耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
94 巻, 6 号
選択された号の論文の15件中1~15を表示しています
  • 西崎 和則
    2001 年 94 巻 6 号 p. 487-495
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Although modern laser systems offer excellent hematostatic ability and accurate cutting, the use of the laser in ear microsurgery has not become widespread other than in stapes surgery, mainly due to cost ineffectiveness and lack of recognition of the laser as an essential tool. However, the refinement of laser technology such as the flashscanner has brought attention to the use of lasers in the treatment of secretory otitis media. Laser assisted tympanic membrane fenestration is discussed with a review of the literature. In addition, a description of the tecnique used for laser assisted tympanoplasty, which we perform for resecting tympanosclerotic lesions in chronic otitis media or extirpating cholesteatoma medial to the ossicles, is reported.
  • 石川 和夫
    2001 年 94 巻 6 号 p. 496-497
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
  • 堀部 晴司, 内藤 健晴, 竹内 健二, 間宮 淑子, 宮田 昌, 堀部 智子, 桜井 一生, 高須 昭彦
    2001 年 94 巻 6 号 p. 499-504
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    We report the case of a 69-year-old male with large mastoid cyst on the right side accompanying cerebellar abscess. The mastoid cyst was surgically removed and the cerebellar abscess was treated palliatively with a systemic ingestion of antibiotics. Microscopical findings showed cholesterin granuloma in the cyst wall. In a review of the mastoid cyst cases reported in the Japanese literature, our case was rare because of the accompanying cerebellar abscess.
  • 工藤 逸大, 吉田 晋也, 松崎 洋海, 川本 彩子, 渡辺 誠
    2001 年 94 巻 6 号 p. 505-510
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    The areas of the middle ear are not available for visual examination. When carcinoma of the middle ear is diagnosed, most lesions have already destroyed bone and invaded cranial nerves. We report two cases of squamous cell carcinoma of the middle ear invading the apex partis retrosae. One patient was a 75-year-old woman. Other patient was a 66-year-old man. In both cases, biopsy was useful for diagnosis. Radiotherapy and chemotherapy were administered in both cases, and radiotherapy was effective in treating cranial nerve damage in the first case. Although either patient had any complaints about swallowing or conducting conversations in daily life, the tumors in both cases remained after treatment.
  • 長嶺 尚代, 飯野 ゆき子
    2001 年 94 巻 6 号 p. 511-516
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Patulous eustachian tube syndrome has become rare and we report here a 33-year-old male diagnosed with a patulous eustachian tube in the right ear, resulting from severe weight loss. The patient reported that sniffing gave a transient improvement of his symptoms such as ear fullness and autophony, but the frequent sniffing seemed to induce vertigo. The fistula symptom was positive and the movement of the eardrum sympathized with breathing was observed under an operation microscope. Although the vertigo disappeared after the patient stopped sniffing, the fistula symptom and the movement of the eardrum remained. At the time of the exploratory tympanotomy, no perilymphatic fistula was observed in the mesotympanum. We reinforced the round window membrane using soft tissue, and in addition, injected atelocollagen around the pharyngeal orifice of the eustachian tube. After the operation, both the fistula symptom and the abnormal movement of the eardrum had disappeared. These results suggested that the excessive negative pressure to the mesotynpanum caused by sniffing may have affected the inner ear through the round window membrane.
  • 内田 真哉, 松波 達也, 村上 匡孝
    2001 年 94 巻 6 号 p. 517-520
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    In patients with severe mental retardation, special surgical treatment should be considered.
    A giant antrochoanal polyp in a 31-years-old man with severe mental retardation is reported. The polyp discovered accidentally after the patient began exhibiting snore and rhinorrhea, and after a few months observation weight loss due to dysphagia was noted. Surgical treatment without nasal tamponade was planned, since we were concerned that the patient would be unable to cooperate with the necessary postoperative treatment; embolization of a maxillary artery, functional endoscopic sinus surgery (FESS) and Argon Plasma Coagulation. Postoperatively, the patient's symptoms and the radiological findings of his sinuses were improved.
