Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 93, Issue 2
Displaying 1-16 of 16 articles from this issue
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  • Focal Microcirculation Disorder and Idiopathic Sudden Hearing Loss
    Tomoyuki HOSHINO
    2000 Volume 93 Issue 2 Pages 89-97
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.89
    JOURNAL FREE ACCESS
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    Focal microcirculation lesion in the lateral wall of the cochlea was made by photochemical reaction in guinea pigs. The damage was made by systemic injection of rose bengal and green light illumination to the bony cochlear wall. The diameter of the lesion was 0.9-1mm. The effects of the lesion were evaluated using a non-contact laser blood flowmeter, the endocochlear potential (EP) and the compound action potential (CAP). The cochlear blood flow gradually decreased during the 30min observation period parallel to the gradual decline of the EP. The average CAP threshold was significantly increased 15min and thereafter. Mid-lesion EP measurements were obtained at various intervals up to 3 weeks. EP reached the minimal value after 3 days and recovered to almost normal after 2 weeks. Off-lesion EP values 3 days after illumination were depressed at all measured sites apical to the lesion but remained unchanged at sites basal to the lesion. Two weeks after illumination, decreased apical EP was found to have returned to normal. Focal damage in the lower cochlear turn may have a depressant effect on EP measured apical to the lesion. This reversible depressant effect of a focal lesion on apical EP could account for the clinical course in certain cases of idiopathic sudden hearing loss.
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  • Traumatic Dislocations of the Ossicles
    [in Japanese], [in Japanese]
    2000 Volume 93 Issue 2 Pages 98-99
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.98
    JOURNAL FREE ACCESS
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  • Postoperative Hearing of Tympanoplasty Patients
    Takeshi SHIMIZU, Kazuhiko TAKEUCHI, Teruhiko HARADA, Yuichi MAJIMA, Ko ...
    2000 Volume 93 Issue 2 Pages 101-106
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.101
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    Between January 1994 and December 1998, 144 patients with middle ear diseases, including 95 cases of cholesteatoma and 34 cases of middle ear infections, were operated on by tympanoplasty in Mie University Hospital. Success rates of hearing improvement, according to the criteria of Clinical Otology Japan (1987), were 87.8% of type I tympanoplasty patients, 100% of type II, 77.3% of type III, and 72.2% of type IV. There was no difference in the success rate between cholesteatoma patients (81.3%) and chronic otitis media patients (85.0%); however, that of patients with postoperative diseases was relatively low (66.7%, 6 of 9 cases). Auto-cartilage was used as a columella for ossicular reconstruction in 54 cases, auto-ossicular bone in 9 cases, and prosthesis in 1 case. Success rate of hearing was not affected by the type of columella. Staged operation was selected in 37 patients, and it was not significantly related to successful results for hearing.
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  • A Case of Giant Cholesteatoma in Mastoid Process after Ear Operation
    Keiko NISHIOKA, Hisako MATSUOKA, Hiroko TOKODA, Yumiko TAKIGAWA, Shins ...
    2000 Volume 93 Issue 2 Pages 107-112
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.107
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    A 66-year-old male complaining of continuous otorrhea in the left ear who had a history of left ear surgery about 60 years ago was reported. A CT scan and MRI revealed a huge abnormal density area at the mastoid process of the left temporal bone. This area was suspected to be a cholesteatoma, and it occupied the whole mastoid process except for the part of the inner ear. Surgical exploration demonstrated that the huge cholesteatoma matrix was expanded to the dura of the middle and posterior cranial fossa. After total removal of the giant cholesteatoma, we obliterated the huge cavity with small chips taken from his ilium bone. Differential diagnosis using MRI for cholesteatoma and the other tumors in temporal bone was discussed.
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  • Meningoencephalocele Following Radical Ethmoid Surgery
    Nobuya FUJIKI, Yoshinao NISHIDA, Jun TSUJI, Hiromi NAGATA, Tadahiko MA ...
