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Yukihiro Sato, Toru Handa, Tsuyoshi Yoshihiro, Takumi Hayashi, Yozo Or ...
1994 Volume 1994 Issue Supplement69 Pages
1-6
Published: March 10, 1994
Released on J-STAGE: November 27, 2012
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The effects of Ca
2+-associated chemical agents applied to the cochlea of the guinea pig by perilymphatic perfusion were studied. Ca
2+ channel blocker 200 ng/ml-1000 ng/ml affected the function of the stria vascularis. Endocochlear DC potential, EP decreased from +80 mV to 0 mV. Heavy metal, La, Cd, Mn, Co and Ni, which block the Ca
2+ chan nel were applied. A concentration, of 10 mM heavy metal decreased EP and CM, but 1 mM had no effect on EP. Bay K 8644, a Ca
2+ channel agonist, was also applied to the cochlea. After EP decreased with nifedipine, Bay K 8644 prevented any further decrease. Palmitoyl carnitine, which inhibits the Na/K pump and protein kinase C, decreased EP. H-7, which also inhibits the Na/K pump decreased EP but, the effect was not as pronounced as that of Palmitoyl carnitine. The Na/K pump was important in maintaining the function of the stria vascularis. Ca
2+ affects c AMP dependent metabolism. From that perspective, Ca
2+ affects the Na/K pump through protein kinase C.
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Takeshi Akisada, Yukihiro Sato, Toru Handa, Tsuyoshi Yoshihiro, Takumi ...
1994 Volume 1994 Issue Supplement69 Pages
7-13
Published: March 10, 1994
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We used three cats with iris versicolor (Waardenburg syndrome) for study of the ear. Under general anesthesia, after the auditory brainstem response (ABR) was performed, the head was perfused in vivo with 2% glutaraldehyde. After removal of the temporal bone and perfusion with 2% osmic acid from the round window to the oval window, specimens of membranous labyrinths to be observed by scanning electron microscopes (SEM) were processed by the surface preparation technique. The results were as follows: Two of the three cats demonstrated a clear wave, but one had no response on ABR. The former showed normal cochlear findings on SEM, but in the latter the hair cells of the organ of Corti had all disappeared, and total degeneration of the organ of Corti and remnants of supporting cells, especially pillar cells were observed on the basilar membrane. The cochlear duct had collapsed and Reissner's membrane was adherent to the upper surface of the tectorial membrane. The stria vascularis was found to have atrophied.
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Masaya Oku, Takeshi Akisada, Yukihiro Sato, Toru Handa, Tsuyoshi Yoshi ...
1994 Volume 1994 Issue Supplement69 Pages
14-18
Published: March 10, 1994
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Among the causes of vertigo or dizziness, diseases of the central nervous system and autonomic inbalance are prominent, but otolaryngeal disease as a cause is rare.
Three cases of brainstem infarction with vertigo or dizziness are reported.
One patient was a 64-year-old male who experienced sudden vertigo, right hearing loss and right facial nerve palsy. The second patient was a 54-year-old male who experienced dizziness, dysphagia and left paraesthesia. The third patient, a 65-year-old female, experienced defect in visual acuity, vertigo, right facial nerve palsy and left paraesthesia.
All three cases recovered with conservative therapy.
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Hidekazu Yamamoto, Tohoru Handa, Takeshi Akisada, Yozo Orita, Hiroshi ...
1994 Volume 1994 Issue Supplement69 Pages
19-22
Published: March 10, 1994
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Over a period of 15 years, we used intraarterial injection therapy for 42 cases of cancer of the nose and paranasal sinuses.
The patients, consistin g of 10 cases of T
1 T
2,19 cases of T
3 and 13 cases of T
4, were predominantly male and ranged in age from 31 to 80 years old.
Thirteen of the 42 patients were treated with a cisplatin combination therapy and 12cases were treated with neo-adjuvant chemotherapy.
At the 60th month and 120th month after treatment, the cumulative survival rates by the Kaplan-Meier method were 50% and 42%, respectively.
Rates of 70% and 49%, respectively, for cisplatin combination therapy and therapy with other drugs were noted at the 51st month.
During the same period, the rate for 12 patients receiving neo-adjuvant chemotherapy was 71%.
We propose that neo-adjuvant chemotherapy combined with cisplatin should be the therapy of choice for cancer of the nose and paranasal sinuses.
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Toshimi Hidaka, Takeshi Akisada, Toru Handa, Akimitsu Kawai, Yasuhiko ...
