Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 94, Issue 12
Displaying 1-16 of 16 articles from this issue
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  • Topical Drug Therapy for Inner Ear Disorders
    Hiroshi YAMASHITA
    2001 Volume 94 Issue 12 Pages 1049-1053
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1049
    JOURNAL FREE ACCESS
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    There is growing otologic interest in treating inner ear disorders with topical drug therapy, for example using steroids or gentamicin. According to recent studies, intratympanic administration resulted in higher perilymph steroid levels than intravenous administration. In addition, glucocorticoid receptor was noted in the cochlea after sound exposure. These results suggest that topical administration of steroid may be useful for acute inner ear disorders.
    Topical treatment of gentamicin is effective for Meniere's disease. Low dose gentamicin therapy does not usually cause hearing loss and can also control vertigo. This therapy is one of the most useful treatments for Meniere's disease.
    Recently, various drug delivery systems for the inner ear were devised, and these systems have been used clinically in the USA. However, as yet there are a limited number of drugs available for the treatment of inner ear diseases. Study about the plasticity of the inner ear has been advanced, and many kinds of drugs may be useful for the recovery of the inner ear function. We made an animal model of the drug delivery system using guinea pigs to investigate the effect of these drugs on the functional recovery of both vestibular and cochlear functions. As a result, we found that steroids, ATP, and aFGF may be effective for the recovery of the inner ear function.
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  • A Traumatic Tympanic Membrane Perforation and Ossicular Damages
    [in Japanese]
    2001 Volume 94 Issue 12 Pages 1054-1055
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1054
    JOURNAL FREE ACCESS
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  • MRA Findings in the Basilar Artery of Healthy Individuals
    Takayuki NAKAGAWA, Tadayoshi TAKASHIMA, Kenta TOMIYAMA
    2001 Volume 94 Issue 12 Pages 1057-1062
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1057
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    We investigated MRA findings in the basilar arterial system of 84 individuals who had no history of balance disorder nor complications associated with atherosclerosis. The existence of stenosis in the basilar artery (BA) and morphology of the BA was estimated based on MRA results. Visualization of branches originating from the BA, posterior cerebral artery (PCA) and superior cerebellar artery (SCA), were also evaluated. Stenosis of the BA was found only in 5% of the subjects, and only one case of severe stenosis was noted. In regard to the morphology of the BA, a straight pattern was observed in 74%, a curved pattern in 19% and a S shaped-pattern in 7%. Bilateral PCAs were confirmed in 93% and bilateral SCAs in 92%. Thus, we considered that BA stenosis and the visualization of PCAs and SCAs were good landmarks for the evaluation of MRA findings in the BA system. However, the morphology of the BA is not suitable for screening for abnormalities in MRA findings in the BA system, because of the extent of variation in morphology.
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  • A Case of Leukemia Revealed by Bilateral Sudden Hearing Impairment
    Tatsuo KIKUGAWA, Mitsuharu NONOMUR, Tsunehisa OHNO
    2001 Volume 94 Issue 12 Pages 1063-1066
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1063
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    A 30-year old man was admitted to Shizuoka City Hospital because of bilateral sudden hearing impairment. He was pale and manifested hepato-splenomegaly. A blood examination revealed chronic myelocytic leukemia in blastic crisis with DIC. He died of multiple cerebral hemorrhages 4 days after his initial visit.
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  • Hearing Restoration in Patients with Sudden Total or Near Total Deafness
    Junko MITSUSHIMA, Mikio SUZUKI, Tsuyoshi KITANISHI, Hiroya KITANO, Yos ...
    2001 Volume 94 Issue 12 Pages 1067-1072
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1067
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    Patients with sudden onset deafness usually show marked hearing restoration, but in patients with sudden onset total deafness or near total deafness full hearing is sometimes not recovered.
    Between 1978 and 2000, we treated 247 patients with sudden deafness at our hospital, of which 71 had total deafness or near total deafness at the initial visit. In this retrospective study we divided patients into two groups: a total or near total deafness group (TD group), and the others group (O group). An analysis of case reports gave the following findings:
    1) There were no significant differences in age, sex, or the number of days from disease onset to initial visit between the two groups.
