Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 96, Issue 4
Displaying 1-17 of 17 articles from this issue
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  • Treatment of Abnormal Facial Movement with Selective Facial Nerve Block Using Doxorubicin (Adriamycin) under Local Anesthesia
    Mitsuru Furukawa, Makoto Ito
    2003 Volume 96 Issue 4 Pages 293-299
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.293
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    Objective: To describe our experience with adriamycin (ADM) selective chemical rhizotomy of facial nerves in a patient with hemifacial spasm (HFS) who refused neuro-vascular decompression surgery. This unique technique was less invasive than intracranial neuro-surgery. It was possible to perform a permanent nerve block under local anesthesia.
    Case report: The patient, a 73-year-old female, had difficulty opening her left eye due to HFS. After treatment with antiepileptic medicine (carbamazepine) was ineffective, the patient received selective intraneural injections of ADM under local anesthesia. One week after the surgery, the spasms had disappeared completely and slight muscle weakness was observed. No major complications were caused by this procedure and no recurrence of spasms was observed two years after the surgery.
    Main outcome: It is thought that recurrence of HFS should be observed after simple neurotomy due to re-growth of nerve fibers. However, this did not occur after selective ADM chemical rhizotomy of facial nerves. This method clearly differs from previously used methods of simple neurotomy because simple neurotomy does not cause severe destructive change in the facial motor nucleus.
    Conclusion: We conclude that selective facial nerve chemical rhizotomy with ADM under local anesthesia may be effective in treating a subgroup of patients with HFS, especially elderly patients and those in high risk groups for general anesthesia and intra cranial neuro-vascular decompression surgery.
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  • The Reconstruction by Platysma Myocutaneous Flap
    S. Fujieda, [in Japanese]
    2003 Volume 96 Issue 4 Pages 300-301
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.300
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  • Bilateral Facial Nerve Palsy due to Adult T cell Leukemia/Lymphoma
    Shin-ichiro Kitajiri, Tsuyoshi Endo, Chihisa Ushijima, Hiroki Watanabe ...
    2003 Volume 96 Issue 4 Pages 303-307
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.303
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    We report a case of bilateral facial nerve palsy caused by adult T cell leukemia/lymphoma (ATLL). A 51-year-old female consulted our department because of right facial palsy. Steroid therapy was performed, and her right facial palsy was recovered. However, sixteen days after the onset of right facial palsy, left facial palsy developed. She was diagnosed as having ATLL based on blood examination. Chemotherapy was performed but the patient died two months later.
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  • Two Cases of Simultaneous Bilateral Idiopathic Facial Nerve Palsy
    Satoko Namiki, Hideki Takegoshi, Shigeru Kikuchi
    2003 Volume 96 Issue 4 Pages 309-312
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.309
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    We report two cases of simultaneous bilateral idiopathic facial nerve palsy.
    About one month of treatment mainly with corticosteroid therapy brought about complete cure of the paralysis bilaterally in both cases. Bilateral simultaneous facial nerve palsy is an extremely rareillness. While idiopathic facial nerve plasy is the most common diagnosis, a comprehensive evaluation must be completed prior to this diagnosis in patients with bilateral facial nerve palsy.
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  • A Case of Actinomycosis of the Tongue
    Kenichiro Nomura, Tatsuya Hayashi, Kan Kishibe, Isamu Kunibe, Satoshi ...
    2003 Volume 96 Issue 4 Pages 313-316
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.313
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    Actinomycosis is an infectious disease that can involve the cervicofacial region, however infection of the tongue is extremely rare. We report a 44-year-old man with poorly controlled diabetes mellitus who developed actinomycosis of the tongue. He complained of odynophagia and pain of the tongue which demonstrated thick fur over the median ulcer. The lesion was diagnosed actinomycosis of tongue based on typical histopathological findings.
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  • Retrospective Study of Patients with Squamous Cell Carcinoma of the Tongue Treated at Our Department
    Kyoichi Terao, Kazunori Mori, Takeshi Kusunoki, Mutsukazu Kitano, Masa ...
