Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 98, Issue 5
Displaying 1-14 of 14 articles from this issue
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  • Multifactorial Processes in the Development and Persistence of Chronic Sinusitis
    Sachio Takeno, Koji Yajin
    2005 Volume 98 Issue 5 Pages 343-354
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.343
    JOURNAL FREE ACCESS
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    In the past decades, a great deal of knowledge has been accumulated about the immunopathology of chronic sinusitis. Introduction of the endoscopic approach and low-dose macrolide therapy to the clinical field facilitated recognition of the significance of impairment of two important mechanisms necessary for healthy sinus function: patency of sinus ostia in the lateral nasal wall and the maintenance of mucociliary clearance, in the development of the sinus disease. The division of chronic sinusitis into allergy-associated and non-allergy associated highlights the heterogenicity in the celluar profile and cytokine expression involved in the sinus mucosa. Recent studies have implicated eosinophils as a central player in persistent inflammation occurring in non-infectious chronic sinusitis. High expression of Th2-type cytokines concomitant with the infiltration of a predominant number of CD4-positive cells and its Th2 subsets play a role in the pathogenesis of eosinophil inflammation. In addition, the finding that part of the non-allergic patients also shared Th-2 type immune responses supports the concept of chronic sinusitis as a Th2-mediated disease process.
    Despite these achievements, management and treatment of chronic sinusitis with typical eosinophilia remain difficult and frustrating work for ENT surgeons. Corticosteroids and leukotriene receptor antagonists are potent anti-inflammatory agents available for symptomatic relief and prevention of the disease after sinus surgery. Emerging views on the molecular biologic action of both glucocorticoid and cysteinyl leukotriene receptors elucidate complex interplay between cytokines, chemical mediators, and inflammatory products in inducing eosinophil accumulation in the sinus mucosa.
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  • Nasopharyngeal Tuberculosis with Tuberculosis Otitis Media
    K. Nibu, [in Japanese]
    2005 Volume 98 Issue 5 Pages 356-357
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.356
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  • Antibiotic Treatment Based on Clinical Stratification of Acute Otitis Media
    Yoko Sato
    2005 Volume 98 Issue 5 Pages 359-365
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.359
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    It is known that the increase of drug-resistant bacteria is caused by overuse of antibiotics. The aim of this study is to demonstrate the effectiveness of non-antibiotic treatment depending on the clinical stratification of acute otitis media (AOM) while awaiting the results of susceptibility testing. Sixty-four patients with an age range of 0 to 12 years took part in this study. We attempted to minimize the use of antibiotics for the first three days until the results of susceptibility testing were obtained. Patients without otorrhea (92%) were classified into three categories according to the scoring system of redness and swelling of the tympanic membrane (clinical stratification): mild (36%), moderate (26%), and severe (30%) AOM. Myringotomies were performed in all severe cases and some of the moderate cases. The isolates from the nasopharynx were mainly Haemophilus influenzae (38%), Streptococcus pneumoniae (33%), and Branhamella catarrhalis (20%), where 28% of H. influenzae was ampicillin-resistant and 54% of S. pneumoniae was penicillin-resistant. Treatments were classified based on the timing of antibiotic treatment: non-antibiotic treatment throughout overall time, antibiotic treatment based on the results of susceptibility testing, antibiotic treatment on the day after the first visit, and antibiotic treatment at the first visit. Their ratios were 57%, 35%, 4%, and 4%, respectively, for mild AOM cases, 6%, 24%, 0% and 70% for moderate AOM cases, and 0%, 11%, 21%, and 68% for severe AOM cases. Our results suggest that mild AOM cases can be successfully treated without using antibiotics until the results of susceptibility testing are obtained. In addition, non-antibiotic treatment for the first three days is acceptable even for some of the moderate or severe AOM cases.
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  • A Study of 209 Consecutive Cases of Middle Ear Surgery in the Oto-rhino-laryngological Surgi-center
    Mikino Kikura, Tomoyuki Hoshino, Mariko Matsumoto, Keiko Kikawada, Tor ...
