Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 93, Issue 8
Displaying 1-16 of 16 articles from this issue
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  • Genetic Analysis of Hearing Impairment
    Shin-ichi USAMI
    2000 Volume 93 Issue 8 Pages 613-621
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.613
    JOURNAL FREE ACCESS
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    Recent progress in molecular genetics has revealed the genes responsible for hearing loss, enabling molecular diagnostic applications for individual affected patients. Our series of studies indicated that mutations of three genes are commonly found among the hearing impaired population in Japan, and thus much attention should be paid to the genetic background of these patients in the ENT clinic.
    First, mutations in connexin 26 (GJB2), the gene responsible for DFNB1 and DFNA3, have recently been of particular interest because these mutations account for up to 50% of congenital deafness in European countries as well as in the United States. Our mutation screening study confirmed that GJB2 mutations are also an important cause of non-syndromic recessive hearing loss in the Japanese population. However, our results indicate that different combinations of GJB2 mutations exist in the Japanese population.
    Secondly, PDS, the gene responsible for Pendred syndrome, also causes non-syndromic hearing loss associated with an enlarged vestibular aqueduct (EVA), known as the most common form of inner ear abnormalities.
    Genetic analysis confirmed that mutations in PDS cause a broader phenotypic spectrum than previously believed, from typical Pendred syndrome to non-syndromic hearing loss associated with EVA.
    Finally, the 1555A→G mitochondrial mutation, the most prevalent mitochondrial mutation found in the hearing impaired population in Japan, was found in approximately 3% of the out-patients. The significance of the 1555A→G mutation among subjects with specific backgrounds, such as aminoglycoside-induced hearing loss, is evident.
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  • Supracricoid Laryngectomy with Cricohyoidoepiglottopexy
    [in Japanese], [in Japanese], [in Japanese]
    2000 Volume 93 Issue 8 Pages 622-623
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.622
    JOURNAL FREE ACCESS
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  • Nodular Fasciitis of the External Auditory Canal
    Kazuma SUGAHARA, Yuji IMATE, Hiroaki SHIMOGORI, Norio SHIMIZU, Tomoko ...
    2000 Volume 93 Issue 8 Pages 625-628
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.625
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    We report a rare case of nodular fasciitis in a 56-year-old female with a soft nodule in the external auditory canal. The nodule was treated by surgical excision, and the pathological diagnosis was nodular fasciitis. There has been no sign of recurrence. This is the first report in Japan of nodular f asciitis in the external auditory canal.
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  • A Retrospective Review of Hospitalized Patients with Epistaxis
    Yukihiro MASUDA, Manabu NAKANOBOH, Tsuyoshi MATSUNAGA, Tetsuya TANABE, ...
    2000 Volume 93 Issue 8 Pages 629-634
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.629
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    We report a 11-year retrospective study of medical records of 47 hospitalized epistaxis patients at the National Defense Medical College Hospital. The study evaluated multiple factors associated with epistaxis: age, sex ratio, month of hospital admission, site of epistaxis, local/systemic complications, treatments, re-bleeding during hospital admission, and blood transfusion requirements. Eighty-seven percent of patients responded to non-surgical treatments (31; packing, ; 10; balloon placement). However, the remaining patients required surgery (5; IMA embolization; 1; formal arterial ligation). There were no complications due to the surgical treatment. Fifty-seven percent of patients showed complications associated with epistaxis. The most common complication was hypertension (15 cases). According to the results and literature, our procedure for intractable epistaxis was satisfactory. However, we must continue to improve the technique. Key words: epistaxis, intractable epistaxis, clinical statistics
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  • Two Cases of Familial Extramedullary Plasmacytoma Primarily Found in the Nasal Cavity
    Michihiro NAKADA, Teruki ASANOBU, Motoharu FUKAZAWA
    2000 Volume 93 Issue 8 Pages 635-640
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.635
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    We report two cases of familial extramedullary plasmacytoma found primarily in the nasal cavity, which was considered to be extremely rare.
    Patient 1(mother) was a 63-year-old woman with an extramedullary plasmacytoma arising in the nasal cavity, which recurred twice in ten years. The first occurrence was observed in the left middle nasal meatus at 53 years of age, which was completely reactive to radiotherapy. In the next year, a local recurrence was found in the primary region, which was treated with surgical resection and chemotherapy. After ten years, we operated on the secondary extramedullary plasmacytoma that recurred in the right nasal septum.
    Patient 2 (daughter) was a 40-year-old woman with an extramedullary plasmacytoma arising in the left nasal septum, which was treated with surgical intervention. An immunohistochemical examination revealed IgA-λ-positive findings in both patients.
    This disease is considered to be a symptom of multiple myeloma. Genetic or environmental factors are considered to be responsible for the onset of multiple myeloma. Therefore, the immunohistochemical findings of these patients are very interesting. The resolution of the mechan-ism, such as genetic or environmental factors, is necessary in the future.