    2000 Volume 93 Issue 2 Pages 113-117
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.113
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    We reported a patient with a meningoencephalocele following radical ethmoid surgery. A 44-year-old man was admitted to our hospital because of frontal encephalitis, the cause of which was suggested to be a recurrence of chronic sinusitis in the left ethmoid sinus. CT and axial MRI images showed no evidence of the brain herniation to the ethmoid sinus. He underwent endonasal sinus surgery under local anesthesia. Nasal polypotomy in the left middle nasal meatus was performed, followed by exposure of the brain tissue. On the next day, closure of this defect in the anterior skull base was undergone under general anesthesia using the anterior craniotomy approach by neurosurgeons.
    The focus of a convulsion attack after the last ethmoid sinus surgery in this patient's history is considered to be the meningoencephalocele. This fact indicates that the meningoencephalocele of this patient might have occurred postoperatively after radical ethmoid surgery, while almost all of them are congenital. The anterior craniotomy approach is suitable for repair of meningoencephaloceles with central nervous system disorders such as the convulsions of this patient. CT scan and axial MRI images are not useful for diagnosis of meningoencephaloceles and coronal or sagittal MRI images are essential.
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  • Three Cases of Pyogenic Granuloma on the Tongue Given a Diagnosis as Pregnancy Tumor
    Keiko ONODA, Kohei SUENO, Yoichiro YAMADA, Yasuyuki NOMURA
    2000 Volume 93 Issue 2 Pages 119-124
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.119
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    It has long been known that pregnancy stimulates a variety of physiological mucosal changes, including pigmentary, elastic, and vascular changes. Pyogenic granuloma represents a vascular lesion observed during gravidism. We present three case reports of pregnancy tumor.
    The patients ranged in age from 26 to 29 years old, and had lesions located on the tongue. In all cases, surgical excision was performed after delivery.
    Histopathologically, pregnancy tumor is identical to pyogenic granuloma of unrelated etiology. The majority of lesions exhibit nodular inflammation hyperplasia and numerous small dilatated vascular channels and proliferating endothelial cells. The surface with a thin atrophic epithelium is almost completely ulcerated and coated with a thick, fibrinopurulent exudate. This “epidermal collarette” surrounds the deeper portion. There are three main pathological features: granulomatous, hemangiomatous, and intermediate types. One case was the hemangiomatous type and two cases were the intermediate type.
    This article also discusses the clinical findings, pathology, therapy and prognosis of pyogenic granuloma.
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  • A Case of MALT Lymphoma Arising in the Submaxillary Gland
    Toshiro YAMANISHI, Hitoshi INOUE, Takuya OKADA, Hiroyuki Ito, Tomoyuki ...
    2000 Volume 93 Issue 2 Pages 125-129
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.125
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    Mucosa-associated lymphoid tissue (MALT) lymphoma, an extranodal low-grade lymphoma arising in the stomach, lung, salivary gland, and thyroid gland has attracted attention recently. We encountered a case of MALT lymphoma arising in the submaxillary gland. A 61-year-old woman presented with a palpable 20×15mm mass on her right lower jaw. After a diagnosis of submaxillary gland tumor was established by ultrasonography, computed tomography, and 67Ga scintigraphy, the tumor was resected. It arose from the anteroinferior part of the submaxillary gland, and had a distinct border.
    The cross-section revealed a yellow-white solid mass. Histological examination revealed invasion by small to medium-sized lymphoma cells resembling centrocytes.
    The cells were accompanied by lymphoepithelial lesions in the submaxillary gland. Based on these findings, a diagnosis of MALT lymphoma arising in the submaxillary gland was made. Twelve months have passed since the resection with no evidence of recurrence.
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  • Effect of Tonsillectomy on Urinary IL-6 in a Patient of IgA Nephropaty Associated with Chronic Tonsillitis
    Reiko NONAKA, Manabu NONAKA, Kazumi KOSAKA, Eriko KAMURA, Shunkichi BA ...
    2000 Volume 93 Issue 2 Pages 131-134
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.131
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    We present a case of IgA nephropathy associated with chronic tonsillitis. The patient had experienced continuous microhematuria, repeated proteinuria and visible hematuria every time when he had acute tonsillitis. Both proteinuria and microhematuria were worse after tonsillar provocation. Because of these results and history, this patient underwent with tonsillectomy. Proteinuria and microhematuria were disappeared two and three months after the operation, respectively. Levels of both serum IgA and urinary IL-6 were slightly higher than the normal levels before the operation. Serum IgA was decreased to the normal level one month after the operation. Urinary IL-6 was also decreased to normal two months after the operation. It is known that there is a correlation between the levels of urinary IL-6 and the pathological stage of mesangial proliferative glomerulonephritis (mesPGN), and that high urinary IL-6 activity indicates the histological progression of mesPGN including IgA nephropathy. The decrease of urinary IL-6 after the operation indicates the pathological improvement of the kidneys in this patient. Our observations suggest that the measurement of urinary IL-6 is helpful for monitoring not only the progression but also the improvement after tonsillectomy of pathological changes of the kidneys in IgA nephropathy.
