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Ikuo Kitano, Yoshiyuki Kitaoku, Fumiko Sonoda, Takashi Matsunaga, Kazu ...
1990 Volume 1990 Issue Supplement37 Pages
1-8
Published: March 20, 1990
Released on J-STAGE: November 27, 2012
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Clinicostatistical study was performed on 997 outpatients, who complained of hearing disturbance.
They consisted of sensorineural hearing loss (447 cases), mixed hearing loss (14 cases), and conductive hearing loss (409 cases).
Three hundred and seventy-two patients complained of tinnitus. Tinnitus with sensorineural hearing loss accouts for 187 cases, with conductive hearing loss accounts for 46cases, and so-called non-hearing -loss tinnitus accounts for 134 cases.256 complained of vertigo or dizziness.
Of the patients with sensorine u ral hearing loss, senile deafness accounted for 41.8%, and unknown origin accounted for 29.3%.
In patients with conductive hear i n g loss, otitis media with exudate (OME) accouted for 33.7%, and chronic otitis for 31.5%.
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Yoshiyuki Kitaoku, Ikuo Kitano, Fumiko Sonoda, Mariko Tanaka, Takashi ...
1990 Volume 1990 Issue Supplement37 Pages
9-16
Published: March 20, 1990
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There were 157 patients with typical and unilateral sudden deafness who had no cause, except for other diseases discovered by course and differential diagnosis, who visited our hospital during the last 8 years and had been treated until the hearing level was fixed.
The result was 29% complete recovery,23% remarkable improvement,19% slight improvement and 29% no improvement.
There was a significa n t difference in prognosis,1) whether sudden deafness had vertigo or not,2) whether it was treated within 9 days or not, after the onset, and 3) whether the mean hearing level was more than 90 dB or not.
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Noriko Kashiwagi, Yoshiyuki Kitaoku, Nobuya Fujita, Kazuhiro Ohta, Tos ...
1990 Volume 1990 Issue Supplement37 Pages
17-25
Published: March 20, 1990
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Surgical treatment for chronic otitis media was done on 261 ears during the 10 years and 6 months from 1978 to 1988,105 ears for chronic suppurative otitis media,126 ears for cholesteatoma, and 30 ears for the second time.
Modified Wullstein III type opration w a s done in 21.2% but in cholesteatoma radical operation was done in 31.8% of the cases. Cholesteatoma recurred in 37.5% after tympanoplasty, and in 17.1% after radical operation. The frequent organisms were pseudomonas aeruginosa, sta. aureus, and proteus mirabilis. Recently gram negative organisms have increased. Postoperatively, hearing results were improved in more than 50% and there was no change regardless of the follow up term.
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Toshiaki Yamanaka, Fumiko Sonoda, Noriko Kshiwagi, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
26-32
Published: March 20, 1990
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The effect of inserting a ventilation tube (VT) in the treatment of severe secretory otitis media (SOM), which has been considered to be caused by sinusitis, tonsillitis, recurrent otitis media and nasal allergy, was evaluated by recording hearing of 51 ears in 30 children after operation (insertion of VT and adenotonsillectomy or adenotomy), and of 62 ears in 32 children for which adenotomy or adenotonsillectomy without insertion of VT was performed.
The cases treated with adenotonsillectomy were improved better than those treated with adenotomy, when VT was inserted but vice versa when VT was not inserted.
In the cases treated with insertion of VT hearing was restored markedly immediately after operation, with no change during tube insertion.
Immediately after insertion of VT the he a ring of cases with recurrent otitis media or nasal allergy was not restored as well as those without either illness.
In the periods of tube insertion the hearing of cases with to n sillitis or nasal allergy was not restored as well as those without either illness.
Especially conservative therapy was nee d ed for cases given tonsillitis or nasal allergy after operation.
In children with each induced factor such as sinusitis, tonsillitis, recurrent otitis media, and nasal bleeding, cases treated with insertion of VT and adenotonsillectomy or adenotomy were improved better than those treated without insertion of VT and with adenotonsillectomy or adenotomy.
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Mariko Tanaka, Fumiko Sonoda, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
33-37
Published: March 20, 1990
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Three hundred and sixty-three outpatients with tinnitus in 1987 were studied.
Sex distribution was approximately equal in both sexes. The incidence of tinnitus increased with age and the greatest incidence was the sixth decade.
About the side of tinnitus, tinnitus of one ear accounted for 62.5% (1t>rt), tinnitus of bilateral ear accounted for 36.4%, and tinnitus originating from head accounted for 1.1%.
According to our classification of primary diseases, tinnitus with presbyacusis and nohearingloss tinnitus acounted for 40-50%.
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Results of Risk Factor Evaluation
Fumiko Sonoda, Yoshiyuki Kitaoku, Ikuo Kitano, Kazuhiro Ohta, Takashi ...
1990 Volume 1990 Issue Supplement37 Pages
38-45
Published: March 20, 1990
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Auditory brainstem responses were recorded in 67 high risk infants in the neonatal intensive care unit of Nara Medical University Hospital to determine initial failure rate and to evaluate risk factors. The latencies of wave I, III, V, the I-V interpeak latency (I-V IPL)and threshold were measured. Recordings were abnormal difined prolongation of the latencies over 1 SD of those of the normal infants and threshold over 50 dBnHL.
