Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 93 , Issue 5
Showing 1-15 articles out of 15 articles from the selected issue
  • Yasuaki HARABUCHI
    2000 Volume 93 Issue 5 Pages 341-352
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    The author reviewed clinical, phenotypic, genotypic, and Epstein-Barr virus (EBV)-findings of 44 patients with nasal lymphomas. In phenotypic analyses, 35 patients were classified as having NK/T cell (CD56-positive) type, 5 as having T-cell type, and the remaining 4 as having B-cell type. Twenty-six (74%) patients with NK/T cell lymphomas had ulcerative/destructive lesions, but 9 NK/T lymphoma patients did not. EBV-encoded small nuclear early region (EBER) transcripts were identified in 35 patients. Monoclonal EBV genome and EBV-encoded nuclear antigen (EBNA)-1 were also detected in all EBER-positive cases tested. The NK/T cell lymphoma patients without ulcerative/destructive lesions had favorable prognoses, but the lymphoma patients with ulcerative/destructive lesions that were clinically lethal midline granulomas had a higher incidence of systemic symptoms, decreased PBL counts, and high serum LDH levels, and showed significantly poorer prognoses. These results suggest that patients with nasal NK/T lymphoma, in which EBV may play a role of lymphomagenesis, may be classified into two distinct subgroups according to involvement of ulcerative/destructive lesions.
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  • [in Japanese]
    2000 Volume 93 Issue 5 Pages 354-355
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
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  • Tatsuya HIBI, Hiromi UEDA, Tsutomu NAKASHIMA
    2000 Volume 93 Issue 5 Pages 357-360
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    A high jugular bulb is often discovered as an incidental finding during examinations for hearing loss, with the high jugular bulb itself sometimes being the cause of the loss of hearing. One mechanism of conductive hearing loss in association with this anomaly is the obstruction of the round window niche. This has been reported infrequently in the literature, and a bilateral case is very rare.
    An 11-year-old boy with bilateral conductive hearing loss was examined, and it was verified that the round window niche was obstructed due to a high jugular bulb. This patient also had malformations of the external, middle and inner ear, and fistulas in his right neck. He also had a history of patent ductus arteriosus and a ventricular septal defect. The operative findings, radiographic and audiometric data are presented.
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  • Nobuyuki BANDOH, Hideyuki ISHII, Takeshi KANAYA
    2000 Volume 93 Issue 5 Pages 361-366
    Published: May 01, 2000
    Released: December 12, 2011
    JOURNAL FREE ACCESS
    Over the 3-year period from 1996 to 1998, eighty-five patients with nasal fracture were diagnosed by X-ray or CTscan in our hospital. Most of the patients (67%) were males in their teens and twenties. The most common cause of nasal fracture was fighting (35%), followed by sports (29%) and traffic accidents (12%). Upon inspection and palpation, displacement of the nose was seen in 67 (79%) of 85 cases; displacement to the right was seen in 34 (40%), displacement to the left was seen in 20 (24%), and depression or saddle nose was seen in 13 (15%). We evaluated the correlation between the cause of nasal fracture and displacement of the nose. In 28 (93%) of 30 patients, the cause was fighting and it was significant that displacement to the right was seen in 18 (60%) of 30. While nasal fracture diagnosed by nasal X-ray film accounted for 69 (87%) of 79, 10 cases (13%) were diagnosed by axial CTscan. CTscan revealed that lateral fracture of both sides was predominant (67%). Nasal fracture was not seen in the upper portion, and it was commonly seen in the middle and lower portions. Nasal fracture gave rise to loosening of the ipsilateral nasomaxillary sutures and the ipsilateral fractures of the nasal bone.
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  • Shigeki KAWAMURA, Mikiya ASAKO, Akiyo MOMOTANI, Hiroki KEDAI, Nobuo KU ...
    2000 Volume 93 Issue 5 Pages 367-372
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    Submucosal turbinectomy with posterior-superior nasal neurectomy has been performed for 20 patients with intractable allergic rhinitis in our institution. The operations were carried out under endonasal endoscopic observation. After the apical mucous membrane of the inferior turbinate was slightly incised and its bone was resected in the submucosa, both the posterior superior nerve and sphenopalatine artery were cut in the sphenopalatine foramen as one mass using a Harmonic scalpel. In the short-term subjective symptoms observed for 2 to 10 months, sneezing, nasal discharge, and nasal obstruction were improved to 90%, 75%, and 100%, respectively. Additionally, no surgical complications such as massive intraoperative hemorrhage, disturbance of lacrimal secretion or facial numbness were observed. Because this operation method was highly effective, was minimally invasive, and very few complications were observed, it is suggested that this is a novel surgical method for allergic rhinitis or vasomotor rhinitis.
