Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 93, Issue 9
Displaying 1-16 of 16 articles from this issue
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  • Otorhinolaryngology and Imaging
    Koichi TOMODA
    2000 Volume 93 Issue 9 Pages 699-707
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.699
    JOURNAL FREE ACCESS
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    Diagnostic imaging has progressed much due to advanced computer technology. The vicissitude of imaging is evidenced by the digitalization of image data, improvement of quality, an inquiry of reality, establishment of functional imaging and support for surgery. It may contribute to making diagnosis easy and to obtaining an informed consent from patients. On the other hand, these computer graphics are utilized to specific fields as the virtual environment and tele-medicine.
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  • Tuberculosis in the Sphenoid Sinus and Clivus with Meningitis
    [in Japanese], [in Japanese]
    2000 Volume 93 Issue 9 Pages 708-709
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.708
    JOURNAL FREE ACCESS
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  • A Case of the Sensorineural Hearing Loss at Higher Frequency than 8000Hz
    Hirohito NISHINO, Kentaro OCHI, Shoji WATANABE, Toru OHASHI, Isao KATO
    2000 Volume 93 Issue 9 Pages 711-714
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.711
    JOURNAL FREE ACCESS
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    A 27-year-old female with tinnitus and fullness of the left ear was audiologically studied. Results of pure tone audiometry and tympanometry were normal with intact otoscopy. Tinnitus was at a level of 12126 Hz, 6 dB SL, according to a tinnitus audiometer. The blood pressure was 100/64 and the Schellong test showed a positive finding.
    Because tinnitus is frequently accompanied by high frequency sensorineural hearing loss, we evaluated the hearing in higher frequency regions using a tinnitus audiometer. As a result, thresholds above 13.9kHz of the left ear were elevated by 20dB higher than those of the right ear. Hearing loss at higher frequency was evidently shown. Considering the hypothesis that the cochlear damage may be generated by a perfusion deficit due to the combined effect of hypotension and imperfect vasomotor regulation, treatment was started with midodrine hydrochloride medication of 4mg, 2 times daily. Seven days after the start of treatment, tinnitus disappeared, thresholds in the high frequency range recovered to normal, and the Schellong test showed a negative finding.
    High frequency audiometry above the conventional frequency range was useful in this case.
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  • A Case of Postoperationally Diagnosed Tuberculous Otitis Media
    Masayuki SAKAMOTO, Nobuo KITAHARA, Satoshi ASANUMA, Shinichi NISHIMURA
    2000 Volume 93 Issue 9 Pages 715-718
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.715
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    Because the suspicion of tuberculous otitis media is low and clinicians are no longer encountering the typical classical features of the disease on a regular basis, there is frequently a considerable delay prior to diagnosis. For that reason, a description of modern features is needed. We report a case of postoperationally diagnosed tuberculous otitis media. The patient had not experienced any otalgia even though the left tympanic membrane had a central perforation. The observation of the tympanic membrane after tympanoplasty revealed that the painless perforation of the tympanic membrane could have been a sufficient feature to indicate tuberculous otitis media. The administration of oral antituberculous drugs can be effective therapy even if the diagnosis is made after tympanoplasty.
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  • Giant Facial Nerve Neurinoma; A Case Report
    Masaya KATO, Keisuke MIZUTA, Mitsuhiro MORI, Masao FUJIGAKI, Yatsuji I ...
    2000 Volume 93 Issue 9 Pages 719-723
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.719
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    A 67-year-old woman who complained of hearing disturbance and a tumor in the external auditory canal experienced complete facial palsy for 30 years. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a tumor that destroyed the posterior wall of the external auditory canal, mastoid process, and extended beyond the stylomastoid foramen. We confirmed these findings during surgery, and removed the tumor piece by piece at the intratemporal lesion. Because of the duration of the facial palsy, we did not graft another nerve or connect the hypoglossal nerve. We must consider facial nerve neurinomas in patients with facial nerve palsy, especially if the condition worsens or repeats. We should pay close attention to patients who show unilateral facial nerve palsy on CT or MRI of the intratemporal bone and extratemporal bone in order to find the neurinoma in the early stage.
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  • Angioleiomyoma of External Auditory Canal; A Case Report
    Takashi GOTO, Akihito WATANABE, Shinichi KAWABORI, Yasuaki HARABUCHI
    2000 Volume 93 Issue 9 Pages 725-729
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.725
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    We report a rare case of angioleiomyoma of the external auditory canal. The patient was a 59-year-old female who complained of hearing loss and blocking in the left ear. A smooth mass protruding to the external auditory canal was found. Excision of the tumor was performed. The diagnosis was confirmed as an angioleiomyoma with microscopic studies. The postoperative course was uneventful, and no sign of recurrence had been noted six months after the operation. The clinical features of angioleiomyoma and other benign tumors of the external auditory canal are discussed.
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  • A Case of Nasopalatine Duct Cyst Reconstructed with Autogenous Cancellous Bone
    Yasutaka KAWATA, Katsura KAWATA, Nobuya FUJIKI, Yosaku SHIOMI, Kyosuke ...
