Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 96, Issue 7
Displaying 1-16 of 16 articles from this issue
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  • Histology and Function of the Human Vocal Fold Macula Flava
    Kiminori Sato
    2003 Volume 96 Issue 7 Pages 567-575
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.567
    JOURNAL FREE ACCESS
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    Maculae flavae (MF) are located at the anterior and posterior ends of the human vocal fold mucosa (HVFM). Their histological structure is unique, but the role of MF in the HVFM has not been clarified. We have postulated that the MF may be related to the metabolism of extracellular matrices (EM) in the HVFM. This hypothesis is supported by the following morphologic results from our past studies.
    Human MF are composed of dense masses of EM that are essential for the EM of the lamina propria in the HVFM. Dense EM in the human MF extend up to those in the HVFM. Ground substance among the fibers in the human MF is composed of abundant and dense hyaluronic acid, which is an important glycosaminoglycan in the HVFM. The cells are dense in the human MF. Many cells (Stellate cells) in the MF have marked morphologic differences from the conventional fibroblasts. They have well-developed intracellular organella and constantly synthesize EM. Newborns already have immature MF at the same sites as in the adult vocal fold. During infancy, the EM synthesized in the MF appear in the membranous portion of the vocal fold at different times to initiate the formation of the three-dimensional EM structure of the HVFM. The MF in newborn and infant vocal folds appears to be related to the growth and development of the HVFM. In aged human adults, age-related changes of cells and EM in the MF can be observed, and presumably affect the EM of the HVFM.
    On the basis of the results of our past studies, the MF in the HVFM are postulated to be involved in the metabolism of EM, which are essential for the viscoelasticity of the HVFM. The MF is considered an important structure in growth, development and aging of the HVFM.
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  • Laser Assisted Tympanic Membrane Fenestration
    M. Hotomi, [in Japanese]
    2003 Volume 96 Issue 7 Pages 576-577
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.576
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  • Cranial Polyneuropathy with Ramsay Hunt Syndrome
    Yumi Ota, Teiji Takemura, Toru Sawada
    2003 Volume 96 Issue 7 Pages 579-584
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.579
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    Ramsay Hunt syndrome is characterized by facial nerve paralysis, herpetic vesicles around the ear and pain. It is often associated with VIII cranial nerve involvement. This syndrome can affect other cranial nerves, so it is thought to be a cranial polyneuropathy caused by the varicela zoster virus. We report 3 cases of Ramsay Hunt syndrome with involvement of VII, VIII, IX, X cranial nerves.
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  • Three Cases of Acute Hearing Loss due to Mumps Infection
    Kazunori Fujiwara, Katsuyuki Kawamoto, Hiromi Takeuchi, Hiroya Kitano
    2003 Volume 96 Issue 7 Pages 585-589
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.585
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    Hearing loss is a rare complication of mumps infection, however improvement of mumps-related deafness is difficult. In Japan, immunization against mumps is not required and mumps-related deafness is thought to have increased.
    We encountered three cases of unilateral sensorineural hearing loss due to mumps infection. The diagnosis was based on criteria determined by the Acute Profound Deafness Committee in Japan. All cases were treated for sudden deafness with routine steroid therapy.
    Case 1 was a 5-year-old boy. He was diagnosed as having mumps-associated hearing loss and his hearing improved. Case 2 was a 27-year-old woman, diagnosed as having mumps-related deafness and her hearing was not improved by therapy. Case 3 was a 43-year-old man, diagnosed as having mumps-associated deafness, but his hearing was not improved with therapy.
    Sensorineural hearing loss due to mumps infection is considered difficult to recover. However, some cases showing improvement have been reported such as our case 1. Early diagnosis and therapy are thought to be needed. Immunization against mumps should be required from the perspective of preserving hearing.
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  • Cerebeller Infarction Presented by Acute Vertigo Caused by the Intraarterial Catheter
    Yumiko Hosoya, Kazuharu Yamazaki, Hiroaki Sato, Kazuo Murai, Kenichi K ...
