Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 94, Issue 2
Displaying 1-17 of 17 articles from this issue
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  • Equilibrium Training
    Yatsuji Ito
    2001 Volume 94 Issue 2 Pages 101-109
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.101
    JOURNAL FREE ACCESS
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    Dizziness and disequilibrium are common symptoms of patients with vestibular disorders. These symptoms can persist for a long time in some patients, despite medication, and the patient's activities of daily living (ADL) can be restricted. Equilibrium training is used to reduce the disability of such patients.
    In 1945 Cawthorne and Cooksey first described a system of rehabilitation for patients with vestibular injury, and many methods of training have been developed. In 1990 the board of the Japan Society for Equilibrium Research presented a standard of equilibrium training for patients with disequilibrium. In this paper, the concept of equilibrium training and the author's experiences with equilibrium training in patients with vestibular disorders are presented.
    In our training program the degree of impairment, disability and handicaps of the patients were evaluated before training started. To evaluate subjective and objective disabilities, the ADL was investigated using a questionnaire and equilibrium function tests were performed. A level of difficulty was selected in order to challenge patients, and the patients performed those exercises three times a day at home. Training was continued until the patient's disabilities were reduced. The effects of training were assessed according to ADL, equilibrium function tests, stabilometry and gait tests.
    We found many differences in disability among patients with similar impairments, and were able to plan an individual training program suitable for each patient. ADL and equilibrium function tests were useful for evaluating disability and the effect of training. Equilibrium training was effective even for older patients with bilateral vestibular disorders who showed chronic disability persisting for more than several weeks after onset.
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  • Infantile Subglottic Stenosis Complicated by MRSA Infection
    [in Japanese], [in Japanese]
    2001 Volume 94 Issue 2 Pages 110-111
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.110
    JOURNAL FREE ACCESS
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  • Long-term Middle Ear Ventilation Tube (Paparella type II ) for Otitis Media with Effusion
    Ryuichi Kobayashi, Hiroshi Furuta, Hiroshi Hoshikawa, Rieko Goto, Masa ...
    2001 Volume 94 Issue 2 Pages 113-117
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.113
    JOURNAL FREE ACCESS
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    The use of long-term middle ear ventilation tubes (Paparella type II) was retrospectively analyzed in 66 ears with otitis media with effusion, in children treated at Kagawa Medical University Hospital between January 1990 and March 1998. The average intubation period was 23.9 months. The average pure tone air conduction threshold showed a remarkable improvement of between 32.7dBHL and 16.9dBHL. Otorrhea was observed in 25 ears (37.8%), obstruction in 2 ears (3.0%), granulation in 3 ears (4.5%) and permanent ear drum perforation in 11 ears (19.6%). No cholesteatma or adhesion of the ear drum was seen. Recurrence of otitis media with effusion was found in 9 of 45 ears (20.0%). In conclusion, Paparella type II tube can be placed for a long-term period and have a low rate of reccurence, but have a high rate of otorrhea and permanent ear drum perforation.
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  • Frontal Osteoma Removed by Endoscopic Endonasal Surgery
    Akihiro SAKAI, Yoshihiko OKINAKA, Takuo IKEDA, Masako MIURA, Tetsuya T ...
    2001 Volume 94 Issue 2 Pages 119-123
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.119
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    The incidence of paranasal sinus osteoma is highest in the frontal sinus, but only a few cases of frontal osteoma have been reported in the Japanese literature. We report a case of frontal osteoma removed by endoscopic endonasal surgery.
    The patient was a 74-year-old female who complained of f rontalgia of unknown origin. We made the diagnosis of frontal osteoma based on the X-ray and CT findings. The tumor was small enough to be removed by endoscopic endonasal surgery. We concluded that surgery is one choice of treatment, even for asymptomatic frontal osteomas, when they can be removed by endonasal surgery.
