Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 95, Issue 12
Displaying 1-18 of 18 articles from this issue
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  • Nasal CPAP Treatment for OSAS in OtolaryngologyTadao Nishimura and Chikaya Hattori
    (Fujita Health University)
    Tadao NISHIMURA, Chikaya HATTORI
    2002 Volume 95 Issue 12 Pages 1197-1203
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1197
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    In 1998, nasal continuous positive airway pressure (nasal CPAP) was added to the list of Japanese health insurance-approved methods for treating obstructive sleep apnea syndrome (OSAS). Since then, nasal CPAP has been increasingly applied to patients with OSAS in Japan. This highlights the need for standardized ideas on non-surgical nasal CPAP if Japanese otorhinolaryngologists are to treat OSAS most effectively.
    According to the terms and conditions of Japanese health insurance, nasal CPAP is covered by insurance for cases either over 40 in apnea hypopnea index (AHI) or over 20 in AHI with improvements in symptoms and PSG brain waves by the use of nasal CPAP.
    The application of nasal CPAP requires titration. Some institutions in Japan employ the function of APAP, and a 90th Gentile pressure is often used.
    OSAS is caused by obstruction of the upper respiratory tract, mainly around the pharynges. Therefore, specialists in this region should take progressive approaches to OSAS. Nasal CPAP is not applicable to patients with either severely- or completely-congested nose. In such a case, nasal surgery in combination with drug therapy are appropriate.
    Generally speaking, patients introduced by internists and psychiatrists are often 5 to 20 in AHI, so nasal CPAP is not applicable in terms of Japanese health insurance. However, this does not necessarily mean that surgery is effective for them. The application of surgery depends on previous surgical data and types of OSAS.
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  • Surgery for Traumatic Ossicular Chain Discontinuation
    [in Japanese]
    2002 Volume 95 Issue 12 Pages 1204-1205
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1204
    JOURNAL FREE ACCESS
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  • A Case Report of Medullary Infarction with Vertigo in a Young Adult
    Akiko ADACHI, Toru SEO, Hiroki YASUNO, Hiroya FUJIKI, Tomonori TERADA, ...
    2002 Volume 95 Issue 12 Pages 1207-1211
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1207
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    It is generally known that cerebral infarction commonly occurs in elderly people. Rarely, cerebral infarction may occur in young adults due to complications such as collagen disease, heart disease, and dissecting aneurysm. We recently encountered a 32-year-old man who had occasionally complained of occipital pain after drinking alcohol since April 1999. As he also experienced sudden onset of vertigo with occipital pain, he went to the Department of Otolaryngology, Takarazuka City Hospital on April 14, 1999. Left-ward horizontal-rotatory spontaneous nystagmus was presented as shown in vestibular dysfunction. There were not any cerebellar signs, but left trigeminal hypesthesia suggested a central nervous system disorder. Moreoever, we found disturbances of touch, temperature, and pain sensations on the right upper and lower extremities.
    MRI showed an infarction in the left lateral medulla oblongata. Vertebral angiography showed an aneurysm in the distal and proximal segments of the left posterior inferior cerebellar artery. These findings indicated that medullary infarction was caused by dissecting aneurysm of the vertebral artery.
    In the present case, it was suggested that the intima of the vertebral artery rapidly deteriorated due to the dehydration resulting from excessive alcohol intake, and that neurological examination should be performed even in juvenile vertiginous cases.
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  • Vertigo Caused by the Dissection of the Vertebral Artery; A Case Report
    Yoshiko SHIOMI, Yousaku SHIOMI, Naoharu ODA, Mitsuko FUJIHARA, Yuichi ...
    2002 Volume 95 Issue 12 Pages 1213-1218
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1213
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    A 21-year-old man consulted our clinic complaining of acute vertigo and nausea. He showed sponta-neous upbeat nystagmus, but there were no other significant neurological findings. As visual suppression (VS) of the manually rotated vestibulo-ocular reflex (VOR) was severely impaired, MRI and MRA examination were immediately ordered. MRA showed stenosis of the left vertebral artery and Ti-weighted MRI demonstrated intramural hematoma in the stenotic region. Further examination with digital subtraction angiography demonstrated stenosis of the left vertebral artery, which was compatible with arterial dissection. Arterial dissection must be considered as a cause of possible central vertigo. VS of the VOR was useful for detecting disorder of the central vestibular system in this case.