  • 福島 一登, 豊田 健一郎, 板東 秀樹, 只木 信尚
    2001 年 94 巻 6 号 p. 521-524
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Twenty-three patients with perennial allergic rhinitis resistant to medical treatment underwent Electro-Coagulation using high frequency current and were followed for at least 2 years. The patients were 12 males and 11 females, aged from 11 to 55 years. The operation was performed as one-day surgery. An improvement in sneezing was noted in 17 of 23 patients (73.9%), and an improvement in nasal discharge was noted in 21 of 23 patients (65.2%), with an improvement in nasal obstruction in 21 of 23 patients (91.3%). Medication Score (MS) preoperatively was 2.43 and the postoperatively was 0.39 (p<0.01). Of the younger patients, 6 of 8 patients improved (75%), and the postoperative score (0.87) was significantly lower than the preoperative score (2.12)(p<0.01). Electro-Coagulation using high frequency current is effective for nasal obstruction, and can also be used for young patients as a minimally invasive surgery.
  • ―その有用性と免疫組織化学的検索―
    高原 幹, 荻野 武, 小林 吉史, 林 達哉, 野中 聡, 原渕 保明
    2001 年 94 巻 6 号 p. 525-530
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Treatment outcomes of tonsillectomy were investigated in 5 Japanese patients with anaphylactoid purpura, all of whom had a history of chronic tonsillitis. The patient group was composed of 2 males and 3 females and the age ranged from 18 to 51 years with a median age of 28 years. The patients were followed for 6 months to 10 years after tonsillectomy. All of the skin lesions disappeared in one patient, 80% of those in 3 patients, and 50% in one, during the follow-up period. To determine the histological characteristics of the tonsils, the T-nodules, B-lymphoid follicles, and the areas of mixed T- and B-cells were quantitatively identified on the tissue section stained by CD20 antibody. The areas were compared with those of each of the 5 tonsils obtained from age-matched patients with recurrent tonsillitis and with IgA nephropathy. The area of Tnodules was significantly larger in both tonsils from patients with anaphylactoid purpura and with IgA nephropathy compared to those from patients with recurrent tonsillitis. These clinical and histological data remind us that anaphylactoid purpura may be an entity of tonsil-related diseases such as IgA nephropathy.
  • 楠 威志, 西田 升三, 沖田 有弘, 寺尾 恭一, 宮崎 和浩, 村田 清高, 戸村 隆訓
    2001 年 94 巻 6 号 p. 531-535
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Apoptosis was observed in palatine tonsil carcinomas (squamous cell carcinoma; 11 cases) by TUNEL staining. The TUNEL labeling index (TLI) of carcinoma cells had no relation to TNM, staging, pathohistological differentiated grades or the efficiency of radiotherapy. TLI (means: 5.2%) of postradiotherapy cases was higher than that of preradiotherapy cases (1.9%). TUNEL positive cells were found in the tissues surrounding cancers. In the surrounding tissues, the TLI (means: 5.1%) of postradiotherapy cases was higher than that of preradiotherapy cases (2.0%). These findings indicated that apoptosis induced by radiotherapy could suppress cancer development. Reversely, the invasion and metastasis of surviving cancers may be promoted by apoptosis induced in the surrounding tissues.
  • 高北 晋一, 北村 薄之, 岩橋 由佳, 前谷 俊樹, 山本 典生, 河田 恭孝, 宮崎 眞和, 楯谷 智子
    2001 年 94 巻 6 号 p. 537-543
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Objective: To ascertain whether prophylactic neck dissection offers an advantage for patients with papillary thyroid carcinoma (PTC) in the absence of clinically metastatic lymphadenopathy.
    Design: A retrospective study of 108 PTC patients without clinically metastatic lymphadenopathy who were treated at Tenri Hospital between 1977 and 1987. We compared the cumulative non-recurrence rate of cervical metastasis between 68 patients who underwent lymphnode operation (OP group) and 40 patients without any lymphnode operation (non-OP group). There were no significant differences in age and the stages of primary tumors between the two groups. Furthermore, we compared the cumulative non-recurrence rate of cervical metastasis among 40 patients with D0, 26 with D1, 27 with D2 and 2 with D3 dissection and found no significant differences in age and the stages of primary tumors. The mean follow-up period was 16.1±3.0 (MEAN±SD) years.
    Results: The rate of occult lymphnode metastasis was 79.4% in the OP group. The 20-year non-recurrence rates were 92.6% in the OP group and 87.5% in the non-OP group and generalized Wilcoxon test showed no significant difference between the two groups. The 20-year non-recurrence rates were 87.5% in D0, 92.3% in D1 and 100% in the D2 and D3 dissection group. Generalized Wilcoxon and Logrank tests showed, that there were also no significant differences among them. No patients died of PTC.