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  • Japanese Cedar Pollinosis in the South of Ibaraki Prefecture
    Takashi ARAI, Akiko NAKAGAWA
    2001 Volume 94 Issue 2 Pages 125-129
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.125
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    A clinical study of 1206 patients with Japanese cedar pollinosis treated between January 1975 and December 1999 was performed and in addition, the amount of Japanese cedar and cypress pollen in the south of Ibaraki Prefecture was measured every spring from 1981 to 1999 (19 years).
    The following findings were observed.
    1) The age distribution of Japanese cedar pollinosis was highest in the 30-39-year-old group of females. In the younger age group (10 years or youger), pollinosis was more common in males than females.
    2) The skin test positive rate for house dust (HD) was 46.3%. The positive rate for pollens, orchard grass, short ragweed, lesser reedmace and Japanese hops, was 16.9, 20.2, 14.6 and 3.9%, respectively.
    3) The RAST positive rate for mites and HD was 46.3 and 21.3%, respectively. The positive rate for pollens, orchard grass, short ragweed and mugwort, was 19.9, 14.8 and 9.5%, respectively.
    4) The mean pollen count of Japanese cedar and cypress over the 19 year period was 4298.5/cm2. The highest pollen count was 16987/cm2 in 1995.
    5) A correlation was noted between the annual variations in the Japanese cedar and cypress pollen counts and the annual change in Japanese cedar pollinosis patient numbers. Since the peak in 1995, Japanese cedar pollinosis has tended to increase.
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  • Long-term Survival in a Case of Malignant Melanoma of the Nose
    Akiko TAURA, Juichi Ito, Kohzo OHTA, Shuji FUJITA, Tsuyoshi ENDO, Tats ...
    2001 Volume 94 Issue 2 Pages 131-136
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.131
    JOURNAL FREE ACCESS
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    A 64-year-old female exhibiting a malignant melanoma of the nose received radiotherapy in 1979. In 1984, ileal metastasis occured and was resected. In 1992, pelvic bone metastasis was discovered and she received radiotherapy. In 1998, a recurrent tumor was discovered in the primary site (left nasal cavity).
    In contrast to some reports that sinonasal malignant melanoma is resistant to radiotherapy, in this case, radiotherapy seems to have been effective. She received only radiotherapy and had distant metastasis, but her long-term survival rate was good. The prognosis of sinonasal malignant melanoma is very poor, but a few cases of prolonged survival have been reported. Malignant melanoma is divided into two types, fulminant and nonfulminant, and the latter has a good prognosis. In theory there should be immunological differences between them, but at present the differences have not been clearly identified.
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  • A Case of Huge Lipoma Originating in the Deep Lobe of the Parotid Gland
    Akira SASAKI, Atsushi Matsubara, Toshimitsu HASHIMOTO, Atsushi NANBA, ...
    2001 Volume 94 Issue 2 Pages 137-140
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.137
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    We treated a patient suffering from a huge lipoma of the neck, which extended into the parapharyngeal space. CT scans and MRI were useful for the diagnosis and we extirpated the lipoma by incising the parotid gland. CT scans, MRI and operative findings showed that this was a case of a very rare lipoma originating in the deep lobe of the parotid gland.
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  • Pustulosis Palmaris et Plantaris and Focal Infection
    -The Perception of Dermatologists and Otolaryngologists in Medical Schools in Japan, Obtained Using a Questionnaire-
    Makoto HAMAMOTO, Toshio MURAKATA, Akikatsu KATAURA
    2001 Volume 94 Issue 2 Pages 141-147
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.141
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    We evaluated the results of questionnaires on Pustulosis Palmaris et Plantaris (P. P. P) and tonsil sent to 118 dermatology departments and 119 otolaryngology departments in university hospitals in Japan.
    The following results were obtained:
    1.81 otolaryngology departments answered the questionnaires; the effective answer rate was 68.1%. 75 dermatology departments answered; the effective answer rate was 63.6%.
    2.99% of otolaryngologists and dermatologists regarded P. P. P as a focal infection. This results showed that both otolaryngologists and dermatologists markedly regarded P. P. P. as a focal infection, in comparison with other dermatosis.
