Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
Volume 98, Issue 12
Displaying 1-15 of 15 articles from this issue
  • Otolaryngologist's Dilemma
    Hideo Yamane
    2005 Volume 98 Issue 12 Pages 907-914
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Surgery for congenital aural atresia is among the most difficult and challenging procedures for both ear surgeons and patients. Some previous reports have not recommended this type of surgery with confidence, because of the difficulty of the surgery itself and because postoperative hearing gain has not been as good as was expected, while postoperative complications such as middle ear infection sometimes occur. How then should the otolaryngologist approach this disease? When microtia coexists with aural atresia, the otolaryngologist sometimes hesitates to decide how to treat atresia because of excessive attention to microtia. The difficulty of atresia surgery should be considered apart from microtia because the microtia itself is not a crucial factor in such surgery. At present, it is hoped that otolaryngologists will develop several strategies such as reliable surgery with good postoperative hearing results without postoperative complications and new devices such as BAHA.
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  • K. Saito, [in Japanese], [in Japanese]
    2005 Volume 98 Issue 12 Pages 916-917
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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  • Miki Shino, Teru Kawamata, Kenichi Kanai, Seido Ooki, Harumi Suzaki
    2005 Volume 98 Issue 12 Pages 919-926
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    A 12-year-old boy who developed Gradenigo syndrome is reported.
    He had acute otitis media and was given antibiotics. Since no improvement was observed, he was referred to our hospital. He had a left side headache and diplopia on left lateral gaze. CT and MRI study showed inflammation of the left petrous apex and loss of the pneumatization of mastoid cells. Gradenigo syndrome with acute otitis media, paralysis of abducens nerve and irritation of the trigeminal nerves was diagnosed.
    After antibiotics were given, otitis media with petrositis was improved and headache from trigeminal pain was resolved, but abducens paralysis was not improved. Steroid therapy and hyperbaric oxygenation therapy were started, and abducens paralysis was relieved. Gradenigo reported a syndrome which consists of acute otitis media, paralysis of abducens nerve and irritation of the trigeminal nerves in 1904. Gradenigo's syndrome has become rare since the introduction of antibiotics. 21 cases of this syndrome were reported in Japan from 1980 to 2005 and the pathophysiology, diagnosis and therapy of those cases and of our patient are discussed.
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  • Nobuhiro Nishiyama, Atsushi Kawano, Kouichi Kitamura, Shigetaka Shimiz ...
    2005 Volume 98 Issue 12 Pages 927-931
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    We reported a rare case of bony destruction of the tympanic promontory in suppurative otitis media without cholesteatoma. A 62-year-old male consulted the hospital in October 2002, with complaints of impaired hearing, otorrhea, dizziness and facial palsy on the right side. Hearing in the right ear was totally gone. CT showed a defect in the cochlear bony wall with abundant soft density tissue in the middle ear cavity, antrum and mastoid cavity. Surgery was performed. The bony structure in the cochlear lower basal turn had been destroyed and membranous labyrinth was confirmed when granulation was removed. The defect was then covered with fascia and an open mastoid cavity was created. The facial nerve was also exposed. The patient showed a good postoperative course: facial nerve palsy improved to normal, dizziness and nystagmus disappeared, but deafness was irreversible.
    Generally, in a case of cholesteatoma, bony destruction is more frequent than in a case of suppurative otitis media and labyrinthine or facial canal dehiscence is a rather common finding. This case report showed that even in the absence of cholesteatoma, these degenerative changes could develop in suppurative otitis media and could extend to the tympanic promontory and facial canal.
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  • Tetsu Iwanaga, Satoru Kaieda, Kenji Takasaki, Hidetaka Kumagami, Haruo ...
    2005 Volume 98 Issue 12 Pages 933-935
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    A 47-year-old woman with diagnosis of otosclerosis in her left ear underwent small fenestra stapedotomy in our clinic. During surgery, after incising the crura of the stapes, the stapes footplate became movable. Considering the risk of sensorineural hearing loss, we chose tympanoplasty type IV by placing a piece of temporalis fascia on the footplate and a shortened teflon-wire piston between the incus and the footplate, rather than stapedectomy. Now 9 months after surgery, she is taking an uneventful course, and the air-bone gap of her left ear has been reduced from 26.6dB to 3.3dB. The stapes not infrequently is fractured or becomes movable during surgery for otosclerosis in Japan, probably because the sclerotic change of the stapes is generally mild in the Japanese population. In order to avoid the risk of sensorineural hearing loss due to perilymph leakage by floating stapes or stapedectomy, the method that we used in the present case was considered one of the good options in such cases, although recurrence of hearing loss due to refixation of the stapes is possible in the future.
