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Tomohiro Anzai
1987 Volume 1987 Issue Supplement10 Pages
1-24
Published: March 05, 1987
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The protective effect of fosfomycin against cisplatin-induced toxicities was studied in rats, and the platinum concentrations in the serum, kidney and perilymph was measured to clarify the mechanism of ototoxic reduction. Also renal function of pa-. tients with cancer of head and neck after the administration of cisplatin with or with-out fosfomycin was studied.
Cisplatin-induced toxic side effects such as body weight loss, nephrotoxicity and ototoxicity were significantly reduced by combined administration of fosfomycin and cisplatin. The protective effect of fosfomycin against the ototoxic side effects of cisplatin was increased by further continued administration of fosfomycin alone after the combined administration of cisplatin and fosfomycin. The mechanism of toxic reduction was considered to be fosfomycin inhibits the accumulation of cisplatin and reduces its concentration in the kidneys. The platinum concentration in the perilymph could be measured, but the mechanism of ototoxic reduction could not be clarified because the low dose administration of cisplatin did not cause any damage to the kidney or in ner ear, and the high dose administration caused such severe damage to general conditions and kidney that was similar to the inner ear damage between the animals with and without fosfomycin administration.
Clinically, in 12 patients (12 cases) who were given cisplatin the first time and were given both cisplatin and fosfomycin the next time, the occurrence rate of abnormality of renal function test (BUN, creatinine, Ccr) was lower after the combined administration of cisplatin and fosfomycin than after the administration of cisplatin alone. The combined administration of fosfomycin and cisplatin seems to be useful clinically for reduction of cisplatin-induced toxic side effects.
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Kohsei Ohtsuki, Iwao Ohtani, Tohru Aikawa, Tomohiro Anzai, Yoshinari H ...
1987 Volume 1987 Issue Supplement10 Pages
25-29
Published: March 05, 1987
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The influence of Fosfomycin (FOM) against the antitumor effect of Cisplatin (CDDP) was investigated using ddY-strain mice. Each mouse was inoculated with Ehrlich carcinoma cells (2×10
6cells/0.2 ml) subcutaneously. One group was given daily doses of 1.0,1.5 or 2.0 mg/kg/day of CDDP for 5 consecutive days, and the other one was given 5.0,7.5 or 10.0 mg/kg of CDDP for only one day. Both groups were treated with or without 300 mg/kg/day of FOM for consecutive 5 days. The tumors were weighed on day 14.
There was no diffe r ence of the tumor weight between the group of CDDP alone and the one in combination with FOM. It is concluded that this combined administration does not influence the antitumor effect of CDDP.
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Iwao Ohtani, Eriko Omata, Tohru Aikawa, Yohko Sato, Masafumi Murakami, ...
1987 Volume 1987 Issue Supplement10 Pages
30-37
Published: March 05, 1987
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The incidence, location and size of dehiscence of the facial canal were determined from histologic examination of serially sectioned temporal bones.
Dehiscence was measured at its widest diameter. One hundred and twenty-one temporal bones from 63 subjects were examined,5 being unpaired. Dehiscences were found in 101 t emporal bones (83%). Dehiscences with diameters 0.5 mm or larger were found in 86 temporal bones (71%). Ninety percent of the dehiscences were located in the tympanic segment and 10% in the mastoid segment. Of all dehiscence,66% were located adjacent to the oval window. Of the 58subjects in which both temporal bones were available for study,44 (76%) showed dehiscences in both ears.
The present stu d y brings to attention the possible frequent occurrence of the dehiscence and close attention should be paid to surgical procedures concerning the eradication of inflammatory granulation tissue or cholesteatoma matrix from the epitympanic space.