Of our NICU population,16.4% showed prolongation of wave I, I II or V,15.6% showed prolongation of I-V IPL,23.9% showed elevation of threshold. Risk factor evaluation revealed a high (22.7-57.1%) incidence of ABR abnormalities in subgroups with risk such as with severe infections, congenital anomalies or congenital metabolic diseases. Subgroups with risk such as low birth weight, respiratory disturbance, with hyperbilirubinemia or with intracranial hemorrhage showed a relatively low (0-25.0%) incidence of ABR abnormalities.
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Kazuhiro Ohta, Nozomu Mori, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
46-50
Published: March 20, 1990
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A case of temporal bone epidermoid with chronic otitis media is reported.
A 20-year-old male had complained of trigeminal paresthesia and left otorrhea. The left ear drum was perforated with discharge. CT-scan showed extensive destruction of left temporal bone. Auditory brainstem response was recorded. The latency of wave I and V was delayed and inter peak latency of wave I and V was delayed on left ear.
Epidermoid in temporal bone was removed and tympanoplasty was c arried out.
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Isao Koh, Yoshiro Wada, Katsuya Akioka, Nobuya Fjita, Yoshiyuki Kitaok ...
1990 Volume 1990 Issue Supplement37 Pages
51-58
Published: March 20, 1990
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A statistical analysis was made on 1820 patients who visited our clinic, complaining of vertigo and dizziness from 1977 to 1986.
The number of patients was increasing, especially patients over 65 years old. Otological origin occupied 32% (Meniere's disease 10%), and unknown origin 47%. Vestibular dysfunction due to ototoxic drugs (KM. SM), cerebrovascular disorder, and vertigo following head trauma were predominant in males, vertigo due to hypotension was in females.
Brain tumor and origin unknown vertigo were predominant in the patients under 15years old, sudden deafness with vertigo in those between 15 and 65 years old, vestibular dysfunction due to ototoxic drugs (SM. KM) and vertigo due to hypotension in those over 65 years old.
Half of the patients complained of vertigo and one third complained of dizziness.
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Yoshiro Wada, Isao Koh, Katsuya Akioka, Nobuya Fujita, Takashi Matsuna ...
1990 Volume 1990 Issue Supplement37 Pages
59-65
Published: March 20, 1990
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A statistical observation was done on 180 patients with Meniere's disease who visited our clinic from 1977 to 1986.
The number of patie n ts with Meniere's disease was 0.28% of the total number of ENT out-patients and 8.0% of the number of patients with vertigo. The number of women was one and a half times as many as that of men. The percentage of patients whose ages were over 60 increased. One third of the patients visited our clinic within one month from the first vertigo attack. The incidence of unilateral and bilateral labyrinthine lesions was 152and 10, respectively. Among the vestibular function tests, abnormal findings were detected frequently by the righting reflex test (23%), the presence of positinonal nystagmus (33%)and caloric test(28%)
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Nobuya Fujita, Yoshiro Wada, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
66-70
Published: March 20, 1990
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Sixty eight cases of benign paroxysmal positional vertigo (BPPV) were studied.
Sexual differences were observed on female predominancy.
The most predominant age of the patients was the fifth decade, followed by the fourth, third and sixth decade.
Vertiginous a ttacks appeared frequently in Feb., Mar., Jun., Nov., and Dec.
Hypertension, head & neck injury, heart disease were significant causative factors.
Vertigo disappeared within the first month in 53% of the cases, but recurred in 18% of the cases. Positional nystagmus was observed in 54% of the cases, positioning nystagmus in 75% of the cases. In 12 cases, unilateral caloric reponses were reduced.
We recommend the established otolith function test in the stu d y of causative factors and clinical condition.
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Yoshiro Wada, Nobuya Fujita, Isao Koh, Takashi Ueda, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
71-77
Published: March 20, 1990
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This study was performed to clarify the hemodynamic of vertebral and common carotid arteries of normal subjects by ultrasonic doppler method. Subjects were 51 in all, i. e.,41males and 10 females, between 22 and 64 years old.
For the vertebral artery, mean blood velocity (BV) was 9.4± 3.5 cm/s, mean blood flow volume (BF) was 1.6 ± 0.6 ml/s and mean vessel diameter (VD) was 4.6 -± 0.5 mm. On the other hand, for the common carotid arteries, BV was 31.5±55.2.2 cm/s, BF was 14.0±3.2 ml/s and VD was 7.5 -±0.6 mm. BV of the vertebral arteries increased in the elderly, whereas BV of the common carotid arteries decreased in the elderly.
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Yoshiro Wada, Nobuya Fujita, Isao Koh, Takashi Ueda, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
78-83
Published: March 20, 1990
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To investigate the effects of drugs for vascular disturbances, the ultrasonic doppler method was used to measure the vertebral and common carotid arterial hemodynamics in patients with vertigo. We used Brovincamine and Moxisylyte to treat cerebrovascular disturbances, and used sodium carbonate (7%) and papaverine as systemic vasodilators. Patients were administered 100 mg of Brovincamine (5 cases),150 mg of Moxisylyte (5cases) 200 mg of papaverine (5 cases) orally, and 50 ml of sodium bicarbonate (5 cases) intravenously. Sixty minutes after administration of Brovincamine or Moxisylyte, mean blood velocity of the vertebral arteries on only the slower side increased, and the difference of blood velocity between the right and left sides decreased.
