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Shigeru Inafuku, Isao Takimoto, Ichio Inuzuka
1994 Volume 1994 Issue Supplement73 Pages
1-12
Published: November 20, 1994
Released on J-STAGE: November 27, 2012
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Age-related changes in the inner ear were investigated histopathologically in senile mice. Histological changes with age were first observed after 12 months of age. In mice, loss of outer hair cells was greater than that of inner hair cells. The characteristics of aging observed in the inner ear included a diminishing number of cells in Corti's organ, stria vascularis and spiral ganglions as well as a decrease in supporting cells. However, we could not classify the age-related changes into sensory, neural, strial and/or cochlear conductive presbycusis.
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Kazumi Yamada, Kazuhiro Izawa, Kaneto Yoshikawa
1994 Volume 1994 Issue Supplement73 Pages
13-18
Published: November 20, 1994
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Sixteen patients (18 ears) with sensorineural hearing loss associated with acute otitis media were clinically evaluated.
The patients range d in age from 6 to 58 years, and 10 were aged 40 years or above. All patients showed mixed hearing loss on pure tone audiometry. Three complained of vertigo, and one showed positional nystagmus.
The treatment was primaril y systemic administration of antibiotics, vitamins and adenosine triphosphate. Tympanotomy was performed in 15 ears. Complete cure of hearing loss was obtained in most patients, and vertigo disappeared in all 3 patients with that symptom.
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Kazutoshi Kato, Noboru Matsumoto, Naoya Shiraki, Ichio Inuzuka, Shiger ...
1994 Volume 1994 Issue Supplement73 Pages
19-24
Published: November 20, 1994
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Thirty-six case of acute low-tone sensorineural hearing loss were reviewed. These patients were treated between 1988 and 1992 at the Department of Otolaryngology, Aichi Medical University. The audiometric criteria of the diagnosis were as follows: 1) unknown etiology,2) acute onset,3) average hearing level of the lower two or three frequencies was greater than 30 dB,4) absence of nystagmus. The gender and age distribution in this series was highest among females aged 20 years old. Symptoms in 48% of the patients were ameliorated. Seven cases developed recurrence. One case was in transition to Meniere's disease. All cases were treated with ATP and vitamin B injection or internal medicine.
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Tomohiko Tashiro, Takao Kamimura, Naoya Shiraki, Hiromichi Ishigami, I ...
1994 Volume 1994 Issue Supplement73 Pages
25-33
Published: November 20, 1994
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The patient showed no response to hydrocortisone (500 mg X 3 days,300 mg X 3 days,100 mg X 3 days), adenosine triphosphate (240 mg/day), and urokinase (60,000 IU X 6 days). There was a history of brainstem infarction, polycythemia was noted and a diagnosis of multiple brain infarction was made by MRI. When a thromboxane A
2 synthesis inhibitor was administered, the mean hearing improved markedly from 82.5 dB to 41.25 dB. Inhibition of thromboxane A
2 production was considered to have induced suppression of platelet aggregation and vasodilation and, thus, increased the blood flow to the inner ear. Thromboxane A
2 inhibitors are usually used in the treatment of cerebral infarction. Their effectiveness in acute sensorineural deafness should be further evaluated.
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Naoya Shiraki, Hiromichi Ishigami, Shigeru Inafuku, Ichio Inuzuka, Mou ...
1994 Volume 1994 Issue Supplement73 Pages
34-43
Published: November 20, 1994
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We evaluated surgical results for middle ear cholesteatoma in new cases treated between 1983 and 1992. Hearing improved in 131 of 211 (62%) ears treated by single stage tympanoplasty and 22 of 48 (45.8%) ears treated by two-stage tympanoplasty. Better results were shown after single stage tympanoplasty. These results were associated with pathological deficits of the stapes. In the two-stage tympanoplasty group, supperstructural defects of the stapes were observed in 21 ears and footplate defects of the stapes in 7 ears.
The closed method was performed in 84.5% of all cases; Residual cholesteatoma w as found in 3.0% during single stage tympanoplasty and 6.3% during two-stage tympanoplasty. The incidence of recurrent cholesteatoma was 8.5% after single stage tympanoplasty and 14.6% after two-stage tympanoplasty. Since two-stage tympanoplasty was used in children and advanced cases, surgical results may have been poorer.
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Ichio Inuzuka, Tatsuyuki Banno, Shigeru Inafuku, Hiromichi Ishigami, I ...