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Tohru Aikawa, Iwao Ohtani, Yohko Sato, Hitomi Kobari, Tomohiro Anzai
1987 Volume 1987 Issue Supplement10 Pages
38-43
Published: March 05, 1987
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A histopathologic study of the temporal bones in two adult cases (four ears) of Down's syndrome is reported. One patient a 38-year-old male with acute myelogenous leukemia, exhibited an obtuse angle of the facial genu, large bony dehiscence in the facial canal, extensive leukemic infiltrate into the middle ear and bone marrow, middle ear effusion, and slightly shortened cochlea. The other patient, a 45-year-old female had a remarkable obtuse angle of the facial genu, large bony dehiscence in the facial canal, and middle ear effusion.
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Yohko Sato, Iwao Ohtani, Tohru Aikawa, Masafumi Murakami, Tomohiro Anz ...
1987 Volume 1987 Issue Supplement10 Pages
44-50
Published: March 05, 1987
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The histopathological findings in the temporal bone of a 36-year-old woman who died of DIG complicated by Wilson's disease are described.
Wilson's disease is characterized by copper depo s ition in liver and basal ganglial lesion of the cerebrum and cornea. In the sections of temporal bones of this case, neither of these abnormal findings were observed.
Hemorrhage due to DIG was observe d in the middle ear and the inner earperilymphatic spaces of the vestibule and cochlea, internal auditory canal, facial nerve and singular nerve. The patient complained of vertigo with left canal paresis and was diagnosed as having vestibular neuritis two years prior to death. However, no morphologic changes related to vertigo were found in the series of the temporal bone slides.
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Masafumi Murakami, Iwao Ohtani, Tohru Aikawa, Yohko Sato, Tomohiro Anz ...
1987 Volume 1987 Issue Supplement10 Pages
51-60
Published: March 05, 1987
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Temporal bone findings in two cases of head injury are reported.
In one patient, longitudinal fractures occurred in bilateral temporal bones, and extended to middle ear in both sides. Bleeding was seen in the tympanic cavity, mastoid air cells, internal auditory canal and facial nerve canal. Bleeding was observed in scala tympani, cochlear aqueduct and endolymphatic sac, but there were no fractures.
In the other patient, bleeding was seen in the internal auditory canal an d facial nerve canal. In right ear, endolymphatic hydrops was observed in all turns of cochlea, but this finding may be inaccurate, because the basilar membrane and osseous spiral lamina curved slightly toward the scala vestibuli like Reissner's membrane.
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Tomohiro Anzai, Iwao Ohtani, Tohru Aikawa, Michio Kobari
1987 Volume 1987 Issue Supplement10 Pages
61-69
Published: March 05, 1987
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The temporal bones from a 44-year-old woman who was diagnosed as having Wegener's granulomatosis are described. Her audiogram showed severe perceptive deafness of both ears. The right temporal bone had many interesting changes. The tympanic cavity, mastoid air cells and eustachian tube were filled with granulation tissue. The crura of the stapes were damaged and foot plate was covered and thinned by granulation tissue. The granulation tissue invaded the round window niche. The round window membrane was swollen and projected into the scala tympani. Reissner's membrane and basilar membrane were torn at the basal and middle turns of the right cochlea, and endolymph-perilymph fistulae were noted. Severe degeneration of the hair cells of the organ of Corti at the sites of the fistulae, and slight degeneration of the stria vascularis were seen.
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Hitomi Kobari, Iwao Ohtani, Kohsei Ohtsuki, Tohru Aikawa, Yohko Sato, ...
1987 Volume 1987 Issue Supplement10 Pages
70-76
Published: March 05, 1987
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Two cases of temporal bone invasion by maxillary cancer are reported.
One patient was a 63-year-old male who died of purulent me n ingitis after the course of five years. Temporal bone findings revealed direct cancer invasion of the petrous apex, polymorphonuclear leukocytes infiltration to the internal auditory canal and modiolus, and otitis media with effusion. The other patient was a 63-year-old female who died of cerebral infarction and cachexia after the course of two years. Temporal bone histopathology revealed otitis media with effusion, extensive neoplastic infiltration to the petrous apex and middle ear, but the labyrinth remained intact.