    2) The incidence of sudden deafness patients with vestibular symptoms in the TD group was significantly higher than in the O group.
    3) In the TD group, the rate of complete recovery and marked improvement was significantly lower than that in the O group.
    4) The rate of complete recovery and marked improvement in the TD patients with vestibule symptoms was significantly lower compared to those with similar symptoms in the O group.
    5) Hearing prognosis in sudden deafness patients with Grade 4a at the initial visit was poorer compared to patients with other Grades. However, 43.5% of sudden deafness Grade 4b patients recovered to Grade 1.
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  • Positive Rate of CAP-BAST in 299 Cases of Suspected Japanese Cedar Pollinosis
    Satoshi OGINO, Hitoshi OGINO, Kenji BABA, Shigeto KANETA
    2001 Volume 94 Issue 12 Pages 1073-1078
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1073
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    It is important to determine the allergen for treatment and prevention in allergic diseases, especially pollinosis. However, few patients have their specific allergen determined prior to treatment. In this study, we investigated the positive rate of specific IgE in 299 patients with suspected Japanese cedar pollinosis. Ten allergens were tested using CAP-RAST in 299 subjects consisting of 175 males and 124 females who visited the OCROM clinic (Suita city). The positive rate was 78.9% for Japanese cedar, 52.5% for D1, 50.8% for D2, 50.5% for HD1, 48.5% for Japanese cypress and 44.1% for orchard grass. About 60% of the patients who were positive for Japanese cedar also showed positive for Japanese cypress. However, no patients were positive for Japanese cypress and negative for Japanese cedar. There were no correlations between positivity rates and age for Japanese cedar. However, in HD1, the positive rate in younger patients was higher than in older patients. The numbers of simultaneously positive allergens was 4.5 in patients under 20 and gradually decreased according to age. It was very interesting that 2 patients were positive only for birch pollen and in these cases, it was very difficult to decide whether the patients had Japanese cedar pollinosis. Based on these results, we suggest that it is necessary to determine the specific allergen before treatment or prevention.
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  • Nasal Antigen Challenge of Japanese Cedar Pollinosis
    -An on Season and off Season Comparison-
    Mani MIYAGI
    2001 Volume 94 Issue 12 Pages 1079-1085
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1079
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    Objective: The antigen-induced nasal mucosal reaction between the pollen and pollen-free seasons was quantitatively compared in Japanese cedar pollinosis patients.
    Subjects: The subjects were 52 patients diagnosed with pollinosis at the outpatient clinic of the Toho University Ohashi Hospital between 1985 and 1990.
    Methods: A cedar antigen disk was bilaterally applied to the anteromedial aspect of the inferior nasal concha, and nasal respiratory resistance was continuously measured bilaterally by rhinography for 8 minutes.
    Results: Nasal respiratory resistance was compared between 18 positive cases during the pollination season and 10 positives cases during the pollen-free season. There was a significant difference between the seasons with respect to the frequency of the nasal mucosal reaction alone as assessed by t-test, but there was no significant difference between the seasons in initial nasal respiratory resistance or nasal mucosal sensitivity. Nasal respiratory resistance was significantly higher in the patients sneezing during the nasal mucosal reaction than in the patients who gave a positive reaction to the provocation test, as assessed by t-test.
    Conclusion: The results showed that the nasal mucosal sensitivity of pollinosis patients is elevated resulting in aggravated nasal obstruction by antigen challenge. Thus, pollinosis patients who sneeze easily and have nasal mucosal hypersensitivity to antigen challenge may be prone to nasal obstruction.