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  • Basaloid Squamous Cell Carcinoma of Hypopharynx
    A Case Report
    Masanori KONISHI, Atsushi TAIRA, Koji ASAKURA
    2000 Volume 93 Issue 2 Pages 135-142
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.135
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    Basaloid squamous cell carcinoma (BSCC) of the head and neck, first described in 1986 and recognized by the World Health Organization in 1991, is a bimorphic variant of squamous cell carcinoma (SCC) with distinct morphological features. BSCC is a very aggressive malignancy.
    In this paper, we report a case of BSCC of the hypopharynx (T1N2cM1). At first, the patient was diagnosed as having a SCC of the left pyriform sinus on fiberscopic biopsy; however, a postoperative histopathological examination revealed BSCC.
    He was treated with neoadjuvant chemotherapy (CDDP+5-FU, 2 courses), left radical neck dissection and radiotherapy. At the time after these treatments, tumorous lesions, including the original tumor and metastatic lesions of bilateral lungs seemed to be controlled. However, a few months later, multiple metastases to bilateral lungs (again), bone, and skin appeared, and he died 11 months after the first diagnosis.
    The clinical and pathological features, prognosis and treatment of BSCC were discussed.
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  • Surgical Treatment for Polypoid Vocal Cord Using KTP Laser
    Kazuhiro YAMAMOTO, Yoshitsugu OGAWA, Yoshiaki IGUCHI, Atsushi OTIAI, A ...
    2000 Volume 93 Issue 2 Pages 143-146
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.143
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    We reported the surgical treatment for Polypoid vocal cord using KTP laser. In this method, edema of the vocal cord is aspirated by the KTP laser without incision of the mucosa of vocal cord by surgical knife. To avoid postoperative cicatrization low-range laser power is used. It is important to avoid aspiration the free edge of vocal cord. In this report, a typical case using this method was presented. The findings of laryngeal fiberscopy and voice assessment by GRABS classification were improved after surgery. It was suggested that this method is useful for surgical treatment of polypoid vocal cords.
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  • Multiple Lymphangiomas of the Neck in an Adult
    A Case Report
    Harukazu HIRAUMI, Takeshi MORITA, Keisaku TABUCHI, Shin-ichiro KITAJIR ...
    2000 Volume 93 Issue 2 Pages 147-150
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.147
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    Lymphangiomas, or cystic hygromas, are congenital malformations of lymphatic channels and are not uncommon in children, but they are rarely found in adults. They are soft, single or multiloculated masses, and sometimes multiple.
    We report a rare case of multiple lymphangiomas arising in the right lateral neck of an adult. The lymphangiomas were situated in the lateral neck of a 20-year-old female. Lesion sizes ranged from smaller than 1cm to 4.5cm. The MRI showed multiloculated cystic masses. The final diagnosis was made with exploratory biopsy.
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  • Endoscopic Transsphenoidal Hypophysectomy
    Teruhiro OGAWA, Mitsuhiro OKANO, Tomoko NAKASHIMA, Kazunori NISHIZAKI, ...
    2000 Volume 93 Issue 2 Pages 151-156
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.151
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    Although surgical approaches to the sellar region (hypophysectomy) traditionally require the use of a microscope, recently rigid endoscopic endonasal surgery has become more common because of advances in optics illumination, and associated instruments, especially when an X-ray or navigation system for hypophysectomy is available. Endoscopic surgery of the sellar region can be performed more safely and effectively nowadays, while providing the surgeon with a view that is superior to that afforded by the microscope.
