Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 92, Issue 6
Displaying 1-18 of 18 articles from this issue
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  • Current Status on Macrolide Therapy in Chronic Sinusitis
    Masaru OHYAMA, Kazuyoshi UENO, Shoji MATSUNE, Yutaka HANAMURE, Hiroshi ...
    1999 Volume 92 Issue 6 Pages 571-582
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.571
    JOURNAL FREE ACCESS
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    The clinical efficacy of low-dose and long-term Macrolide therapy such as Erythromycin (EM), Roxithromycin (RXM), and Clarithromycin (CAM) in the treatment of chronic sinusitis was analysed retrospectively over the past 8 year period as represented in the Japanese literature.
    Patients treated with these macrolides demonstrated an improvement in both quality and quantity of nasal discharge. Notably, patients who received RXM demonstrated better improvement of rhinorrhea than patients treated with EM or CAM. CAM was judged to be useful in the treatment of sinusitis in children, showing greater improvement and a faster recovery period as compared to improvements in adults.
    The Excellent synergism of both Ciprofloxacin and RXM or CAM on P. aeruginosa in biofilms was discussed from the standpoint of their pharomacological action in biofilms. Combined therapy using sinus irrigation or a YAMIK catheter for treatment of sinus secretion and macrolide administration was presented as a new therapeutic modality for treatment of chronic sinusitis.
    Drug interactions with EM, CAM, but not with RXM, and antiallergic agents such as Terfenadine and Astemisole were demonstrated as one of the adverse effects occurring in clinical practice.
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  • A Case with Multiple Cartilage Lesions in the Head and Neck
    [in Japanese], [in Japanese]
    1999 Volume 92 Issue 6 Pages 584-585
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.584
    JOURNAL FREE ACCESS
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  • Clinical Evaluation of Vestibular Schwannomas and other Cerebellopontine Angle Tumors
    Atsushi HARIMAYA, Tetsuo HIMI, Yasuaki HARABUCHI, Kohji ASAKURA, Akika ...
    1999 Volume 92 Issue 6 Pages 587-593
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.587
    JOURNAL FREE ACCESS
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    Clinical studies of forty cerebellopontine angle tumors including thirty-one vestibular schwannomas were performed. The results of audiological and radiological testing were analyzed and screening methods for Cerebellopontine angle tumors were evaluated. Although auditory brainstem response (ABR) tests reveal the highest positive rate of detection in vestibular schwannoma patients, ABR tests are difficult to perform routinely in hospitals, especially in private clinics. The combination of conventional radiographs (Stenvers views) and caloric tests had a higher positive rate of detection than ABR tests, whereas these testing methods alone both had lower positive rates. Our data shows the high efficiency of routine radiographs and caloric tests for detection of patients with suspected acoustic neurinomas. Further evaluation including ABR tests and magnetic resonance imaging (MRI) should be performed after initial testing. In our study, all of the other cerebellopontine angle tumors showed abnormalities in ABR tests. ABR tests are also efficient in the investigation of patients with other cerebellopontine angle tumors.
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  • Idiopathic Sudden Sensorineural Hearing Loss and Sensation of Aural Fullness
    Shinichi KANEMARU, Hideyuki FUKUSHIMA, Hajime Nakamura, Yoshihiro TAMU ...
    1999 Volume 92 Issue 6 Pages 595-600
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.595
    JOURNAL FREE ACCESS
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    The relationship between the sensation of aural fullness and average hearing level, tinnitus and vertigo, the typical symptoms of idiopathic sudden sensorineural hearing loss was studied. Forty-six patients with idiopathic sudden sensorineural hearing loss of more than 50 dB from intial average hearing level were treated with interferon therapy. The sensation of aural fullness was classified into 4 grades: very strong, intermediate, subtle and nothing, on the basis of patient complaints. We found that the levels of hearing loss did not always correlate with the degree of sensation of aural fullness but there was an tendency toward improvement of the sensation of aural fullness in accordance with the recovery of hearing. In addition, there was no statistical relationship between the sensation of aural fullness and the presence of vertigo, but there was a statistical correlation with tinnitus. These results suggest a close relationship between the sensation of aural fullness and dysfunction of the cochlea.
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  • Effects of an Impact Noise on the Intelligibility of Speech through a Hearing Aid
    Ken-ichi KANEKO, Kazuhiko SHOJI, Hisayoshi KOJIMA, Ryo ASATO, Shigeru ...