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  • he Tullio Phenomenon in a Patient with Traumatic Perilymph Fistula
    Hiroaki Sato, Kazuo MURAI, Koichi SUGIHARA
    2002 Volume 95 Issue 12 Pages 1219-1223
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1219
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    A 19-year-old male who exhibited the Tullio phenomenon after barotrauma in the right ear is presented. The patient had developed right otalgia, vertigo, and nausea during exposure to loud sound after the right ear was beaten by a musical instrument five months earlier. Otoscopic examination demonstrated perforation scar in his right eardrum, however there was no cause of hearing impairment that could be identified. Fistula symptom was positive, but nystagmus could not be identified under Frenzel's glasses because the patient had congenital nystagmus. Exposure to tone burst sound stimulation with 1000 Hz at 90 dB to the right ear caused ocular deviation to the right and upward following nystagmus toward the left and upward. Surgical exploration of the right ear demonstrated perilymph leakage from the round window, but neither hypermobility nor subluxation of the stapes was found. The fistula was closed using a piece of temporal fascia and fibrin glue. Subjective symptoms of Tullio phenomenon disappeared postoperatively, but a slight downward nystagmus persisted during tone burst sound stimulation.
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  • Ceruminous Adenocarcinoma; A Case Report
    Jun Sato, Makoto HAMAMOTO, Masato HATA, Tetsuo HIMI
    2002 Volume 95 Issue 12 Pages 1225-1228
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1225
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    Tumors of ceruminous glands origin are rare in humans. We report a case of ceruminous adenocarcinoma presented with a swelling of the right external auditory canal. The patient underwent excision of the auditory canal. The patient has not shown any sign of recurrence or distant metastasis for 1 year since surgery. The clinical aspect of this tumor is discussed, followed by a brief literature review.
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  • Clinical Study of Carcinoma Associated with Papilloma of the Nasal Cavity and Paranasal Sinuses
    Tomoko TATEYA, Hiroyuki KITAMURA, Kazuhiko SHOJI, Shin-ichi TAKAGITA, ...
    2002 Volume 95 Issue 12 Pages 1229-1233
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1229
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    Thirty-nine cases of nasal and paranasal papilloma treated in Tenri Hospital during the last 20 years were reviewed. In 6 cases (15%), squamous cell carcinoma was accompanied by papilloma and all were inverted papilloma. Two were male and 4 were female. The mean patient age in these 6 malignant cases was 73 years old, which was 13 years older than that in benign cases. In the 6 malignant cases, the lesions tended to be more extensive and more often involved the frontal sinus or sphenoid sinus than lesions in benign cases. Clinical symptoms and bone destruction in radiographic studies did not clearly characterize the existence of malignancy.
    Three cases were preoperatively diagnosed as carcinoma and were treated with a combination of surgery, irradiation and chemotherapy. The other cases were diagnosed as carcinoma from surgically obtained materials and two received postoperative radiotherapy while one case did not. The 3-year survival rate was 80%.
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  • Four Cases of the Parotid Gland Abscess
    Ryoji ISHIDA, Hiroyuki YAMADA, Shin-ichiro NISHII, Toshiharu TOKURIKI
    2002 Volume 95 Issue 12 Pages 1235-1239
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1235
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    Four patients with parotid abscesses were treated at our department in 2001. All patients were in good general condition, and there were no signs of systemic diseases.
    In all cases, CT scan demonstrated an area of ringed enhancement in the parotid gland.
    Antibiotic administration was effective in only one patient, and drainage of the parotid glands was performed in three patients. In one patient, recurrence of the parotid abscess was observed, and lateral lobectomy was performed in this case.
    In general, drainage of the abscess in the parotid gland is necessary and effective. Lateral lobectomy may occasionaly be required when drainage of the abscess does not achieve a cure.
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  • A Case of Pleomorphic Adenoma Arising from Accessory Parotid Gland
    Yoko HAGIIKE, Hirofumi AKAGI, Nobuhiko KIMURA, Motoharu Eguchi, Michiy ...
