Practica Oto-Rhino-Laryngologica

Response to Abnormal Sensation in the Throat

Toshio Ogoshi

2006 Volume 99 Issue 11 Pages 891-896
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.891

JOURNAL FREE ACCESS

Show abstractHide abstract

Abnormal sensations in the throat can be induced by a wide variety of causes, and therefore requires both mental and physical approaches to treatment. In addition, malignant tumors maybe detected in a small number of patients with complaints of abnormal sensations in the throat, and this must never be overlooked. While there have been numerous reports descring various tests, diagnostic methods for determining the causes of abnormal sensations in the throat as well as administration the of therapeutic drugs vary among facilities and few reports have investigated cases of abnormal sensations refractory to initial treatment. Furthermore, although the involvement of psychogenesis in this illness is not small, the extent of its involvement is extremely difficult to assess. While therapeutic determination using various psychological tests and the effects of mild tranquilizers has been attempted, clarification of the extent of psychogenic involvement in this illness remains difficult, as does the treatment of this illness as a psychosomatic illness in the field of otolaryngology.
Improvement in abnormal sensations in the throat is determined by changes in the subjective symptoms of the patient. Many reports on the treatment of abnormal sensations in the throat have focused on the effects of administering a specific drug in response to a defined cause of illness, and few have reported the final improvement rates of the patients included in these studies. In other words, it is important to investigate secondary and tertiary treatment methods and the extent to which abnormal sensations in the throat has been improved in patients with abnormal sensations refractory to initial treatment, as well as the appropriate course of action when improvements are not observed.

View full abstract

Download PDF (883K)
Intra-canalicular Tumors

the Middle Cranial Fossa Approach

Y. Inoue

2006 Volume 99 Issue 11 Pages 898-899
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.898

JOURNAL FREE ACCESS

Download PDF (2251K)
A Case of Dissociated Taste Impairment after Injury of the Major Petrosus Nerve

Masakazu Goda, Kazunori Sekine, Katsuhiko Nakamura, Noriaki Takeda

2006 Volume 99 Issue 11 Pages 901-903
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.901

JOURNAL FREE ACCESS

Show abstractHide abstract

We report the case of a 16-year-old female patient with taste impairment of the soft palate. After receiving a skull fracture due to a traffic accident, she experienced the taste of bitter chocolate. CT showed the fracture around the right temporal bone. Electrogustometry showed that the decreased sensation of taste was restricted to the right soft palate. Shirmer test showed that lacrimal secretion of the right eye was decreased. These findings indicated that the selective injury of the major petrosus nerve on the right side due to the fracture caused taste impairment of the soft palate. It has been reported that the sensation of a sweet taste is more sensitive in the soft palate of young women. Therefore, it is suggested that the taste impairment of the soft palate caused the dissociated impairment of a sweet taste, resulting in the taste of bitter chocolate in the present case.

View full abstract

Download PDF (2233K)
Clinical Features of Benign Paroxysmal Positional Vertigo of the Horizontal Canal

Yasuo Ogawa, Mamoru Suzuki, Akihide Ichimura, Akira Hagiwara, Naoharu ...

2006 Volume 99 Issue 11 Pages 905-911
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.905

JOURNAL FREE ACCESS

Show abstractHide abstract

It has been considered that both ageotropic and geotropic direction-changing nystagmus frequently arise from central lesions, but lately, reports showing that direction-changing positional nystagmus is induced by peripheral lesions have increased. This study was designed to investigate the clinical features of horizontal canal variants of paroxysmal positional vertigo (HC-PPV). A retrospective study of 151 patients with HC-PPV was done. Patients complained of positional vertigo associated with direction-changing horizontal positional nystagmus, and either geotropic or ageotropic were examined. Horizontal nystagmus was triggered in all patients when rolled to either side in a supine position. The patients were 44 men and 107 women ranging from 24 to 88 years old (average 58.2 years old). The nystagmus was geotropic in 75 and ageotropic in 76 patients. There were many cases without latency in ageotropic cases, whereas there was latency in geotropic cases. As for the duration of the nystagmus, many ageotropic cases lasted more than one minute, whereas in many geotropic cases, the duration of nystagmus was less than one minute. Pure horizontal nystagmus was observed in most ageotropic cases, but in most geotropic cases, horizontal nystagmus with a torsional component was observed. Autotherapy was given to both geotropic and ageotropic cases. Geotropic cases tended to be cured in a short period compared with ageotropic cases, but some cases needed a longer time to cure in both groups. The “barbecue rotation” maneuver for treatment was performed in some cases. The effect of this maneuver was not so good as the Eply maneuver for BPPV.