    3. There was a considerable difference between the recognition of therapeutic effects between otolaryngologists and dermatologists. Judgment on treatment outcome made by both otolaryngologists and dermatologists will be necessary in the future.
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  • Desmoid Tumor in the Neck; A Case Report
    Toshio ISHIKAWA, Hitoshi TOJIMA, Chikako YAMADA
    2001 Volume 94 Issue 2 Pages 149-154
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.149
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    A 27-year-old man presented with a slow-growing, large, elastic hard, fixed, and non-tender mass on the right side of his neck. Computed tomographic scans revealed a large mass of 4.5×6.5×14.0cm in the right neck. Excision was performed and the pathological diagnosis was an extra-abdominal desmoid tumor.
    Though a desmoid tumor is histologically benign, it has a tendency to invade the surrounding tissue and often recurs locally, and it is necessary to remove the tumor with an ample safety margin.
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  • Cartilaginous Choristoma of the Tongue
    Hitoshi FURUNO, Hirohito UMENO, Yoshimi MIYAJIMA, Tadashi NAKASHIMA
    2001 Volume 94 Issue 2 Pages 155-158
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.155
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    We report an 18-year-old man who exhibited an asymptomatic tumor at the center of the tongue. The patient had been aware of the mass for 7 years, but did not receive any treatment for it. On first examination, the tumor was approximately 12mm in diameter.
    Under local anesthesia, the tumor was excised using a CO2 laser. Histological investigation revealed that the tumor had hyaline cartilage characteristics and was diagnosed as cartilaginous choristoma.
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  • Hemangiopericytoma of the Parapharyngeal Space
    Yoichiro TOMIYAMA, Jun-ichi YOSHIDA, Yoichiro HONJO, Kenji MITANI, Shi ...
    2001 Volume 94 Issue 2 Pages 159-166
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.159
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    A 47-year-old woman complaining of a sore throat was referred to our hospital. Previously, the patient had been operated on twice for parapharyngeal tumors in other locations. Magnetic resonance imaging of the area revealed a well-defined round mass in the parapharyngeal lesion that was surgically removed. Histopathological analysis of the surgical specimen revealed a hemangiopericytoma. Subsequently, the tumor recurred twice over the next six years, and multiple distant metastasis, including lung, liver and bone, proved to be fatal. Autopsy specimens from each metastasis lesion showed homogeneous cells of markedly different grades, suggesting that the process of tumor evolution and progression can generate biological diversity, and that the parent tumor is heterogeneous.
    In conclusion, this clinical course is useful for suggesting biological diversity in the primary tumor.
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  • A Case of Malignant Lymphoma in the Parapharyngeal Space with a Differential Diagnosis from Tuberculous Lesion
    Kazuhiro YAMAMOTO
    2001 Volume 94 Issue 2 Pages 167-171
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.167
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    A case of a 49-year-old male who had a mass with tenderness in his right infraauricular region is reported. CT scan revealed that the mass occupied the parapharyngeal space. The tuberculin reaction was strongly positive. Histological findings suggested the possibility of tuberculous lesion but there were atypical lymphoid cells in the soft tissue infiltrated by the mass. Malignant lymphoma was diagnosed by immunohistological findings.
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  • A Case of Carcinoma Arising from a Thyroglossal Duct Remnant with Difficulty Discrimination
    Takeshi KUSUNOKI, Arihiro OKITA, Shoji NISHIDA, Yukio Tanaka, Kiyotaka ...
    2001 Volume 94 Issue 2 Pages 173-178
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.173
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    We encountered a case of thyroglossal duct carcinoma with adenomatous goiter in the thyroid. In this case, 77-year-old male was referred our hospital exhibiting an anterior cervical tumor. Preoperative findings of this tumor showed a hard mass of 30×30×20mm in the midline of the neck at the level of the thyroid cartilage, and skin invasion. On preoperative examination, tuberculin reaction (+) can appear similar to necrotic lymphnodes on MRI, and it is necessary to differentially diagnose tuberculous lymphadenitis and metastatic lymphnodes. Frozen biopsy during the operation could not discriminate between thyroglossal duct carcinoma and metastatic lymphnodes but postoperative pathohistogic diagnosis was papillary carcinoma. After 5 weeks, total thyroidectomy was performed for the tumors in the thyroid, and the pathohistologic diagnosis of thyroid tumor was adenomatous goiter, suggesting primary thyroglossal duct carcinoma.