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Comparison of Data of Audiogram of Hearing Loss and Hearing Level
Manabu Honda, Iwao Ohtani
1987 Volume 1987 Issue Supplement10 Pages
77-82
Published: March 05, 1987
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Data management using a personal-computer was carried out for 6,278 audiograms, especially, a comparison of audiographic data on hearing loss and hearing level.
A difference was observed in the frequency of the perceptive deafness, bu t no such difference was seen in the mother group in results of hearing level and hearing loss.
Analysis of the extent of hearing revealed a 5% difference in results of hearing level and hearing loss in the normal group.
Right and left difference of over 20 dB was seen 14.1% and a difference of over 60 dB was noted in 3.5%.
We also evaluated the usefulness and shortcomings of management of audiographic data by a personal-computer.
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Yukio Ohkouchi, Manabu Honda, Tetsuya Akaike, Iwao Ohtani
1987 Volume 1987 Issue Supplement10 Pages
83-91
Published: March 05, 1987
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Auditory brainstem responses (ABR) were examined in 393 patients treated in our clinic over a 3.5-year period.
ABR patterns were cla s sified into 5 groups: 1) normal responses,2) normal responses to loud sound but prolongation in latency or elevated threshold to low sound,3) prolongation in latency to loud sound,4) partial wave disappearance, and 5) no response. The severity of change in the ABR patterns paralleled roughly the degree of hearing level.
Wave V latency, the interaural latency difference for wave V (IT
5) and the I-V interpeak latency interval (IPL) of retrocochlear hearing loss were prolonged or increased more than that of cochlear hearing loss.
Compared with other intracranial tumo r s, the ABR in cerebellopontine angle tumors showed prolonged wave V latency, or IT
5 and I-V IPL were increased with no responses in many cases.
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Manabu Honda, Yukio Ohkouchi, Iwao Ohtani
1987 Volume 1987 Issue Supplement10 Pages
92-95
Published: March 05, 1987
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Patients with tinnitus were analyzed by the standard test of tinnitus. Most of the patients were in their 40's and came to our clinic within 6 months after the onset of the disease. Many of the patients reported nearin a high-pitched tone. Multiple kinds of tinnitus were found 38% (49/155) of the patients.
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Iwao Ohtani, Kohsei Ohtsuki, Tohru Aikawa, Tomohiro Anzai, Tetsuya Aka ...
1987 Volume 1987 Issue Supplement10 Pages
96-106
Published: March 05, 1987
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Forty-three ears that underwent planned staged tympanoplasty were compared with 52 ears that underwent one-stage tympanoplasty for cholesteatoma. Planned staged tympanoplasty was mainly performed in children, compared with one-stage tympanoplasty; The rate of planned staged tympanoplasty was 64% in children under 9 years, and 59% in teenagers, but it was only 30% in patients over twenty years old.
Patients who underwent planned staged tympanoplasty generally had greater hearing loss than those who underwent one-stage tympanoplasty. Preoperative hearing was within 40 dB in 64% of those in the one-stage tympanoplasty group, but only in 29% of those in the planned staged tympanoplasty group.
In one-stage tympanoplasty, the closed method was performed in two-thirds of the cases and open method was performed in remaining cases. In planned staged tympanoplasty, the open method was performed in two-thirds of the cases.
Residual cholesteatoma was found in 13.2% at the second-stage operation, and it was found more frequently in children under 9 years (27.3%) than in patients over 10 years (7.4%). Residual cholesteatoma appeared in 8.0% treated by the open method and in 23.0% treated by the closed method.
In patients followed for more than 1 year, postoperative hearing level was remained within 40 dB or showed a gain of over 20 dB in 75.0% of those receiving planned staged tympanoplasty and in 68.3% of those receiving one-stage tympanoplasty.
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Tetsuya Akaike, Iwao Ohtani, Tohru Aikawa, Tomohiro Anzai, Kazuo Takeu ...
