Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 96, Issue 1
Displaying 1-18 of 18 articles from this issue
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  • Applying Evidence Based Medicine to Clinical Otolaryngology
    Juichi Ito
    2003 Volume 96 Issue 1 Pages 1-5
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.1
    JOURNAL FREE ACCESS
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    Evidence Based Medicine (EBM) is a term widely used among practitioners of clinical medicine. Furthermore, the Ministry of Health and Labour Welfare has strongly supported the use of EBM in day clinics since 1998.
    The Ministry established guidelines based on EBM for 47 common diseases. In the field of Otolaryngology, nasal allergy, otitis, and chronic sinusitis were included in this guideline. The process of evaluating clinical evidence in medical research papers is as follows. 1) Areas of uncertainty in day clinic practice are determined. (Doubts or reservations among day clinic practitioners are addressed) 2) Medical research papers are carefully studied and referred for confirmation. 3) Each paper is evaluated according to the standard of evidence considered appropriately by the Agency for Health Care Policy and Research (AHCPR). 4) Clinical evidence is analyzed, and treatment is adapted for Japanese patients.
    After rigorous evaluation of clinical evidence, it has become possible to set guidelines for the treatment of certain diseases.
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  • Spontaneous Hemorrhage of the Larynx; A Case Report
    M. Takahashi, [in Japanese], [in Japanese]
    2003 Volume 96 Issue 1 Pages 6-7
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.6
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  • A Case of Anti-phospholipid Syndrome Presenting Unilateral Sensorineural Hearing Loss
    Hayabusa Nozawa, Isamu Kunibe, Mitsuru Yanai, Akihiro Katada, Tatsuya ...
    2003 Volume 96 Issue 1 Pages 9-13
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.9
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    Anti-phospholipid syndrome (APS) was first reported by Harris in 1985 as one of a variety of clinical features associated with episodes of arterial or venous thrombosis. We report a rare case of acute sensorineural hearing loss due to APS. A 40-year-old woman complained of acute sensorineural hearing loss. She had been diagnosed with APS because of positivity for serum anti-phospholipid antibody and 3 episodes of natural abortion. The hearing loss was improved by treatment with predonisolone, but after 4 months, hearing loss recurred. Since she refused steroid therapy and anticoagulation therapy, continuous administration of aspirin was performed. Six months later, her hearing had recovered. If a patient presents with sudden sensorineural hearing loss, it is important to suspect APS and inquire into histories such as thrombosis and recurrent abortion.
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  • A Case of Parathyroid Adenoma with Sudden Deafness and Vertigo
    Takeshi Nishio, Shigenobu Yasuda, Kaichiro Ikebuchi, Tatsuyuki Fukushi ...
    2003 Volume 96 Issue 1 Pages 15-19
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.15
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    It is generally reported that parathyroid adenoma is relatively rare. However, we can easily diagnose hyperparathyroidism including asymptomatic due to the development of measurement of serum calcium and PTH. The authors have experienced a case of primary parathyroid adenoma with deafness and vertigo. A 71-year-old male developed sudden deafness with vertigo and treated under hospitalization. He was found to have hypercalcemia on laboratory examinations during a search for the cause of vertigo. Further examinations such as serum PTH and Tc-MIBI scintigraphy indicated a parathyroid tumor. Extirpation of parathyroid tumor was performed and a high level of serum PTH and calcium decreased to the normal range post operatively. Moreover, vertigo did not recur thereafter.
    The authors reviewed four cases of deafness or vertigo with hypercalcemia reported in the Japanese literature. Relationship between hypercalcemia and internal ear function is discussed.
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  • Operation for van der Hoeve Syndrome
    Masaki Matsunaga, Men-dar Wu, Masaaki Sumiya, Syuntaro Inagawa, Takao ...
    2003 Volume 96 Issue 1 Pages 21-24
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.21
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    Van der Hoeve syndrome is a hereditary disease which has three symptoms: blue sclera, hearing loss and osteogenesis imperfecta. The symptoms are caused by the obstruction of collagen synthesis, and there are many possible complications in surgery for this disease. We report a case of van der Hoeve syndrome treated by partial stapedectomy of unilateral ear.
    In operative findings, it showed an otosclerotic lesion along with the stiffening and fixation of the stapes footplate on the oval window. In postoperative audiogram, the air-bone gap in the main speech frequency range was down to 20-30dB, however there were no improvements in the bone conductive thresholds as compared to preoperation.