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  • Hiroaki Imaishi, Hisa Naganuma, Tomohiro Yoshizawa, Seiichi Yamaji
    2005 Volume 98 Issue 12 Pages 937-940
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    A patient who was undergoing treatment for diabetes developed necrotizing external otitis due to Pseudomonas aeruginosa infection. The patient was a 75-year old man, and the main complaint were earache and otorrhea of the right ear. Daily intravenous antibiotic administration and ear examination were performed after hospitalization. However, because control of inflammation was not achieved, Burow's solution was used. Otorrhea improved following administration two times. Because granulation tissue was reduced, we discharged the patient.
    Burow's solution was effective for malignant external otitis.
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  • Masayuki Ishida, Motoyoshi Maruyama, Masatsugu Asai, Yukio Watanabe
    2005 Volume 98 Issue 12 Pages 941-944
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Epistaxis is a common complaint facing the otolaryngologist. Some of these patients need hospitalization.
    Here we report a case of intractable epistaxis of 46-year-old man. He was initially treated with anteroposterior packing. But he was often rebleeding during hospital admission so anemia was increasing. He was treated by superselective intra-arterial embolization of the sphenopalatine artery. A micro coil was delivered into the sphenopalatine artery by the catheter. He needed a blood transfusion before and after embolization. After the procedure, he did not rebleed and had no complications.
    Therapeutic intra-arterial embolization is considered to be an effective therapy for intractable epistaxis in cases where the bleeding point is undetectable. Possible complications of intra-arterial embolization will be discussed.
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  • Takehito Kishino, Masayuki Karaki, Kazunori Miyabe, Nozomu Mori
    2005 Volume 98 Issue 12 Pages 945-951
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Paranasal mycosis is divided into non-invasive and invasive types. The invasive type is rare, but sometimes fatal; it can extend up to the skull base and affect the orbital cavity with bone destruction. We encountered a case of invasive paranasal-skull base mycosis resistant to surgical and pharmacological treatments. A 78-year-old man developed persistent headache and retro-ocular pain in June, 2004, and consulted the Department of Neurosurgery and Otorhinolaryngology, Ritsurin Hospital on July 20. CT scan demonstrated a soft tissue shadow in the ethmoid and sphenoid sinus with bone destruction of the skull base. We performed endonasal endoscopic biopsy on July 30, but we could not open the sphenoid sinus because of bleeding. Therefore, we only opened the bilateral ethmoid sinuses. The result of biopsy showed granulation tissue. On August 11, endonasal endoscopic surgery was performed to obtain biopsy and culture as well as to drain the sphenoid sinus. The second histopathological examination demonstrated a fungus ball. Culture of this fungus ball demonstrated Aspergillus fumigatus. Post-operative CT scan showed the persistent residue of a soft tissue shadow and expansion of a bone defect of the skull base. The patient was referred to Kagawa University for further treatment. Endonasal endoscopic surgery was performed again to remove residual fungus on August 20. Antifungal drug therapies had been administered throughout the treatment period, but we failed to control the fungal disease. The patient died on September 21.
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  • Junichi Wakashima
    2005 Volume 98 Issue 12 Pages 953-957
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    This study was performed to review the experience of 3 patients with sinonasal inverted papilloma who underwent transnasal endoscopic medial maxillectomy. The average operative time was 1 hour 38 minutes and the average blood loss was 123ml. There was no recurrence with average follow-up of 28.7 months. I discuss the management of the medial wall of the maxillary sinus during resection of the tumor. Transnasal endoscopic medial maxillectomy is an effective technique for inverted papilloma with extension to the maxillary sinus.