1987 Volume 1987 Issue Supplement10 Pages
107-112
Published: March 05, 1987
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We compared the results of 33 patients receiving autogenous bone graft (a part of the ossicle or cortical bone) and 12 receiving Plastipore (PORP, TORP) for ossicular chain reconstruction in tympanoplasty. All cases were followed up for at least 6 months after operation with hearing examination.
In the autogenous bone graft group, the hearing results were good, and there was no extrusion. In the Plastipore group, though the hearing results were similar to those in the autogenous bone graft group, extrusion was present in 20% of the cases in which the bone chip was placed between the Plastipore prosthesis and the tympanic membrane (or temporal fascia). However, all of the exhibiting extrusion had poor eustachian tube function. Plastipore should be used for ossicular reconstruction in patients with good eustachian tube function.
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Michio Kobari, Iwao Ohtani
1987 Volume 1987 Issue Supplement10 Pages
113-117
Published: March 05, 1987
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A case of conductive deafness due to head trauma in a 12-year-old girl is reported. The patient sustained head injury at the age of 5, and conductive deafness was noted during routine hearing examination at 10 years of age. She was treated for the otitis media with effusion, but with no improvement. Tympanotomy performed at the age of 12 revealed discontinuity of the incudostapedial joint. The ossicular chain was reconstructed using the incus body as the columella, and remarkable hearing gain was obtained.
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Hitomi Kobari, Yukio Ohkouchi, Tohru Aikawa, Iwao Ohtani
1987 Volume 1987 Issue Supplement10 Pages
118-123
Published: March 05, 1987
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A case of exostosis of the external auditory canal is reported. The patient was a 31-year-old man who was an active surfer of 9 years' duration. On examination there was almost total occulsion of the right ear canal and severe bony stenosis of left. Bilateral exostoses were removed surgically and examined by light and electron microscopy. The histopathological appearance revealed lamellated bone structure devoid of a fibrovascular channel. The long period of cold water stimulation was thought to be the most likely cause of exostosis.
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Histopathologic Pattern and Prognosis
Masafumi Murakami, Tohru Aikawa, Iwao Ohtani, Hiroshi Hojo, Haruki Wak ...
1987 Volume 1987 Issue Supplement10 Pages
124-132
Published: March 05, 1987
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Twenty-two cases of adenoid cystic carcinoma arising in head and neck region were studied. Ten of the patients died as a result of tumor, being the direct cause in nine with distant metastasis and one with local recurrence.
Histopathologic features were classified with 3 patterns: cribriform pattern, tubular pattern and solid pattern. In the tumor, these patterns were seen mixed with more than two patterns or singly. The relationship between these histopathologic findings and prognosis was studied. Grade I (cribriform pattern only) was associated with good prognosis and grade III (solid pattern, only or with other patterns) had very poor prognosis. Grade II (tubular pattern, only or with cribriform pattern) with intermediated prognosis between the two grades. Particularly, patients with a solid pattern, if it was only a part of the tumor, had poor prognosis. It is suspected that the solid pattern reflected high malignancy and histopathologic classification of adenoid cystic carcinoma is important for prognostic diagnosis.
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Yukio Ohkouchi, Hitomi Kobari, Kohsei Ohtsuki, Iwao Ohtani
1987 Volume 1987 Issue Supplement10 Pages
133-140
Published: March 05, 1987
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Angiofibroma originating in areas other than nasopharynx is extremely rare. Four cases of angiofibroma originating in nasal cavity without involvement of nasopharynx are reported.
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Michio Kobari, Iwao Ohtani, Kohsei Ohtsuki, Hitomi Kobari
1987 Volume 1987 Issue Supplement10 Pages
141-145
Published: March 05, 1987
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The patient was a 73-year-old female who complained of swelling in the right cheek. The excised tumor was histopathologically found to be chondrosarcoma. Ten months after the operation, the tumor recurrence was found in the operated maxillar sinus. The tumor was excised.
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Kazuo Takeuchi, Kohsei Ohtsuki, Tohru Aikawa, Hitomi Kobari, Hiro-oki ...