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  • A Case of Nasopharyngeal Lipomatous Hamartoma
    Muneo Nakaya, Ichirou Morita, Kosei Takeda, Masatoshi Horiuchi, Tomoak ...
    2000 Volume 93 Issue 8 Pages 641-644
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.641
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    We report a case of a 37 year-old male with a lipomatous hamartoma of the nasopharynx. The hamartoma measuring 24×13×9 mm was attached by a short pedicle near the right torus tubarius. Using endoscopic techniques with a nasal snare and a C02 laser, the tumor was completely resected and diagnosed histologically as a lipomatous hamartoma.
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  • The Importance of Preoperative Diagnosis for Parotid Carcinomas
    Ryo KAWATA, Toshiaki SHIBATA, Hiroshi Nakano, Kaori KAYANO, Shigeru NA ...
    2000 Volume 93 Issue 8 Pages 645-651
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.645
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    A preoperative diagnosis of a parotid carcinoma is more difficult than other head and neck carcinomas, especially the histological type. Therapy should be carried out according to each histological type because each has different tumor activity. We reviewed 32 cases of previously untreated carcinomas arising in the parotid gland over a 10-year period and investigated the accuracy of the preoperative diagnosis and the first operation. Fine-needle aspiration biopsy (FNA) of the salivary gland is an accepted, sensitive and specific technique in diagnosing tumors. FNA was performed for all patients with parotid carcinomas, and the FNA findings were compared with the final pathologic diagnosis of the surgically resected specimen. In 32 cases of parotid carcinomas, FNA correctly diagnosed 21(6 histologically, and 15 were malignant), and failed in 11. Because the accuracy of the FNA findings was poor, we performed on open biopsy in 8 patients prior to the operation, and an accurate diagnosis of the histology and grading were obtained in all patients. The problem of contaminating the operative field with tumor cells in an open biopsy was solved by removing the skin during the operation and shortening the time between the open biopsy and the operation. Twelve of 14 patients accurately diagnosed histologically underwent the appropriate operation, while 6 of 9 patients diagnosed with benign tumors preoperatively underwent inappropriate operations. Forty persent of the patients underwent on inappropriate operation mainly because of inaccurate preoperative diagnosis. An open biopsy should be performed to accurately diagnose patients with parotid carcinomas and to improve their prognosis.
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  • Benign Lymphoepithelial Lesion of the Bilateral Submandibular Gland; A Case Report
    Kouichi NAKAZAKI, Koji IWASAKI, Reiko Kuroda, Izumi OIDA
    2000 Volume 93 Issue 8 Pages 653-656
    Published: August 01, 2000
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.653
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    A benign lymphoepithelial lesion is a rare disorder, which shows sialadenitus type tissue findings that are pathologically similar to those observed in Sjögren's syndrome. We recently treated a 72-year-old male with a benign lymphoepithelial lesion in the bilateral submandibular gland. There was no xerostomia. A definite diagnosis was achieved from the pathological appearance of the resected tissue. Because benign lymphoepithelial lesions may lead to Sjögren's syndrome or malignant lymphoepithelial lesions, patients must be followed up, carefully.
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  • Küttner's Tumor with the Unclassified Connective Tissue Disease; A Case Report
    Sumihito KINOSHITA, Yukio OYAMADA, Eiji YUMOTO
    2000 Volume 93 Issue 8 Pages 657-661
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.657
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    We report a case of Küttner's tumor in a patient with an unclassified connective tissue disease. The patient was an 82 year-old female. About 5 years before, skin itching and a low grade fever appeared. She was diagnosed with an unclassified connective tissue disease and followed-up with an externally applicated medicament. Serum IgG levels increased gradually, whereas the IgA and IgM levels reduced when bilateral submandibular gland swelling appeared. Therefore, an open biopsy was performed, and the histolopathological diagnosis was chronic sclerosing sialoadenitis, so-called Küttner's tumor. The microscopic findings were characterized by few acini and a large number of infiltrated lymphocytes and proliferation of the connective tissue. Serum IgG showed a polyclonal pattern. We speculate that a Küttner's tumor may be a type of systemic immune disorder.
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  • A Case of Ectopic Thyroid in the Left Submandibular Region
    Masahiro SUZUKI, Yasuhiro TADA, Takashi MATSUZUKA, Hiroshi OGAWA, Mako ...
    2000 Volume 93 Issue 8 Pages 663-667
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.663
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    We report a case of a 46-year-old female with an ectopic thyroid located in the left submandibular region. The pre-operative thyroid function showed normal values. First, Tc 99m scintigraphy confirmed the presence of a normally placed thyroid, and the ectopic thyroid could not be distinguished from a salivary gland tumor.
    It was not surgically excised because a histological examination of the open biopsy revealed that the tumor consisted of normal thyroid tissue. The post-operative thyroid function showed normal values. In reviewing the literature, we found three cases in which the surgical removal of an ectopic submandibular thyroid led to hypothyroidism. Post-operative I123 scintigraphy disclosed a nodular uptake in the left submandibular region. The ectopic thyroid showed normal functioning by the immuno-histologic examination of anti-thyroglobin antibody.