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Nobuya Fujita, Yoshiro Wada, Shigeo Suzumura, Takshi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
84-91
Published: March 20, 1990
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Fourteen cases of benign paroxysmal positional vertigo (BPPV) were studied with cervical circulation using DSA & Doppler. DSA study showed 7 abnormal cases out of 10cases of BPPV. The abnormal findings included 5 cases of stenosis and 5 cases of coiling and kinking in cervical vertebral arteries.
Doppler study showed that v e rtebral a. and also carotid a. had low volume and high laterality of cervical blood circulation in parameter of flow and velocity.
These findings suggest the cervical circulation disorder was o ne of background factors in pathogenesis of BPPV.
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Kazuhiro Ohta, Nozomu Mori, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
92-97
Published: March 20, 1990
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Results of the comparison of summating potential (SP) in trans-(TT) and extratympanic (ET) methods in 8 ears of Meniere's disease are reported.
The polarity of SP is negative in the ET method and in the TT method at click and middle frequency tone burst. The polarity of SP is changed in the TT method by high frequency stimuli depending on the electrode position.
The clinical value of SP and + SP in Meniere's desease is discussed.
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Katsuya Akioka, Nobuya Fujita, Yoshiyuki Kitaoku, Kazuhiro Ohta, Takas ...
1990 Volume 1990 Issue Supplement37 Pages
98-103
Published: March 20, 1990
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We applied the glycerol test, electrocochleogram and the furosemide tests using caloric stmuli and/or centric & eccentric pendular rotation stimuli to 92 patients with Ménière's disease for the purpose of diagnosing endolymphatic hydrops in comparison with 53 patients with sudden deafness without vertigo.
The group with Ménière's disease had a significantly higher positive rate than the group with sudden deafness without vertigo in all the tests except for the furosemide test with caloric stimuli.
The group with definite Ménière's disease had a higher positive rate than the group with suspected Ménière's disease in all the tests except for the furosemide test with caloric stimuli.
The patients with Ménière's disease had a significantly higher positive rate during the vertigo attack stage than in the absence of vertigo remission stage in all the tests except for the furosemide test with caloric stimuli. The diagnosis of endolymphatic hydrops part in Ménière'ss disease were very useful to separate definite Ménière'ss disease from suspected Ménière's disease.
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Nozomu Mori, Kazuyo Yura, Naruhiko Uozumi, Shunichi Sakai
1990 Volume 1990 Issue Supplement37 Pages
104-106
Published: March 20, 1990
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To assess the role of aldosterone in the endolymphatic sac, the effect of aldosterone and its antagonist on the endolymphatic sac, the DC potential (ESP) was examined in the guinea pig. The extrinsic aldosterone (1 mg/kg, i. v. ) induced no change in the ESP for 1 hr after the administration. However, canrenoate, an aldosterone antagonist produced a dose-dependent decrease in the ESP. Pretreatment of extrinsic aldosterone attenuated the ESP change by canrenoate. Therefore aldsterone may play an important role in the function of the endolymphatic sac.
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Clinical Report of 57 Cases
Shigeo Suzumura, Nobuya Fujita, Takashi Matsunaga, Kimihiko Kichikawa, ...
1990 Volume 1990 Issue Supplement37 Pages
107-113
Published: March 20, 1990
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Fifty-seven cases of vertigo were screened by means of intravenous digital subtraction (IVDSA).
Abnormal findings were noted in 49 cases. Stenosis findings were noted in 28 cases, with 18 on the right, and 8 on the left, and 2 bilaterally.
The difference between right and left steno s is could, possibly, be related to anatomical variation of vertebro-basilar artery system.
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Hirokazu Kaneda, Yoshihiro Tsuruta, Osamu Tanaka, Hiroshi Miyahara, Ta ...
1990 Volume 1990 Issue Supplement37 Pages
114-120
Published: March 20, 1990
Released on J-STAGE: November 27, 2012
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We have investigated 147 cases of surgical treatments for chronic sinusitis from 1983 to 1988, based on the medical charts in our ENT clinic. We investigated the age, sex, clinical history, chief complaint, intranasal findings, preoperative progress, X-ray findings, contents of surgical treatments, operative findings and postoperative progress.
The male-female ratio was three to one. The most prevalent chief complaint was nasal obstruction and then nasal discharge and post nasal droppings. Polyps were seen in 77%and ratio of bilateral chronic sinusitis was higher than on unilateral chronic sinusitis by the rate of the growth of polyps. As to the preoperative process, cases judged for an adaptation of the operation were 88% by the first medical examination of our clinic. According to Xray finding,26% were cases of unilateral chronic sinusitis,23% had a difference between right maxillary sinus and left maxillary sinus, and 41% had no difference between right maxillary sinus and left maxillary sinus. Operations under local anesthesia were accounted for 92%, operations of ethmoidal sinus were performed in 94% and operations of counter opening were performed in 79%. During 6 months, recurrent sinusitis was found in operated patients who were discharged, so we must observe postoperative patients for at least 6 months.
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Takashi Ueda, Yoshihiro Tsuruta, Osamu Tanaka, Hiroshi Miyahara, Takas ...
1990 Volume 1990 Issue Supplement37 Pages
121-127
Published: March 20, 1990
Released on J-STAGE: November 27, 2012
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Recent patients with cystic diseases of the paranasal sinus in our clinic,78 patients, were observed clinically and statistically.