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  • Functioning Thyroid Nodule
    Norio YAMAMOTO, Hiroyuki KITAMURA, Shinichi TAKAGITA, Yuka IWAHASHI, Y ...
    2001 Volume 94 Issue 2 Pages 179-183
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.179
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    The incidence of functioning thyroid nodules is considered to be low in Japan. However, we perform 123I scintiscan in most cases of thyroid tumors and when thyroid nodules are hot on scintiscan, we advise patients that thyroid nodules should be excised. In this study, we retrospectively reviewed the incidence, diagnostic and operative methods and pathologic characteristics of functioning thyroid nodules from 1991 to 1997 at Tenri Hospital.
    Among 1177 cases of thyroid diseases in which scintiscans were performed, ninety-one cases (7.7%) had hot nodules and the incidence of functional thyroid nodules is higher than has been reported in Japan.
    The incidence of euthyroid nodules was higher than expected among those clearly diagnosed as autonomously functioning thyroid nodules by triiodothyronin (T3) suppression test. This result and one false positive case of preoperative fine needle aspiration cytology showed the importance of 123I scintigrams as an initial diagnostic method of thyroid nodules.
    Thyroid lobectomies or total thyroidectomies were performed in 48 cases. Papillary carcinomas coexisted in eleven cases (22.8%), and four functioning nodules themselves were papillary carcinomas. In consideration of this data and the difficulty of controlling hyperthyroidism due to functioning thyroid nodules, operations should be used as a primary treatment method, even though in our study, postoperative hypothyroidism occurred in ten cases (22.2%) in which thyroid lobectomy was performed.
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  • Four Cases of Cat Scratch Disease
    Keiko KASHIBA, Keijiro FUKAZAWA, Seiichi TOMOFUJI, Masafumi SAKAGAMI
    2001 Volume 94 Issue 2 Pages 185-189
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.185
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    Cat scratch disease, zoonosis, is caused by contacting with a cat or a kitten and the clinical features are lymphadenopathy, fever and skin lesion. We encountered four cases of cat scratch disease in which all patients presented with cervical lymphadenopathy and had a history of contact with kittens or cats. In addition, the IgG antibody levels to Bartonella henselae were elevated in all cases. In the diagnosis of cat scratch disease, it is important to ask the patient about prior contact with cats or kittens and to test for an elevated IgG antibody level to Bartonella henselae.
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  • Analysis of Breathing Patterns in Sleep Apnea by Image Analysis System
    Sumiko USHIKUBO, Mikiko TAKAYAMA, Tetsuo ISHII, Yoshifumi NISHIDA
    2001 Volume 94 Issue 2 Pages 191-198
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.191
    JOURNAL FREE ACCESS
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    In the measurement of sleep apnea the attachment of monitors to the patient's body can impose a burden. Thus, only visual observation of the respiration pattern has been reported and in the present study, we evaluated an image analysis system that did not require the attachment of any monitors, or invasive procedures, to measure respiration. This system was initially reported by Takasaki et al. in 1998. In the present study, we observed sleep apnea in 12 patients using the image analysis system and also a Microsleep simple monitor. The findings in both methods showed a regular respiratory pattern resembling Cheyne-Stokes respiration. A comparison of the respiration patterns resembling Cheyne-Stokes respiration in a 1-hour period (CSI), the apnea index (AI), and the decrease in blood oxygen saturation index (ODI4), showed a correlation between CSI and AT and ODI4. Thus, our results showed that the image analysis system was effective for studies of sleep apnea syndrome.
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  • The Preservation of Recurrent Laryngeal Nerve in Neck Surgery
    [in Japanese], [in Japanese]
    2001 Volume 94 Issue 2 Pages 200-201
    Published: February 01, 2001
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.94.200
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