    In this report, the usefulness of an endoscope in sellar transsphenoidal surgery was discussed particularly in comparison with that of the microscope. The use of the endoscope was evaluated during recent microsurgeries of eight patients with sellar lesions: three lesions were prolactin (PRL)-secreting adenomas, two were growth hormone (GH)-secreting adenomas, two non-functional adenoma, and one Rathke's cyst. Tumor sizes of these are varied from 7mm to 30mm (20mm in average) in diameter. All tumors were resected all transsphenoidally via the superior nasal meatus in two cases, middle nasal meatus in two cases, and nasal septum in four cases.
    These approaches provide appropriate exposure of the sella and adequate working space. This technique also reduces the bleeding amount and operating time needed. Therefore endoscopic surgery allowed not only less invasive surgery but also closer inspection and identification of the tumor tissue. For this reason, neurosurgeons and ENT surgeons should co-operate regarding and discuss sellar lesion patients.
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  • The Central Processing Mechanism for Visual and Tactile Language Demonstrated by Functional Brain Imaging Technique
    -A Review of Literature-
    Ichiro TATEYA, Shigeru HIRANO, Yasushi NAITO, Hisayoshi KOJIMA
    2000 Volume 93 Issue 2 Pages 157-165
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.157
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    We reviewed the literature related to the processing of visual and tactile language in the central nervous system as demonstrated by functional brain imaging techniques. Written word recognition activates not only the visual association areas but also the temporal region, especially in lexicsemantic processing. In lip reading and sign language recognition, the auditory association areas may play an important role in addition to the visual association areas both in the case of normal subjects and congenitally deaf subjects. In the case of congenitally blind subjects, visual association areas may play an important role in the processing of speech and Braille reading. In the case of congenitally deaf subjects, the auditory cortex may be involved in the processing of vibratile stimuli. These findings suggests the cross-modal plasticity of the brain in the processing of language. This paper also discusses problems to be resolved in the future.
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  • Inhibitory Effects of TNF-alpha and IFN-gamma on Ciliary Beat Frequency of Cultured Human Sinus Epithelial Cells and its Modulation by Ambroxol Hydrochloride
    Naoyuki UEDA, Sachio TAKENO, Jin Hong CHEN, Rika OSADA, Hiroko KAWAMOT ...
    2000 Volume 93 Issue 2 Pages 167-173
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.167
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    A number of recent reports have demonstrated that proinflammatory cytokines play an important role in the regulation of the mucociliary clearance system in the upper respiratory airway. In this study, we focused on the in vitro effect of TNF-alpha and IFN-gamma on the ciliary beat frequency (CBF) of cultured human sinus epithelial cells. Sinus mucosal explants were successfully cultured on poly-L-lysine coated dishes with abundant outgrowth of ciliated cells. CBF measurement was carried out by photoelectric method at specific predetermined sites of 7 to 14 day cultured specimens. TNF-alpha at a concentration of 10ng/ml decreased CBF in a time dependent manner with a maximal decrease of 21.3% (p<0.01). A 13.9% decrease in CBF was also observed 24 hours after treatment with IFN-gamma alone (10ng/ml, p<0.01). Morphological investigation by scanning electron microscopy (SEM) revealed that epithelial desquamation and loss of the cilated cells after treatment with TNF-alpha, which was compatible with results from CBF measurements. We further examined actions of ambroxol hydrochloride, a mucolytic agent with cilioregulatory and antioxidant effects, in cytokine-induced cilioinhibition. Ambroxol at concentrations of 10-4M and 10-5M both increased CBF by 8.1% (p<0.01) and 13.5% (p<0.01), respectively. The cilioinhibitory effects of TNF-aplha and IFN-gamma were canceled by treating specimens with 10-4M of ambroxol. We speculate that regulatory effects of these proinflammatory cytokines on human sinus mucosa involve the modulation of CBF by nitric oxide (NO) as a second messenger. In addition, cilioinhibition by TNF-alpha may be partly due to cytotoxic phenomenon caused by excess generation of reactive oxygen species inside the epithelial cells.
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  • Submucosal Tumors of the Oral Cavity
    [in Japanese]
    2000 Volume 93 Issue 2 Pages 174-175
    Published: February 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.174
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  • Erratum to : The Prognosis of Juvenile Bilateral Sensorineural Deafness of Unknown Etiology (JBSNDUE)
    2000 Volume 93 Issue 2 Pages e1
    Published: 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.2_e1
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