    This result indicates that stapes surgery in van der Hoeve syndrome is useful for hearing enhancement.
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  • Foreign Bodies in the Auditory Tube; A Case Report
    Itomi Nishijima, Sayoko Goto, Yukie Yamamura, Michiko Sato, Akio Shino ...
    2003 Volume 96 Issue 1 Pages 25-27
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.25
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    A case of a foreign body in the auditory tube is reported. A 1-year-old female ate a leaf of sawara (Japanese False Cypress) accidentally. There after, her mother tried to make her vomit it. The girl vomited bloody saliva, and she was brought to emergency section of the hospital. Pediatricians found the leaf of the sawara in the epipharynx. Most of the leaf was removed, but parts of the leaf remained in the right pharyngeal ostium of the auditory tube. The infant was admitted to our hospital, and the foreign particles were removed completely under general anesthesia. Postoperative course was uneventful. Foreign bodies in the auditory tube are extremely rare. Only six cases have been reported in the Japanese literature.
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  • A Case of Lyme Disease with Facial Nerve Palsy
    Masaaki Adachi, Kazumi Yoshino, Yoshiya Ishida, Yusuke Abe, Nobuyuki B ...
    2003 Volume 96 Issue 1 Pages 29-32
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.29
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    Lyme disease is an infection transmitted by ticks and caused by spirochete Borrelia burgdorferi. This disease is a complex multiple organ disorder with neurological complications. We encountered a case of Lyme disease with left facial palsy as a form of neuroborreliosis and report the case here. A 35-year-old man consulted our hospital complaining of left facial palsy following a tick bite with localized erythema migrans and positivity of serum anti-Borrelia burgdorferi antibody indicating a diagnosis of neuroborreliosis. He was treated with antibiotics (intravenous ceftriaxon and piperacillin following oral minocycline) and prednisolone for 22 days. After therapy, he made a complete recovery from the disease.
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  • Massive Epistaxis due to Rupture of Non-Traumatic Carotid Aneurysm
    Akihiro Sakai, Hironobu Goto, Muneki Hotomi, Kazuya Kinosita, Keiji Fu ...
    2003 Volume 96 Issue 1 Pages 33-36
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.33
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    A case of massive epistaxis due to rupture of non-traumatic aneurysm of the internal carotid artery (ICA) is reported. A 51-year-old male developed severe, recurrent epistaxis. The bleeding site was not found by routine examination, but carotid angiography demonstrated an aneurysm in the cavernous portion of the right ICA that apparently ruptured into the sphenoid sinus. Thus, the diagnosis of epistaxis due to intracavernous carotid aneurysm was confirmed. The patient was treated by intravascular obliteration with a Gugielmi detachable coil and has been followed up for over 1 year with no further epistaxis.
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  • A Study of Nasal Epithelial Changes; A Clinical Evaluation by Eosin Stain Test
    Kazuto Nagata
    2003 Volume 96 Issue 1 Pages 37-44
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.37
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    (1) In a pathological study using the eosin stain test on nasal abnormalities in 343 out patient clinic patients from October 1997 to April 1998 a period in which pollen epidemics were not prominent, eosinophilic cells were not always found (60%) in allergic rhinitis or allergic sinusitis. In both diseases the color of the stained background was purple-pink to purple. Otherwise, in sinusitis the color was pink. (2) Ciliated columnar cells had a tendency to form clusters in allergic rhinitis and allergic sinusitis. Otherwise in sinusitis not clustered. (3) These findings show that nasal ciliated columnar cells behave like a kind of sensor of the nasal environment.
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  • Atempt of Endoscopic Manipulation of Parotid Sialolithiasis
    Mutsumi Kenmochi, Kentarou Ochi, Toru Ohashi, Hirohito Nishino, Shiger ...
    2003 Volume 96 Issue 1 Pages 45-50
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.45
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    Sialolithiasis is an obstructive salivary disease, that usually occurs in the submandibular gland. Sialolithiasis of the parotid gland is relatively rare. We encountered two cases of sialolithiasis in the parotid gland and attempted a minimally-invasive approach by sialendoscopy. In this study we used two kind of fiberscopes for the sialendoscopy: one was the rigid type, 1.7-mm outer diameter (OD) without a working channel, and the other was the flexible type, 2.8-mm OD with a working channel. In terms of size, the former was more appropriate for sialendoscopy than the latter. However, the working channel was important for examination of the stensens duct and for treatment. Treatment was not performed, however, because in the first case the parotid stone was extracted unintentionally by the rigid endoscope during examination, and in the second case the stone dislodged by itself. We suggest that sialendoscopy is a useful approach. It is minimally-invasive, easy, inexpensive and presents a low patient burden.