1994 Volume 1994 Issue Supplement69 Pages
23-27
Published: March 10, 1994
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One hundred patients with epistaxis requiring hospitalization during the past fifteen years were analyzed statistically. Epistaxis was observed more frequently in males (66)than in females (34) and occurred more frequently in May. The bleeding site was more often observed in other than the Kiesselbach's area. The patients exhibited complications due to some systemic diseases, especially hypertension. Almost all cases were treated with conservative balloon tamponade therapies and 38 cases underwent surgery.
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Toru Handa, Yozo Orita, Takeshi Akisada, Yukihiro Sato, Takuji Takemot ...
1994 Volume 1994 Issue Supplement69 Pages
28-32
Published: March 10, 1994
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Two cases of severe and recurrent epistaxis were treated by superselective intra-arterial embolization of the internal maxillary artery. Since a 5-6 Fr catheter was used for selective angiography, a 3 Fr catheter was employed for superselective angiography and embolization. Gelform powder was delivered into the distal internal maxillary artery by the 3 Fr catheter.
There were no complications due to these procedures in either of the cases in this study. Epistaxis occurred after embolization in one case and bilateral facial artery ligation was performed.
Therapeutic intra-arterial embolization of the internal maxillary artery is considered to be an effective therapy for severe epistaxis and facial artery ligation is useful for selected cases.
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Akimitsu Kawai, Yozo Orita, Takeshi Akisada, Toru Handa, Tsuyoshi Yosh ...
1994 Volume 1994 Issue Supplement69 Pages
33-41
Published: March 10, 1994
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There has been an increase in the number of fungal infections of the nasal and paranasal cavity in recent years. We reviewed 13 cases of fungal infection of the paranasal sinuses that were treated at our hospital between 1986 and 1992. The 13 patients (4 males and 9 females) ranged in age from 32 to 76 years old. The most common chief complaint was nasal obstruction followed by rhinorrhea, cheek pain and nasal post drip. A diagnosis of paranasal aspergillosis was made in all cases by pathological examination of mucosa taken during surgery or biopsy specimens of the nasal cavity. However, there was no mycosis on cultures of rhinorrhea, necrotic debris or mucosa of paranasal sinus. In 11 cases, surgical procedures were performed and in 5, surgery was accompainied by oral administration of an antifungal drug. Only antral irrigation was carried out in 2 cases. In all cases, aspergillosis was cured and a good prognosis was ensured. We considered systemic, local and host-parasite relations as etiological factors in these cases.
Magnetic resonance imaging (MRI) and CT were performed in two cases with paranasal fungal infection and one case with unilateral maxillary sinusitis. The MRI findings appeared to be more characteristic of fungal sinusitis than the CT findings, especially on T2 weighted images.
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-A Foreign Body in the Paranasal Sinus-
Kanae Hori, Yozo Orita, Takuji Takemoto, Hiroshi Fujita, Hidekazu Yama ...
1994 Volume 1994 Issue Supplement69 Pages
42-46
Published: March 10, 1994
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Foreign bodies in the paranasal sinus are not rare in the field of otorhinolaryngology. Here we report a case of a foreign body retained the paranasal sinus for 13 years.
The patient was a 26-year-old woman whose chief complaint was postnasal drip. Thirteen years earlier, she had fallen from a bicycle into a bamboo thicket and a piece of bamboo had pierced the outer part of the right root of the nose. She had undergone operqtuon to remove the bamboo by an external incision, but a residual foreign body was observed by CT. We removed the foreign body by radical surgery on the paranasal sinus. Postoperative CT showed no residual foreign body and the course was good. There were no complications such as oculomotor disturbances before or after surgery.
This case is reported as a patient with a long-term foreign body in the paranasal sinus. Some discussion of the literature also presented.
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Toru Handa, Yozo Orita, Takeshi Akisada, Yukihiro Sato, Akimitsu Kawai ...
1994 Volume 1994 Issue Supplement69 Pages
47-51
Published: March 10, 1994
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An 80-year-old man visited our hospital because of nasal obstruction and rhinorrhea. Examination of the nasal cavity revealed large nasal polyps causing significant airway obstruction. CT and MRI films revealed a large tumor of the left maxillary sinus. The left orbit, ethmoidal sinus and hard palate were invaded.