    2003 Volume 96 Issue 7 Pages 591-596
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.591
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    Vertigo is one of the frequent signs of cerebrovascular disease. It is easy to make the diagnosis if other neurological deficits are present besides vertigo. However, it often mimics a unilateral vestibular disorder in some patients with cerebeller infarction without other neurological deficits, leading to misdiagnosis.
    We report a 72-year-old woman, who had right cerebeller infarction presenting with acute vertigo, vomiting and nausea. There were no other neurological symptoms noted except for beating nystagmus to the right. Computed tomography (CT) on the first hospital day did not show any abnormalities. The next morning, dysarthria and right dysmetria in the finger nose test occurred, but spontaneously resolved during the course. A CT scan obtained five days after the onset showed a low density area in the right cerebeller hemisphere. In the past, the patient had undergone surgery to insert an indwelling catheter into the left subclavian artery to treat metastatic hepatic cancer. Magnestic resonnance angiography (MRA) performed on the 20th hospital day did not detect clinical signs, suggesting that the intraarterial catheter is the most likely source of this infarction.
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  • A Case of Otitic Hydrocephalus Induced by Masked Mastoiditis
    Mika Adachi, Kaoru Ito, Sachiko Matsutani
    2003 Volume 96 Issue 7 Pages 597-602
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.597
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    The use antibiotics has significantly reduced the complications of acute otitis media. On the other hand, it has altered their clinical picture. Masked mastoiditis is now becoming an important problem, causing severe complications without typical symptoms.
    We present the case report of a 16-year-old female who developed symptoms of raised intra cranial pressure 3 weeks after an episode of otitis media. Although otoscopy revealed no significant change in her tympanic membrane and there was no otologic symptom, magnetic resonance imaging showed thrombosis in her bilateral lateral sinuses and shadows in her mastoid cells.
    We considered that the antibiotic therapy caused masked mastoiditis, obscuring typical signs and symptoms of otitic hydrocephalus.
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  • Two Cases of Primary Orbital Lymphoma
    Jun Shuto, Junichi Bundo, Fumihiko Hori
    2003 Volume 96 Issue 7 Pages 603-607
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.603
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    We report the successful treatment of two patients with primary orbital non-Hodgkin's lymphoma by radiotherapy followed by surgical resection. The chief complaint of both patients was orbital swelling. One patient, a 66-year-old female, had stage IA disease (Ann Arbor staging system), and the other was an 85-year-old female with stage IVA disease. The pathological diagnosis of the stage IA patient was follicular lymphoma (new WHO classification: mainly diffuse, grade 3) and that of the stage IVA patient was diffuse large B-cell lymphoma (new WHO classification). Lymphoma cells in both patients showed a B-cell phenotype. We recommended chemo-radiotherapy treatment to the stage IVA patient, but she and her family rejected this opinion because of her advanced age. We obtained good results by administering a total dose of 34Gy in 17 daily fractions to each patient, with lead eye shield protection. We consider that the patients received identical total doses of radiotherapy. We were concerned that cataracts or other radiation side effects would occur, but none has appeared during 1 year of follow-up care. Carefully planned radiotherapy accompanied by ocular shielding appears to be safe and effective for orbital lymphoma.
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  • A Case of Primary Amyloidosis of Salivary Glands with Bronchial Amyloidosis
    Shu Kikuta, Hidehiko Takeda, Kozo Kumakawa, Masaaki Yamane
    2003 Volume 96 Issue 7 Pages 609-613
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.609
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    Amyloidosis is a disease of unknown cause characterized by the accumulation of an amorphous, proteinaceous material in various organs and tissues of the body. In the oral region, tongues are most affected. Lips, cheeks, and salivary glands may also be affected, but few cases have been reported so far. We report a case of AL (amyloid light chain) amyloidosis in the left floor of mouth with bronchial amyloidosis. A 56-year-old woman was diagnosed with AL primary bronchial amyloidosis with no predisposing disease and was followed in the department of internal medicine. Three years after diagnosis, she noticed swelling of the left floor of her mouth.
