Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 96, Issue 11
Displaying 1-16 of 16 articles from this issue
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  • Deafness Genes and Ear Disease
    Ken Kitamura, Katsumasa Takahashi, Yuya Tamagawa, Yoshihiro Noguchi, H ...
    2003 Volume 96 Issue 11 Pages 939-947
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.939
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    The pathophysiology of sensorineural hearing loss, which is a common clinical disorder, remains to be determined. Many genes responsible for sensorineural hearing loss have been identified during the last decade, and the underlying mechanisms causing hearing loss have begun to be clarified due to recent developments in molecular genetics. In this review article, deafness genes are briefly described. We also presented our recent study of the histopathology of the temporal bone from a patient with MELAS (mitochondrial encephalopathy, lactic acidosis and stroke-like episodes) as well as quantitative analysis of mitochondrial DNA (mtDNA) mutation at nucleotide 3243 in the inner ear, and a new deafness gene (sans) identified in the Jackson shaker mouse.
    To date, 51 autosomal dominant, 39 autosomal recessive, and 8 X-linked nonsyndromic sensorineural hearing impairment loci have been mapped and 34 genes have been identified. Histopathological examination of the temporal bone from a patient with MELAS demonstrated severe degeneration of the stria vascularis and degenerative changes in spiral ganglion cells. Quantitative DNA studies showed high amounts of mutant mtDNA in the inner ear. The Jackson shaker (js) mouse carried a recessive mutation causing phenotypes such as deafness, abnormal behavior (circling and/or head-tossing) and degeneration of inner ear neuroepithelia. Two alleles have been identified to date, the original js and jsseal. A gene encoding new scaffold-like protein Sans was identified to show mutations in the two js mutants. Sans were highly expressed in the inner and outer hair cells of the cochlea, where abnormalities are found in js mice. The Sans protein was expected to mediate protein-protein interactions with cytoskeletal structures that might be involved in signal transduction in the cochlear hair cells. Mutations of SANS in the human ortholog were demonstrated to cause Usher 1G syndrome.
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  • Monopolar Electric Knives during Lobectomy of the Parotid Gland
    R. Kawata
    2003 Volume 96 Issue 11 Pages 948-949
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.948
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  • Myringoplasty by Under-Lay Method with Fibrin Glue
    Hiroyuki Yamada, Ryoji Ishida, Shin-ichiro Nishii
    2003 Volume 96 Issue 11 Pages 951-954
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.951
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    Myringoplasty by the under-lay method was performed in 74 ears with the perforation of the tympanic membrane in our hospital from 1997 to 2002. Three had traumatic perforations, 11 had residual perforations after insertion of tympanic drain and/or myringotomy, and 60 had simple chronic otitis media among the treated ears. The postoperative closure rate was 96.9% in Grade I perforation, 90.6% in Grade II perforation, 75.0% in Grade III perforation, and only one ear with Grade IV perforation was closed after myringoplasty. We succeeded in hearing gain at a rate of 73.0% in 74 ears.
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  • Clinical Statistics on Nasal Injury
    Yoshimi Miyajima, Hiroyuki Fukunaga, Tadashi Nakashima
    2003 Volume 96 Issue 11 Pages 955-958
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.955
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    More than 100 patients visit Aso Iizuka Hospital every year with injury to the nose. During a period of 3 years between January 1, 1998 and December 31, 2000, 266 patients visited the E. N. T. clinic of the hospital suffering from nose injuries. In this study we analyzed the age distribution of the patients, the season and the cause of injury, complications, symptoms and time delay before visiting the clinic after injury. In each patient, nasal fracture was detected by the Water's view, Okamoto's view and lateral soft roentgenograms.