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  • A Case of Huge Epulis Osteoplastica
    Kenichiro Nomura, Tatsuya Hayashi, Isamu Kunibe, Toshihiro Nagato, Kan ...
    2003 Volume 96 Issue 1 Pages 51-55
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.51
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    A case of a huge epulis arising in the gingiva of a mandible is reported. The patient was a 59-year-old man whose oral cavity was filled with a huge tumor. His condition was complicated with dysphagia and dyspnea, so we needed to perform tracheotomy. The tumor was so large and growing so rapidly that we suspected at first that it was a malignant tumor. But histopathologically it was diagnosed as epulis osteoplastica.
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  • A Case of Basaloid Squamous Cell Carcinoma of Oropharynx
    Tetsuya Murakawa, Tetsuya Tanabe, Yasuhiro Murata, Yukihide Isoda, Hit ...
    2003 Volume 96 Issue 1 Pages 57-61
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.57
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    Basaloid squamous cell carcinoma (BSCC) is characterized by an aggressive nature and typical pathological features. BSCC is a very aggressive malignancy and the prognosis is very poor because most cases develop both lymph node metastasis and distant metastasis. BSCC is a bimorphic variant of squamous cell carcinoma with distinct morphological features and the differential diagnosis is difficult. We reported a rare case of basaloid squamous cell carcinoma of oropharynx. A 67-year-old woman complained of dysphagia for three years and an oral mass was detected. Three years later the mass has elevated, and she had developed dyspnea at night. We suspected an oral tumor arising from the base of tongue. We performed a biopsy of the oral mass, which suggested inverted papilloma. Laryngoscopic examination could not determine the structure of the larynx except the vocal cord. We attemped to resect the tumor, but it bled easily, so we performed tumor reduction surgery. The final pathological diagnosis based on the surgically resected specimen was BSCC. The patient declined radical surgery, so we performed chemoradiotherapy. The tumor decreased and dyspnea disappeared, but six months after the treatment, lung metastasis was found. We performed chemotherapy and the metastatic lesion decreased. The patient is currently surviving with carcinoma, and her quality of life has improved. She has currently survived 32 months since the initial diagnosis.
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  • Cervical Lymph Node Recurrence after Curative Radiation Therapy in Early Laryngeal Cancers
    Tomoko Tateya, Kazuhiko Shoji, Shin-ichi Takagita, Shinji Suzuki, Yasu ...
    2003 Volume 96 Issue 1 Pages 63-66
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.63
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    One hundred and thirty-three patients with early laryngeal cancer received curative radiation therapy at Tenri Hospital from 1983 to 2000. Four patients (3%) experienced cervical lymph node recurrence and had their primary tumor controlled. They underwent salvage treatment including neck dissection. Two of them later had local recurrence and underwent total laryngectomy, which was unsuccessful in one case. The others have been disease-free after salvage treatment. We conclude that cervical lymph nodes recurrence does not indicate total larygectomy at that time if the primary site is clinically disease-free.
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  • Chemotherapy for Stage IV Oral and Oropharyngeal Cancer
    Keiji Tabuchi, Tetsuro Wada, Masamitsu Senarita, Hideki Okubo, Kazuhik ...
    2003 Volume 96 Issue 1 Pages 67-71
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.67
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    Present study evaluated the effect of chemotherapy on the survival of patients with advanced oral or oropharyngeal cancer. A total of 51 patients with a stage IV squamous cell carcinoma of the oral cavity or oropharynx (40 males and 11 females), treated at the University of Tsukuba Hospital from 1988 to 2001, were included in the study. Nineteen patients were treated by full-dose irradiation and 32 patients underwent surgery after radiotherapy. Chemotherapy consisting of cisplatin (50-80mg/m2) or carboplatin (300mg/m2) followed by administration of fluorouracil (500mg/body) or peplomycin (5mg/body) for 5 days was given to 25 patients. The effect of chemotherapy on disease-free survival rate was of slight significance (0.05<p<0.1). The approach using chemotherapy for advanced oral or oropharyngeal cancer warrants further investigation.