    Initially, it was 1cm in size, but showed rapid growth to about 3cm in 4 months. Enucleation of the mass revealed that this was the salivary gland, with diffuse and nodular amyloid deposition. The amyloid protein was identified as protein AL by immunohistochemical method and did not react to AA protein. There were no findings associated with multiple myeloma. Histological examinations showed this amyloid protein had the same composition as amyloid protein deposited in the tracheal tissues. This case seems specific in that amyloid deposition occured in the salivary gland and its size rapidly increased, resembling a tumor.
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  • A Case of Fish Bone Foreign Body and Stuck in the Deep Cervical Fascia
    Gengo Ishii, Hirohito Umeno, Keiichi Chijiwa, Tadashi Nakashima
    2003 Volume 96 Issue 7 Pages 615-618
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.615
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    We described a rare case of fish bone foreign body which pierced the pharynx and stuck in the deep cervical fascia.
    A 62-year-old male suffered from a sore throat after he swallowed fish, and a foreign body in the pharynx was suggested. Under routine fiberscopic examination, however, no fish bone was detected, so the patient was prescribed antibiotics, and sore throat disappeared. Because swelling of the pharynx persisted for six days, CT examination was carried out and the foreign body was found at the posterior part of the pharynx.
    By extra-cervical incision, the foreign body was found penetrating the retropharyngeal space, stuck in the deep cervical fascia.
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  • A Case of Calculus of the Lingual Tonsil
    Hideki Bando, Toshiyuki Uno, Fumiaki Nin, Kou Tei, Takashi Shinomiya, ...
    2003 Volume 96 Issue 7 Pages 619-622
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.619
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    A 42-year-old woman came to our hospital with a 1-month history of foreign body sensation in the pharynx. Lateral neck radiograph and computed tomography scan showed a calcification in the root of the tongue. We suspected that the object was a foreign body, because her symptom had appeared just after a meal. Extirpation with direct laryngoscope was done under general anesthesia. The location of the object was easily detected with fluoroscopy. Infrared spectrum revealed that it was a calculus of the lingual tonsil. 37 cases of tonsillolith have been reported previously in Japan, but all cases were calculi of the palatine tonsil. This case is the first report to our knowledge of calculus of the lingual tonsil.
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  • A Case of Toxic Shock Syndrome after Peritonsillar Abscess
    Takeshi Hasegawa, Hideki Takegoshi, Daisuke Aoki, Hiroo Tabe, Shigeru ...
    2003 Volume 96 Issue 7 Pages 623-627
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.623
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    We describe a patient hospitalized for peritonsillar abscess who developed toxic shock syndrome. A 38-year-old male sought medical advice because of persistent high fever and sore throat with severe pain during swallowing. Physical examination found gross unilateral swelling of the palate and anterior pillar with medial displacement of the right tonsil. We diagnosed peritonsillar abscess and performed surgical drainage under antibiotic coverage. By the third hospital day the patient became afebrile and was gradually able to eat. However, he had a spiking temperature up to 40°C and his blood pressure was 80/50mmHg on the sixth day. He complained of nausea, vomiting and diarrhea. Laboratory data demonstrated a WBC count of 31, 800/μl, CRP level of 19.5mg/dl, BUN level of 27mg/dl, GOT and GPT level of 59 and 40IU/I. A stool culture revealed toxic shock syndrome toxin-1 (TSST-1) producing Methicillin Resistant Staphylococcus aureus (MRSA).