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  • Masayuki SAKAMOTO, Kazuya ABE, Shinichi NISHIMURA, Nobuo KITAHARA
    2000 Volume 93 Issue 5 Pages 373-376
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    We described a case of radiation myelopathy occurring after radiotherapy of 70 Gy to the nasopharyngeal carcinoma. Because the cervical spine was included in the radiation area, the neurological symptoms of the area progressed, and MRI did not reveal the recurrent tumor compressing the cervical spine, the condition was diagnosed as radiation myelopathy. Although oral medication of a corticosteroid failed to reverse the progression of the myelopathy, the patient is able to move about inside or outside the home with a wheelchair.
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  • Mariko HIZUME, Toshio YOSHIHARA, Tetsuo ISHII
    2000 Volume 93 Issue 5 Pages 377-381
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    Case 1 involved a 56-year-old female who complained of abnormal oral sensations. Case 2 involved a 60-year-old male who experienced bleeding and pain from the palate and the alveolar bone of the left mandible. Both cases showed a bone-like hard mass in the hard palate. CT scan showed that these two lesions were considered to be torus palatinus. They were resected under general anesthesia, and the postoperative courses were uneventful. Histologically, these specimens showed lamellar bone with loose fibrosis. The pathological diagnosis of both cases was exostosis.
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  • Hajime ZEN, Masataka MURAKAMI, Tatsuyuki FUKUSHIMA, Chihisa USHIJIMA, ...
    2000 Volume 93 Issue 5 Pages 383-388
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    A case of schwannoma at the soft palate that puts into focus the problems of pre-operative diagnosis is reported. The patient was a 23-year-old female with a 13-year history of a mass at the soft palate. First, we suspected pleomorphic adenoma. CT and MRI revealed compatibility with an image of schwannoma. The surface of the tumor was smooth, but we observed small development of ulceration, and therefore, we considered the possibility of a low grade malignant tumor. Each FNA that was performed 3 times was class I.
    In the case of pleomorphic adenoma, we can diagnose its histological type at a considerably high
    rate of precision using FNA.
    Deducing from the results of FNA, which was performed 3 times, and was in each case class I, along with the distinctive images obtained by CT and MRI, we should have suspected schwannoma from these observations.
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  • Akiko SADAMOTO, Masamitsu HYODO, Hidemitsu Sato, Eiji YUMOTO
    2000 Volume 93 Issue 5 Pages 389-393
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    Oncocytic carcinoma is an extremely rare tumor often arising in the salivary gland. In this paper, a case of oncocytic carcinoma of the parotid gland in a 55-year-old man is described. The patient complained of swelling in the left parotid region and underwent superficial lobectomy of the parotid gland. Four months after the operation, the left parotid gland showed a rapid recurrence of swelling. MRI demonstrated a large tumor of the left parotid gland extending to the parapharyngeal space. With a diagnosis of local recurrence of parotid carcinoma, he underwent left total parotidectomy with facial nerve resection and left radical neck dissection. He underwent 50 Gy of postoperative radiotherapy. Histological examination revealed that the tumor consisted of large, granular, and eosinophilic cells with mitosis. Phosphotungstic acid hematoxylin (PTAH) staining showed a presence of numerous mitochondria in the cytoplasm. The diagnosis of oncocytic carcinoma was confirmed based on these findings. The clinical course has been uneventful for 18 months postoperatively.
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  • Kenichiro FUJITA, Shigeru FURUTA, Taro MAEDA, Yuichi FUJITA, Chikako K ...
    2000 Volume 93 Issue 5 Pages 395-400
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    We present a prospective analysis of an endoscopic diurnal sleep study using diazepam and the clinical efficacy of laser-assisted uvulopalatoplasty (LAUP) for patients with snoring problems. Between February 1998 and August 1999, 91 patients visited our hospital for treatment of snoring problems. Among them, 69 patients were examined by the present sleep study, and 87.0% involved snoring caused by airway obstruction in the soft palate. Fifty-eight patients who were diagnosed as having snoring arising from the soft palate underwent LAUP, and 38 patients completed postoperative questionnaires. The mean of snoring scores significantly decreased from 10 to 4.1±0.8 at 1 month after LAUP. Other subjective symptoms also showed significant improvements, including onset of sleep apnea, wakening at night, daytime somnolence, and frequent daytime fatigue. These desirable improvements persisted for 18 months. It is concluded that our sleep study was useful for examination of patients with snoring problems, and that LAUP is an effective method, especically for snoring arising from the soft palate.
