalitis and subdural abscess without neurosurgical procedures. Clinical features and management in this disease were briefly reviewed.
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  • Mucocele of the Sphenoid Sinus, a Late Complication of Transsphenoidal Pituitary Surgery
    Kiyomi Kawano, Toshio YOSHIHARA
    1999 Volume 92 Issue 10 Pages 1097-1100
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1097
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    A case of sphenoid sinus mucocele which occurred after transsphenoidal hypophysectomy for pituitary adenoma is reported. The patient was 44-year-old female complaining of visual complication and general fatigue.
    The mucocele wall was resected as much as possible via a transnasal approach with endoscopy, and a drainage was routed into the nasal cavity.
    Mucocele recurrence was not detected within a 14-month follow-up period.
    This case suggests that the postoperative radiologic follow-up should be performed after removal of pituitary tumors to detect sphenoid sinus mucocele as well as the tumor recurrence.
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  • A Foreign Body in the Maxillary Sinus Removed under Endoscopic Sinus Surgery
    -The extracted Tooth in the Maxillary Sinus-
    Takahiro YAMANISHI, Kazuaki CHIKAMATSU, Keisuke MASUYAMA, Eiji YUMOTO
    1999 Volume 92 Issue 10 Pages 1101-1105
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1101
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    In this report, we report of a patient with a dental foreign body in the maxillary sinus, which was considered to be a decayed tooth. The patient was a 23-year-old woman with nasal purulent discharge, fever, and pain in the right cheek. She had no previous history of nasal or sinus problems. However, past history included treatment for decay in the 7th upper right tooth. Her symptoms persisted despite temporal improvement with conservative treatments. The plain sinus x-ray film and the CT scan revealed findings consistent with chronic maxillary sinusitis. In addition, these examinations demonstrated a tooth-shaped calcification, suggesting the presence of a foreign body from a decayed tooth in the center of the right maxillary sinus. Endoscopic sinus surgery (ESS) was performed under general anesthesia. After removing the uncinate process, the natural ostium was identified. An enlargement of the natural ostium and the creation of a nasoantral window were performed. The foreign body was easily identified and removed. There were neither edematous changes nor fluid retention in the right maxillary sinus. In the follow-up period, the patient had no symptoms. ESS could be a useful technique to remove foreign bodies in the maxillary sinus.
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  • Traumatic Maxillary Artery Aneurysm with Rupture into the Maxillary Sinus
    Shinji SUZUKI, Masaharu SUDO, Hideyuki YAMAMOTO, Yuichi KIMURA, Myojo ...
    1999 Volume 92 Issue 10 Pages 1107-1110
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1107
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    A case of traumatic aneurysm was reported. A 25-year-old man was admitted to our hospital with severe epistaxis and oral hemorrhage caused by a fall. Multiple maxillofacial fractures were found by CT. Nasal packing for the epistaxis and reduction of the fractured mandible were immediately performed. The patient seemed to be doing well; however, epistaxis reoccured 13 days after the injury. Nasal packing was not effective for the recurrent bleeding.
    To confirm the bleeding site, angiography by the Seldinger technique was performed. Angiography demonstrated the presence of an aneurysm in the area of the left maxillary artery. Therefore, superselective embolization using microcoils was performed. After this procedure, epistaxis was completely controlled.
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  • Primary MALT Lymphoma of the Parotid Gland
    Susumu MARUYAMA, Makoto YASUDA, Itaru YAMAMICHI
    1999 Volume 92 Issue 10 Pages 1111-1116
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1111
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    Only 1-2% of salivary gland tumors are malignant lymphomas, and malignant lymphomas are rare among the parotid tumors. A 58-year-old female complained of anteroauricular swelling. Flowcytometric examination of the biopsy specimen revealed MALT (mucosa-associated lymphoid tissue) lymphoma. Superficial parotidectomy and upper neck dissection were performed, and involvement of one superficial cervical lymph node was found. After the operation, subcutaneous swelling of the forearm was excised, which was revealed to be associated with the lymphoma. We performed three courses of CHOP therapy after the operation. Eight months post operatively, no recurrence has been detected.
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  • A Pseudo-Malignant Warthin's Tumor with Inflammatory Changes
    Yoichiro TOMIYAMA, Jun-ichi YOSHIDA, Shiro AKAHANI, Kenji MITANI
    1999 Volume 92 Issue 10 Pages 1117-1123
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1117
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    We report a pseudo-malignant Warthin's tumor with inflammatory changes. A 25 year-old man had been complaining of a painless right sub-auricular swelling for 2 years and 6 months. On examination, there was a 3.5×3.5cm firm mass in the right parotid region, fixed deeply but not to the skin. There was no associated lymphadenopathy. Magnetic resonance imaging of the area revealed a mass of mixed intensity in the right parotid gland involving both the superficial and deep lobes and extending beyond the confines of the capsule. A clinical diagnosis of a malignant parotid tumor was made. A total parotidectomy was performed sacrificing of a buccal branch of the facial nerve. A peroperative frozen section of the tissue was read as an abscess. However postoperative histological examination showed a Warthin's tumor with severe inflammation, partial fibrosis and necrosis. There was no evidence of malignancy.
