Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 97, Issue 1
Displaying 1-16 of 16 articles from this issue
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  • Day Surgery in Otolaryngology
    Juichi Ito
    2004 Volume 97 Issue 1 Pages 1-4
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.1
    JOURNAL FREE ACCESS
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    In 2000, the day surgery unit was established in Kyoto University Hospital. The annual number of surgeries in 2002 was approximately 2000 total and 277 in Otolaryngology. Average age of patients was 45.3 for men and 46.0 for women. The number of male patients was greater than that of female in patients aged under 40, and we assume this tendency was caused by the minimum disruption of daily life of day surgery.
    A critical path was applied for the better utilization of patient information among medical personnel. No major accidents were reported until now.
    Day surgery should be utilized not only to reduce cost by replacing inpatient surgery but also to create a new medical service for patients by its convenience.
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  • Widened Retrolabyrinthine Approach for Vestibular Schwannoma Surgery
    T. Kobayashi, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    2004 Volume 97 Issue 1 Pages 6-7
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.6
    JOURNAL FREE ACCESS
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  • Results of Stapes Surgery
    Hiroyuki Yamada, Shin-ichiro Nishii, Ryoji Ishida
    2004 Volume 97 Issue 1 Pages 9-13
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.9
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    In the past 9 years and 5 months, 14 stapes surgeries were performed in our department. Eight patients had otosclerosis, 2 had congenital foot plate ankylosis, 2 had chronic otitis media, 1 had cholesteatoma after the first stage operation, and 1 with traumatic foot plate fracture were included in this group.
    The patients underwent total stapedectomy in 11 ears, and small fenestra stapedectomy in 3 ears.
    The stapes were reconstructed with teflon piston in 11 ears, and with hydroxyapatite (TORP) in 3 ears.
    Only one ear underwent reoperation due to the dislocation of the prosthesis. After the stapes surgeries, hearing was improved in 13 of 14 ears.
    Although the stapes surgery should be performed by skillful ear surgeons, all operators performing middle ear surgery should be prepared for stapes surgery.
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  • Drug Resistance of Streptococcus Pneumonie and Clinical Outcome in Children with Acute Otitis Media
    Sawako Masuda, Takashi Nakano, Hitoshi Kamiya
    2004 Volume 97 Issue 1 Pages 15-19
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.15
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    The incidence of acute otitis media caused by drug-resistant strains of Streptococcus pneumonie has increased among the children in Japan.
    Sixty-four pneumococcal isolates from the middle ear, otorrhea, or the nasopharynx of 56 children with acute otitis media from February 2001 to January 2003 was evaluated by polymerase chain reaction (PCR) for mutation of penicillin-binding protein (PBP) and other genes. The results showed mutation of all three PBP genes, pbp 1a, pbp 2b, and pbp 2x, in 64.1% of the isolates, while 96.9% were found to possess various PBP gene mutations. The mutation of mef E and erm AM, which contribute the resistance to macrolide, were detected in 56.3% and 31.3%, respectively.
    Seventy-nine percent of the 56 children were between 6 to 23 months old. Seventy-six percent were attending day-care centers. Myringotomy was performed in 66.1% of all children. Twenty-nine of the 56 children were hospitalized, and 26 were treated with PAPM/BP. There was no clinical improvement noted after treatment with PAPM/BP in 3 cases. However, they were cured by injecting CTX together with PAPM/BP.
    The ratio of penicillin and macrolide-resistant strain in Streptococcus pneumonie were higher than those reported in previous studies. Clinicians who treat children with acute otitis media in hospitals should be alert to the possibility of resistance to multiple antibiotics.
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  • Biotic Foreign Body in the External Auditory Canal (Dermacentor sp); Case Report
    Takashi Masaki, Isao Hoshino, Makito Okamoto
    2004 Volume 97 Issue 1 Pages 21-24
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.21
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    A 24-year-old female was admitted to our hospital complaining of right otalgia persisting for a few days after a trip to Nepal. Otoscopic examination showed a tick in the right external auditory canal. The tick was removed with forceps. The tick was identified as a nymphal Dermacentor sp. There was no sign of serious complication such as tick paralysis or facial palsy.
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  • A Clinical Study of Olfactory Disturbance
    Ken Uehara, Takeharu Kanazawa, Masahiro Hasegawa, Masaharu Ura, Yutaka ...
    2004 Volume 97 Issue 1 Pages 25-30
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.25
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    Recently, olfactory disturbance caused by various diseases has been an important symptom. In this study, 76 patients with olfactory disturbance seen at University of the Ryukyus Hospital between 1997 and 2001 were analyzed. Distribution of the disease caused by olfactory disturbance was as follows: 26 cases of rhinosinusitis, 47 of viral infection and 3 of head trauma. Patient characteristics, initial treatment and results of T & T olfactometry or intravenous olfactometry (Alinamin® test) did not significantly differ between the rhinosinusitis group and the viral infection group. To investigate whether the prognosis could be estimated by T & T olfactometry and intravenous olfactometry, the initial results of T & T olfactometry or intravenous olfactometry and improvements after treatment were longitudinally compared in the rhinosinusitis group and in the viral infection group. As a result, improvements in the disturbance were significantly correlated with T & T olfactometric findings in both groups. Similarly, improvements were significantly correlated to findings on olfactometry. These results suggested that initial examination for olfactory disturbance should be able to estimate the prognosis of the disturbance caused by various diseases.