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  • A Case of Extramedullary Plasmacytoma in the Epipharynx and Palatine Tonsil
    Masaaki ADACHI, Kazuhiko HOKUNAN, Chikako YOSHIDA, Yasuaki HARABUCHI
    2001 Volume 94 Issue 12 Pages 1087-1091
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1087
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    A rare case of extramedullary plasmacytoma in the epipharynx and palatine tonsil is reported. A 63-year-old woman with left hearing loss due to otitis media with effusion was examined at our hospital. Physical examination and MRI showed mass lesions in her epipharynx and right palatine tonsil without cervical lymphadenopathy. Histological studies of biopsy specimens from both lesions showed extramedullary plasmacytoma. Immunohistological study revealed that tumor cells were positive for kappa chain of immunogloblin light chain, but negative for heavy chain. There were no abnormal findings in the serum immunoglobulin level, serum and urine protein levels, or bone marrow biopsy. Surgical resection of the tumors was performed followed by radiotherapy with a total dose of 60 Gy to the upper neck including the epipharynx and palatine tonsil. Post treatment, she has been free from disease for 15 months.
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  • A Case of Multiple Facial Bone Fractures
    -Treatment Using Dismasking Flap-
    Osamu HORIIKE, Yuji IMATE, Tetsuya TAHARA, Norio SHIMIZU, Tomoko Nakan ...
    2001 Volume 94 Issue 12 Pages 1093-1098
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1093
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    We report here a patient with multiple facial bone fractures who was treated using a dismasking flap.
    The patient was a 47-year-old male who was injured in a logging accident. Using the dismasking flap we were able to obtain an extensive working space and we could completely reconstruct the multiple facial bone fractures.
    We concluded that the dismasking flap is a very useful technique with excellent cosmetic and functional results and minimal complications.
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  • A Case of Papillary Cystadenocarcinoma in the Parapharyngeal Space Originating from the Parotid Gland
    Yoshiaki IGUCHI, Masatoshi HIRAYAMA, Kazuhiro YAMAMOTO, Daimon HASHIMO ...
    2001 Volume 94 Issue 12 Pages 1099-1104
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1099
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    We report a case of high-grade papillary cystadenocarcinoma in the parapharyngeal space that we considered originated from the parotid gland. The patient was a 52-year-old man with a chief complaint of unilateral earache and MRI revealed a parapharyngeal tumor. The tumor was removed and postoperative radiation and chemotherapy were performed but local recurrences were found 1 month later. Although we first considered that the tumor was a low-grade malignancy, it was highly malignant.
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  • Salivary Duct Carcinoma in the Parotid Gland; Two Case Reports
    Tsuyoshi KITANISHI, Hiroya KITANO, Akira SHIBANO, Michiko YOSHII, Tomo ...
    2001 Volume 94 Issue 12 Pages 1105-1110
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1105
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    Salivary duct carcinoma (SDC) is a high-grade aggressive malignancy of the salivary gland, that was first described by Kleinsasser et al. in 1968. We report here two cases of salivary duct carcinoma in the parotid gland. The first patient was a 64-year-old male, who presented with a mass in the right parotid region. The tumor in the parotid gland was treated using en bloc resection with modified neck dissection and postoperative radiation therapy was performed. The patient is alive without recurrence for three years postoperatively. The second patient was an 80-year-old male, who presented with a bulky mass in the right parotid region. In this case, en bloc resection with cutaneous reconstruction with a pectoralis major musculocutaneous flap was performed. The patient is also alive wtihout recurrence at one year postoperatively. In both cases, the characteristic microscopic features of SDC were observed, which are comedo necrosis and the cribriform pattern of intraductal growth. An en bloc resection in combination with adjuvant radiotherapy is currently the principal treatment for SDC, but in the future other alternative therapeutic modalities, such as the hormonal therapy used in prostatic carcinoma, should be considered.
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  • Pre-Operative Diagnosis of Neurinoma in the Head and Neck Region
    Nobuo TAKAGI, Tatsuyuki FUKUSHIMA, Masataka MURAKAMI
    2001 Volume 94 Issue 12 Pages 1111-1116
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1111
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    Neurinoma occasionally arises in the head and neck region and pre-operative diagnosis is difficult. In this study we analyzed 7 cases of neurinomas in the head and neck region, and we also discuss the problems of pre-operative diagnosis.