    2003 Volume 96 Issue 4 Pages 317-322
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.317
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    One hundred twenty-four previously-untreated patients treated for squamous cell carcinoma of the tougue from 1975 (opening of the department) through 2000 at our department were retrospectively reviewed. The mean age of the patients was 58.8 years (28-88 years), and the ratio of male to female was 1.9:1. Clinical stage I, II, III and IV was noted in 22 (17.7%), 44 (35.8%), 28 (22.6%) and 30 (24.2%) of the patients, respectively. Thirty-one (25%) had received mainly radiation therapy and 93 (75%) had been treated by surgery. The overall 5-year survival rate was 51.0% by the Kaplan-Mayer method, (clinical-stage I: 80.0%, stage II: 52.7%, stage III: 59.6%, stage IV: 12.0%). The most common death cause was lymph node metastasis, in 25 of 43 patients, 58.1%. We selected neck dissection by T classification. We suggested that patients with tumors over T2 should undergo elective neck dissection, and those with lymph node metastasis over 3 should undergo adjuvant therapy.
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  • Recurrent Pleomorphic Adenomas of the Parotid Gland
    Sayoko Goto, Toshio Yoshihara, Akio Shino
    2003 Volume 96 Issue 4 Pages 323-328
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.323
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    Three hundred and eleven parotid tumors were excised in our hospital between January 1989 and March 2002. The clinical courses, pathological findings and methods of therapy in 11 patients with recurrent pleomorphic adenomas of the parotid gland are presented.
    Of these 11 patients, 4 were male and 7 were female. The interval to first recurrence was 5-30 years. Six were first recurrent cases, 3 were second recurrent cases and 2 were third recurrent cases. Four were single recurrent tumors and 7 were multiple recurrent tumors. The initial pathogical diagnosis was pleomorphic adenoma in all 11 cases, however, 2 cases showed malignant changes: one was mucoepidermoid carcinoma, and the other was adenocarcinoma. Surgery was performed in all cases: 6 were partial parotidectomy, 3 were total parotidectomy, and 2 were tumor resection. Post operatively, one case showed facial paresis, but this case has almost completely recoverd at present. There was neither evidence of Frey's syndrome nor recurrence in any of the 11 cases post operatively.
    Recurrent pleomorphic adenomas of the parotid gland may occur in the following cases: 1) cases receiving tumor enucleation, 2) cases with rupture of the capsule during surgery, or 3) cases in which myxoid stroma predominates in the tumor.
    The appropriate treatment for recurrent pleomorphic adenoma is complete resection. Therefore, we must make an exact preoperative evaluation of the parotid region by CT and MRI image.
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  • Accuracy of Diagnosis Based on Clinical Symptoms in Pediatric Obstructive Sleep Apnea Hypopnea Syndrome
    Takeshi Morita, Kyosuke Kurata, Nobuya Fujiki, Yasuyuki Hiratsuka
    2003 Volume 96 Issue 4 Pages 329-332
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.329
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    The decision to perform adenotonsillectomy or tonsillectomy for treatment of pediatric Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is often based solely on clinical history such as snoring, sleep apnea or sleep disturbance, not on an objective evaluation. To determine the accuracy of clinical diagnosis of OSAHS in children, we performed overnight objective measurements in 35 patients (1.9-12 years old: 21 boys and 14 girls) who presented at our clinic from January 1997 to December 2000. An oxygen desaturation index (ODI)>5/h or minimal oxygen saturation (min SaO2)<90% were the defining criteria for OSAHS. Only 22 of 35 patients who had clinical diagnosis of OSAHS met the criteria. The remaining 13 patients were diagnosed as having simple snoring. There was no significant differences in age, gender, obesity, tonsil size and adenoid hypertrophy between OSAHS and the simple snoring patients group. OSAHS in children cannot be reliably distinguished from simple snoring by clinical diagnosis alone.