1994 Volume 1994 Issue Supplement73 Pages
44-51
Published: November 20, 1994
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Forty-three cases of labyrinthine fistula due to chronic otitis media with cholesteatoma were treated in our clinic between April 1983 and March 1992. During this period,392cases of otitis media with cholesteatoma were treated. Thus the incidence of labyrinthine fistula was approximately 11.0%. The fistulae were located in the lateral semicicular canel in 37 cases, the lateral and anterior semicicular canel in 3 cases and the cochlea in 3 cases. The matrix of the cholesteatoma on the fistula was excised in all but one case.
Postoperative cochlear function was preserved in most cases, but hearing deteriorated in 6 cases. One case involved a cochlear fistula, one had a large fistulae in the lateral and anterior semicicular canel, the third had a perforation of the endostium of the lateral semicanal, which drained the endolymph and the remaining three cases involved large fistulae of the lateral semicicular canel. After excision of the matrix of the fistula, more extensive care is required.
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Yukihiko Hyo, Kaoru Suzuki, Kazutoshi Kato, Ichio Inuzuka, Shigeru Ina ...
1994 Volume 1994 Issue Supplement73 Pages
52-58
Published: November 20, 1994
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Preoperative neurootological examinations were conducted in 23 cases of acoustic neurinoma and the relation between tumor size and neurootological findings was in vestigated. Although there was no correlation between tumor size and hearing level or frequency characteristics, variations of gaze nystagmus were dependent on tumor size.
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Mizuyo Hori, Isao Takimoto, Hiromichi Ishigami, Shigeru Inafuku, Ichio ...
1994 Volume 1994 Issue Supplement73 Pages
59-67
Published: November 20, 1994
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Twenty-six patients with malignant tumor of the external auditory canal or middle ear were treated between June 1974 and May 1993 at Aichi Medical University.
There were 13 malignant tumors of the external auditory can a l and 13 of the middle ear.
Mean patient age was 41.9 years old, ranging from 2 to 77 years. There were 15 cases of squamous cell carcinoma,4 cases of embryonal rhabdomyosarcoma,2 cases of adenoid cystic carcinoma,1 case of metastatic adenocarcinoma,1 case of malignant melanoma,1case of neurofibroma,1 case of enchondroma, and 1 case of unknown histology. Four children had rhabdomyosarcoma.
Bloody o t o rrhea, severe otalgia, and facial nerve palsy were important clinical symptoms of malignant tumor of the ear. The 5-year cumulative survival rate calculated by Kaplan-Meier's method was approximately 29%.
For optimal results, early diagnosis and e arly treatments especially multimodal treatment including neo-adjuvant chemotherapy with CDDP or CBDCA and 5FU for malignant tumor of the ear are needed. VAC-therapy obtained good results for rhabdomyosarcoma.
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Toshiya Shimono
1994 Volume 1994 Issue Supplement73 Pages
68-76
Published: November 20, 1994
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The goal of physical therapy for peripheral facial nerve palsy is functional recovery of facial muscles as soon as possible. In the acute phase which lasts two weeks after onset, patients undergo electrodiagnostic examination to estimate their prognosis and protect their eyes. Following the examination, patients without denervation who seem to have a good prognosis, do not need physical therapy, but patients with denervation begin physical therapy in the following stages.
1) Patients without vol untary contraction: Patients are given electrotherapy to prevent muscle atrophy and maintain good contractility.
2) Patients with voluntary contrac tion: When voluntary contraction becomes possible, electrotherapy is stopped and nerve-muscle reeducation exercises are started. These exercises consist of the following three stages. The first stage consists of muscle strengthening exercises to counter hypertrophy of muscle and to encourage the recruitment and firing rate of activity nerve. The second stage consists of developing functional patterns of activity in the muscles. This exercise helps the patients recover facial expression and improves activities of daily living. The third stage consists of exercises to prevent and reduce synkinesis. During physical therapy, unusual synchronization of muscle is prevented and the patients perform separate muscle contraction exercises to discourage synkinesis. The best results are produced when nerves and muscle are retrained at the same time. Biofeedback exercise using EMG and a mirror maximizes the results of physical therapy for peripheral facial nerve palsy.
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Yukihiko Hyo, Ichio Inuzuka, Shigeru Inafuku, Hiromichi Ishigami, Isao ...
1994 Volume 1994 Issue Supplement73 Pages
77-80
Published: November 20, 1994
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Preoperative neurootological investigation were conducted in 21 patients treated for hemifacial spasm (HFS) by microvascular decompression. There were no significant findings from these investigations. We supposed that the neurovascular compression which caused HFS did not affect the eighth cranial nerve.