    1999 Volume 92 Issue 6 Pages 601-606
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.601
    JOURNAL FREE ACCESS
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    The purpose of this investigation was to examine how speech intelligibility is affected by an impact noise for listeners wearing a hearing aid. In this experiment, the subjects consisted of 10 sensorineural hearing-impaired and five normal hearing listeners. Sentences mixed with a single impact noise or without noise were presented randomly to subjects wearing a hearing aid. The hearing aids used in this experiment were digital hearing aids (TD-1) which compress the signals in the time domain, and conventional analog hearing aids with peak clipping (PC) or automatic gain control (AGC). The results demonstrated that the intelligibility of sentences mixed with an impact noise decreased when the hearing-impaired subjects wore the analog hearing aid. Interestingly, the decline in intelligibility arose in the phrases not only after the impact noise, but also before the noise. On the other hand, there was none or only a slight decrease in intelligibility, regardless of the impact noise, in the normal hearing subjects and the hearing-impaired wearing TD-1. These results indicate that the compression method adopted by TD-1 is useful for patients with sensorineural hearing loss even under conditions with impact noises. We believe that incompletely suppressed impact noises mask the speech signal, and thus causes a decrease in the speech recognition of hearing-impaired subjects wearing analog hearing aids.
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  • Endolymphatic Sac Drainage and Steroid-insertion Surgery for Intractable Meniere's Disease
    Tadashi Kitahara, Noriaki Takeda, Yasuo Mishiro, Junko Murata, Hidehir ...
    1999 Volume 92 Issue 6 Pages 607-611
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.607
    JOURNAL FREE ACCESS
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    Endolymphatic sac surgery is one of the most widely accepted techniques used to treat intractable Meniere's disease. In order to improve sac surgery, we have developed some new techniques. A simple mastoidectomy was performed, exposing the endolymphatic sac in the area between the sigmoid sinus and the inferior margin of the posterior semicircular canal. The sac was opened and filled with a mass of prednisolone. A bundle of absorbable gelatin films was then inserted into the sac lumen to expand its volume, followed by gelatin sponges dipped in a high concentration dexamethasone. The short-term results (1-8 months) in 8 patients with intractable Meniere's disease treated with the above techniques, i. e. endolymphatic sac drainage and steroidinsertion surgery are as follows: vertigo was completely controlled, hearing was improved and annoyance due to tinnitus was decreased in all cases.
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  • Clinical Observation on Reimplantation of Cochlear Prosthesis
    Akira HAGIWARA, Atsushi Kawano, Akio KATO, Mamoru SUZUKI
    1999 Volume 92 Issue 6 Pages 613-617
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.613
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    Reimplantation of cochlear prostheses was reviewed for 130 cases of nucleus cochlear implants. Nine patients who underwent reimplantation due to postoperative complications were analyzed. The causes of reimplantation included slipping out of the electrodes in 6 patients and mechanical failure of the electrodes in 3. Reimplantation was difficult in some patients because of massive fibrosis and ossification of the cochlear lumen. Postoperative hearing was correlated with the number of reinserted electrodes.
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  • CATCH22 Syndrome Associated With Chronic Otitis Media; A Case Report
    Tsuyoshi KITANISHI, Yoshiro YAZAWA, Yuko ASADA, Eiji TAKEUCHI, Kazutom ...
    1999 Volume 92 Issue 6 Pages 619-623
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.619
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    CATCH22 syndrome, as defined by D. I. Wilson, is associated with the following features: Cardiac anomalies, Abnormal facies, Thymic hypoplasia, Cleft palate, and Hypocalcemia resulting from microdeletions of chromosome 22q11. We encountered a patient with chronic otitis media, who was diagnosed as having CATCH22. We performed a right tympanoplasty and reported subsequent findings in this CATCH22 patient.
    The case was a 9-year-old female who complained of bilateral otorrhea. She was diagnosed with CATCH22 syndrome on the basis of clinical findings and a genetic analysis before visiting our clinic. Tympanoplasty revealed the handle of the malleus to be severely bent and ossicular movements seemed to be slightly restricted. Other anomalies were not observed. She was discharged without any further symptoms.
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  • Bezold's Abscess; A Case Report
    Masanori KONISHI, Tetsuo HIMI, Hisao MURAKATA, Iwao YOSHIOKA
    1999 Volume 92 Issue 6 Pages 625-629
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.625
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    A 76-year-old woman was referred to Sapporo Med. Univ. Hosp. with right lateral neck swelling, otorrhea, and anorexia, but without any local pain or high fever. She was diagnosed as having otitis media and a deep neck abscess by CT-scan. Emergency drainage of the neck abscess was performed. Bacteroides intermedius was cultured from the pus. Three days after the drainage, a mastoidectomy was performed. The well-developed mastoid cavity and air cells were filled with the flaccid granulation and pus. The mastoid tip was revealed to have a bone defect, and the mastoid cavity was considered to be continuous with the neck abscess. Several suggestions for treatment of elderly patients was discussed.