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  • Salmonella and Acute Suppurative Thyroiditis
    Isao Morizane, Hiroshi Aritomo, Masanori Asai, Aki Taguchi
    2003 Volume 96 Issue 7 Pages 629-635
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.629
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    Acute suppurative thyroiditis due to salmonella is an extremely rare condition because the thyroid gland is totally encapsulated and has a high local iodide content, with a rich lymphatic and vascular supply. We report a case of acute suppurative thyroiditis in a 50-year-old woman. She presented with a painful swelling in the left neck. She had neither symptom nor history of gastroenteritis. Ultrasound examination of the thyroid suggested an abscess of the inferior pole of the left thyroid lobe. Purulent fluid obtained by fine needle puncture grew Salmonella Anatum. The abscess got worse despite the intravenous administration of antibiotics, and surgical drainage was performed. No evidence of piriform sinus fistula was found in barium swallowing examinations two and five months after surgery. Although the route of infection remained unclear, a hematogenous route seemed to be the most likely.
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  • A Case of Calcific Retropharyngeal Tendinitis with a Differential Diagnosis of Retropharyngeal Abscess
    Tsukasa Takaoka, Katsuhiko Nakamura, Katsushi Miyazaki, Masahiro Ando, ...
    2003 Volume 96 Issue 7 Pages 637-640
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.637
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    We report a case of Calcific retropharyngeal tendinitis that was difficult to distinguish from retropharyngeal abscess. The patient was a 36-year-old woman who complained of severe cervical pain. Clinical findings of moderately elevated WBC count and MRI findings of fluid filling the retropharyngeal space suggested retropharyngeal abscess. However, the patient was not very sick, without high fever or sore throat. CT scan showed a clump of calcification in front of the C1-C2 cervical spines, which is characteristic of calcific retropharyngeal tendinitis. Emergency drainage operation was avoided and the patient fully recovered after treatment by NSAIDs.
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  • A Case of Tuberculosis Forming Cervical and Abdominal Abscesses
    Mariko Hosokawa, Tamie Mimura, Hideo Hayashi, Mitsuo Tominaga, Seiichi ...
    2003 Volume 96 Issue 7 Pages 641-645
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.641
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    The patient was a 31-year-old man with a chief complaint of cervical mass close to the right submandibular region. At first, we used several antibiotics, which proved to be ineffective.
    Radiological and laboratory investigations were performed, including chest X-ray and computed tomography of the neck. Purified protein derivative test (PPD test) was positive. Definitive diagnosis of mycobacterial cervical lymphadenitis was made according to the findings of pathological examination and positive mycobacterial culture of the biopsy material.
    Since the patient had irritation in the stomach at the same time, we examined his abdomen by gastrofiberscope and MRI. As a result, abdominal abscesses were detected with high activity of adenosinedeaminase in the fluid inside. These results suggested that they also were tuberculous abscesses.
    Four months were required for this patient to recover from mycobacterial cervical lymphadenitis after combined antituberculous pharmacotherapy. After one year, we have also seen improvement in his abdominal abscesses.
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  • Evaluation of Cervical Lymph Node Tuberculosis
    Katsuyuki Kawamoto, Hiromi Takeuchi, Kei Nakahara, Shigeru Higami, Hir ...
    2003 Volume 96 Issue 7 Pages 647-652
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.647
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    From January 1990 to December 1999, we treated twelve patients with cervical lymph node tuberculosis. The diagnosis was confirmed by histopathological findings of biopsy, 10 cases by resection of lymph node, 1 case by fine needle aspiration biopsy and 1 case was diagnosed following resection of lymph node at another hospital. After diagnosis, all patients received antituberculous chemotherapy and one patient with pocket formation underwent total resection of neck masses with infectious skin. Four cases were lost to follow-up, but the others showed good response and had no recurrence.
    Tuberculosis is an important infectious disease demanding constant attention because of the possibility of herd infection. We should consider tuberculosis when cervical lymph node swelling is seen, and early diagnosis and treatment are needed to prevent the spread of infection to others. Antituberculous chemotherapy is effective, however, when pocket and abscess formation occur, combination therapy of chemotherapy and operation such as neck dissection are needed in early course.
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  • Diagnosis of Sleep Related Breathing Disorder
    S. Miyazaki
    2003 Volume 96 Issue 7 Pages 654-655
    Published: July 01, 2003
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.96.654
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