Postoperative cysts were predominant accounting for 76%. Many of them occurred in the maxillar sinus and non-operative ones were found frequently in the frontal sinus.
The male patients tended to be more in the postoperative cysts with a sex ratio o f 2: 1, but difference due to sex was not observed in the non-postoperative patients.
The age distribution in patients with postoperative cysts was c ompared with that reported hitherto. Although the age distribution of the first operation for sinusitis was unchanged, there was tendency to predominance in elderly patients as for the age of cysts occurrence with a mean age of 43.2 years, because the time that elapsed after operation became longer. Onset at advanced ages was found more in patients with non-postoperative cysts than in those with postoperative ones and mean age in the former was 58.5 years.
The age distribution was analyzed by sex in patients with postoperative cysts. Since the age of the first operation for sinusitis was greater in males, the age of onset of cysts tended to shift to a higher ages than in the cases of females.
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Yoshihiro Tsuruta, Takashi Matsunaga, Hiroshi Miyahar, Osamu Tanaka, T ...
1990 Volume 1990 Issue Supplement37 Pages
128-133
Published: March 20, 1990
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We reviewed the radiological findings on 47 cases of postoperative maxillary cyst that had been operated on between 1983 and 1988.
Our radiographic classification using p olytomographic frontal section was done according to air containing cavity connected to Pars membranacea, as retraction of lateral sinus wall and inferior extension of the cyst. We classified all cases into four types and found statistical results as follows.
A postoperative c yst located in the lower portion of the maxillary sinus was observed in many cases (20 cases,43%). The type without postoperative exchange of maxillary sinus and the type of cyst with lower extension had a high incidence. In the former type, the period after the first operation due to chronic sinusitis was shortest of all other types. Therefore the cyst was considered to be caused by closure of the internasal opening from the maxillary sinus to nasal cavity. In the latter type, first operative age due to chronic sinusitis was oldest of all other types, therefore we could not disregard the relation between inferior extension of cyst and maxillary growth and root of teeth.
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Hiroshi Miyahara, Reiki Yakata, Yoshiyuki Kitaoku, Yoshihiro Tsuruta, ...
1990 Volume 1990 Issue Supplement37 Pages
134-138
Published: March 20, 1990
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A 36-year-old male with ethmoid fibrous dysplasia is reported. The tumor-like lesion was detected by chance with a CT scan when the patient was ill with a transient cerebral ischemic attack. The expansive tumor of the right ethmoid sinus was a non-homogenous high density image in the CT scan. Extirpation of the tumor-like lesion was performed by the extended Denker's method, revealing the red brown sherbet-like lesion. It was pathologically diagnosed as fibrous dysplasia.
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Masao Matsumoto, Yoshihiro Tsuruta, Osamu Tanaka, Hiroshi Miyahara, Ta ...
1990 Volume 1990 Issue Supplement37 Pages
139-143
Published: March 20, 1990
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Eight hundred and sixty-five patients with epistaxis were observed during the past 3years (From January 1985 to December 1987). There were 501 males and 360 females.
There were 861 cases of epistaxis among 15790 outpatients, the incidence w as 5 percent. Epistaxis was observed more frequently in males than in females (the male/female ratio is 3 to 2). Epistaxis occurred more frequently in June.
The age distribution showed an increase in frequenc y between the age group of 5 to 10years, and the age group of 50 and 55 years.
The majority of epistaxis cases ori g inated from the anterior part of the nasal septum (Little's area).
After the age of 40, epistaxis was accompanied frequently by systemic diseases such as hypertension. Most epistaxis cases could be controlled in the hospital otorhinolaryngeal room or emergency room.
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Hiroyuki Yamamoto, Yasuteru Yamanaka, Reiki Yakata, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
144-149
Published: March 20, 1990
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Sinobronchial syndrome (SBS) frequently associated with developmental deficiency of frontal sinuses. We evaluated,36 SBS patients and 178 controls who underwent simple 3way parasinus roentgen examination. Developmental deficiency of frontal sinuses was seen in 72.2% of the SBS patients, and 25.0% in the control group. Now SBS is believed to be caused by some dysfunction of the ciliary transport system in the respiratory tract. The dysfunction of the ciliary trasport system may be independent of the developmental deficiency of frontal sinuses.
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Experimental Use of Flownasalitygraph
Hiroyuki Yamamoto, Yasuteru Yamanaka, Atsuko Inoue, Hirokazu Kaneda, T ...
1990 Volume 1990 Issue Supplement37 Pages
150-155
Published: March 20, 1990
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We used Flownasalitygraph SN-01 to evaluate the quantitative difference in respiratory method and phonation between patients with sinobronchial syndrome SBS and healthy adluts. Of the 15 SBS patients, mouth airflow was observed in 8, and mean value of the highest mouth airflow was 102.9 ml/s.
On phonating rhinolalia apert a such as a consonant “Na”, SBS showed higher nasal airflow ratio.
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Atsuko Inoue, Takashi Matsunaga, Tsuneo Ashida, Yukio Eto, Tsuneo Yosh ...
1990 Volume 1990 Issue Supplement37 Pages
156-160
Published: March 20, 1990
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We studied the clinical statistics of the nasal allergic patients between 1984 and 1988. The average number of patients suffering from allergic rhinitis were about 6% of the total number of otorhinolaryngology patients over the 5-year test period. In our clinic, the number of patients suffering from Japanese cedar pollinosis was a little greater than the number of perennial allergic patients.