A biopsy was performed after admission, a nd the pathological report indicated adenoid cystic carcinoma. Thereafter,250 mg of 5-FU was infused 10 times via the left superficial temporal artery and 2700 rad of radiation was administrated. Gross Denker's maxillectomy was performed. The final pathological report was polymorphous low-grade adenocarcinoma.1800 rad of radiation was given after surgery.
The incidence of polymorphous low-grade a denocarcinoma of the maxillary sinus is rare, so we discussed this case and the differential diagnosis.
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Yoshihiro Urabe, Toru Handa, Yozo Orita, Yukihiro Sato, Yasuhiko Higas ...
1994 Volume 1994 Issue Supplement69 Pages
52-55
Published: March 10, 1994
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A case of ethmoidal fibrous dysplasia extending into the nasal cavity in a 55-year-old female who had complained of nasal obstruction and headache is reported.
CT examination revealed high and low density areas in the left e thmoidal sinus and left nasal cavity. The tumor was partially excised by the gross Denker procedure to reduce nasal obstruction. It was diagnosed pathologically as fibrous dysplasia.
This case of fibrous dysplasia is discussed and the literature is reviewed.
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Takumi Hayashi, Takeshi Akisada, Yukihiro Sato, Toru Handa, Tsuyoshi Y ...
1994 Volume 1994 Issue Supplement69 Pages
56-62
Published: March 10, 1994
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Forty-one cases of oral cancer (tongue: 27, oral floor: 5, cheek mucosa: 4, gingiva: 2, hard palate: 2, lips: 1) treated initially or secondarily between January 1982 and December 1992 were studied. The five-year cumulative survival rate for all patients was 49.1%, and those in stages I, II, Ill and IV were 100%,50%,37.9%, and 20.6%, respectively. Partial resection with a CO
2 laser was effective for cases in Stage I ⋅ II. The prognosis of patients with metastasis to the neck lymph nodes was obviously inferior to that of the group without neck metastasis. It was suggested that a more effective regimen of neo-adjuvant chemotherapy and broad resection to the primary lesion is required for progressive cases.
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Takeshi Akisada, Yukihiro Sato, Toru Handa, Yozo Orita, Hidekazu Yamam ...
1994 Volume 1994 Issue Supplement69 Pages
63-69
Published: March 10, 1994
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A retrospective analysis was made of 40 cases of carcinoma of the hypopharynx and cervical esophagus treated between 1974 and 1992. Twenty-two lesions occurred in the piriform sinus, four in the postcricoid, five in the posterior wall, seven in the cervical esophagus and two were of unknown origin. Of the total,55.3% were T
3 or T
4, and the rate of cervical lymph node metastasis was 52.6%. Of the total,76.3% were Stage III or IV. The initial treatment methods applied in 38 cases were: irradiation including chemotherapy in 30 cases, surgery in seven cases, and no treatment in one case. Surgery for the local carcinomas including three recurrent cases consisted of pharyngolaryngectomy in four and pharyngolaryngoesophagectomy in six. Two-year and five-year survival rates for all patients were 36.8% and 14.8%, respectively.
There were no significant d i fferences in the two-year survival rates between the surgery group and the radiation group.
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Hidekazu Yamamoto, Yozo Orita
1994 Volume 1994 Issue Supplement69 Pages
70-73
Published: March 10, 1994
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We report a case of Küttner's disease occurring in the parotid gland of a 71-year-old female who complained of a painless tumor, CT and ultrasonography led to the diagnosis of benign parotid gland tumor. Histopathological findings, however, suggested chronic sclerosing sialadenitis. The etiology and treatment of Küttner's disease are discussed.
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Tsuyoshi Yoshihiro, Takeshi Akisada, Takumi Hayashi, Akimitsu Kawai, K ...
1994 Volume 1994 Issue Supplement69 Pages
74-82
Published: March 10, 1994
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Ninety cases of laryngeal cancer, treated between 1982 and 1993 at our hospital, were investigated retrospectively. The ratio of male to female was 9: 1. There were 51 cases originating in the glottis (56.7%),31 in the supraglottis (33.4%) and 7 in the subglottis (7.8%).
According to the UICC TNM classification system (1978),34 cancers were stage I (37.8%),19 (21.1%) stage II,20 (22.2%) stage III and 17 (18.9%) stage IV. The overall five-year survival rate was 59.6%.
The five-year survival rates for stage I to IV were 93.8%,70.8%,39.2% and 24.5%, respectively.
The successful radiation control rate for primary glottic tumors in stage I was 92.0%.
In advanced cases, more aggressive therapies, such as combinations of irradiation and chemotherapy with surgery, appear to be required.