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  • A Review of 77 Cases, Tonsillectomy in Children
    Rie Karaki, Seiko Fujiwara
    2003 Volume 96 Issue 4 Pages 333-337
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.333
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    Results of tonsillectomy in 77 patients consisting mainly of children from October 1998 to September 2001 are reported. The patients were divided into four illness groups: 40 patients with tonsil hypertrophy, 30 with recurrent tonsillitis, 5 with chronic tonsillitis, and 2 with focal tonsillitis. The ages ranged from 1 to 21 years. Sixty percent of the patients were under 6 years of age. Chief complaints were recurrent tonsillitis, snoring and sleep apnea.
    A questionnaire survey was performed to investigate the postoperative effects of tonsillectomy on subjective symptoms for 77 patients. Improvement of preoperative subjective symptoms was found in 41 of 42 patients (97.6%). Almost all patients were satisfied with having undergone tonsillectomy.
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  • Gas Gangrene in the Neck caused by Peritonsillar Abscess; A Case Report
    Nansei Yamada, Takashi Hiramatsu, Michinori Murai
    2003 Volume 96 Issue 4 Pages 339-343
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.339
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    The patient was 89-year-old male who complained of sore throat and swallowing pain. X-ray and CT showed gas formation in the neck. We performed an emergency operation, found necrotic tissues and diagnosed gas gangrene. In our earlier experiences with gas gangrene, there were many bacteria in the pathological specimen. In this case, anaerobic bacteria were detected in the necrotic tissues, contributing to the pathological diagnosis. Furthermore, we paid attention to the change in LDH based on past experiences. In the blood test, LDH rose simultaneously as his condition got worse. Findings of necrotic tissues in the pathological investigation was useful to the detection of bacteria and LDH showed the degree of gas gangrene.
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  • Two Cases of Laryngopharyngeal Reflux Disease (LPRD) with Collagen Disease
    Takashi Kato, Yusuke Watanabe, Hiroshi Muta, Yoshiharu Sakata, Takeshi ...
    2003 Volume 96 Issue 4 Pages 345-350
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.345
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    Gastroesophageal reflux disease (GERD) which includes otorhinolaryngologic symptoms is called laryngopharyngeal reflux disease (LPRD). GERD shows a high incidence in progressive systemic sclerosis (PSS) and mixed connective tissue disease (MCTD).
    Two cases of LPRD with collagen disease, MCTD and PSS, are reported. The chief complaints were globus sensation and hoarseness. Arytenoid swelling, vocal cord edema and interarytenoid pachydermia were found by laryngeal fiberscopy. The clinical symptoms and findings disappeared after administration of proton pump inhibitor (PPI).
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  • The Early Detection of Occult Metastasis from Oral Cancer
    Ryo Kawata, Yuichiro Tsuji, Kotetsu Lee, Masashi Imanaka, Ibuki Hayash ...
    2003 Volume 96 Issue 4 Pages 351-355
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.351
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    We examined occult metastasis to cervical lymph nodes in ten cases of early oral and oropharyngeal (uvula origin) cancer. In all ten cases, partial excision alone was performed, without performing prophylactic neck dissection. Ultrasonic echo was carried out once every few month after the initial cancer treatment, and tried to detect occult cervical metastasis early. Metastatic lymph node was defined as showing a minor axis/major axis >0.5, and a minor axis >6mm on ultrasonic echo. The period from primary treatment to detection of metastatic lymph node ranged from 4 to 16 months. The average size of the lymph nodes at diagnosis of metastasis was 16×11mm. Pathological diagnosis of metastatic lymph node was detected by FNA in nine cases and excisional biopsy in one case. Although there was a case in which the observation period was short, seven cases survived and the results were better than the previous reports. It is important to perform ultrasonic echography after the initial treatment for early oral cancer in which prophylactic neck dissection was not performed. These results suggest that early detection of occult metastasis from oral cancer by ultrasonic echo can be expected to improve prognoses in cases of occult metastasis.
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  • Cervical Ectopic Thymus in Infant
    Atsushi Kondo, Masako Watanabe, Junichi Wakashima, Hiroyuki Takezawa, ...
    2003 Volume 96 Issue 4 Pages 357-360
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.357
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    we reported a case of cervical ectopic thymus in a 5-years-old girl. The mass presenting in the left neck was removed, and the histology showed normal thymic tissue. Preoperative diagnosis was difficult. In the case of cervical mass, diferential diagnosis should include ectopic thymus.