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  • Blood Boil of the Maxillary Sinus; A Three-Case Report
    Ken WATANABE, Ryouji SASAKI, Masanori UMEMOTO
    1999 Volume 92 Issue 6 Pages 631-636
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.631
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    We describe three cases of blood boils of the maxillary sinus that were suspected to be malignant tumors. The patients were a 27-year-old female, a 52-year-old male and a 24-year-old male. The chief complaints in all cases were unilateral nasal obstruction and nasal bleeding. CT examination showed that the tumors occupied the entire unilateral maxillary sinus, and expanded with maxillary bone thinning. Biopsies performed through the nasal cavity revealed the tumorous masses to be benign. Ultimately, the tumorous masses were surgically extirpated without any transfusion, and the histopathological diagnosis turned out not to be the more typical hemangioma, but rather so called blood boil.
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  • A Case Report of Sebaceous Carcinoma of the Parotid Gland
    Tomoaki Nakano, Hiromasa CHOU, Masahiko SUGITA, Hayato SHIOTANI
    1999 Volume 92 Issue 6 Pages 637-642
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.637
    JOURNAL FREE ACCESS
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    Primary sebaceous carcinoma of the salivary gland is extremely rare, although sebaceous glands are commonly present in the parotid and submandibular glands.
    We report the youngest case of sebaceous carcinoma of the right parotid gland with metastasis to the lymph node beneath the right parotid gland. The patient was a 13-year-old female. Sebaceous carcinoma is widely believed to be associated with Muir-Torre syndrome. This case, however, suggests that sebaceous carcinoma of the parotid gland is not associated with the visceral malignancies.
    After extirpation of the tumor and coservative neck dissection, there has been no evidence of recurrence for 20 months.
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  • Clinicopathological Study of Recurrent Factor for T1·T2 Carcinoma of the Tongue
    Hirohito UMENO, Mitsuji TAMURA, Kazunori MORI, Yoshimi MIYAJIMA, Keiic ...
    1999 Volume 92 Issue 6 Pages 643-649
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.643
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    Significant factors related to primary recurrence of T1/T2 carcinoma of the tongue and neck lymph node metastasis were analyzed with the use of logistic analysis in 108 patients. All patients had undergone Cot laser resection between March 1980 and April 1997. The factors analyzed included: (1) primary site of the carcinoma, (2) differentiation of squamous cell carcinomas, (3) diameter of the primary tumor, (4) absence/presence of perineural invasion of the primary tumor, (5) absence/presence of intravascular invasion of the primary tumor, (6) absence/presence of in-tramuscular invasion of the primary tumor, (7) depth of primary tumor invasion. (8) surgical margin of the resected primary tumor, and (9) absence/presence of irradiation. Significant risk factors for primary recurrence were a surgical margin of less than 4 mm and tumor coverage of the posterior third of the mobile tongue. A significant risk factor in neck lymph node metastasis was depth of primary tumor invasion of more than 4 mm, no other significant factors for the primary recurrence or regional recurrence were observed. The results suggested that a deep surgical margin of more than 10 mm was nesessary, and that if the primary lesion occupied the posterior third of the mobile tongue, an extended surgical resection was nesessary. In addition, if the depth of the primary tumor invasion is more than 4 mm, preventive modified radical neck dissection is recommended.
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  • Surgical Treatment for Squamous Cell Carcinoma of the Lateral wall of the Oropharynx; A Transoral Approach
    Hiroshi NISHINO, Hidetaka Tanaka, Kazuhiro ISHIKAWA, Takeharu KANAZAWA ...
    1999 Volume 92 Issue 6 Pages 651-656
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.651
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    The outcome of radiation therapy or surgery was studied retrospectively in 30 previously untreated patients with squamous cell carcinoma (SCC) of the lateral wall of the oropharynx. Twenty-two patients with tonsillar SCC and 8 patients with tonsillar pillar SCC were treated between 1978 and 1997 at the Jichi Medical School Hospital. The group consisted of 25 men and 5 women, aged 34 to 82 years (average, 63 years). In the tonsillar SCC group, lesions were T1 in 2 cases, T2 in 2, T3 in 13, and T4 in 5; 5, 3, 12 and 2 patients had NO, N1, N2, and N3 disease, respectively. In the tonsillar pillar SCC group, lesions were T2 in 5 cases, T3 in 2, and T4 in 1; 6 patients had NO, 1 had N1, and 1 had N2 disease. Fourteen patients were treated with radiation and 16 were treated with surgery, 14 of whom also received preoperative irradiation. Eleven patients in the surgery group underwent resection by a transoral approach and 5 underwent extended surgery with reconstruction. Disease-free survival rate at 3 years by the Kaplan-Meier method was 64% in the radiation group and 78% in the surgery group (not significantly different) in those with tonsillar SCC, and 67% and 82%, respectively, (not significantly different) in those with tonsillar pillar SCC. The surgical approach was transoral in patients with noninvasive T2 or T3 primary lesions. No local recurrence was observed. Transoral resection appears to be useful for treating noninvasive lateral wall SCC of the oropharynx.