    2005 Volume 98 Issue 5 Pages 367-371
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.367
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    Objective: The aim of the present study is to examine the outcome of middle ear surgery in terms of hearing functions, graft take rate, complications, prognoses, and safety of same day middle ear surgery with 3-day admission.
    Design: Prospective cohort study in consecutive middle ear surgery patients.
    Setting: University-affiliated municipal oto-rhino-laryngological surgi-center.
    Methods: We prospectively analyzed the surgical outcome of 209 consecutive cases of middle ear surgery (176 patients) with regard to postoperative hearing functions, graft take rate, complications including infections, prognoses, and safety.
    Results: There were 198 tympanoplasties (Type I: 131, Type III: 46, Type IV: 10, and Type 0: 11) and 11 other operations. In the 198 tympanoplasties, the rate of reperforation of the eardrum was 4.5% in Type I, 2.2% in Type III, and 0% in Type IV and Type 0 tympanoplasties. There were two occurrences of post-operative ear infection in chronic otitis media (tympanoplasty I), and the infection rate for all middle ear procedures was 1.0%. Analysis of the results revealed that hearing functions and graft take rates of tympanoplasties, and the incidence of complications were comparable to the results of previous studies in outpatient settings.
    Conclusions: This study provided an appropriate characterization of the outcomes of middle ear surgery, and this information will be useful in the areas of informed consent, patient counseling, surgical treatment decisions, and cost analysis. This study confirms the safety of same-day middle ear surgery during 3-day admission even in Type III and Type IV tympanoplasty with mastoid obliteration.
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  • A Case of the Inverted Tooth in Maxillary Sinus
    Hideki Oka, Sadamu Takayasu, Keijiro Fukazawa, Masafumi Sakagami
    2005 Volume 98 Issue 5 Pages 373-376
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.373
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    A case of an inverted tooth in the maxillary sinus was reported. The patient was a 56-year-old man who presented with cheek pain of the left side. Computed tomography showed a tooth-like mass in the left maxillary sinus. Thereafter, the patient underwent endoscopic endonasal surgery. The mass was located posteriorly in the antrum. A small hole was made at the lateral wall of the inferior meatus and the mass was directly removed with forceps through the hole. The mass was diagnosed as an inverted tooth and the patient's complaint of cheek pain immediately disappeared. We considered that this approach was less invasive than the conventional approach. In this paper, the relation of the surgical approach to the site of the inverted tooth are discussed.
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  • Clinical Studies of Idiopathic Paranasal Cysts
    Hiroshi Sakaida, Masayoshi Kobayashi, Atsushi Yuta, Yuuichi Majima
    2005 Volume 98 Issue 5 Pages 377-380
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.377
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    Clinical studies were conducted on 39 patients with an idiopathic paranasal cyst at Mie University Hospital over 20 years, between January 1983 and December 2002. Cases included 14 ethomoid sinus, 11 frontal sinus, 6 maxillary sinus, 4 sphenoid sinus and 4 frontal and ethomoid sinus. Most of the cases had a simple cyst, and only 2 cases had multiple cysts. Swelling of the eyelid, exopthalmos and double vision were frequently noted in frontal cysts, ethmoid cysts and frontoethmoid cysts. Cheek swelling or pain was noted in maxillary sinus cysts. Three cases of four sphenoid cysts were found accidentally on MRI without ocular symptoms. Ethmoid and sphenoid cysts were treated by intranasal operation and frontal cysts were done by rhinotomy. Maxillary cysts were treated intranasally or by rhinotomy by opening the anterior wall of the maxillary sinus. Prognoses of most cases were good, while 3 cases of ethmoid cyst re-appeared.
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  • Clinical Analysis of Orbital Blowout Fractures: A Review of 29 Cases
    Suetaka Nishiike, Miki Nagai, Aya Nakagawa, Masaki Konishi, Takashi Ka ...