    CT, MRI, ultrasonography and fine needle aspiration cytology (FNA) were performed and CT, MRI and ultrasonography produced compatible images of the neurinoma. However, FNA that was performed all cases were diagnosed as class I or II. We also report the diagnostic significace of CT, MRI, ultrasonography and FNA.
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  • A Case of Descending Necrotizing Mediastinitis Extending from Deep Neck Infection
    Mitsuo TOMINAGA, Hayato MISAWA, Masaaki TERANISHI, Akihide Ito, Hideo ...
    2001 Volume 94 Issue 12 Pages 1117-1122
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1117
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    We report a 34-year-old female with deep neck infection extending into disseminated intravascular coagulation (DIC), septic shock, and descending necrotizing mediastinitis (DNM). The origin of infection was right mandibular dental caries. The patient was successfully treated with antibiotics, steroids, γ-globulin, and emergency surgical treatment. The surgery consisted of cervical drainage and mediastinal drainage without thoracostomy. Continuous irrigation was performed after the operation in the intensive care unit. DNM is recently a rare inflammatory lesion due to the development of antibiotics. Due to the difficulty of detecting the disorder, it takes a serious clinical course even if intensive care is given. For the diagnosis of DNM, it is necessary to check a chest X-ray film and a computed tomography scan of the mediastinum. Once a diagnosis is established, it is essential to perform adequate surgical drainage immediately and begin intensive systemic care.
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  • Deep Neck Infection; Two Contrastive Cases
    Norihiko NARITA, Shigeharu FUJIEDA, Gouta TSUDA, Shigehito MORI, Yuuic ...
    2001 Volume 94 Issue 12 Pages 1123-1129
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1123
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    A deep neck infection is generally induced by infection of the tonsil and the pharynx and in some cases an abscess can develop deep in the neck. Although many antibiotics are available to treat this condition, some patients with risk factors including high age, diabetes mellitus and poor nutrition have high mortality due to septic shock. We report here two cases of deep neck infection with contrasting courses.
    A 32-year-old man without any underlying diseases developed an abscess deep in the neck on the oral floor. Drainage was successful and the abscess disappeared by the administration of combined antibiotics.
    In contrast the second patient was a 33-year-old man without any underlying diseases who also developed an abscess deep in the neck. He was treated with combined antibiotics, but the abscess advanced to the mediastinum. Drainage surgery was performed in the neck and mediastinum and he recovered well and was discharged 78 days after admission.
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  • Pranlukast Produces Beneficial Effects in Nasal Symptoms on Patients with Perennial Allergic Rhinitis when Used in Combination with an Antihistamine
    Shinichiro NARITA, Hideaki SHIRASAKI, Kazumasa WATANABE, Kazuya KIKUCH ...
    2001 Volume 94 Issue 12 Pages 1131-1138
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1131
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    We investigated the effects of the combination therapy of leukotriene receptor antagonist (Pranlukast) and an antihistamine (Clemastine Fumarate) on patients with perennial allergic rhinitis. There was no significant difference between the combination (Pranlukast and Clemastine Fumarate) group (n=14) and the single (only Pranlukast) group (n=14) in terms of global improvement rating. In regard to improvements in the three major symptoms of allergic rhinitis, suppression of sneezing and rhinorrea were significantly better in the combination group in comparison with the single group at assessments one and two weeks after the start of administration (p<0.05). However, there was no significant difference between the two groups in regard to congestion. Moreover, in regard to intra nasal findings, the mean score of the nasal secretion of rhinoscopic findings was significantly decreased after administration in the combination group, but there was no significant change in the score in the single group (p<0.05).
    These findings suggest that Pranlukast, in combination with an antihistamine, produces beneficial effects on sneezing and rhinorrea in patients with perennial allergic rhinitis.
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  • Otoscierosis with Sensorineural Loss
    [in Japanese]
    2001 Volume 94 Issue 12 Pages 1140-1141
    Published: December 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.1140
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