Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 92, Issue 8
Displaying 1-18 of 18 articles from this issue
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  • Gaseous Neurotransmitters Involved in Laryngeal Innervation
    Yasuo HISA
    1999 Volume 92 Issue 8 Pages 811-815
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.811
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    The involvement of nitric oxide (NO) and carbon monoxide (CO) in laryngeal innervation of the dog and rat was investigated by immunohistochemistry using antisera against nitric oxide synthase and heme oxygenase, in addition to NADPH-diaphorase histochemistry.
    NO and CO are involved in the regulation of blood flow and glandular secretions in the larynx. NO participates in nociception in the larynx although the role of NO is minor in this system. CO is considered not to participate in sensory innervation of the larynx. Nitrergic neurons were found between the muscle fibers of the intrinsic laryngeal muscles suggesting a role in proprioception in place of muscle spindles. Induction of NO was detected in the motoneurons of the nucleus ambiguus after injury to the recurrent laryngeal nerve. Further investigation of this phenomenon would facilitate understanding of the pathogenesis of recurrent laryngeal paralysis.
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  • Cochlear Implant of Clarion-S System
    [in Japanese], [in Japanese], [in Japanese]
    1999 Volume 92 Issue 8 Pages 816-817
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.816
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  • Idiopathic Sudden Sensorineural Hearing Loss and Cell-mediated Immunity
    Shinichi KANEMARU, Hideyuki FUKUSHIMA, Hajime Nakamura, Yoshihiro TAMU ...
    1999 Volume 92 Issue 8 Pages 819-825
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.819
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    In order to characterize the immunological mechanisms responsible for idiopathic sudden sensorineural hearing loss (ISSHL), changes in the ratio of the Tcell-subsets in the peripheral blood were investigated before and after treatment in 77 ISSHL patients who visited our clinic within 1 week from the onset of their ISSHL. Forty-three patients who had an average hearing ability of≥60dB before treatment (group I) received interferon therapy. Thirty-four patients who had an average hearing ability of≤59dB before treatment (group II) received steroid tapering therapy.
    Upon the first examination of many cases of from group I, a decreased number of whole lymphocytes, a decreased ratio of Tcells (CD3) in the lymphocytes population, especially CD4+Tcells (Helper T/Inducer Tcell), and a decreased ratio of CD4/CD8 cells were observed. After treatment in almost all cases from group I, the ratio of the Tcell-subsets recovered from these low levels to their CD4 dominant state. These changes in the ratios of the Tcell-subset were not observed in almost all of the cases in group II. Therefore, in ISSHL, there is a difference in cellmediated immune function according to the degree of hearing loss.
    These results suggest that one of possible etiologies for ISSHL is an immunological disorder caused by viral infection, etc.
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  • A Case of Transitory Bilateral Deafness Suspected to be due to Denaturation Disease
    Tatsunori KOSHINO, Masatoshi HIRAYAMA, Mitsukuni NITTA, Hajime SANO, M ...
    1999 Volume 92 Issue 8 Pages 827-832
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.827
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    A 19-year-old female visited our hospital with the chief complaint of hearing loss. We felt that she was suffering from a psychological illness. We thought she had no lost of hearing, and we suspected she was feigning illness at the first medical examination. A subsequent hearing test as a result bilateral sensorineural hearing loss. In cases of bilateral sudden deafness, the possibility of the mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) characteristic of denaturation disease, should be investigated. Even if we suspect feigning further testing is requested to obtain a definitive diagnosis.
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  • Modified Canalith Repositioning Procedure for Benign Paroxysmal Positional Vertigo
    Ken HAYASHI, Mamoru SUZUKI, Naoki HAYASHI, Toru TANIGAWA, Meiko OKADA, ...
    1999 Volume 92 Issue 8 Pages 833-838
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.833
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    The majority of benign paroxysmal positional vertigo (BPPV) cases with posterior canal lesion can be easily cured by the canalith repositioning procedure (CRP). BPPV with lateral canal lesions can also be cured by a modified CRP specifically designed by the authors. There are some cases which present with a combination of pure-torsional nystagmus and direction-changing geotropic nystagmus. This type of BPPV could involve both posterior and lateral semicircular canals. Twelve cases of such a combined type of BPPV were treated by applying the CRP for each canal. Complete remission was obtained in 5 cases, and a substantial decrease in the nystagmus was observed in the other 7 cases. The CRP should be applied to cases of BPPV with combined lesions as the first choice of treatment.