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  • Preoperative Diagnosis of Metastatic Lymph Nodes on Thyroid Cancers
    Takeshi KUSUNOKI, Kiyotaka MURATA
    1999 Volume 92 Issue 6 Pages 657-661
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.657
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    Cervical lymph nodes with tumors were observed to have a long diameter in addition to a distinctive form and signal intensity with MRI, by various preoperative imaging examination methods(echo, CT and MRI). Data for metastatic lymph nodes and non-metastatic lymph nodes were compared. Metastases were examined by postoperative histopathology. Lymph nodes which exceeded 10 mm in diameter and which were spherical in form were more frequently observed to be metastatic than non-metastatic. While some metastatic lymph nodes showed high intensity on T1 weighted MRI, non-metastatic lymph nodes did not. These results suggest that a combination of the three factors(long diameters, spherical form and T1 weighted MRI) could predict whether lymph nodes are metastatic or not.
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  • A Case of Adult-onset Primary Tracheal Papilloma
    Susumu MARUYAMA, Itaru YAMAMICHI, Motooki YASUNO
    1999 Volume 92 Issue 6 Pages 663-668
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.663
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    Primary tracheal tumor is rare, and the majority of primary tracheal tumors are malignant. Many of the reported tracheal papillomas have occurred with previous or co-existent laryngeal papillomatosis.
    A case of adult-onset primary tracheal papilloma is presented here. A 54 year-old female complained of a foreign body sensation in the throat. Echogram, MRI and CT showed the presence of a tracheal tumor. Bronchofiberscopic findings subsequently revealed a cauliflower-like tumor arising from the lateral wall of the trachea. Histopathological examination of a biopsy specimen suggested papilloma, and malignancy was not ruled out. CO2 laser therapy was performed after tracheostomy.
    The presence of human papilloma virus (HPV) DNA type 6 was detected by the PCR (polymerase chain reaction) method.
    Up to six months after the operation, no recurrence of the tumor has been detected.
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  • The Scope of Activities and Roles of the Speech-Language-Hearing Therapist (SHT) for the Hearing Handicapped
    Hiroshi HATTORI
    1999 Volume 92 Issue 6 Pages 669-675
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.669
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    The wide variety of activities and the important roles of the Speech-Language-Hearing Therapist for the hearing handicapped were discussed in the following areas.
    1. Facilitation of early identification of infants with hearing loss for referrals to further asses hearing impairment, and to asses candidate suitability for cochlear implant surgery.
    2. Provision of audiological support to facilitate auditory learning in various educational settings, such as training centers for deaf young children, deaf schools, hard of hearing classes and normal schools.
    3. Working as audiometrists in various settings, such as hospitals, medical centers, rehabilitation centers, etc.
    4. Working as indispensable professionals in the hearing clinics in hospitals, and contributing to reorganization of the hearing aid dispensing system in Japan.
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  • Effects of Neurotrophic Factors on Regeneration of Denervated Recurrent Laryngeal Nerve in the Rat
    Masahiro KOMORI
    1999 Volume 92 Issue 6 Pages 677-686
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.677
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    Three kinds of neurotophic factors were evaluated in adult rats for their effects on regeneration of the denervated recurrent laryngeal nerve (RLN). After transection of the left RLN, a silicone tube was placed between the nerve stumps, and the gap of the nerves was filled with one of the following solutions; nerve growth factor (NGF), ciliary neurotrophic factor (CNTF), basic fibroblast growth factor (bFGF) and phosphate buffer (PBS) for control. A total of 116 rats were subjected to the present study; 32 were for each of the NGF, CNTF and bFGF studies, 16 for the PBS study and 4 for no treatment. Electromyographical and histlogical evaluations were conducted either 3 weeks or 5 weeks after the transection. Results can be summarized as follows:
    1. Recovery of the evoked electromyographic response at 3 weeks postoperatively was facilitated by local administration of NGF or bFGF.
    2. CNTF and bFGF increased the total number of regenerating nerve fibers at 3 weeks postoperatively. Recovery of the myelinated nerve fibers were facilitated only by application of bFGF.
    3. NGF and bFGF were effective in the prevention of the decrease in the size of the motor neuron in the nucleus ambiguus due to transection and following adaptation of the recurrent laryngeal nerve.
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  • Orbital Complications of Sinusitis
    -Managements for Complicated Cases-
    [in Japanese]
    1999 Volume 92 Issue 6 Pages 688-689
    Published: June 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.688
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