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  • A Case of Ectopic Thyroid Gland in the Submandibular Region
    Masao FUJIGAKI, Koichiro ASANO, Masaya KATO, Shigeo SAWAI, Yatsuji Ito ...
    2000 Volume 93 Issue 8 Pages 669-674
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.669
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    We report a rare case of an ectopic thyroid gland that developed in the right submandibular region. The patient was a 65-year-old female. She complained of a mass (4.0×3.0cm) in her neck, and was admitted to our hospital. An ultrasonic scan, CT scan and fine needle aspiration biopsy were performed before the resection. Results of these examinations did not give diagnostic information. After the resection, the histological appearance showed an adenomatous goiter. This could not be clinically distinguished from a tumor of the submandibular gland. Ectopic thyroid tissue should be considered in the differential diagnosis of a mass in the submandibular portion.
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  • Graves' Disease Precipitated by External Stimulus; Two Case Reports
    Kazuhiro YAMAMOTO
    2000 Volume 93 Issue 8 Pages 675-678
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.675
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    Two cases of Graves' disease precipitated by external stimulus are reported.
    Case 1 was a 45-year-old female. She had a right thyroid mass and normal thyroid function. A fine-needle aspiration biopsy of the mass was performed. Eight months later, Graves' disease was diagnosed.
    Case 2 was a 32-year-old male. He was brought to Ako City Hospital complaining of head and neck trauma after a traffic accident. Emergency tracheostomy was performed due to laryngeal edema and neck hematoma due to thyroid trauma. Two months later, Graves' disease was diag-nosed. He denied any previous history or significant symptoms of Graves' disease.
    The possibility of Graves' disease precipitated by external stimulus is reported.
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  • A Case of Polyostotic Fibrous Dysplasia
    Mitsuru ASANOME, Akihiro KATADA, Kizuku NAKAJIMA, Yasuaki HARABUCHI
    2000 Volume 93 Issue 8 Pages 679-683
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.679
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    We report a 6-year-old female with polyostotic fibrous dysplasia. She complained of mild swelling of the left cheek. A craniofacial CT examination showed sclerotic changes of the left maxilla, sphenoid and temporal, right ethmoid and occipital bones. Bone scintigraphy showed high uptakes at not only these craniofacial bones but also the bilateral femoral and tibial ones. A biopsy of the maxilla bone was performed, and a histopathological examination revealed typical findings of fibrous dysplasia. Therefore, we diagnosed her with polyostotic fibrous dysplasia. Because the cheek swelling was mild and no dysfunction was noted, surgical treatment was not performed.
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  • A Case of Brainstem Tumor with the Onset of Abnormal Sensations in the Throat
    Yuko MATSUMURA, Tetsuya TANABE, Takehiro KARAHO, Satoshi KITAHARA, Yuk ...
    2000 Volume 93 Issue 8 Pages 685-690
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.685
    JOURNAL FREE ACCESS
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    A-23-year-old man complained of abnormal sensations in his throat and dysphagia for 4 months. He had a variety of other complaints such as general fatigue, anorexia, nausea, and vomiting. He was diagnosed with dysautonomia, but the complaints persisted. He consulted our clinic on Dec. 2, 1996. Videofluoroscopic findings showed aspiration, retention of barium in valleculae and pyriform sinuses, and an incomplete opening of the upper esophageal sphincter (UES). Manometric findings revealed abnormal relaxation of the UES, low pharyngeal pressures during pharyngeal contraction, and simultaneous contractions of the pharynx, which suggested a swallowing disorder. MRI revealed the existence of a brainstem tumor. Videofluoroscopy and manometry were useful for objectively assessing the abnormal sensations in his throat and dysphagia.
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  • A Case of Internal Jugular Vein Thrombosis Caused by Gastric Carcinoma
    Miki TAKAHARA, Yoshifumi Kobayashi, Satoshi NONAKA, Yasuaki HARABUCHI, ...
    2000 Volume 93 Issue 8 Pages 691-695
    Published: August 01, 2000
    Released on J-STAGE: December 12, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.691
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    A 79-year-old male presented with painful induration in the left side of the neck. A CT examination illustrated thrombosis of left internal jugular vein.
    The patient was treated with anticoagulation agents. Tarry stool appeared and a gastric fiberscope revealed an advanced gastric carcinoma.
    A total gastrectomy was then performed. After surgery, the thrombus disappeared.
    We conclude that malignant diseases should be considered in patients presenting with spon-teneous internal jugular vein thrombosis with no other predisposing factors.
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  • Fluctuating Sensorineural Hearing Loss
    [in Japanese]
    2000 Volume 93 Issue 8 Pages 696-697
    Published: August 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.696
    JOURNAL FREE ACCESS
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