View full abstract

Download PDF (1181K)
Acute Mastoiditis: A Review of Nine Cases

Kyo Yasuda, Rei Kitani, Akira Sasaki, Hideichi Shinkawa

2006 Volume 99 Issue 11 Pages 913-918
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.913

JOURNAL FREE ACCESS

Show abstractHide abstract

From 2000 to 2002, we treated 9 cases (4 males and 5 females) of acute mastoiditis following acute otitis media. Most of these cases complained of otalgia, otorrhea and hearing loss, and one each had retroauricular swelling and headache. Four cases had serious complications such as facial nerve palsy, subperiosteal abscess, bacterial meningitis, labyrinthitis and Gradenigo syndrome. All patients revealed mixed hearing loss on pure-tone audiometry and all but 1 case showed complete recovery of hearing. Etiological bacteria from the middle ear were cultured and there were 2 cases each of Streptococcus pneumoniae and Staphylococcus aureus. 3 patients were cured by conservative therapy consisting of intravenous antibiotics, myringotomy or insertion of a ventilation tube. Six patients underwent surgical therapy with a simple mastoidectomy and postoperative antibiotic therapy. Facial nerve decompression was performed in 1 case.
The clinical features and conservative or surgical intervention of mastoiditis are discussed.

View full abstract

Download PDF (5712K)
Two Cases of Primary Small Cell Carcinoma of the Nasal Cavity and Paranasal Sinus

Ryuta Kamekura, Hiroshi Tsubota, Tomoko Shintani, Ryokichi Imai, Nohuh ...

2006 Volume 99 Issue 11 Pages 919-927
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.919

JOURNAL FREE ACCESS

Show abstractHide abstract

Small cell carcinoma is relatively common in the lung, but very rare in the head and neck region. We describe our experience with two extremely rare cases of small cell carcinoma arising in the nasal cavity and paranasal sinus.
(Case 1) The patient was a 54-year-old man who had complained of left eyelid swelling and diplopia. He had a mass in the left maxillary sinus. He was treated with irradiation and chemotherapy. However, during the treatment, distant metastasis appeared in the skin and he died 4 months after the initial treatment.
(Case 2) The patient was a 47-year-old woman who had complained of left nasal obstruction. She had a mass in the left nasal cavity. Surgical resection and postoperative radiotherapy were performed. However, after the initial treatment, a metastatic swelling of the left cervical lymph node appeared. Left neck dissection was performed, and she underwent two courses of adjuvant chemotherapy. Following the initial treatment, no evidence of recurrence has been observed for 29 months.

View full abstract

Download PDF (9244K)
Examination of MRI and Histopathological Findings of Hematocele in the Maxillary Sinus

Shinpei Nagato, Kazuma Sugahara, Koichi Watanuki, Kuniyoshi Tanaka, Ta ...

2006 Volume 99 Issue 11 Pages 929-934
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.929

JOURNAL FREE ACCESS

Show abstractHide abstract

It is known that MRI imaging shows multiple findings in patients with hematocele of the maxillary sinus. Therefore, the diagnosis of hematocele is difficult with only imaging examination. In the present study, the relationships between MRI findings and histopathological findings were examind in 5 patients with hematocele in the maxillary sinus. MRI examinations showed various intensities in the lesions. The portions which showed the highest intensities in T2 enhanced images and which also showed a contrasted effect were diagnosed as old hematomas on histopathological examination. In contrast, the portions which did not show a contrasted effect were diagnosed as connective tissues and irritated mucosa. The portions which showed the high intensities in both T1 and T2 enhanced images were located in the peripheral region of the maxillary sinus and were diagnosed as swollen mucosa with inflamation. These results suggest that the findings of MRI imaging can provide surgeons with much information. Therefore, MRI examination may be important in preoperative diagnosis.

View full abstract

Download PDF (8239K)
Clinical Study of Endoscopic Endonasal Dacryocystorhinostomy

Teppei Tani, Shigehiro Owaki, Taichirou Miyake, Michiyo Mitta, Norikun ...