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  • Motoharu UEHARA, Shinichi KAWABORI, Yasuaki HARABUCHI
    2000 Volume 93 Issue 5 Pages 401-404
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    Birch pollinosis is often accompanied by an oral allergy syndrome (OAS) to fruits such as apples. The only option for patients with this type of allergy has been to avoid etiologic fruits. Thus, we administered suplatast (IPD®), which suppresses the production of IgE antibodies, and pemirolast potassium (Alegysal®), which suppresses mast cell reactions and then investigated the degree of improvement in allergic symptoms during administration and changes in the level of birch pollen and fruit-specific IgE antibodies. The degree of improvement in allergic symptoms was assessed approximately three months later. The allergic symptoms of all patients either completely disappeared or were markedly improved in which only mild pruritus was noted. In terms of CAP-BAST, the post-administration value (UA/ml) was lower than the pre-administration value in one patient, and there were no marked changes in two patients. These findings suggest that the improvements in allergic symptoms were attributable to the effector phase of the drugs (e. g., suppression of the release of chemical transmitters) and not to the level of allergen specific IgE antibodies.
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  • Tetsuya MURAKAWA, Michiya KOSAKA, Yoshito MORI
    2000 Volume 93 Issue 5 Pages 405-412
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    Malignant tumors arising from laryngeal gland cells are extremely rare. No more than 1% of the epithelial malignancies of the larynx are nonsquamous carcinomas. Moreover, adenoid cystic carcinomas make up fewer than 0.25% of all malignancies of the larynx. In the Japanese literature, only 28 cases have been reported. We have encountered a case of laryngeal (supraglottic) adenoid cystic carcinoma.
    A 68-year-old woman complained of hoarseness and slight dyspnea of six months' duration. We suspected a thyroid carcinoma and laryngeal tumor. We performed fine needle aspiration for the thyroid mass, and findings suggested papillary carcinoma. Laryngoscopic examination revealed a smooth mass involving the right false vocal cord and epiglottis. The pathology report indicated adenoid cystic carcinoma. The patient underwent total laryngectomy, subtotal thyroidectomy, right neck dissection, and reconstruction with LDMC. We examined the resected specimens histologically by whole organ serial sectioning and discussed the evaluation, treatment, clinical course and prognosis of adenoid cystic carcinoma of the larynx. The overall 10-year survival rate is worse than the overall 5-year survival rate. Therefore, we must observe cases of adenoid cystic carcinoma for over 10 years.
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  • Satoshi KITAHARA, Yukihiro MASUDA, Etsuyo TAMURA, Naoyuki KONO, Tetsuy ...
    2000 Volume 93 Issue 5 Pages 413-417
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    In this paper, we reported the clinical statistics of 1544 patients who have undergone microlaryngeal surgery in the National Defense Medical College hospital since 1979, when the hospital was established.
    They ranged widely in age from 4 to 89. The number of male patients was 935 (60.6%). That of females was 609 (39.4%). When they were divided by ten year groups, the biggest group consisted of those in 50's.
    The most common disease was vocal fold polyp (672 cases, 43.5%). The second was laryngeal cancer (256 cases, 16.6%). The third was Reinke's edema (158 cases, 10.2%). We performed microlaryngeal surgery with a laser instrument in 386 cases (25.0%). The most common diseases were laryngeal papilloma, laryngeal cancer, and hyperkeratosis of the larynx.
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  • Akihito WATANABE, Shinichi KAWABORI
    2000 Volume 93 Issue 5 Pages 419-424
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
    We evaluated the efficacy of emedastin difumarate (DAREN®) given before or during the birch pollen season.
    Twenty-three patients received the drug at least 2 weeks before the day when birch pollen began to become airborne. Another fifteen patients received the treatment after the pollen had become airborne.
    Evaluation by symptom score designed for allergic rhinitis revealed the efficacy of preseasonal administration, especially in the early stages of the birch pollen season. These results suggest that DAREN® is effective as a prophylactic drug for treatment of birch pollinosis.
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  • [in Japanese]
    2000 Volume 93 Issue 5 Pages 426-427
    Published: May 01, 2000
    Released: November 04, 2011
    JOURNAL FREE ACCESS
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