    There were patients with nasal injury in all age groups but there was a marked predominance in the age group from 10 to 19. The nasal injuries occurred most frequently in June and December. The causes of the trauma were accidents at home, traffic accidents, assaults, sports and others. Most of the patient visited the emergency room of the hospital on the same day they were injured. Complicated bone fractures with nasal injury were 21 orbital floors, 8 zygomas and maxillas, 4 skulls, 2 mandibles and 7 others. The most common symptoms accompanying nasal injury were deformity, nasal pain and epistaxis, and roentgenograms revealed nasal fracture in 127 of 266 patients. Injury occurred most frequently in the early summer and at the end of the year, possibly because of the influence of sports and drinking. Many of the patients visited the emergency room, because the injuries frequently occurred in the evening. As treatment, early reduction of the nasal fracture brought satisfactory results without open surgery.
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  • Adenoid Cystic Carcinoma of the Sphenoid Sinus; Report of a Case
    Rika Kohanawa, Keiji Tabuchi, Hideki Okubo, Kazuhiko Takahashi, Hiroak ...
    2003 Volume 96 Issue 11 Pages 959-962
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.959
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    A case of adenoid cystic carcinoma of the sphenoid sinus is reported. The patient was a 38-year-old male presenting with diplopia. Computed tomography (CT) scan revealed a tumor originating from the sphenoid sinus and invading to the orbital apex and the cavernous sinus. Histological examination using specimens taken in an exploratory sphenoidectmy revealed adenoid cystic carcinoma. The patient died of disease approximately 3 years after radiotherapy at a dose of 60Gy.
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  • A Case of Mucoepidermoid Carcinoma in the Maxillary Sinus
    Kazuo Sakurai, Toshiko Mamiya, Hisayuki Kato, Katsuhiko Komori, Shouji ...
    2003 Volume 96 Issue 11 Pages 963-967
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.963
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    A case of mucoepidermoid carcinoma in the maxillary sinus is reported. The patient was an 88-year-old female who complained of swelling of the left cheek. CT scan showed a low density tumor mass in the left maxillary sinus, and the tumor infiltrated into the hard palate. Histopathological examination revealed a high grade mucoepidermoid carcinoma. Although partial maxillectomy performed, she relapsed with a lesion in the maxillary sinus 6 months after the operation. We performed radiotherapy for a total of 50Gy, and the relapsed tumor disappeared completely after irradiation. However, she died of bone metastasis 12 months after radiotherapy.
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  • Small Cell Carcinoma of the Parotid Gland
    Masahiro Matsui, Saburo Mimaki, Yumiko Imamura, Masataka Murakami
    2003 Volume 96 Issue 11 Pages 969-973
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.969
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    There are many kind of malignant tumors in the parotid gland. Mucoepidermoid carcinoma, adenocarcinoma, adenoid cystic carcinoma are common. Small cell carcinoma in the parotid gland is a rare malignant tumor. However, there are two forms of small cell carcinoma that can affect this gland: Small cell ductal carcinoma and small cell neuroendocrine carcinoma. Here we report the latter type. A 54-year-old female consulted our hospital with a mass in the left anterior parotid gland region. The result of fine needle aspiration at the initial medical examination demonstrated class II. So we followed this tumor without surgical treatment. After 8 month's observation, extirpation of the tumor was performed. Pathological examination confirmed the diagnosis of small cell carcinoma. Immunohistochemical studies of the specimen confirmed a diagnosis of small cell neuroendocrine carcinoma because NSE was positive. Therefore, radiotherapy was performed post operatively. There has not been any evidence of recurrence since the last treatment.
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  • A Case Report of Granular Cell Tumor in the Inferior Auricular Lesion
    Kaoru Okumura, Tsuyoshi Kitanishi, Fumito Itoh, Hohmei Suga
    2003 Volume 96 Issue 11 Pages 975-978
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.975
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    Granular cell tumor (GCT) is a relatively uncommon soft tissue tumor first described by Abrikossoff in 1926. In this report, we present one case of granular cell tumor in the inferior auricular region. A 54-year-old female complained of left subaural mass and enbloc resection was performed. Histopathological features of the specimen included proliferation of large, polygonal cells with an eosinophilic granular cytoplasm in the dermis and subcutaneous tissue. Immunohistochemically, the tumor cells were positive for S-100 protein, and this tumor is thought to derive from Schwann's cell. The boundary between the tumorous and non-tumorous part was indistinct since the tumor cells invaded into adjacent connective tissue. The treatment of choice is radical resection with clear surgical margins. To rule out late recurrences, patients should be followed by annual physical examinations.