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  • Effect of CO2 Laser Vaporization for Nasal Allergy
    A Questionnaire Survey of Long-term Effect
    Masahiro Kikuchi, Masako Nakai, Takeshi Morita, Hiromi Nagata, Yosaku ...
    2004 Volume 97 Issue 1 Pages 31-36
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.31
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    Between 1994 and 1998, we treated 48 patients with perennial allergic rhinitis refractory with conservative therapy by vaporizing the inferior turbinates once for all using a CO2 laser at Kyoto University Hospital. We conducted a questionnaire survey of these patients to determine the long-term effects of CO2 laser vaporization. Of the subjects, 27 patients responded to the questionnaire. The severity of nasal symptoms was rated on a scale of 4 (0-4 points) and the response to treatment by nasal symptom was evaluated according to the improvement of scores. The rates of improvement in nasal obstruction, nasal discharge and sneezing were 56%, 41% and 33%, respectively when reduction of score by more than one point was regarded as effective. To evaluate their long-term prognosis, the subjects were divided into the following two groups according to the period between surgery and questionnairing: patients who underwent surgery during the past three years (short-term group, n=15) and patients who underwent surgery more than three years ago (long-term group, n=12). Regarding improvement in scores for individual nasal symptoms, the two groups showed no significant difference. Although the rates of improvement for individual nasal symptoms were as low as approximately 50%, prolonged therapeutic effects could be expected when treatment was effective.
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  • A Case Report of Neurilemmoma of the Larynx
    Yuka Iwahashi, Hiroyuki Kitamura, Shin-ichi Takagita, Norio Yamamoto, ...
    2004 Volume 97 Issue 1 Pages 37-41
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.37
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    Neurilemmoma of the larynx is an uncommon lesion. In Japan, the first case was reported in 1948, and since then, only 59 cases have been reported to our knowledge. We recently treated a 22-year-old female with a neurilemmoma of the larynx. She had suffered from hoarseness for 5 years. The lesion was located in the right false cord and vocal cord, and was found to be a submucosal tumor. It was resected by laryngofissure, resulting in improved phonation, and no recurrence has been noted in 13 months of follow up.
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  • Acquired Laryngomalacia
    Shigenori Ode, Tsuneo Inoue, Akiko Tokumaru, Tsugio Abe, Kensuke Watan ...
    2004 Volume 97 Issue 1 Pages 43-46
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.43
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    We reported a case of inspiratory dyspnea due to epiglottal prolapse that developed when the patient was 14 years old. This condition is very rare in adolescence and there are no published reports involving patients less than 20 years old. There was neither a history of head and neck surgery, nor any head injury or coma. On laryngofiberscopy, there were no abnormal findings.
    However, prolapse of the epiglottis during inspiration was noted when constrained respiration occurred with the cervix in a lordotic posision. The diagnosis was acquired laryngomalacia. A partial epiglottectomy (half) with a CO2 laser improved the respiratory condition, but the cause of the laryngomalacia was not pathologically clarified.
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  • Intraarterial Infusion Therapy with an Implantable Reservoir System for Head and Neck Carcinomas
    Hiroaki Nakatani, Shoichi Sawada, Taizo Takeda, Mitsuhiko Nakahira, Yo ...
    2004 Volume 97 Issue 1 Pages 47-54
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.47
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    We herein report the results of superselective intraarteial CDDP infusion therapy with an implantable reservoir system combined with radiotherapy for 10 patients with head and neck carcinomas. Two tumors originated from the external and middle ear, 4 from the maxillary sinus, 3 from the mesopharynx and 1 from the larynx. At first, we implanted an IVH reservoir system for administration of the neutralizing agent (sodium thiosulfate) to cisplatin (CDDP). After identification of the main arterial supply by the Seldinger technique and the first intraarterial infusion, we implanted an intraarterial reservoir system, using the facial, superficial temporal and superior thyroid arteries. CDDP infusion was performed from 3 to 7 times (average 4.8). The complete and partial response rates were 50% and 40%, respectively. Occlusion of the catheter and the artery occured in 2 and 1 patient, respectively. We conclude that the implantable resorvoir system for both CDDP and STS administration is an easy, low-invasive method for intraarterial infusion therapy.
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  • Examination of the Relationship between OSA and Obesity
    Mutsumi Kenmochi, Shigeki Sato, Yasuhiro Miyamoto, Akemi Sugita, Yasuh ...