    2005 Volume 98 Issue 5 Pages 381-388
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.381
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    We examined 29 cases of blowout fractures (30 operations) in which repair surgery was performed at our department. There were 24 orbital floor fractures, 3 orbital medial wall fractures and 2 combined fractures of floor and medial wall. In subjective evaluation, the disturbance of eye movement was improved or cured in all cases. In subjective evaluation, the disturbance of eye movement evaluated by the Hess chart was significantly improved after the operation. The disturbance of eye movement at the first examination in the patients less than 19 years old was significantly worse than that in the patients more than 20 years old. The prognosis of eye-movement in cases of strong disturbance of eye movement at the first examination was significantly worse than in cases of weak disturbance at the first examination. The prognosis of eye-movement in cases with a linear fracture was significantly worse than in cases with a punched-out fracture. The prognosis in cases that were operated on within 9 days after injury did not differ from cases operated after 10 days. The decision to operate for blowout fractures could be made after an adequate observation period of more than 7-10 days.
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  • A Case of Tuberculous Parotitis
    Yohji Asama, Fumiyuki Goto
    2005 Volume 98 Issue 5 Pages 389-393
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.389
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    We report a case of tuberculous parotitis following acute tonsillitis. A 30-year-old female was admitted to our hospital because of sore throat, right subauricular swelling, fever, and headache. Initial CT examination demonstrated inflammatory changes in the right parotid gland and bilateral tonsils. She was discharged after intensive antibiotics therapy. Two weeks later swelling of the right parotid gland recurred. The second CT examination demonstrated abscess of the right parotid gland and adjacent lymph node swelling. Intensive antibiotics therapy had no significant effect. We performed surgical drainage of the parotid gland and biopsy of the lymph node. The specimen showed milliary abscess together with giant cells which were quite similar to Langerhans cell. Although Ziehl-Neelsen straining of the specimen and PCR of the discharge did not disclose any acid-fast bacilli, we speculated that tuberculosis infection was present. Therefore, we performed tuberculin skin test, which showed an intense positive reaction. The patient had a history of medical work in which she came in close contact with tuberculosis patients. Antimycobacterial therapy was started based only on these clinical manifestations. All of the clinical symptom disappeared. We report the difficulty in diagnosing tuberculosis of the parotid gland.
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  • Six Cases of Minor Salivary Gland Tumors
    Suzuyo Okazaki, Kenji Hattori, Nobuko Iwata, Yoshihiro Uno
    2005 Volume 98 Issue 5 Pages 395-400
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.395
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    Minor salivary gland tumors are rare, and we experienced 6 cases in 5 years. The occurrence rate this type of tumor was 9.1% of all patients with salivary gland tumors. The patients included 3 male and 3 female, the average age was 61.3 years with a range of 47 to 84 years. Three of 6 cases had a tumor in the hard palate, the other patient had a tumor in the tongue, the nasal septum, and the upper lip. Histopathological examination revealed that 3 cases were pleomorphic adenoma, two cases were carcinoma ex pleomorphic adenoma, and one case was papillary cystadenocarcinoma. Because minor salivary gland tumors tend to be malignant, it is extremely important to resect the tumor en bloc in the first operation.
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  • Endoscopic Observation of the Stenon's Duct in a Patient with Extreme Dilatation of the Duct
    Mikio Suzuki, Satoshi Sonoda, Jin Hoshi, Takao Ogawa, Ichiro Tojima, M ...