2006 Volume 99 Issue 11 Pages 935-939
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.935

JOURNAL FREE ACCESS

Show abstractHide abstract

Nasolacrimal duct obstruction is normally treated with extranasal dacryocystorhinostomy, but nasal endoscopic dacryocystorhinostomy has recently become more common due to the development of nasal endoscopy. The subjects of the study were 23 patients who underwent nasal endoscopic dacryocystorhinostomy between December 2001 and July 2005 at Kohka Public Hospital, and who were followed for 6 months or longer. The presence or absence of lacrimal canaliculus obstruction was examined in a lacrimal probe test before surgery, and lacrimal contrast XP and CT were performed. During surgery, a Nunchakutype silicon tube was indwelled usually. The silicon tube was removed 3 months after surgery, and the success of the surgery was evaluated based on the improvement of subjective symptoms. The success rate was 88%, but obstruction recurred in 3 patients. Nasal endoscopic dacryocystorhinostomy was repeated in all recurrent cases, and obstruction recurred again in 1 patient. Pus was retained in the lacrimal sac in the recurrent cases, suggesting the involvement of infection.

View full abstract

Download PDF (5024K)
Parotid Gland Abscess with Facial Nerve Paralysis

Kazuhiko Nario, Hiroshi Miyahara, Hiroshi Kajikawa

2006 Volume 99 Issue 11 Pages 941-944
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.941

JOURNAL FREE ACCESS

Show abstractHide abstract

A case of parotid gland abscess with facial nerve paralysis was reported. A 61-year-old woman with pain and swelling of the left parotid gland was referred to our hospital. Two weeks previously, she had been diagnosed with parotitis and treated with an oral antibiotic. The pain and swelling of the left parotid gland initially improved; however, they returned and were much more severe. On examination at our hospital, a 6-cm, red, firm, painful mass was present at the left parotid gland. There was no pus from the orifice of the parotid duct. After admission she was treated with an intravenous antibiotic.
One day after admission, incomplete facial nerve paralysis occurred. Computed tomography demonstrated a low density area within the left parotid gland. She was diagnosed with parotid gland abscess with facial nerve paralysis. We emergently drained the abscess in the left parotid gland. Two weeks after the operation, her complaints subsided and the swelling of the parotid gland disappeared. Three months later, the facial nerve paralysis completely recovered.

View full abstract

Download PDF (2893K)
Immunohistochemical Features of Myoepithelioma and Myoepithelial Carcinoma

Yoichi Hasegawa, Kenji Hattori, Yoshihiro Uno, Suzuyo Okazaki

2006 Volume 99 Issue 11 Pages 945-949
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.945

JOURNAL FREE ACCESS

Show abstractHide abstract

Myoepithelioma (ME) and myoepithelial carcinoma (MEC) are both rare salivary neoplasms. We report cases of ME and MEC. The ME case was a 36-year-old female complaining of a painless mass in the parotid gland present for four years. The MEC case was a 50-year-old male suffering from nasal obstruction caused by the recurrence of a previous pleomorphic adenoma which arose from the hard palate, extending to the nasal cavity. Both tumors were surgically removed. Histopathological examination demonstrated that both tumors consisted of spindle and plasmacytoid cells, and, in the MEC case, infiltrative growth and cytologic abnormalities. Immunohistochemical study revealed positive reactions for SMA, vimentin, S-100 protein, and CK-14 in both tumor cell types, and significantly higher expressions of p53 and Ki-67 in the MEC case.

View full abstract

Download PDF (9597K)
Smoking is a Risk Factor of Peritonsillar Abscess

Atsushi Kamijo, Takanobu Shimada, Motohiro Moriyama, Goro Takahashi, K ...

2006 Volume 99 Issue 11 Pages 951-954
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.951

JOURNAL FREE ACCESS

Show abstractHide abstract

Background: Peritonsillar abscess (PTA) is rare in infants and children; however, it is common in males in their 20s, 30s, and 40s in Japan. The age and sex distribution led us to speculate that smoking might be one of the risk factors of PTA.
Patients: A retrospective study of inpatient charts over 10 years (from 1996 to 2005) was performed on 32 patients diagnosed as having PTA and 21 patients diagnosed with cervical abscess (CA). The ages, smoking habits, and bacteriological histories were collected from the charts and compared in each group.
Results: The male to female ratio was 7:1 in the PTA group, whereas it was 1:1 in the CA group. Only one out of 32 cases was equal to or less than 15-years-old in the PTA group, and 4 of 21 cases in the CA group. Seventy-five percent of the PTA group were smokers, which was significantly higher than the smoker prevalence in the CA group (23.8%). More than one species of anaerobes were isolated from 12 cases in the PTA group, and, among those cases, 11 (91.7%) had a smoking habit.
Conclusion: We conclude that smoking could be one of the risk factors of peritonsillar abscess by promoting anaerobic bacterial infection.