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  • Cervical Lymph Node Metastasis from an Unknown Primary Tumor
    Futoshi Watanabe, Etsuo Yamamoto, Yousaku Shiomi, Makito Tanabe, Keizo ...
    2003 Volume 96 Issue 4 Pages 361-364
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.361
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    Between January 1992 and January 2002, we treated 12 patients with metastatic carcinoma in cervical lymph nodes from an unknown primary tumor. Of 12 patients, the histological diagnosis was squamous cell carcinoma in 10 and adenocarcinoma in 2. Three patients were in clinical stage N3, 8 patients were in N2 and 1 patient was in N1. Among them, 6 patients with resectable lymph nodes were treated mainly with surgery, and 6 patients with unresectable lymph nodes or distant metastasis were treated with radiotherapy and/or chemotherapy. After these treatments, a primary lesion appeared in only one patient, who was diagnosed as having nasopharyngeal carcinoma. The loco-regional control rate in all patients was 75%. The control rate in the patients treated with surgery was 100%, and that in patients treated with radiotherapy and/or chemotherapy was 50%. Distant metastasis after treatment appeared more often in open-biopsy cases than in those receiving fine-needle aspiration (FNA) or open-biopsy with simultaneous radical neck dissection.
    According to these results, radical neck dissection appeared to be effective in controlling neck disease. For initial pathological diagnosis, FNA is recommended, while open biopsy should be avoided, if possible.
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  • A Study of the Distribution of Facial Nerve Conduction Velocities by Transcranial Magnetic Stimulation
    Akira Arai, Takuya Yamakawa, Akiko Hagiwara, Hiroshi Yoshikawa, Ginich ...
    2003 Volume 96 Issue 4 Pages 365-373
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.365
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    Objective: The purpose of this study was to evaluate by the collision method the distribution of nerve conduction velocities (DNCVs) of the facial nerve under transcranial magnetic stimulation (TMS), to better understand its neurophysiological characteristics.
    Materials and Methods: The subjects were 13 normal volunteers and 3 patients with Bell's palsy. The experiments were carried out using Magstim model 200, a large coil measuring 90mm in diameter with a maximal output of 2.0 tesla (T), and a Neuropack 8 (Nikon Kohden, Japan) to control the stimulation and record the electromyographical findings. The labyrinthine segment of the facial nerve within the temporal bone was selected as the site for transcranial magnetic stimulation, and the main trunk of the facial nerve that runs subcutaneously in the parotid region was selected as the site for electric stimulation. The reference electrode of the bipolar lead was placed over the mentalis muscle. The amplitude of compound muscle action potentials (CMAP) to the mentalis muscle was studied by the collision method.
    Measurement and Results: The peak of DNCV was detected at 22 to 24m/sec in 13 normal volunteers. The data showed a decrease in the number of thicker fibers, which tended to show faster conduction velocities, in Bell's palsy patients.
    Conclusions: We were able to investigate the DNCVs of the facial nerve by TMS. Thicker myelinated fibers may be more susceptible to compression damage. From this finding it can be said that the compression of the nerve results in a state comparable with Bell's palsy.
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  • Study of Expression of L-Selectin and Mac-1 in Pre- and Post-Operative Patients with Obstructive Sleep Apnea Syndrome
    Ryutaku Kim, Fuyuki Enomoto, Takeshi Kataoka, Yoko Yamasaki, Hidenori ...
    2003 Volume 96 Issue 4 Pages 375-379
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.375
    JOURNAL FREE ACCESS
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    In obstructive sleep apnea syndrome (OSAS), it has recently been reported that complications such as hypertension, ischemic heart disease, and cerebral disease occur at high rates. In this study we assessed the function of neutrophils in patients with OSAS. By taking blood samples before and after operative treatment, we measured the levels of neutrophil-adhesive molecules, L-selectin and Mac-1.
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  • Management of Acute Epiglottitis
    I. Honjo
    2003 Volume 96 Issue 4 Pages 380-381
    Published: April 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.380
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