1987 Volume 1987 Issue Supplement10 Pages
146-150
Published: March 05, 1987
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A case of vascular leiomyoma of the nasal cavity is reported.
The patient was a 59-year-old male who complained of intermittent nasal bleeding in his thirties. A spherical tumor was seen on the right inferior turbinate. He was treated surgically via the transmaxillary aproach under general anesthesia. The histopathological findings revealed vascular leiomyoma.
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Hiro-oki Okamura, Tohru Aikawa, Tomohiro Anzai, Kohsei Ohtsuki, Iwao O ...
1987 Volume 1987 Issue Supplement10 Pages
151-155
Published: March 05, 1987
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A 15-year-old female complained of bilateral nasal obstruction. Examination revealed an enormous choanal polyp in her choanal cavity, and its stroma originated in the left middle meatus. X-ray examination showed no inflammatory sign in the paranasal sinuses. Pathologic findings revealed bone formation in polyp tissue.
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Tetsuya Akaike, Kohsei Ohtsuki, Tomohiro Anzai, Masafumi Murakami, Iwa ...
1987 Volume 1987 Issue Supplement10 Pages
156-160
Published: March 05, 1987
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A 20-month-old female presented with heart failure. She had marked nasal obstruction, stridor, tachpnea and labial cyanosis. Her tonsils and adenoids were remarkably enlarged. Chest X-ray film showed marked cardiomegaly. A diagnosis of heart failure with cor pulmonale secondary to tonsilloadenoid hypertrophy was made. After heart failure improved by O
2 therapy, digitalization, duretics and antibiotics, adenotonsillectomy was performed. Postoperatively, nasal obstruction and stridor disappeared, and cardiomegaly improved.
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Case Report
Kazuo Takeuchi, Kohsei Ohtsuki, Tohru Aikawa, Hitomi Kobari, Iwao Ohta ...
1987 Volume 1987 Issue Supplement10 Pages
161-166
Published: March 05, 1987
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A case of myoepithelioma occurring in the parotid gland of a 16-year-old male is reported. The tumor was gourd-shaped and firm in consistency, surrounded by a thin capsule, and was composed of spindle cells with eosinophilic cytoplasm and oval nuclei. The nuclei containing discernible nucleoli, were generally hyperchromatic. Ultrastructually, the cells contained many microfilaments about 6 nm in diameter. Based on these observations, this tumor was classified as myoepithlioma.
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Hiro-oki Okamura, Manabu Honda, Tomohiro Anzai, Kohsei Ohtsuki, Iwao O ...
1987 Volume 1987 Issue Supplement10 Pages
167-171
Published: March 05, 1987
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We encountered a 70-year-old female with parotid lipoma. Swelling occurred in the right infraauricular region and enlarged very slowly. There was no spontaneous pain or facial palsy. The parotid tumor was mobile, soft and flat, and was considered to be benign tumor. The tumor was histopathologically diagnosed as parotid lipoma.
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Hiro-oki Okamura, Kohsei Ohtsuki, Iwao Ohtani
1987 Volume 1987 Issue Supplement10 Pages
172-176
Published: March 05, 1987
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Fifty-nine cases of foreign bodies in the esophagus and airway were treated in our clinic from 1981 to 1985. Of the 33 patients with esophageal foreign bodies,14 were males and 19 were females. Many of the esophageal foreign bodies were found in subjects younger than 5 years or older than 50 years of age. Coins were mainly found in the children younger than 5 years, and PTP pieces and artificial teeth were mainly found in those older than 50 years. Many of these were lodged at the entrance of esophagus.
Of the 26 patients with foreign bodies in the airway,23 were males and 3 were females. Most of foreign bodies in the airway occurred in the children, particularly between the age of 1 to 2 years. Peanuts were found in 16 cases. Most the foreign bodies in the airway were lodged at the right bronchus, but peanuts were lodged almost equally in the right and left bronchi.
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