Most of the male patients w ere younger than 20 years old, but in females those 30 to 40years old were most frequent. Among the perennial allergy, most of the patients were under 20, and males out-numbered females by a factor of about 1.7. Among Japanese cedar pollinosis, female patients out-numbered males by a factor of about 1.2.
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Atsuko Inoue, Takashi Matsunaga, Hirokazu Kaneda, Tsuneo Ashida, Yukio ...
1990 Volume 1990 Issue Supplement37 Pages
161-167
Published: March 20, 1990
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We investigated the relationships between the daily and weekly pollen count of the Japanese cedar, the number of patients, and weather in 1986 and 1987. Daily pollen counts were obtained by the gravity method in Kashihara city, Nara city, and Kawakami village. The weather data were taken from Nara meteorological observatory. Sunny warm days and humidity influenced the pollen count a little. Maximum windspeed influenced the pollen count very little. The pollen count influenced the number of the patients one week later.
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Yoshinobu Ogawa, Yoshihiro Tsuruta, Osamu Tanaka, Hiroshi Miyahara, Ta ...
1990 Volume 1990 Issue Supplement37 Pages
168-171
Published: March 20, 1990
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A 5-year-old boy who had developed respiratory distress associated with acute inflammatory disease and presented with cyanosis was reported. The tonsils became markedly hypertrophic, and X-rays of the lateral view of the nasopharynx revealed that the respiratory tract was narrowing. Adenotonsillectomy was performed while waiting for stabilization of the condition with the use of an antibiotics and oxygen inhalation. The adenotonsillectomy markedly improved the respiratory distress and contributed to favorable course of the patient.
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Tsuneo Yoshikawa, Kazuhiro Ohta, Yukikazu Hyo, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
172-176
Published: March 20, 1990
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A case of Pickwickian syndrome in a 28-year-old male is reported.
The patient was diagnosed as having Pickwickian syndrome, which was confirmed by both clinical finding and all-night polysomnographic recordings. He had markedly hypertrophic faucial tonsillar tissue.
After tonsillectomy, his obstructive sleep apnea disappeared and the hypersomnia markedly improved, but there still were central sleep apnetic episodes in postoperative
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Yoshihiro Tsuruta, Ikuo Kitano, Osamu Tanaka, Hiroshi Miyahara, Takash ...
1990 Volume 1990 Issue Supplement37 Pages
177-182
Published: March 20, 1990
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We retrospectively reviewed the medical records on 48 patients with acute epiglottitis in our hospital between 1983 and 1988 period.
They were 32 males and 16 females, between 22 and 71 years and the onset tended to be frequent in spring. The clinical manifestations were sore throat and pain in swallowing (77%), dysphagia (31%), dyspnea (17%), hoarseness (10%), hemosputum (6%), cervical swelling (6%), and lump sensation in the throat (13%). One case required trachetomy and three cases required local incision and drainage of abscess by surgical procedure. In the remaining 44 patients treatment with antibiotics, and steroids injected intravenously in 32 patients was effective. Thirty patients were hospitalized and average adimission period was 7days. Air-way obstruction ensued in one case of 48 subjects (2%). One patient died of cervical abscess followed by pulmonary abscess complicated with uncontrolled diabetes. The overall mortality rate was 2%.
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Katsunari Yane, Osamu Tanaka, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
183-187
Published: March 20, 1990
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A 13-year-old boy was admitted to our hospital because of chest pain, dyspnea and neck swelling, which suddenly occurred prior to the admission. There was no causal disease or apparent precipitating episode. Physical examination disclosed Hamman's sign and the subcutaneous emphysema of the cheek, neck and chest, but pharyngeal emphysema was not noted visually. Chest X-ray and CT revealed intramediastinal air, subcutaneous emphysema and pharyngeal emphysema. He was treated prophylactically only with antibiotics, and dyspnea, subcutaneous emphysema and mediastinal emphysema subsided spontaneously within about 10 days.
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Keiko Nakatsuji, Teizo Mukai, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
188-195
Published: March 20, 1990
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Three cases in which dental restorative materials may have caused oral mucosal changes are reported. The different materials may at contact create currents so-called oral galvanic currentsin the salivary milieus. In this study, measurement of the direct currents of dental materials were performed. In all cases, with lower currents, their symptoms on the local findings were improved. It was considered that the oral galvanic currents may exchange salivary milieus and have some effect on oral tissues. We called the stomatitis that may be associated with galvanic currents, galvanic stomatitis.
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Takashi Ueda, Yoshihiro Tsuruta, Masao Matsumoto, Osamu Tanaka, Hirosh ...
1990 Volume 1990 Issue Supplement37 Pages
196-201
Published: March 20, 1990
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We have experienced 2 cases of so-called Küttner tumor. Both were located at the submandibular gland; the one was bilateral and the other unilateral. Abnormal autoimmunity seemed to be involved in the onset in both cases. The bilateral case was complicated with gastric cancer. The etiology of this disease is not clear and it seems to be necessary to make an immnological examination and to investigate the findings and complications seen in autoimmune disease to elucidate the etiology of this disease. In addition, we considered that surgical resection should be performed in principle in the treatment of this disease.
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Kazuhiro Ohta, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
202-208
Published: March 20, 1990
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Mucosal inflammation in the pharynx and larynx was investigated in patients with the lump sensation in the throat.