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  • A Case of Hypopharyngeal Lipoma with Papillary Carcinoma of the Thyroid Gland
    Kazuhiko Nario, Hiroshi Miyahara, Hiroshi Kajikawa
    2003 Volume 96 Issue 11 Pages 979-982
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.979
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    We reported a rare case of lipoma in the hypopharynx with thyroid carcinoma. A 49-year-old man complaining of pharyngeal discomfort and feeling of dyspnea was referred to our hospital. Fiberscopy demonstrated a smooth mass arising from the posterior wall of the hypopharynx. He also demonstrated an elastic-hard mass in the left thyroid gland. Computed tomography (CT) and magneteic resonance imaging (MRI) demonstrated a well circumscribed mass in the hypopharynx. Under general anesthesia, hypopharyngeal tumor was excised by lateral pharyngotomy not by rigid esophagoscope. Because of difficulties in distinguishing between lipoma and liposarcoma preoperatively, we chose lateral pharyngotomy. At the same time, we performed hemithyroidectomy with neck dissection. There has been no sign of recurrence over a two-year follow-up period.
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  • Antibiotics Therapy for Acute Bacterial Tonsillitis
    Shinya Takano, Hideki Kurihara
    2003 Volume 96 Issue 11 Pages 983-987
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.983
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    We reviewed the treatment of 96 patients with acute bacterial tonsillitis.
    Using multivariate analysis, we examined whether oral or intravenous administration of antibiotics (cephems, penicillin, other β-lactams, tetracycline, clindamycin, new quinolones, and macrorides) had an influence on the treatment period.
    We found that the best class of oral antibiotics for acute bacterial tonsillitis was cefcapene pivoxil (CFPN-PI) and the best intravenous agent was sulbactum/cefoperazone (SBT/CPZ).
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  • Using a Questionnaire to Diagnose Sleep Apnea Syndrome
    Mutsumi Kenmochi, Shigeki Sato, Yasuhiko Tanaka, Hirohito Nishino, Shi ...
    2003 Volume 96 Issue 11 Pages 989-994
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.989
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    We used a questionnaire to study sleep apnea syndrome (SAS) in 53 patients (46 males and 7 females) who were referred to our hospital complaining of sleeping disturbance, then the relationship between questionnaire-rated SAS score and factors, such as sex, age and obesity, and Epworth sleepiness scale was investigated. Overnight changes in questionnaire ratings and in the degree of apnea as examined using polysonography (PSG) and SpO2 were recorded. There was a statistically significant correlation between apnea-hypopnea index and SAS score, whereas there was no significant correlation between SpO2 level and SAS score. We conclude that our questionnaire can be used to diagnose SAS.
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  • A Case of Fungal Infection of the Larynx Requiring Differential Diagnosis from Laryngeal Carcinoma
    Naotaka Aizawa, Katsuro Sato, Masahiro Kawana, Naobumi Nonomura, Sugat ...
    2003 Volume 96 Issue 11 Pages 995-998
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.995
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    A case of fungal infection of the larynx requiring differential diagnosis from laryngeal carcinoma is reported. A 75-year-old male was referred to our clinic with a complaint of hoarseness, and a mass lesion was detected on the left vocal cord. Biopsy under laryngeal fiberscopy was performed on suspicion of laryngeal carcinoma. Resection and vaporization of the lesion was carried out using a KTP laser, because the intraoperative histopathological diagnosis was dysplasia. The final histopathological diagnosis was revised to dysplasia with an infection of Aspergillus. Additional therapy for the fungal infection was not performed, but no reccurence was seen for 3 years after surgery. The post-vaporization lesion on the vocal cord was covered with intact mucosa. KTP laser was found to be effective in this case.