    Conclusion: Although patients with PTC in the absence of clinically metastatic lymphadenopathy had many occult metastases, the frequency of recurrences of cervical metastasis was low. Furthermore, non-recurrence rate in patients without any prophylactic operation was not significantly different compared to patients who underwent some prophylactic dissection. Thus, prophylactic neck dissection does not seem to offer any advantage for patients with PTC in the absence of clinically metastatic lymphadenopathy.
  • 梅野 博仁, 松田 洋一, 森 一功, 千々和 圭一, 梅野 哲義, 中島 格
    2001 年 94 巻 6 号 p. 545-549
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Twenty patients under 20 years old age with malignant head and neck tumors were treated at Kurume University Hospital between 1979 and 1998. There were eight males and twelve females and the mean age was 14 years old. Histologically, rhabdomyosarcoma and papillary carcinoma were observed in 5 patients, squamous cell carcinoma in 4 patients, neuroblastoma and malignant lymphoma in 2 patients, and Langhans cell histiocytoma and leiomyosarcoma in 1 patient. Their 5-year survival rate was 82.6%. Team practice is required to treat juvenile patients with malignant head and neck tumors.
  • 竹内 英二, 北野 博也, 北嶋 和智
    2001 年 94 巻 6 号 p. 551-554
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    We report two cases of external dental fistula and a recent review of the literature. Both of the cases were diagnosed as typical external dental fistula. External dental fistula usually appears on the mandibular or dental regions as erythematous nodulocystic, suppurative lesions. External dental fistula usually develops from a apical periodontitis, which most commonly results from carious disease. In many patients, the external dental fistulas are not recognized and the interventions are either improper or insufficient. In order to correctly evaluate a case of external dental fistula, the clinician must be aware of the disorder and the potential for a dental abscess to drain through the skin of the face. The diagnosis is readily confirmed by X-ray examination of the teeth. A permanent cure can be expected using dental therapy, such as root canal treatment or dental extraction.
  • ―モルモット蝸牛の免疫組織化学的検討―
    篠森 裕介
    2001 年 94 巻 6 号 p. 555-565
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    Na+-K+-2Cl- cotransporter 1 (NKCC1) and c-Jun N-terminal kinase (JNK) were immunohistochemically studied in guinea pig cochlea following the induction of endolymphatic hydrops by blocking the endolymphatic duct. Postoperative survivals were set to 1 day (n=3), 3 days (n=4), 1 week (n=3), 2 weeks (n=4), 1 month (n=4) and 3 months (n=4). The most striking finding was an increase in the immunoreactivity for NKCC1 at type 1 fibrocytes of the spiral ligament throughout the survival times. This suggests that the affected cells shrink as the result of surgical intervention and upregulate NKCC1 to restore the volume of the cells. The shrinkage of type 1 fibrocytes should reduce gap junctional connectivity among cells of the ligament, which could reduce K+ supply into the stria vascularis and disturb ionic homeostasis in the endolymph. On the other hand, JNK, which has been reported to activate NKCC1 by phosphorylation, showed a consistent decrease in immunoreactivity in the types 1 and 2 fibrocytes in hydropic ears, indicating that JNK does not play an important role in the activation of NKCC1 in the cochlea.
    The findings in the present study suggested that endolymphatic homeostasis depends on cell integrity within the spiral ligament and that NKCC1 in type 1 fibrocytes is crucial in maintaining cochlear fluid homeostasis.
  • 太田 伸男, 笠島 直子, 青柳 優, 稲村 和俊, 権 誠基, 川合 正和, 川口 和浩
    2001 年 94 巻 6 号 p. 567-573
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
    The clinical effect of IPD® in patients with Japanese cedar allergy was investigated by comparing treatment before the start of the pollen season and treatment after the pollen had been scattered. Based on the symptom score, medication score and symptom-medication score, treatment before the pollen season had a significantly lower value that that of treatment after the pollen had been scattered.
    These results indicate that IPD® is useful for the treatment of Japanse cedar pollinosis.
  • 中島 務
    2001 年 94 巻 6 号 p. 574-575
    発行日: 2001/06/01
    公開日: 2011/11/04
    ジャーナル フリー
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