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  • Tympanoplasty for Middle Ear Cholesteatoma in Children with Down Syndrome
    Yukako IMAMURA, Yukako IINO, Jun-ichi SUZUKI
    1999 Volume 92 Issue 8 Pages 839-844
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.839
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    We studied the clinical characteristics and postoperative courses of 9 children with Down syndrome who underwent ear surgery for middle ear cholesteatoma. Canal down procedure with canal reconstruction was performed in all children. At the time of operation, otitis media with effusion was frequently seen either on the cholesteatoma side or on the opposite side, and various types of cholesteatoma, such as the pars flaccida type, posterosuperior quadrant type and central type, were observed. Residual cholesteatoma was found in 1 of the 3 children who underwent the second stage operation, while no recurrent cholesteatoma (newly formed retraction pocket) was noted in any of the children during the follow-up period. However, middle ear effusion persisted for a long period and reaeration was poor. In addition, severe stenosis of the external auditory canal was observed 2 to 3 months after the operation in all children. Four children required another operation to wide the external auditory canal followed by insertion of a stent.
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  • Tympanoplasty and Tinnitus
    Sachio TAKENO, Hiroshi KAGA, Chie KOJIMA, Yukiko IINO, Kazuoki KODERA, ...
    1999 Volume 92 Issue 8 Pages 845-850
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.845
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    We examined the time course changes of tinnitus after tympanoplasty in 30 patients. All patients exhibited disorders of symptomatic tinnitus preoperatively. Pitch match test and loudness balance test, in combination with pure tone audiometry were employed to obtain data on their characteristics. The patients were further subdivided into two groups, the middle tone group and the high tone group, based on whether their tinnitus could be pitch-matched relatively to low to middle frequency sounds (125Hz to 1kHz) or high frequency sounds (2 to 8kHz). In addition, a series of questionnaires was administered to both groups to evaluate the following subjective complaints: 1) the degree of loudness, 2) duration period, and 3) the degree of disturbance in daily life.
    Fifty-five percent of the patients in the middle tone group and 48% in the high tone group showed changes to the pitch matched frequency 1 week after surgery. One week later, 63% of the patients in the former group still retained altered frequency matching to their tinnitus, whereas the percentage for the latter group decreased to 30% indicating that about 20% of the patients with high tone tinnitus returned to their original conditions. Results from subjective assessment by the questionnaire substantiated the difference in symptom severity between the two groups. Three weeks after the surgery, 70% of the patients in the middle tone group showed decreased scores for subjective loudness, whereas only 25% of the high tone group showed relief. On the other hand, the scores for tinnitus duration periods and the degree of disturbance in daily life remained unchanged after the surgery, and no significant difference was observed between the two groups. Although the relationship between the pathologic conditions of the middle ear cavity and exacerbating parameters of tinnitus is not fully understood, we speculate that tinnitus cases showing lower frequency tone are more likely to be dependent on abnormal sound transmission caused by middle ear diseases.
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  • Prophylactic Endoscopic Laser Surgery for Severe Pollinosis
    Kiminori Sato
    1999 Volume 92 Issue 8 Pages 851-855
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.851
    JOURNAL FREE ACCESS
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    Endoscopic CO2 laser surgery was performed before the onset of pollen scattering in 50 cases of severe Japanese cedar pollinosis, in which conservative treatment had no effect. Nineteen cases were pollinosis without perennial nasal allergy and 31 cases were pollinosis with perennial nasal allergy. A rigid endoscope and thin pipe guide were used in the surgical procedure. The inferior turbinate was prophylactically vaporized with a defocused carbon dioxide laser beam. During the first pollen season, 94% of the patients had excellent or good results without medication. No patients complained of severe nasal symptoms. During the second season after laser surgery, 79% of the patients had excellent or good results without medication. Two cases complained of severe nasal symptoms. The efficacy of laser surgery decreased somewhat during the second season. Prophylactic endoscopic laser surgery is a effective method of treatment for sever pollinosis.
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  • A Case of Antral Choanal Polyp
    Masayuki SAKAMOTO, Keiichi ICHIMURA
    1999 Volume 92 Issue 8 Pages 857-860
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.857
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    We describe a case of antrochoanal polyp. Computed tomography revealed soft tissue density areas in the right maxillary sinus without bone defects and at the nasopharynx with some air spaces between the pterygoid process. When the specimen was obtained for pathohistological study, the polyp bled and angiofibroma could not be denied. Following arterial embolization, polypectomy and Caldwell-Luc's operation were performed. Cases of antrochoanal polyp angling to the mesopharynx must be distinguished from other diseases. Since antrochoanal polyp and nasopharyngeal angiofibroma show many similar clinical features, if angiofibroma is present, careful treatment is needed.
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  • Intranasal Ultrasonography
    Hirofumi TANAMOTO, Katsuhiko Nakamura
    1999 Volume 92 Issue 8 Pages 861-868
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.861
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    The purpose of this study was to evaluate the usefulness of Intranasal ultrasonography.