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  • A Rare Case of Kimura's Disease of the Epiglottis Treated with Herbal Medicine “Saibokutoh”
    Akihiro Tasei, Toshiyuki Tsutsumi, Yuzo Shimode, Aya Itoi, Hideo Matsu ...
    2003 Volume 96 Issue 11 Pages 999-1004
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.999
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    A 72-year-old female with Kimura's disease in the epiglottis is reported. Although the patient was initially treated for epiglottitis, eosinophilic granuloma (Kimura's disease) was finally diagnosed by tissue biopsy. After consideraing the side effects of prolonged steroid usage an herbal medicine, “Saibokutoh”, was administered concurrently to relieve effects and facilitate weaning from steroid treatment. Local findings demonstrated a good condition without any change in lesion size and without complaints from the patient. Herbal Medicine seems to be useful as a steroid substitute when it is necessary administer steroids for a prolonged period.
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  • A Case of Bronchogenic Cyst with Dextrocardia
    Koji Miyata, Tomoya Nagata
    2003 Volume 96 Issue 11 Pages 1005-1008
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.1005
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    We report a case of bronchogenic cyst with dextrocardia. A 55-year-old male visited our hospital with a complaint of right parotid gland tumor. Dextrocardia had previously been detected. A cytic mass in the upper mediastinum was incidentally found at the time of computed tomography examination, but the patient did not complain of any symptoms.
    Operations for the parotid gland tumor and the mediastinal mass were performed and the cystic mass in the upper mediastinum was removed without any complications. At the time of closure of the wound, an ectopic cartilage mass was found in the cervical subcutis and removed. Histopathological examination identified the parotid gland tumor as Warthin's tumor and the cystic mass as a bronchogenic cyst.
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  • Development of a Micropump for the Treatmet of Otitis Media with Effusion
    Kiyomi Kawano, Mikiko Takayama, Tetsuo Ishii
    2003 Volume 96 Issue 11 Pages 1009-1016
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.1009
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    For the treatment of otitis media with effusion, aspiration of fluid through a suction tube is conventionally performed after puncture or myringotomy. However, hypertrophy scars and sclerosis of the tympanic membrane can occur when the radial fiber bundles are cut by myringotomy. It is also very difficult to aspirate the hyperviscous fluid. We thus developed a micropump for use with a small caliber needle to avoid unnecessary injuries to the tympanic membrane. It is also equipped to mechanically transport viscous fluid.
    The micropump is composed of a motor and needle to puncture the tympanic membrane. Two spiral helical wires inside the needle which are connected to the airspindle (first model) or electric (second model) rotation machine rotate to remove even highly viscous fluid. We used standard viscosity oil to test the relationship between the viscosity of fluid and removal speed. We found that the faster the rotation, the quicker the removal of fluid, independent of viscosity. We confirmed the clinical usefulness of the new micropump and needle system for otitis media with effusion because the puncture needle is fine enough to perform a minimally invasive puncture of the tympanic membrane.
    We treated 16 patients (19 ears) with otitis media with effusion using this electric micropump between October 2000 and April 2001. In 15 ears, effusion was removed successfully, in 2 ears, we almost totally removed the effusion with very little residual fluid, and in 2 ears we could not remove the effusion due to the extremely high viscosity.
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  • The Therapeutic Efficacy of IPD® for Patients with Pollinosis due to Japanese Ceder
    Toshihisa Ito, Shigeharu Fujieda, Yuichi Kimura, Hideyuki Yamamoto, Ak ...
    2003 Volume 96 Issue 11 Pages 1017-1021
    Published: November 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.1017
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    The effect of IPD® (suplatast tosilate) is known to suppress the activity of cytokine production from type 2 helper T cells and IgE. We clinically evaluated the combined efficacy of IPD® and anti-histamine for patients with pollinosis before or during the pollen season. The clinical outcome and quality of life (QOL) score of pollinosis patients were assessed every 2 weeks. The QOL score of the group receiving IPD® and anti-histamine increased significantly compared with that of the group receiving only anti-histamine IPD®. These results suggest that combined therapy with IPD® increases the level of satisfaction with pollinosis treatment.
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