    2002 Volume 95 Issue 12 Pages 1241-1245
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1241
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    Although accessory parotid glands are found in 20-70% of normal persons, tumors arising from accessory parotid glands are reportedly rare. We demonstrated a case of pleomorphic adenoma arising from the accessory parotid gland. A 43-year-old female was brought to our hospital with a left cheek mass. Imaging demonstrated an oval-shaped tumor on the masseter muscle located in the mid-portion of her cheek, without any evidence of relationship with the parotid gland. Surgically the tumor was completely removed through a transparotid approach and pathologically diagnosed as pleomorphic adenoma.
    Reports of the incidence of accessory parotid glands in humans are inconsistent, so we investigated the various reported values. We concluded that over 55% of normal people have accessory parotid glands in their left or right cheeks.
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  • Aspiration Cytodiagnosis in Salivary Gland Tumor
    Ichiro ANDO, Fuyuki ENIMOTO, Eiko NAKAZAWA, Masato FUJIMORI
    2002 Volume 95 Issue 12 Pages 1247-1254
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1247
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    Clinical observations in 123 cases of salivary gland tumors (carcinoma: 11, pleomorphic adenoma: 81, warthin's tumor: 31) between 1991 and 2000 are reported and the cytodiagnosis of fine needle aspirated cytological materials from 114 cases (carcinoma: 10, pleomorphic adenoma: 78, warthin's tumor: 30) are discussed.
    Results and conculusions were as follows:
    1. In warthin's tumor, possible cytological classification diagnosis of benign tumor (class II) was made in 90% (27 cases), histological type suspicious diagnosis of warthin's tumor in 90% (27 cases) and 3 cases yielded unsatisfactory materials.
    2. In pleomorphic adenoma, we were possible classification diagnosis of benign tumor (class IIIa-II) was made in 91.9% (68 cases), histological diagnosis of pleomorphic adenoma in 90.5% (67 cases) and 6 cases yielded unsatisfactory material.
    3. In carcinoma cases, possible cytological classification diagnosis (class V-IIIb) of malignannt tumor was made in 50% (5 cases), histological type diagnosis of carcinoma in only 30% (adeno carcinoma: 2 cases, sucamous cell ca: l case) and 2 cases yielded unsatisfactory materials.
    4. Overall cytological results showed a sensitivity of 62.5%, specifity of 100%, false negative findings in 37.5%, false positive findings in 0% and unsatisfactory materials in 9.6%.
    5. When reexamination of malignant 10 cases was attemped postoperatively, it confirmed correct cytological diagnosis in 2 cases of adenoidcystic ca and a case of mucoepidermoid ca. Thus the cytological sesitivity rate rose from 62.5% to 75.0%.
    6. FNAC (Fine Needle Aspiration Cytology) for salivary gland tumor is a useful diagnostic method, becase the differential diagnosis of benign or malignant tumor and suspicious diagnosis of histologic type are possible.
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  • Clinical Study of Squamous Cell Carcinoma of the Tongue
    Nobuaki HIRAKI, Masafumi YOSHIDA, Tsuyoshi UDAKA, Takashi MORIO, Naoki ...
    2002 Volume 95 Issue 12 Pages 1255-1260
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1255
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    Forty-five cases of carcinoma of the tongue were newly diagnosed and treated in our hospital of U. O. E. H between February 1990 and March 1999. The five-year survival rates were 71.8% overall, 100% for stage I, 79.4% for stage II, and 50% for stage III+IV.
    Prophylactic neck dissection was not performed in the clinically negative neck at our institution. As a result, cervical metastasis was not found in T1NO, but was found in 3 of 15 T2NO cases, and was not found in T3, T4NO cases. Therefore, we thought that prophylactic neck dissection was not necessary for T1NO carcinoma of the tongue or for most cases of T2N0 carcinoma of the tongue.
    However, we thought that further examination is necessary since our series is small, and many other reports have suggested prophylactic neck dissection.
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  • Retrospective Study of Treatment for Peritonsillar Abscess
    Shinya TAKANO, Keisuke MIYAJIMA, Eisaku SUGIURA, Hajime ARAMAKI
    2002 Volume 95 Issue 12 Pages 1261-1265
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1261
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    We reviewed the treatment of 86 patients with peritonsillar abscesses.