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  • Two Cases of Squamous Cell Carcinoma of the Head and Neck with Concurrent Non-Hodgkin Lymphoma
    Shintaro Satoh, Aya Kakizoe, Masabumi Uchida, Seiichiro Hayashida, Jun ...
    2003 Volume 96 Issue 1 Pages 73-78
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.73
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    Two patients with squamous cell carcinoma of the head-and-neck with concurrent non-Hodgkin lymphoma were reported. One patient was a 77-year-old man, he had well differentiated squamous cell carcinoma of the oropharynx with neck metstasis, and non-Hodgkin's lymphoma (REAL classification: Peripheral T-cell lymphomas, unspecified) of the neck lymph nodes simultaneously. The other patient was a 61-year-old man, he had well diffrentiated squamous cell carcinoma of the vocal cords, and non-Hodgkin's lymphoma (REAL classification: Mantle cell lymphoma) of the palatine tonsil simultaneously. Double primary malignant tumors composed of squamous cell carcinoma of the head-and-neck and malignant lymphoma are relatively rare, especially those detected simultaneously are very rare.
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  • A Case Presenting Hepatic Dysfunction Caused by Ensure Liquid®
    Masami Suzuki, Satoshi Katayama, Ken Kitamura, Norihiko Ishikawa, Seij ...
    2003 Volume 96 Issue 1 Pages 79-82
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.79
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    A 72-year-old male patient with tongue carcinoma was admitted because he could not eat due to intense lingual pain. We prescribed Ensure Liquid®, an enteral nutritional medication, for feeding control and morphine hydrochloride for pain control. His temperature became elevated to 39 degrees three days later, and hepatic function deteriorated. Morphine hydrochloride was continued due to the necessity for pain control, and only Ensure Liquid® was discontinued. Hepatic dysfunction and fever improved after discontinuing administration of Ensure Liquid®. This clinical course suggested that the hepatic dysfunction and fever were caused by side effects of Ensure Liquid®. Although the amount of Ensure Liquid® prescribed for the patient was within the normal standards, his liver function was suggested to be inadequate for metabolizing the medication.
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  • 2002 Survey of Airborne Pollen in Wakayama City with a Real-Time Pollen Counter (KH-3000)
    Satoshi Seno, Tadao Enomoto, Yoshihiro Dake, Hiroki Ikeda, Takema Sako ...
    2003 Volume 96 Issue 1 Pages 83-90
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.83
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    We studied the usefulness of a real-time pollen counter (KH-3000, Yamato Manufacturing Co. Ltd.).
    Airborne pollen was measured with a Durham pollen counter and a KH-3000 from February 1, 2002 to April 30, 2002 in Wakayama city, and the results were analyzed and compared with each other statistically. We took account of the influence of weather conditions on the results. In addition, a characteristic of circadian rhythm of airborne pollen was examined.
    The features of the pollen scatter pattern in 2002 were as follows: The counts for Japanese cedar pollen and Japanese cypress pollen were smaller than the average year. The Japanese beech pollen count was larger than the average year. Correlations between the outcomes of the 2 pollen counters were r=0.65 for Japanese cedar pollen and r=0.61 for the total pollen, except pine pollen.
    The circadian rhythm of the airborne pollen observed with the KH-3000 did not correlated significantly to temperature, humidity, atmospheric pressure or wind velocity. However, a tendency did emerge: on a clear day, a large amount of pollen was observed in the evening and at night. On a cloudy day, no obvious peak of pollen dispersion was observed in a day. On a rainy day, a large number of pollen was observed before the start of rainfall, but no pollen grains were observed during the rain. No pollen was observed on snowy days, however unexpected peaks were recorded that were not related to the pollen count. The peaks were thought to be caused by snow.
    We concluded that the KH-3000 is a useful device for measuring pollen, however, the Durham pollen counter presently used is still needed to measure pollen, because the operation of the KH-3000 was influenced by weather: it could not distinguish pollen from snow. Our findings suggest the circadian rhythm of airborne pollen depends on the weather.
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  • Diagnosis and Treatment of Spontaneous Cerebrospinal Fluid Otorrhea
    K. Gyo
    2003 Volume 96 Issue 1 Pages 92-93
    Published: January 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.92
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