    Intranasal ultrasonography was used to identify the membranous part of the lateral nasal wall, the so called “fontanelle”, and the lamina papyracea. The type SSD 550 ultrasound system (ALOKA Company), which is designed for viewing small tubes and cavities, was employed. This system features a catheter-style radial probe, 6 French in diameter, which is designed to obtain 360 degree B-mode ultrasound images. Intranasal ultrasonography was performed under monitoring with nasal endoscopy on 32 patients who were examined previously by Computed Tomography (CT). The ultrasonography images were evaluated in comparison to CT findings of the nose. The ultrasound images observed intraoperatively in four out of the 32 patients were compared with the surgical findings.
    The bone of the lateral nasal wall was revealed to be a high echo region and the fontanelle was consistently demonstrated to be a low echo region in all of the patients. Moreover, the area represented exclusively as a low echo region in the lateral nasal wall was confirmed to be the fontanelle by surgical methods in three of the patients. The lamina papyracea was revealed as a high echo region in three of the patients who's ethmoid sinus had been opened with sinus surgery.
    Further development of an appropriate probe would make it possible to identify bone defects in any part of the lamina papyracea and the skull base using intraoperative intranasal ultrasonography, which may in turn prevent complications during endoscopic sinus surgery.
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  • Basaloid Squamous Cell Carcinoma of the Maxillary Sinus; A Case Report
    Takashi GOTO, Yoshifumi Kobayashi, Masanobu IMADA, Mitsuaki Takahashi, ...
    1999 Volume 92 Issue 8 Pages 869-873
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.869
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    We reported a rare case of Basaloid squamous cell carcinoma of the maxillary sinus. The patient was a 60-year-old female with a swollen hard palate. A smooth large mass protruding into the hard palate and spreading to the nasal cavity was found. A CT scan and MRI demonstrated a mass occupying an area extending from the ethmoid sinus to the hard palate. No metastatic lesions were detected. A biopsy specimen revealed basal cell carcinoma. Excision of the tumor was performed. Based on surgical findings, the medial wall of the maxillary sinus was considered to be the original focus of the tumor. Microscopic studies confirmed the diagnosis of basaloid squamous cell carcinoma. The clinical features of basaloid squamous cell carcinoma are discussed.
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  • Clinical Studies of Oral Cancer
    Masayuki MINAMINO, Hirobumi KUMAZAWA, Hiroyuki TSUJI, Toshiya INOUE, T ...
    1999 Volume 92 Issue 8 Pages 875-880
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.875
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    Seventy-three cases of oral cancer (tongue: 47, oral floor: 10, buccal mucosa: 10, gingiva: 4, hard palate: 2) treatedinitially from 1985 to 1995 were reviewed retrospectively. The cumulative five year survival rate was 71.4% for all of the patients, and 75.8% for carcinomas of the tongue, 88.9% for carcinomas of the buccal mucosa and 42.2% for carcinomas of the oral floor. Further strategies are required in advanced cases with T4 staging in order to improve the survival rate and quality of life of oral cancer patients.
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  • A Case Report of Basaloid-Squamous Cell Carcinoma of the Hypopharynx
    Harukazu HIRAUMI, Yasuyuki HIRATSUKA, Hiroaki Sato, Keisaku TABUCHI, S ...
    1999 Volume 92 Issue 8 Pages 881-884
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.881
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    Basaloid-squamous cell carcinoma (BSC), which has recently been reported in the English literature, is a rare variant of squamous cell carcinoma and is characterized by it's aggressive nature and typical histopathologic feature.
    BSC is now recognized as one distinct variant, however reports are quite rare in Japan. We present a patient with BSC in the hypopharynx who died of progressive metastatic disease 12 months after radical surgery.
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  • Hospitalized Patients with Acute Inflammation of the Tonsil
    -In Relation to Infectious Mononucleosis-
    Setsuko MORINAKA, Sumie INOMATA
    1999 Volume 92 Issue 8 Pages 885-890
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.885
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    Forty patients with acute inflammation of the tonsil were hospitalized in Kobe Teishin Hospital between April 1989 and December 1998. Seven cases were patients with infectious mononucleosis, 17 acute tonsillitis and 16 peritonsillitis & peritonsillar abscess. The ratio of infectious mononucleosis to acute tonsillitis was 1 to 2.4. It was generally considered that EBV induced acute infectious mononucleosis was rare in Japan, but our findings revealed that infectious mononucleosis was not as rare in our hospital as acute tonsillitis. Hepatic function was affected in patients with not only infectious mononucleosis (71%) but also peritonsillitis & peritonsillar abscess (63%). Cases of peritonsillar abscess complicating infectious mononucleosis have been reported previously in Europe and America. Therefore, peritonsillitis & peritonsillar abscess might be associated with infectious mononucleosis in some cases and further study concerning their association is needed in the future.