View full abstract

Download PDF (611K)
A Case of Epiglottitis Associated with Tsutsugamushi Disease

Hiromi Nagano

2006 Volume 99 Issue 11 Pages 955-959
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.955

JOURNAL FREE ACCESS

Show abstractHide abstract

The case was a 74-year-old man who presented with fever and sore throat. As previous treatment, an internal antiphlogistic had been administered, but subjective symptoms were not improved, and consciousness and blood pressure gradually decreased. The patient was transported by helicopter from a remote island to our hospital. He was diagnosed with acute epiglottitis from local findings and a tracheostomy was not performed. The symptoms and inflammatory reaction subsided with fluoroquinolones and was diagnosed as tsutsugamushi infection from seroreaction. Acute epiglottitis cases unresponsive to antibiotics in tsutsugamushi outbreak areas should be considered for tsutsugamushi for discrimination.

View full abstract

Download PDF (4386K)
Clinical Study of Facial Bone Fracture

Toshifumi Hasegawa, Kazuo Kumoi

2006 Volume 99 Issue 11 Pages 961-965
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.961

JOURNAL FREE ACCESS

Show abstractHide abstract

One hundred and four cases (79 males and 25 females) with facial bone fractures treated at Himeji Medical Center between June 2000 and May 2004 were reviewed. Patient ages ranged from 2 to 78 years with an average of 30.8 years. There were 127 sites of facial bone fractures, which were the nasal bone (54 cases), the orbit (37 cases), the maxilla (11 cases), the mandible (6 cases), the zygoma (17 cases), and the frontal bone (2 cases). Orbital bone fractures consisted of 19 orbital floor fractures, 16 medial orbital wall fractures, and 2 lateral orbital wall fractures with 4 cases showing combined fractures of the floor and median wall. The causes of fractures were 1) traffic accidents (32.3%), 2) accidents or falls (24.4%), 3) sports (23.6%), and 4) violence or fights (19.7%).
Surgical treatments were performed for 61 (48.0%) of 127 sites and the remaining cases were treated conservatively. There were 32 cases (59.3%) undergoing reduction of the nasal bone, 19 cases (51.4%) reduction of the orbit, one case (9.1%) reduction of the maxilla, 6 cases (100%) reduction of the mandible, and 3 cases (17.6%) reduction of the zygoma. Nasal fractures were reduced under local anesthesia in 29 (90.6%) patients. We used the transorbital approach with sub-ciliary incision for 14 cases of the orbital floor fracture and the endonasal approach with an endoscope for 5 cases of medial orbital wall fracture. Eleven (84.6%) of 13 orbital floor fractures needed orbital floor reconstruction with iliac bone grafts.
Seventeen cases (16.3%) had additional fracture sites or injuries in the body and needed treatment provided by staff from several different departments. For 6 cases, the facial bone fracture was repaired at the same time as other orthopedic procedures under general anesthesia.

View full abstract

Download PDF (841K)
The Efficacy of Early Treatment by Ramatroban in Combination with Antihistamine in Patients with Japanese Cedar Pollinosis

Satoshi Seno, Masayuki Shibayama, Masahiko Arikata, Ichiro Tojima, Tak ...

2006 Volume 99 Issue 11 Pages 967-977
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.967

JOURNAL FREE ACCESS

Show abstractHide abstract

We evaluated the efficacy of early treatment by ramatroban and antihistamine in patients with Japanese cedar pollinosis by comparing treatment before the start of the pollen season and treatment after the pollen had been dispersed. A pollinosis diary and Japanese allergic rhinitis standard QOL questionnaire (JRQLQ No. 1 and No. 2) were used to evaluate the effectiveness.
Huge amounts of Japanese cedar pollen and Japanese cypress pollen were disseminated in Shiga prefecture in 2005. The nasal symptom score, medication score, and symptom medication score showed better outcomes in the early treatment group not only during the Japanese cedar pollen season but also the Japanese cypress pollen compared to the other group. The early treatment group also showed better results in every category of JRQLQ No. 1 and No. 2 compared with the late treatment group. No harmful side effects were observed through the course of this study.
We concluded that early treatment by ramatroban in combination with antihistamine in patients with Japanese cedar pollinosis was useful not only for improving symptoms but also retaining the quality of life during such a heavy pollen-producing year.

View full abstract

Download PDF (1202K)
Kanpo Therapy for Otorhinolaryngology Disease

T. Akisada

2006 Volume 99 Issue 11 Pages 978-979
Published: November 01, 2006
Released on J-STAGE: October 07, 2011

DOIhttps://doi.org/10.5631/jibirin.99.978

JOURNAL FREE ACCESS

Download PDF (425K)

Register with J-STAGE for free!