The incidence of m u cosal inflammation in the pharynx was 74%,52% in the larynx on inspection. Mucosal inflmmation findings were classified into diffuse type, local type and normal type.36% were diffuse type,48% local type and 18% normal type. The relation between the local findings and symptoms was investigated by observing the clinical course. Symptoms improved with the improvement of local finding in most patients with diffuse type, but not in most patients with local type.
Bacteriological study of oropharynx revealed that the incidence of identifying Haemophilus group was relatively high.
Histological study on posterior wall in pharynx indicated that cell infiltration was frequently observed in diffuse type.
We speculated that the lump sensation in the throat was caused by mucosal inflammation, particularly, in the diffuse type.
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A Clinical Observation of 166 Cases
Yoshinobu Ogawa, Osamu Tanaka, Hiroshi Miyahara, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
209-215
Published: March 20, 1990
Released on J-STAGE: November 27, 2012
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We made a clinical statistical review on 166 patients with recurrent nerve paralysis who encountered between Junuary 1982 and July 1988.
There were 94 men and 72 woman. The paralysis was found unrelated to surgery, (non-surgical paralysis) in 99 cases (59.6%) while post-surgical paralysis was found in 45cases (27.1%). Lung cancer and thyroid cancer were predominant among the cases of nonsurgical paralysis {33 cases (19.9%) and 20 cases (12.1%), respectively}. When these cases of non-surgical paralysis were further divided into men with right-side paralysis and leftside paralysis and women with right-side paralysis, esophageal cancer was the most common among men with right-side paralysis and lung cancer was predominant among men with left-side paralysis, whereas thyroid cancer was the most common among women with rightside paralysis as well as among women with left-side paralysis and lung cancer was more frequently found among women with left-side paralysis. Post-surgical paralysis could be most commonly explained by thyroid cancer and intra-tracheal intubation {13 cases (7.8%) and 12 cases (7.3%), respectively}. The cause of paralysis could not be identified in 31 cases (18.7%) including the cases of idiopathic paralysis. The percentage of unidentification was smaller than the ones so far reported.
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Ryo Oka, Yoshihiro Tsuruta, Noriko Kashiwagi, Hiroshi Miyahara, Takash ...
1990 Volume 1990 Issue Supplement37 Pages
216-222
Published: March 20, 1990
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A statistical study was made on 70 cases of polypoid vocal cord (Polypoid VC),182cases of two types of vocal cord polyp (VCP) a broad base type and a slender stalk type, and 87 cases of vocal cord nodule (VCN).
Most patients with polypoid vocal cords were smokers over 40 years old. Two types of VCP appeared predominantly at the border of the anterior and middle third of the vocal cord. Most males with VCN were younger than 20 years old; Most females with VCN were in their thirties. Patients with VCN complained of laryngeal pain second to hoarseness.
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Takashi Ueda, Yukio Eto, Noriko Kashiwagi, Kazuhiro Ohta, Osamu Tanaka ...
1990 Volume 1990 Issue Supplement37 Pages
223-229
Published: March 20, 1990
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A statistical study was made on the cases of the foreign bodies in the tracheo-bronchus and esophagus treated in our clinic between 1972 and 1986.
Thirty cases in the tracheo-bronchus, (male to female ratio was 2 to 1), were treated. The annual incidence was not remarkably changed. About 85 percent of the total cases were below age 10, especially 43 percent were one-years-old babies. Beans as the foreign bodies were most,50 percent. The difference in the incidence between the right bronchus and left was not observed.
There were 256 cases in the esophagus with a sex ratio of 1 to 1 were found. The incidence had no remarkable change. Two peaks were observed in the age distribution, the one in children below age 10 and the other in aged people above 60. About 45 percent of foreign bodies were coins,14 percent fish bone and 11 percent pieces of meat. Almost coins observed in the cases of children and pieces of meat were found frequently in the aged. The incidence of PTP foreign bodies appeared to be increasing.
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Yoshinobu Ogawa, Hiroyuki Kitamura, Kouji Miyata, Yoshiro Yamawaki, Fu ...
1990 Volume 1990 Issue Supplement37 Pages
230-241
Published: March 20, 1990
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We made a clinical statistical study of 537 patients (269 males and 268 females) with malignant tumors of head and neck who had consulted three leading hospitals in Nara Prefectural between 1986 and 1988.
There were 494 cases of epithelial tumors and 43 cases non-epithelial tumors. The regions of epithelial tumors were the thyroid in 188 cases, the oral cavity in 97 cases, the larynx in 87 cases, the pharynx in 74 cases and the maxillary sinus in 25 cases.37 cases,86.0% of non-epithelial tumors were malignant lymphoma. There were 33 patients with double cancer.10 of them had laryngeal cancer (index cancer).
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Hiroshi Miyahara, Takashi Matsunaga, Yukikazu Hyo, Osamu Tanaka, Kouno ...
1990 Volume 1990 Issue Supplement37 Pages
242-250
Published: March 20, 1990
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Between Jan.1979 and Dec.1988,517 cases of head and neck malignancies were treated in our department. There were 473 cases of epithelial malignancies (mostly squamous cell carcinoma),37 cases of non-epithelial malignancies,3 cases of malignant histiocytosis and 4 cases of malignant melanoma. The variety of sites included laryngeal cancer (140 cases), thyroid cancer (117 cases), oral cancer (70 cases), pharyngeal cancer (65cases), nasoparanasal cancer (59 cases), malignant lymphoma (50 cases) and others. Their patients were divided into 311 males and 206 females and most patients were in their 60's.