    2005 Volume 98 Issue 5 Pages 401-408
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.401
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    We report a 47-year-old male with extreme dilatation of the Stenon's duct resulting from parotid papilla obstruction. He visited our clinic with a painless swelling in his left cheek and oral cavity after eating. The swelling had been present for four months. Physical examination, computed tomography, and magnetic resonance imaging showed that the lesion was due to extreme dilatation of the Stenon's duct. The obstruction was corrected by the surgical creation of a new, larger orifice. The cheek swelling immediately disappeared and has not returned after three months. Endoscopic examination of the Stenon's duct using a dacryoendoscope and nasal endoscope was carried out during surgery. These endoscopes were easily inserted into the Stenon's duct and provided adequate resolution of images of the duct lumen. Inflammatory debris and ductal swelling with hyperemia were observed in the lumen and gradually diminished from the parotid papilla to the parotid gland. In the parotid gland, the lumen was dilated, but did not show debris or ductal swelling. This endoscopic examination was very useful in understanding the etiology of the extreme dilatation of the Stenon's duct.
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  • Evaluation of Superselective Intraarterial Chemotherapy for Advanced Head and Neck Cancer
    Shoichiro Takeda, Koshiro Nakamura, Taisuke Kobayashi, Shiho Ando, Ken ...
    2005 Volume 98 Issue 5 Pages 409-414
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.409
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    Between January 2001 and August 2003, 15 patients (13 males, 2 females) with advanced head and neck cancer were treated by superselective intra-arterial chemotherapy with cisplatin and irradiation. Chemotherapy was performed through a catheter inserted into the feeding artery via the right forearm artery. The dose of cisplatin was 150mg/m2 per infusion session. Irradiation was started on day 9. The complete and partial response rates were 46.7% (seven patients) and 40% (six patients), respectively. None of the patients experienced Grade 4 chemotoxicity such as hematological, renal dysfunction or gastrointestinal symptoms. Only one of nine patients who underwent neck dessection demonstrated residual cancer cells in the neck lymphnodes on pathological examination. One of six patients who underwent radical surgery for the primary tumor showed Grade IV on Oboshi's pathological criteria. The other four patients were classified in Grade IIB. The remaining one patient was Grade IIA.
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  • One Case of Giant Cervical Lipoma
    Manabu Nakamura, Eriko Shibosawa, Kouichiro Tsutsumi, Izumi Koizuka
    2005 Volume 98 Issue 5 Pages 415-419
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.415
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    We encountered a patient with an untreated giant lipoma and report the imaging findings with a review of the literature. A 57-year-old man had a chief complaint of right neck tumor. He noticed a mass in the right cervical region in 1994, and although the mass increased, he did not seek treatment. He became impaired in daily life by the mass, and was examined for the first time at this hospital on July 29, 2003. There was giant mass on the clavicle from the chin of the right cervix. The mass had diameter of 18cm and the appearance was smooth and soft. We diagnosed the mass as lipoma on CT/MRI and performed tumorectomy under general anaesthesia on September 30, 2003. The resected giant tumor weighed 1050g and measured 18×18×9cm. The tumor was confirmed as lipoma on pathology. This was the heaviest lipoma resected in Japan according to a literature search regarding cervical lipoma. One year postoperatively there is no sign of relapse, and the course has been good.
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  • Papillary Carcinoma Arising from the Lateral Branch Remnant of the Thyroglossal Duct
    Ryusuke Hori, Tomoyuki Haji
    2005 Volume 98 Issue 5 Pages 421-425
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.421
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    An 81-year-old man visited our hospital for a lateral neck mass outside the thyroid cartilage. Fine needle aspiration of the neck mass showed class V, papillary carcinoma, but thyroid class I. Total thyroidectomy and D2a neck dissection were performed, and histological diagnosis revealed papillary carcinoma of the neck mass, but, no tumor of the thyroid. In this case, the lateral neck mass was clinically diagnosed as primary papillary carcinoma arising from the lateral branch remnant of the thyroglossal duct.
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  • Neurovascular Compression Syndrome
    K. Tomoda, [in Japanese], [in Japanese]
    2005 Volume 98 Issue 5 Pages 426-427
    Published: May 01, 2005
    Released on J-STAGE: October 07, 2011
    DOIhttps://doi.org/10.5631/jibirin.98.426
    JOURNAL FREE ACCESS
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