    2004 Volume 97 Issue 1 Pages 55-59
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.55
    JOURNAL FREE ACCESS
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    Obesity is one of most important risk factors for obstructive sleep apnea syndrome (OSA). In this studys, we examined the importance of a rapid and considerable increase in body weight in OSA using a weight changing index (WCI). We investigated 39 patients (35 males and 4 females) that were referred to our hospital complaining of snoring and sleeping disturbance, and we employed body mass index (BMI) to evaluate obesity. The BMI was estimated as body weight divided by height to the second power: BMI (kg/m2)=body weight/(height * height). WCI was estimated as the previous BMI around the time the patients noticed sleeping disturbance, minus the present BMI. We evaluated degrees of OSA using the apnea-hypopnea index (AHI) as measured by polysomnography. We found a significant correlation between AHI and BMI, confirming that obesity greatly influences OSA. In younger subjects, the correlation between OSA and increases in WCI was more prominent than that in older subjects, whereas the BMI values did not differ significantly with age. Since WCI appeared to reflect the accumulation of visceral fat, we suggest that visceral-fat obesity most strongly influences OSA. The increasing prevalence of obesity is likely to produce social problems associated with a higher incidence of OSA. It is therefore important to develop suitable methods for the detection and treatment of OSA.
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  • Frequency of Autoimmune Chronic Thyroiditis in Outpatients of an Otorhinolaryngological Department
    Setsuko Morinaka, Akinari Hidaka
    2004 Volume 97 Issue 1 Pages 61-67
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.61
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    During the period between August and October 2002, there were 44 ambulatory patients with chronic autoimmune thyroiditis in our Otorhinolaryngological Department. The prevalence of chronic autoimmune thyroiditis was 6.8% of outpatients and the male/female ratio was 1:4.5. Chronic autoimmune thyroiditis was more frequent in patients aged 50-70 years. Among them, 20 patients were revealed to have normal thyroid function. Ten patients had hypothyroidism, 8 patients had subclinical hypothyroidism, one patient had thyrotoxicosis and 5 patients had subclinical thyrotoxicosis. Most patients had almost no symptoms related to thyroid function and thyroiditis was found by palpation of the thyroid gland. All 10 patients with hypothyroidism and 5 out of 8 patients with subclinical hypothyroidism were treated by thyroid hormone replacement therapy. Thyrotoxicosis and subclinical thyrotoxicosis were mild and transient, and no therapy was necessary for them.
    It is important to palpate the thyroid gland during examination of the neck, as chronic autoimmune thyroiditis is considered to be common. Therefore, it is important for general otorhinolaryngologists not to overlook thyroid diseases, and to palpate the thyroid glands routinely.
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  • Effective Cimetidine Treatment for Periodic Fever in an Elderly Woman
    Kousei Takeda, Masatoshi Horiuchi, Hideji Okuno, Ichirou Morita, Keiic ...
    2004 Volume 97 Issue 1 Pages 69-72
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.69
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    A 78-year-old female was admitted to our hospital four times between July and October 2000 because of periodic fevers associated with aphthous stomatitis, pharyngitis and cervical adenitis. Episodes continued for about one week and recurred every three to four weeks. She was healthy until these episodes. Body temperature was elevated to a maximum of 37.8°C. The number of leukocytes did not exceed 9000/mm3, but shifts of the nuclei to the left were seen in each attack. C-reactive protein (CRP) was markedly elevated to more than 9.4mg/dl, serum IgE was slightly elevated to 770IU/ml, and other laboratory studies were within normal limits. Her pathogenesis was compatible with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenitis) syndrome except for advanced age, so cimetidine therapy (200mg four times daily) was chosen after the fourth episode and continued for two and half months. The patient has been asymptomatic for more than two years since cimetidine therapy.
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  • A Case of Spontaneous Retropharyngeal and Mediastinal Emphysema
    Masayuki Sakamoto, Yukiko Shinjo, Ryuzaburo Higo
    2004 Volume 97 Issue 1 Pages 73-75
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.73
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    We report a case of spontaneous retropharyngeal and mediastinal emphysema. An 18-year-old female noticed that the right side of her neck was swollen. CT examination findings demonstrated air in the retropharyngeal and mediastinal regions. The condition was diagnosed as spontaneous retropharyngeal and mediastinal emphysema. The condition was resolved after four days rest.
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  • Film Dressing for Primary Suture of the Neck
    Shinji Suzuki, Kazuhiko Shoji, Shinichi Takagita, Satoshi Ikegami, Yas ...
    2004 Volume 97 Issue 1 Pages 77-80
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.77
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    We attempted to eliminate the need for epithelial sutures in closure following neck surgery, to obtain a fine scar without suture marks and avoid the pain involved in suture removal. Film dressing (Op-site®) was selected as suitable for covering the primary suture and the clinical results were as follows.
    1) We could observe the wounds through the film without taking off the dressing, and could detect postoperative hematomas earlier.
    2) Disinfection and gauze exchange became unnecessary, and our medical treatment burden was mitigated. Furthermore, medical wastes with infection were also decreased.
    3) Patients could bathe at an early postoperative stage.
    Although gauze dressings are commonly used on primary suture wounds because of their low cost, film dressings are superior to gauze dressings in many respects.
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  • Notable Points of Foreign Bodies
    H. Hirabayashi
    2004 Volume 97 Issue 1 Pages 82-83
    Published: January 01, 2004
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.97.82
    JOURNAL FREE ACCESS
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