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  • The Utility and the Limitations of Ultrasonography for Lymph Node Metastases
    Ryo KAWATA, Toshiaki SHIBATA, Hirotsune OHNISHI, Hiroshi Nakano, Nobuo ...
    1999 Volume 92 Issue 8 Pages 891-895
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.891
    JOURNAL FREE ACCESS
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    Ultrasonography (US) is a very useful examination tool to evaluate cervical lymph node swelling in cases of head and neck cancer. Many reports have demonstrated that US is more reliable than palpation, CT or MRI for evaluating lymph nodes. Cervical lymph nodes removed by radical neck dissection from 19 cases with head and neck carcinomas were examined histopathologically, and observations were compared with preoperative US findings. Metastatic lymph nodes were diagnosed by size on US. Lymph nodes exceeding 7mm in Level 1 and 6mm in other cervical regions were diagnosed as metastases. A total of 457 lymph nodes were removed by radical neck dissection and 58 lymph nodes were positive for metastasis histopathologically. Twenty-nine of 58 lymph nodes were determined to be positive for metastases by preoperative US and they were all positive in histopathological examinations after operation. Since it is often difficult to detect the number of positive lymph nodes by US, there is a high possibility of multiple metastatic lymph nodes when one metastatic lymph node is detected by US findings. The prognosis of head and neck carcinomas is thought to depend on the number of metastatic lymph nodes, therefore, radical neck dissection should be performed in cases of positive lymph nodes detected by US findings.
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  • Etiology of Middle Ear Cholesterol Granuloma
    Keinosuke SAKASHITA, Yasuo HATTORI
    1999 Volume 92 Issue 8 Pages 897-907
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.897
    JOURNAL FREE ACCESS
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    Cholesterol of cholesterol granulomas is found in pooled fluid in the mastoid antrum and in the granulation tissue. The cholesterol may be related to erythocytic membranes rich in freecholesterol. The reasons why erythrocytes exude and why cholesterol precipitates remain unknown.
    In surgical cases of cholesterol granuloma (35 ears), we investigated the history of otitis media and the incidence of complications involving the upper respiratory tract.
    The lipid peroxide concentration in the pooled fluid in the mastoid antrum was measured by a free radical reaction.
    The temporal bone pathologic anatomy in two ears affected by cholesterol granuloma was evaluated during autopsy.
    The history of otitis media included acute repetitive purulent otitis media in 76% and acute purulent otitis media in 18% inflammation of the upper respiratory tract was a complication in 73%. The lipid peroxide level was 17nmol/ml, which was 1.8 times higher than that in cases of otitis media with effusion.
    Since acute purulent otitis media is present in many cases of cholesterol granuloma, inflammation often remains in the mastoid antrum which is blocked.
    Recurrence of concealed otitis media may follow eustachitis resulting from infection of the upper respiratory tract. The mastoid air cells become narrow due to edematous mucosa resulting in negative pressure. Since the blood vessels within neogranulomas are weak, erythrocytes may exude.
    As the disease advances the effusion lacks ventilation and leukocytes engulf intiltrated inflammatory cells, releasing active oxygen. This destroys the erythrocytic membranes by hyperoxidation, resulting in lipids from the broken membrane and tissue fragments and cholesterol precipitation through clasmatosis.
    The proliferative mucosa in the effusion is replaced with granulation tissue and cholesterol granuloma slowly forms.
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  • Clinical Efficacy of Clarithromycin (Clarith) for Acute Upper Respiratory Infections
    Masaharu ISHIKAWA, Kunio ICHIMURA, Akiko TOZAWA, Hiroshi WATANABE, Yui ...
    1999 Volume 92 Issue 8 Pages 909-915
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.909
    JOURNAL FREE ACCESS
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    Clarithromycin (Clarith) is a new macrolide antibiotic derived from erythromycin. The clinical efficacy of clarithromycin (Clarith) for acute upper respiratory infections was evaluated in 115 cases; including 45 cases of acute pharyngolaryngitis, 16 cases of acute tonsillitis, 18 cases of acute sinusitis and 23 cases of acute change in chronic sinusitis. The efficacy rate was 80.0% for acute pharyngolaryngitis, 75.0% for acute tonsillitis, 77.8% for acute sinusitis and 72.3% for acute change in chronic sinusitis. Side effects were observed in 3 cases but the symptoms were mild.
    A post treatment questionnaire survey was done with 23 cases of acute sinusitis and acute change in chronic sinusitis. Improvement in symptoms was seen in 91.3% of the cases.
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  • Endoscopic CO2 Laser Surgery for Early Laryngeal Cancer
    [in Japanese], [in Japanese]
    1999 Volume 92 Issue 8 Pages 916-917
    Published: August 01, 1999
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.92.916
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