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Akimitsu Kawai, Takeshi Akisada, Yozo Orita, Hidekazu Yamamoto
1994 Volume 1994 Issue Supplement69 Pages
83-90
Published: March 10, 1994
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General complications are sometimes associated with the treatment of head and neck tumor. We review a case of fatal tongue cancer with multiple complications.
A 57-year-old female complained of tongue swelling. Sh e had a 5 × 3 × 2 cm well differentiated squamous cell carcinoma (T3N2M0) on the right side of the tongue. Complications before treatment included diabetes mellitus, a pre-cirrhotic liver and renal dysfunction. We performed surgery after chemotherapy by intraarterial injection.
Following surgery, she developed fatal complications; severe hypoalb u minemia, lung edema, severe
Pseudomonas aeruginosa infection, septic shock, disseminated intravascular coagulation (DIC) and peritonitis cartinomatosa. Twenty-four days after surgery, she died of multiple organ failure. Paying attention to pre-, intra-, and postoperative general conditions while treating head and neck malignancies is important.
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Yasuhiko Higashikawa, Akimitsu Kawai, Yozo Orita, Hidekazu Yamamoto
1994 Volume 1994 Issue Supplement69 Pages
91-95
Published: March 10, 1994
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A case of subglottic stenosis following endotracheal intubation in a child treated using a Silicone T-tube is reported.
During the placement of a T-tube, restenosis occurred after infection, and obstruction developed due to sputum. After approximately 100 days, the T-tube was removed. In children, however, using a Silicone T-tube is better using other techniques.
Care during T-tube insertion is very important, but advantages a Silicone T-tube has greater than other techniques in pediatric cases.
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Kotaro Take, Takeshi Akisada, Yukihiro Sato, Akimitsu Kawai, Kanae Hor ...
1994 Volume 1994 Issue Supplement69 Pages
96-99
Published: March 10, 1994
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We report an unusual case of a 1-year-old child with an intrabronchial foreign body. He had been coughing very hard and his face was cyanotic.
Chest X-ray showed atelectasis in the left lower lung field and pulmonary emphysema in the right lung field.
A diagnosis o f suspected left intrabron chial foreign body was made.
Bronchoscopy was performed immediately and a foreign body was extracted from the left main bronchus. The foreign body looked like mold in the bronchus.
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Toru Handa, Yozo Orita, Takeshi Akisada, Yukihiro Sato, Tsuyoshi Yoshi ...
1994 Volume 1994 Issue Supplement69 Pages
100-105
Published: March 10, 1994
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We treated 13 head and neck tumor patients by selective and superselective intraarterial infusion chemotherapy combined with radiotherapy since 1990.
Under fluoroscopic guidance, an angiographic catheter was i nserted into the main feeding artery of the tumor via the femoral artery. Since a 5-6 Fr. catheter was used for selective angiography and infusion chemotherapy, a 3 Fr. catheter was employed for superselective angiography and infusion chemotherapy. For chemotherapy,60 mg/m2 of CDDP and 350 mg/m
2 of CBDCA were used.
All of the patients had squamous cell carcinoma. The lingual artery was used for the treatment of tongue tumors, the lingual and facial arteries for oral tumors, the suprathyroidal artery for hypopharyngeal and laryngeal tumors, and the external carotid artery for oropharyngeal tumors. The thyrocervical trunk was used for neck lymph node metastasis treatment.
A comp l e te response rate of 85% was achieved for primary tumor treatment. All 9 patients with neck-lymph node metastasis showed a partial response. The total response rate was calculated as 92%.
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Kanae Hori, Yozo Orita, Takeshi Akisada, Yukihiro Sato, Toru Handa, Ta ...
1994 Volume 1994 Issue Supplement69 Pages
106-111
Published: March 10, 1994
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We performed reconstructive surgery for head and neck cancers, either primary or recurrent, on 29 patients (53 cases) admitted to the our department between April 1,1990and March 31,1993.
We mainly report the reconstructive region, reconstructive material and postoperative course.
Patients tended to be men in their sixties with parotid gland cancer. The most common reconstructive region was the neck.
As reconstructive material, we employed free flaps, mostly from the thigh flaps. Postoperative complications occurred in 24 of the 53 cases. The prognosis for survival as of March 31,1993 was positive in 14 of 29 patients.
Discussion includes a consideration of the literature.
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Akimitsu Kawai, Yozo Orita, Takeshi Akisada, Yukihiro Sato, Toru Handa ...