Since 1984, the number of patients with thyroid cancer has increased gradually. It was peculiar that thyroid cancer was being treated actively.
Sex and age distributions, and the staging of those patients were analyzed according to site.
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Hiroshi Miyahara, Takashi Matsunaga, Osamu Tanaka, Kazuhiro Ohta, Nobu ...
1990 Volume 1990 Issue Supplement37 Pages
251-258
Published: March 20, 1990
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Between September 1986 and December 1987 we treated 82 patients with head and neck malignancies in our department, of which 45 were males and 37 were females. There were 43.1% 70 years old or older. The primary sites included thyroid cancer (22 cases), laryngeal cancer (19 cases), oral cancer (12 cases) and others. There were 65.4% advanced cases of stage III and IV.
Various complicat i ons were found including hypertension, angina pectoris, cerebral arteriosclerosis, respiratory dysfunction, diabetes mellitus and others. The level of serum immunosupressive substances were elevated in the advanced cases.
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Hiroshi Miyahara, Takashi Matsunaga, Osamu Tanaka, Yoshihiro Tsuruta, ...
1990 Volume 1990 Issue Supplement37 Pages
259-267
Published: March 20, 1990
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Between Feb.1987 and March 1989 the serum levels of tumor associated antigen (CEA, TA-4) and immunosuppressive substances (IS) were determined in 85 patients with head and neck epithelial malignancies. In the serum levels of CEA and TA-4, the positive ratios were low,23.2% and 22.5 respectively. They were high only stage IV prior to treatment. In the serum levels of immunosuppressive substance, the positive ratio was 32.4%, and the mean values were elevated reflecting clinical staging. Especially for the patients in stage IV, a 75.0% positive ratio was seen prior to treatment. After treatment, the serum levels of each marker were normal in cases with no evidence of disease, but in recurrent or uncontrolled cases, such serum levels were elevated.
It seems that the serum levels of each m a rker is useful for monitoring the controlled or uncontrolled condition of malignancies.
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Yoshihiro Tsuruta, Osamu Tanaka, Hiroshi Miyahara, Yukikazu Hyo, Takas ...
1990 Volume 1990 Issue Supplement37 Pages
268-273
Published: March 20, 1990
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The clinical, histological and prognostic features of 36 patients with non-Hodgkin lymphomas treated in the Nara Medical University hospital between January,1982 and June,1988 were reviewed.
Twenty one patients were male and 15 were female. The age range was from 11 to 79years of age and had a peak in the seventies. In our clinic, elderly patients were dominant and could not be treated by intensive chemotherapy. According to the stage distribution for Ann Arbor classification,12 cases were stage I,15 were stage II,6 were stage III and 2were stage IV. Stage I and stage II accounted for 75%. Five-year survival showed 92% in stage I,47% in stage II,0% in stage III and IV and 52% in all cases. By site grouping,21cases were Waldeyer's ring,7 were nodal and 8 were extranodal except for Waldeyer's ring. Waldeyer's ring was the most common site of extranodal lymphomas, these tumors adopting more favorable courses. Histologically, these cases were categorized according to the working formulation. Three cases were low grade,26 were intermediate grade and 3were high grade. The 5-year survival rate was 67% with low grade,55% with intermediate grade and 0% with high grade.
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Hiroshi Miyahara, Takashi Matsunaga, Osamu Tanaka, Nobuya Fujita, Yosh ...
1990 Volume 1990 Issue Supplement37 Pages
274-279
Published: March 20, 1990
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Two cases of maxillary cancer with coexisting inverted papilloma are reported. The first case was a 57-year-old female who complained of right nasal osbstruction with a nasal polyp. She showed postero-lateral and medial bone destructions on a CT scan. Pathohistology by exploratory antrotomy showed squamous cell carcinoma with coexisting inverted papilloma. After chemotherapy and irradiation, a partial maxillectomy was performed. Extended total maxillectomy was performed later, because of tumor recurrence.
The second case was a 66-year-old male who complained of right nasal obstruction with nasal papilloma. He showed only medial bone destruction on a CT scan. After an extended Denker's operation, irradiation was performed. Pathological findings showed inverted papilloma with a partial malignancy.
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Hiroshi Miyahara, Takashi Matsunaga, Osamu Tanaka, Yoshiyuki Kitaoku, ...
1990 Volume 1990 Issue Supplement37 Pages
280-285
Published: March 20, 1990
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Four cases of hypopharyngeal cancer in 87-year-old males are reported. All cases originated from the piriform sinus and were treated with pharyngo-laryngectomy or pharyngo-laryngo-esophagectomy under general anesthesia (1 case) or local anesthesia (3cases). Three cases were in stage III and one case was in stage IV. We emphasized the precise examination of accompanying complications, the physical and psycho-social condition and the value of subsequent radical surgery for the purpose of evaluating quality of life of the aged patients.
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Osamu Tanaka, Masao Matsumoto, Hiroshi Miyahara, Takashi Matsunaga, Ts ...