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  • Youhei Kumabe, Yoshihiro Tamura, Masako Nakai, Seishi Hasebe
    2005 Volume 98 Issue 12 Pages 959-964
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Spontaneous regression of any malignant tumor is a rare event, occurring in about 1 per 60, 000-100, 000 among the total number of cases of malignant tumor. We report a case of the spontaneous regression of the hypopharyngeal carcinoma with multiple pulmonary metastases.
    The patient was a 75-year-old man who complained of dysphagia. He was found to have squamous cell carcinoma of the hypopharynx with multiple pulmonary metastases. Since his airway was almost occluded by the tumor, tracheostomy was performed urgently. About two weeks later, while preparing for chemotherapy for the tumor, the primary tumor began to reduce without any treatment. Subsequently not only the primary tumor but also metastatic lesion continued to reduce spontaneously, and about four months later, they disappeared completely.
    It is thought that elucidation of the mechanisms of spontaneous regression of malignant tumors could possibly lead to a more effective therapy for cancer.
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  • Tomoyasu Tachibana, Michihiro Nakada, Teruaki Takishita, Toru Watanabe
    2005 Volume 98 Issue 12 Pages 965-968
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    We experienced a case of laryngeal amyloidosis. The patient was a 54-year-old woman who complained of hoarseness and throat discomfort. We found a yellow smooth-surfaced tumor in the right false vocal cord by laryngeal fiberscopy. The mobility of the right vocal cord was restricted. Biopsy findings by laryngomicrosurgery were consistent with amyloidosis. The lesion was not found in any other organization. Considering the risk of dyspnea, the mass was excised and vaporized with a KTP laser. There have been no remarkable recurrent signs.
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  • Tsuyoshi Kojima, Kazuhiko Shoji, Satoshi Ikegami, Shinji Suzuki, Yo Ki ...
    2005 Volume 98 Issue 12 Pages 969-972
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Most malignant thyroid nodules are surgically treated. This report reviews changes in size of malignant thyroid nodules; none of them received any medical and surgical treatment. Three hundred and three nodules were diagnosed as malignant using fine needle aspiration biopsy (FNAB) and ultrasonography from 1997 to 2003. In 17 patients (19 nodules), they were observed for more than 6 months. We examined the transition of their major axis by ultrasonography. Large nodules (>10mm) and nodules in younger patients (age<50) tend to increase in size. As compared with benign nodules, malignant nodules tend to increase in large nodules (>10mm).
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  • Atsuko Takamaki, Ryo Kawata, Ayumi Hayashi, Koutetsu Lee, Tetsuya Tera ...
    2005 Volume 98 Issue 12 Pages 973-977
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    Total parathyroidectomy and autotransplantation of parathyroid glands were performed in 9 patients and subtotal parathyroidectomy was performed in 7 patients with secondary hyperparathyroidism resulting from chronic renal failure. The detection rate of enlarged parathyroid glands by preoperative imaging was 38% by computed tomography, 77% by ultrasonography, and 44% by MIBI scintigraphy. The removal rate of parathyroid glands by operation was 89%.
    In order to remove supernumerary glands, we need to improve operation methods. It is appropriate that the resection of pre- and paratrachial tissues should be performed in addition to the simple parathyroidectomy in cases in which not all parathyroid glands can be found.
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  • Ayumi Hayashi, Ryo Kawata, Masaaki Higashino, Tetsuya Terada, Hiroshi ...
    2005 Volume 98 Issue 12 Pages 979-983
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
    First branchial cleft anomalies were diagnosed in 4 patients between 2000 and 2004; 3 cases were cysts and 1 case was a fistula. It is difficult to diagnose first branchial cysts before operation. An operation is often performed as for a parotid tumor, especially Warthin tumor located in the inferior pole. Although first branchial cleft anomalies account for less than 10% of all branchial abnormalities, some cases may be misdiagnosed as parotid gland tumor. On the other hand, first branchial fistula was easy to diagnose because it was open to the external auditory canal and/or infra-auricular skin. However, since first branchial fistula are often close to facial nerves, it is necessary to perform the surgery carefully.
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  • Y. Ito
    2005 Volume 98 Issue 12 Pages 984-985
    Published: December 01, 2005
    Released on J-STAGE: October 07, 2011
    JOURNAL FREE ACCESS
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