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  • A Study on Allergies Participating in an Abnormal Sensation in the Throat
    Mikikazu YAMAGIWA, Reiko NIIYAMA
    1999 Volume 92 Issue 10 Pages 1125-1131
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1125
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    An upper airway allergy to inhaled or ingested allergens may induce an abnormal sensation in the throat (AST). However, little has been investigated about the incidence of allergic patients among patients with AST.
    Using the AlaSTAT system, we measured total IgE levels and antigen-specific IgE antibodies to pollen (cedar, cypress, birch), house dust, apple and two broad screening panels of food in 182 patients (75 males and 107 females; mean age was 57.7 years) with AST.
    Eighty-eight (48.4%) of 182 patients showed abnormally high (250<U/ml) total IgE levels and/or a positive (AlaSTAT class 1≤) IgE antibody to one or more allergens. These patients were classified into group A and compared with the other patients (group Non-A).
    A statistically significant difference (p<0.05 by Mann-Whitney U test) between groups A and Non-A was shown for the total IgE value (A>Non-A), average age (A<Non-A), average month after the onset of AST (A<Non-A), location of AST and average CIJ score by the Cornell Medical Index-Health Questionnaire. These findings indicate that upper airway allergies should be taken into consideration as a cause of AST.
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  • The Effect of Therapy on Sleep Apnea and Simple Snoring
    Muneo Nakaya, Ichirou Morita, Kosei Takeda, Tomoaki Kai, Nobuo Usui
    1999 Volume 92 Issue 10 Pages 1133-1138
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1133
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    A sleep test was performed 108 times on 85 patients at the Self-Defense Forces Central Hospital for one year between September 1997 and August 1998. 36 patients (42%) had sleep apnea and 46 (57%) had simple snoring. Surgery was performed on 41 patients (55%) and a dental splint was used on 3 (4%). We issued a questionnaire about the effect of the therapy to the 44 patients after surgery and dental splint use. We received questionnaires back from 34 patients (77%). The improvement ratio of snoring was 94% and that of apnea during sleep was 93% after surgery. 88% of the patients raised their health awareness and 82% and significantly decreased their body weight after therapy.
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  • Results of Treatment and the Prognostic Factor for Oropharyngeal Carcinoma
    Junichi WAKASHIMA, Tetsuo HIMI, Koji ASAKURA, Akikatsu KATAURA, Yasuak ...
    1999 Volume 92 Issue 10 Pages 1139-1145
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1139
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    We reviewed sixty-six patients with oropharyngeal carcinoma treated between 1983 and 1997 at Sapporo Medical University. The study consisted of 62 men and 4 women, 39 to 84 years old (an average of 61.0 years). The tumors were staged by TNM classification (UICC 1987) as follows stage I: 3, stage II: 9, stage III: 16, stage IV: 38. As the initial treatment, 48 patients underwent radical radiotherapy, whereas the remaining 18 were treated mainly by surgery after pre-operative radiation. Survival distributions were estimated by the Kaplan-Meier method as a univariate analysis, and compared using the generalized Wilcoxon test. The overall five-year cumulative survival rate was 50.4%. Significant clinicopathological variables that influenced survival were T stage (p=0.0251), N stage (p<0.0001), clinical stage (p=0.0085), and age (p=0.0367). The results from the multivariate analysis by Cox's proportional hazards model identified N stage as a significant independent prognostic factor. Evaluation of the therapeutic modalities revealed that a better prognosis in the surgical group than the radiotherapy group was significant in stage IV. These data suggest that surgical treatment is recommended for stage IV patients to improve their survival rate.
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  • A Case of Psoas Abscess due to Methicillin Resistant Staphylococcus Aureus after Total Laryngectomy
    Hiroshi SUNOSE, Toshihiko CHIBA, Mitsuru SUGAWARA, Masaru TOSHIMA
    1999 Volume 92 Issue 10 Pages 1147-1151
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1147
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    A 78-year-old Japanese man was admitted to Iwaki Kyoritsu General Hospital for treatment of laryngeal cancer (T2N2aM0). Total laryngectomy with bilateral modified neck dissection was performed, and the patient initially showed good recovery. On the 12th postoperative day, the patient suddenly obtained a high-grade fever. Sustained lumbago followed two days later. Broad spectrum antibiotics were administered under suspicion of a bacterial infection. However, the antibiotics were not effective. Hemoptosis from gastric ulcer appeared on the 19th post-operative day, causing anemia and deterioration of his general condition. Since computed tomography revealed bilateral psoas abscess on the 20th postoperative day, open drainage under general anesthesia was performed. At the end of the operation, cardiac arrest of unknown origin occurred. Bacteriological examination of the abscess and blood after surgery proved Methicillin resistant staphylococcus aureus. Consciousness of the patient was never recovered, and the patient died on the 44th day after the initial surgery. This is the first case of psoas abscess reported as a postoperative complication after head and neck surgery in Japan. The pathogenesis of psoas abscess in this patient was discussed.
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  • Microsurgery of Vocal Nodules
    [in Japanese]
    1999 Volume 92 Issue 10 Pages 1152-1153
    Published: October 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.1152
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