    2000 Volume 93 Issue 9 Pages 731-735
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.731
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    Nasopalatine duct cyst is a nonodontogenic cyst that arises from the remains of the nasopalatine duct. It is comparatively rare among all cysts of the maxilla.
    A 29-year-old male visited our clinic because of an increasing anterior midline palatal mass. MR imaging showed a large cystic lesion, which was 32 mm in diameter, arising within the nasopalatine duct. After removal of the cyst, a large dead space remained. It was reconstructed with autogenous cancellous bone of the iliac crest. At the time of 6 months after the surgery, 3 dimensional CT demonstrated good contour of the palatal bone. Autogenous cancellous bone is very useful and reliable material for the reconstruction of palatal bone defects.
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  • Isolated Bilateral Sphenoid Sinuses Aspergillosis Presented with Bilateral Optic Neuropathy; A Case Report
    Takuro TOSHO, Isamu KUNIBE
    2000 Volume 93 Issue 9 Pages 737-741
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.737
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    A 55-year-old female presented with sphenoid sinus aspergillosis. The patient had taken steroid medication for optic neuritis of the left eye without benefit for two months. She was referred to the Department of Otolaryngology at Nayoro City Hospital because of a sudden onset of visual disturbance and temporal hemianopsia in the right eye. A CT scan showed opacification of the bilateral sphenoid sinuses with an intact bony wall. The MR image findings were highly suggestive of fungal sinusitis.
    An endoscopic endonasal sphenoidectomy was immediately performed to establish adequate sinus drainage. Although a fungal culture of sinus fluid was negative, the diagnosis of aspergillosis was made by a histological examination of the material obtained from the sinus. The visual acuity in the right eye was restored to relatively normal limits after the operation, but she still counts fingers with the left eye. An early diagnosis and the advantage of endoscopic sinus surgery (ESS) in the treatment of sphenoid sinus aspergillosis is important.
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  • Primary Frontal Sinus Carcinoma Found after Injury; A Case Report
    Satoru FUKAMI, Kunitaka SHIRASAKA, Nobuyuki MURAI, Yoshiyuki TANIGAITO ...
    2000 Volume 93 Issue 9 Pages 743-748
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.743
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    Compared to the maxillary sinus, a carcinoma of the frontal sinus is very rare and difficult to detect early. We report a case of a frontal sinus carcinoma that was not diagnosed in the early stage. A 75-year-old male fell down in his home garden and bruised his forehead. He visited the Shimotsuga General Hospital complaining of swelling of the central part of the forehead. CT showed a defect of the frontal bone and an abnormal shadow of the left frontal sinus. A pathological examination was carried out using a specimen of the ulcer lesion of the forehead, and he was diagnosed with an inflammatory granulation tissue. Antibiotics were admitted for 3 weeks but without improvement. Then, an extranasal frontal sinusectomy was performed. The final pathological diagnosis was a squamous cell carcinoma. Radiotherapy was performed immediately, but unfortunately, he died of bronchopneumonia. Generally speaking, a frontal sinus carcinoma has a very poor prognosis. We emphasize that frontal sinus carcinomas have to be detected at an early stage, and treatment must be started immediately.
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  • A Case of Maxillary Sinus Foreign Body Unidentified before Surgery
    Isao HORIKAWA, Shinji TATSUTOMI, Tomokazu YOSHIZAKI, Takaki MIWA, Mits ...
    2000 Volume 93 Issue 9 Pages 749-755
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.749
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    We report a case of a maxillary sinus foreign body that was not identified before surgery. A 53-year-old man visited our hospital complaining of nasal obstruction and nasal discharge. X-ray and CT examinations revealed left maxillary sinusitis. We therefore performed endoscopic sinus surgery under the diagnosis of chronic sinusitis. Two foreign bodies were removed from the maxillary sinus, which turned out to be root canal filling agents called gutta-percha point. Because the patient has been free of complaints after removing the root canal points, this sinusitis could be attributable to movement of the root canal point. We should be aware of foreign bodies that go undetected by radiologic examinations.
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  • A Case of Adenoid Cystic Carcinoma Required Total Palatectomy
    Michihiko SONE, Jun YAMAMOTO, Toshiaki FURUTA, Hisashi YOKOI
    2000 Volume 93 Issue 9 Pages 757-761
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.757
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    Most cases of neoplasms arising from the palate can be treated by partial excision of the palate, reconstruction with local flaps and a palatal prosthesis. Several methods of reconstruction with free flaps have also been reported to correct surgical defects of the palate.
    We report a case of adenoid cystic carcinoma in the palate, which required a total palatectomy. A preoperative CT examination revealed that the tumor had spread extensively and destroyed anteriorly the alveolar process of the maxilla and the pterygoid process of the sphenoid bone posteriorly. The defect of the palate was corrected with a fibular free flap. Blood loss during the operation was over 6000ml, however, the patient has been well after being discharged.
    Functional reconstruction of the palate is a complicated problem, and the quality of life of patients should always be taken into consideration when treating an aggressive neoplasm.