1990 Volume 1990 Issue Supplement37 Pages
286-292
Published: March 20, 1990
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Seventy-four cases of major salivary gland tumors operated on in our clinic were studied during the past 7 years from 1982 through 1988. The tumors arose in the parotid gland in 61 patients, the submandibular gland in 12 patients, and the sublingual gland in one patient.
For parotid benign tumor extracapsular removal with preservation of the facial nerve was the principal method. The results were satisfactory without any recurrence. On the other hand, for parotid malignancies near-total parotidectomy, with or without preservation of the facial nerve, were performed. Radical neck dissection was performed when cervical nodes were palpable. The 3-year cure rate was 33%. Tumors of the submandibular and sublingual gland were removed totally with those glands.
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Osamu Tanaka, Takashi Matsunaga, Hiroshi Miyahara, Kazuhiro Ohta, Tsun ...
1990 Volume 1990 Issue Supplement37 Pages
293-297
Published: March 20, 1990
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A 22-year-old woman with thyroid carcinoma and coincident Graves' disease is reported. She was preoperatively treated with antithyroid medication for hyperthyroidism and subtotal thyroidectomy was performed 7 months later. Eighteen months after the operation, she remained euthyroid and no recurrence of malignancy. Pathological examination revealed that the tumor was papillary carcinoma.
We reviewed the reported frequency of coexisting thyroid carcinoma and Graves'disease.
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Osamu Tanaka, Takashi Matsunaga, Hiroshi Miyahara, Nobuya Fujita, Atsu ...
1990 Volume 1990 Issue Supplement37 Pages
298-304
Published: March 20, 1990
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Autonomously functioning thyroid nodules (AFTN) are characterized by growth, function and iodine uptake that are independent of TSH control. The incidence of AFTN is reported to be from 0.7% to 2.4% of thyroid nodular lesions in Japan. Four female AFTN patients were treated surgically in our clinic. Two patients were euthyroid and 2 were hyperthyroid. Only one of hyperthyroid case required preoperative antithyroid therapy. In all patients, the measurment of thyroid hormones and thyroid scintiscans were performed preoperatively. A T
3 suppression test was carried out on 3 patients.
All patients had hemi-or subtotal thyroidectomies on the in volved side. Histologically,3 of them were follicular adenoma and one was adenomatous goiter. Postoperative followup for 6 to 18 months has shown a favourable course and no recurrence in all patients.
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Hiroshi Miyahara, Yoshihiro Tsuruta, Takeo Sato, Kunitoshi Yoshino, Ka ...
1990 Volume 1990 Issue Supplement37 Pages
305-309
Published: March 20, 1990
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A 38-year-old male with occult thyroid cancer is reported. The patient visited our hospital complaining of hoarseness for about one month. A direct laryngoscopy showed right recurrent palsy. In further examination, no thyroid tumor, hypopharyngeal tumor or other lymph node swelling were detected. Seven months later, right neck lymph node swelling improved. By neck dissection, metastasis of thyroid papillary adenocarcinoma was detected. Right hemithyroidectomy was then performed. A tiny lesion of the thyroid gland was detected, and it also became clear that the patient's recurrent palsy was due to metastasis to the paratracheal lymph node.
The importance of precise follow-up in cases of ill-defined recurrent palsy is stressed.
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Yoshinobu Ogawa, Masayo Kubo, Toshiaki Yamanaka, Takashi Ueda, Yoshihi ...
1990 Volume 1990 Issue Supplement37 Pages
310-321
Published: March 20, 1990
Released on J-STAGE: November 27, 2012
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The patient was a 46-year-old male. He consulted our department complaining mainly of a gradually growing mass at the right cervical portion.
The mass is painless and compression did not ca u se hoarseness and cough. Total extirapation including neurectomy was performed for the mass, and a diagnosis of neurilemmoma originating from the vagal nerve was made on the basis of anatomic location of the mass and of pathohistological study. The frequency of this kind of tumor has been said to be relatively low, and totaled only 63 cases in Japan including the present case as far as we could investigate.
However, the number of its report has been increasing these years and the frequency of onset did not to be so low as reported hitherto. Biopsy was necessary in the diagnosis, and diagnostic imaging did not allow a qualitative diagnosis, even MRI only indicated the anatomic location of the tumor. With the treatment total extirapation including severance of the vagal nerve has been recommended hitherto, but reports that vocal cord movements could be preserved by subcapsular extirapation have been increasing recently and this seems to be a treatment method to be considered depending on the condition of the tumor.
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Yoshihiro Tsuruta, Osamu Tanaka, Hiroshi Miyahara, Takashi Matsunaga
1990 Volume 1990 Issue Supplement37 Pages
322-326
Published: March 20, 1990
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Investigations regarding the prognostic value of DNA content (aneuploidy) have been greatly facilitated by the application of flow cytometry using nuclei isolated from paraffinembedded tissue. We have applied this technique to head and neck tumors. Aneuploidy was found in 78% of cases. The method could be useful in retrospective studies.
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Ryuji Kataoka, Yukikazu Hyo, Tsutomu Hoshiya, Toshiaki Okasaka, Kazuo ...
1990 Volume 1990 Issue Supplement37 Pages
327-339
Published: March 20, 1990
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Two cases of malignant oncocytoma are reported. The first case was a 58-year-old male with tumor of right parotid gland. The second case was a 37-year-old male with tumor of right maxillary sinus origin. In spite of treatments both patients died with metastatic lesions. These cases were diagnosed by histochemical examination and electron microscopy.
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