    We examined by m. a. whether the otolaryngological procedure and the antibiotics (cephems, penicillin, other f3-Ractums and clindamycin) used influenced the treatment period.
    We found that otolaryngological therapy is the best treatment for peritonsillar abscesses, especially incision and drainage. When aspiration is done, it is necessary to administer penicillin.
    Any intravenous antibiotics are effective for peritonsillar abscess after incision and drainage except for clindamycin alone.
    It is necessary to avoid clindamycin monotherapy, and to use clindamycin together with penicillin after aspiration.
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  • Pedunculated Tonsil of the Eustachian Tube
    Nobuhiro KONNO, Kohji ASAKURA, Atsushi TAIRA, Tetsuo HIMI
    2002 Volume 95 Issue 12 Pages 1267-1270
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1267
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    I report a 42-year-old female with a pendunculated tonsil. A Pedunculated tonsil usually arises from the palatine tonsil, rarely from epipharyngeal tissue. The tumor-like mass in this patient had originated from the juxta-orifice of the left eustachian tube. After surgical resection, histological examination revealed that it was composed of atrophic lymphoid follicles and was covered by a squamous epithelium with an underlying rim of fibrous tissue, without evidence of malignancy.
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  • Voice Therapy for Adductor Spasmodic Dysphonia
    Aki TAGUCHI, Masamitsu HYODO, Joji Kobayashi
    2002 Volume 95 Issue 12 Pages 1271-1275
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1271
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    Adductor spasmodic dysphonia is a phonatory disorder of uncertain etiology. Appropriate treatment for this disease remains controversial. Various surgical procedures have been reported including selective section of the recurrent laryngeal nerve branch, type 2 thyroplasty, TA myectomy and botulinum toxin injection into the thyroarytenoid (TA) muscle. Voice therapy has been introduced as a conservative therapy for the disease. We also treated four patients by voice therapy, and favorable results were obtained. The main therapeutic procedure was relaxation exercise. Two patients showed complete improvement after several months' treatment. Partial improvement was obtained in one patient. The post-treatment courses have been good in the 3 patients without recurrence. Although voice therapy requires long-term treatment, we suggest this approach should be considered when choosing of treatment for adductor spasmodic dysphonia.
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  • A Case of Multiple Schwannomas
    Tsunehisa OHNO, Mitsuharu NONOMURA, Tatsuo KIKUGAWA
    2002 Volume 95 Issue 12 Pages 1277-1280
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1277
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    We report a case of multiple schwannomas. A 51-year-old male complained of swelling in the regions of the right neck and the left poll. Preoperative MRI examination demonstrated two tumors in the regions of the right neck and the left poll, and a tumor at the left root of the tongue. We performed a modified method of intracapsular enucleation for the cervical tumors, and excised the tumor at the left root of the tongue. Histopathological diagnosis of all specimens was schwannoma. Postoperative palsy has not developed after surgery.
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  • Treatment of Bilateral Hypoglossal Nerve Transection
    Shigenori ODE, Shintarou YAMAGUCHI, Atsuyoshi TATSUMI, Tsuneo INOUE, K ...
    2002 Volume 95 Issue 12 Pages 1281-1285
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1281
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    Bilateral hypoglossal nerve transection is a rare complication of neck trauma because this injury generally results in death due to hemorrhage from a disrupted internal carotid artery or internal juglar vein. We report a case of bilateral hypoglossal nerve transection. The patient was 20-year-old man who suffered suprahyoid lacerations. He received emergency treatment, and two weeks after injury he underwent nerve grafting using the greaterauricular nerve on the right side and end to end anastomosis of the nerve on the left side. One and a half months after operation, weak tongue movement appeared. Two months after operation, he could move his tongue toward the right side. Three and a half months after operation, he could move his tongue toward the left side. One year after operation, he had good quality of life with out dysphagia or dysarthria.
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  • Laryngeal Tuberculosis
    [in Japanese], [in Japanese]
    2002 Volume 95 Issue 12 Pages 1286-1287
    Published: December 01, 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.1286
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  • Erratum to : Laser STAMP for the Treatment of Otoscierosis
    2002 Volume 95 Issue 12 Pages e1
    Published: 2002
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.95.12_e1
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