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  • Tumor of the Intrathyroidal Parathyroid Gland; Two Case Reports
    Kazuhiro YAMAMOTO, Nobuya YAGI, Seishi HASEBE
    2000 Volume 93 Issue 9 Pages 763-768
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.763
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    Two cases of intrathyroidal parathyroid tumors are presented.
    Case 1: A 62-year-old female had hyperparathyroidism and a solid cystic mass in the right side of her thyroid gland. CT and MRI scans did not reveal a parathyroid mass, but an uptake in the mass was recognized by 99mTc-MIBI scintigraphy. A parathyroid hormone (PTH) assay of the intrathyroidal mass examined by fine-needle aspiration biopsy (FNA) was performed. The PTH determination was 2, 400, 000pg/ml.
    Case 2: A 77-year-old female had hyperparathyroidism and a huge cystic mass in the right anterior area of her neck. A PTH assay of this cystic mass examined by FNA was performed. The PTH determination was 2, 200, 000pg/ml. The surgical and pathological findings revealed that the mass was surrounded by ring-shaped thyroid tissue at the caudal portion.
    The importance of FNA in the diagnosis of a parathyroid tumor is discussed.
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  • Thyroid Carcinoma Metastatic to the Parapharyngeal Space
    Kenji HATTORI, Nobuko IWATA, Akiko OKUYAMA, Takashi NAKAGAWA, Yuko MIY ...
    2000 Volume 93 Issue 9 Pages 769-773
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.769
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    The parapharyngeal space is a complex area where a variety of both primary and metastatic neoplasms can originate. Metastatic lymph nodes in this region are common in pharyngeal squamous cell carcinoma. However it is a rare clinical occurrence that a metastatic thyroid carcinoma occupies the parapharyngeal space. We reported a 58-year-old male who had been operated upon for a thyroid carcinoma at 44 years of age and had a large metastatic lymph node in the right parapharyngeal space. We removed the metastatic lymph node by the mandibular swing-transcervical approach. Rouviere described a direct lymphatic pathway from the posterior surface of the superior thyroid lobe to lateral retropharyngeal lymph nodes. The possibility must be considered that thyroid carcinoma existing in that particular region can metastasize to the parapharyngeal space.
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  • Weber-Christian Disease in Cheeks and Neck; A Case Report
    Harukazu HIRAUMI, Keisaku TABUCHI, Shin-ichiro KITAJIRI
    2000 Volume 93 Issue 9 Pages 775-779
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.775
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    Weber-Christian disease (relapsing febrile nonsuppurative nodular panniculitis) is an idiopathic systemic recurrent panniculitis. It usually presents with relapsing fever and subcutaneous nodules that sometimes leave depressions of the skin. The nodules often occur in the head and neck regions, especially the cheeks. Reports of this disease from otorhinolaryngologists are quite rare. We report a case of Weber-Christian disease in the head and neck region.
    A 57-year-old woman presented with a low grade fever and relapsing nodules in the bilateral cheeks and neck. She had a past history of non-Hodgkin's lymphoma, rheumatoid arthritis, and diabetes mellitus. An exploratory biopsy was performed, and the histology showed granuloma and panniculitis, which indicated Weber-Christian disease. Because we were unfamiliar with this disease, we were unable to make a diagnosis. Afterwards, pleural effusion and nodules in the bilateral forearms occurred, and then the diagnosis of Weber-Christian disease was made.
    She was successfully treated with prednisolone.
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  • Low-Dose Fosfomycin Therapy for Intractable Sinusitis in Asthmatic Patients; A Preliminary Study
    Hiroyoshi SUGIMURA, Naonobu TAKEUCHI, Yoh-ichiro MAEDA, Akira NAITO, K ...
    2000 Volume 93 Issue 9 Pages 781-787
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.781
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    Long-term, low-dose macrolide therapy has been recognized to be effective for intractable sinusitis. However, association with asthma has proved to involve a poor prognosis. Furthermore, patients with asthma often take theophylline, which has potent cardiac toxicity when used with macrolides. Fosfomycin (FOM) demonstrated immunomodulating action similiar to that observed with macrolides and does not enhance cardiac toxicity of theophylline, because it is not metabolized by P450 in the liver. We investigated the clinical efficacy of low-dose FOM therapy for intractable cases of sinusitis in asthmatic patients.
    After obtaining informed consent from the patients, we administered 1500mg of FOM (a dose corresponding to 1/2 of the ordinary dose) 3 times daily to the patients. Thirteen patients who had orally taken FOM for more than 3 months were selected and the efficacy of the drugs was evaluated.
    Remarkable improvement was noted in 4 cases, moderated improvement in 6 cases, and slight improvement in 3 cases. No abnormal changes in the electric cardiogram (ECG) were found in any of the 12 cases examined, and no adverse reactions were observed in the circulatory organs in any case.
    Low-dose FOM therapy was suggested to be effective against intractable sinusitis cases complicated with asthma. Low-dose FOM therapy may have a role as an adjunct to medical treatment for intractable sinusitis in asthmatic patients.
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  • Surgical Technique for Laryngomicrosurgery
    [in Japanese]
    2000 Volume 93 Issue 9 Pages 788-789
    Published: September 01, 2000
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.93.788
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