1994 Volume 1994 Issue Supplement69 Pages
112-120
Published: March 10, 1994
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We reviewed and clinically analyzed 31 cases of pleomorphic adenoma treated at our hospital between 1978 and 1992. These cases (9 males and 22 females) ranged in age from 19 to 80 years old with a mean age of 44.7 years. There were 20 cases with adenoma in the parotid gland (64.5%),7 cases in the submandibular gland (22.6%), and 4 cases in the minor salivary glands (12.9%). The chief complaint was tumor palpation.
Spontaneous pain and tenderness were found in a few cases. Ultrasonics, scintigraphy, computed tomography and magnetic resonance imaging were useful for preoperative diagnosis, with ultrasonography, in particular, showing more characteristic findings than other methods.
The adenoma in 30 cases was surgically removed. One case was diagnosed as a malignant mixed tumor by aspiration biopsy and only radiotherapy was performed. All cases were followed by histopathologic examinations, but there were no case diagnosed as carcinoma in pleomorphic adenoma. There were no cases of recurrence or malignant change. In conclusion, complete removal in the initial surgery, precise histopathologic examination and long-term follow-up are required in the treatment of pleomorphic adenoma.
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Takuji Takemoto, Takesi Akisada, Yukihiro Sato, Toru Handa, Yozo Orita ...
1994 Volume 1994 Issue Supplement69 Pages
121-125
Published: March 10, 1994
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A case of hemangiopericytoma of the right temporal fossa is described. An 80-year-old female presented with a right temporal tumor. A CT scan revealed a scattered low density area with marked contrast when enhanced. Therefore, surgical resection of the tumor was performed. Histopathology of this tumor showed ovoid to spindle-shaped cells that around a sinusoidal vascular component that formed staghorn channels. Based on these findings the tumor was diagnosed as a hemangiopericytoma.
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Teruhito Aihara, Hidekazu Yamamoto, Takeshi Akisada, Yukihiro Sato, Ka ...
1994 Volume 1994 Issue Supplement69 Pages
126-130
Published: March 10, 1994
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A 52-year-old female was admitted to our hospital with a complaint of left submandibular mass. Ultrasound echo, CT-scanning and MRI-scanning revealed a cystic lesion. The mass was resected and diagnosed as a trichilemmal cyst pathologically.
All the reports of trichilemmal cyst have been presented b y dermatologists in Japan, and a trichilemmal cyst in the submandibular region is very rare. This is the first report of a trichilemmal cyst by an otorhinolaryngologist
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Takeshi Akisada, Yukihiro Sato, Toru Handa, Takuji Takemoto, Kanae Hor ...
1994 Volume 1994 Issue Supplement69 Pages
131-137
Published: March 10, 1994
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The incidence of deep neck infections has recently increased. Twelve cases of deep neck infections treated between January 1986 and January 1993 are reported. The chief complaint was painful swelling of the neck, trismus and dyspnea following sore throat. In all cases, chemotherapy was done, and in nine cases, surgical drainage was performed. Bacteriologically, α-Streptococcus was predominant among aerobes and Bacteroides was predominant among anaerobes. Eleven patients were promptly cured, but one patient died on admission because of septic shock. Computed tomography was useful for both diagnosis and treatment. Prompt surgical drainage of the abscess and therapy with antibiotics for anaerobic pathogens and with steroids for a short period are required.
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Kotaro Take, Takeshi Akisada, Yukihiro Sato, Toru Handa, Yozo Orita, H ...
1994 Volume 1994 Issue Supplement69 Pages
138-142
Published: March 10, 1994
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Acute suppurative thyroiditis (AST) is a rare inflammatory disease of the thyroid gland. We reported AST in a 38-year-old female. She complained of painful swelling of the right anterior neck region. The pain developed after swallowing of a fish bone. CT showed a deep neck infection and we performed surgery. We could not detect a piriform sinus fistula, but we speculated that the neck infection was caused by swallowing the fish bone.
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Hidekazu Yamamoto, Makoto Kawada, Hiroshi Fujita, Tohoru Handa, Yozo O ...
1994 Volume 1994 Issue Supplement69 Pages
143-146
Published: March 10, 1994
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The distance from the bifurcation of the common carotid artery to the lingual artery on 106 carotid angiograms of 53 cadavers was measured. The average distance was 12.16 mm. The prevention of cerebral infarction during intraarterial injection therapy for the head and neck cancer is discussed.
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