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Kaoru Suzuki, Shigeru Inafuku, Hiromichi Ishigami, Isao Takimoto
1994 Volume 1994 Issue Supplement73 Pages
81-87
Published: November 20, 1994
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Two hundred ten cases that required emergency hospitalizaiton for vertigo during the last 5 years were reviewed. Among patients with peripheral vertigo, we found Meniere's disease (typical and atypical), sudden deafness, labyrinthitis due to otitis media, and acute inner ear impairment, in that order; and among those with the central type, we often encountered vertebral basilar insufficiency (VBI)/central vascular impairment. Regarding the median age for the respective diseases, labyrinthitis due to otitis media and acute inner ear impairment occurred more frequently among younger patients, while VBI/central vascular impairment was more common among the elderly. Onset tended to be most frequent in the spring. Meniere's disease (typical and atypical), sudden hearing loss and VBI/central vascular impairment required longer hospitalization. Blood sugar, lipids and blood pressure were very frequently abnormal in such cases.
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Takao Kamimura, Shigeru Inafuku, Isao Takimoto, Meiho Nakayama
1994 Volume 1994 Issue Supplement73 Pages
88-92
Published: November 20, 1994
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Vertebro-basilar insufficiency (VBI) is one of the most common central types of vertigo. Patients with VBI are studied by radiology and otoneurology, and we perform vertebral angiography (VAG) on patients who are difficult to diagnose by CT or MRI.
In this case, with the supine straight head position, VAG showed normal findin g s, but in the supine right lateral head position, VAG demonstrated a contraction point of vertebral artery.
To prevent severe organic brain disorder, VBI should be diagnosed and treated as soon as possible.
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Moutatsu Go, Shigeru Inafuku, Isao Takimoto, Kazumi Yamada, Meiho Naka ...
1994 Volume 1994 Issue Supplement73 Pages
93-98
Published: November 20, 1994
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Generally, sudden sensorineural hearing loss is regarded as an inner ear disease, but in some cases it is associated with central nystagmus. We present a case in which central disequilibrium appeared 11-months after sudden sensorineural hearing loss. The etiology was considered a cerebellovascular disorder.
Additionally, on vertebral a n giography, vascular occlusion of the left posterior cerebral artery (left PCA) was detected unexpectedly without prior clinical symptoms; it was thought that the left PCA arose from the internal carotid artery.
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Masato Kuroda, Ichio Inuzuka, Shigeru Inafuku, Hiromichi Ishigami, Isa ...
1994 Volume 1994 Issue Supplement73 Pages
99-105
Published: November 20, 1994
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We encountered 15 cases of malignant lymphoma of the nose and paranasal sinuses during the past 15 years. Malignant l y mphoma of the nose and paranasal sinuses most frequently occurs in patients between 40 and 70 years of age. However, this disease has also been noted in younger patients. As th e re are no specific clinical symptoms, it is generally difficult to diagnose this type of malignant lymphoma during the early stage. Histological diagnosis of malignant l ymphoma is frequently impossible even after several biopsies of the tissue. The timing for early treatment is therefore very important. In starting treatment after a definite diagnosis has been made, it is necessary to determine the precise stage of the disease as well as the sites of all lesions to predict progression of the tumor. Against localized malignant lymphoma of the nose and paranasal sinuses, radiotherapy in combination with chemotherapy is necessary and surgery is sometimes required. In conducting chemotherapy, it is necessary to consider the side effects of drugs.
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Haruko Nonoyama, Tatsuaki Satoh, Naoya Shiraki, Hiromichi Ishigami, Is ...
1994 Volume 1994 Issue Supplement73 Pages
106-113
Published: November 20, 1994
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A 32-year old man with rhinogenic brain abscess is reported. The Patient underwent emergency hospitalization because of consiousness disturbance. Rhinogenic meningitis was suspected on CT examination. Endoscopic surgical treatment of the right ethmoidal and sphenoidal sinus under general anesthesia was carried out. Four days after surgery, subdural abscess was revealed. After subdural drainage and chemotherapy, almost complete recovery was obtained 11 weeks after admission.
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Michitaka Kato, Ichio Inuzuka, Shigeru Inafuku, Hiromichi Ishigami, Is ...
1994 Volume 1994 Issue Supplement73 Pages
114-119
Published: November 20, 1994
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Two cases of odontogenic cyst encountered in our department are reported and the literature is reviewed.
The first case involved a 28-year-old male with a radicular cyst which grew gradually inducing secondary sinusitis. After removal of the cyst, Caldwell-Luc's surgery was performed.
The second case involved a 59-year-old male with a follicular dental cyst. After removal of the cyst, the wound was sutured primarily without complication.
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Kazuhiro Izawa, Kazumi Yamada, Kaneto Yoshikawa
1994 Volume 1994 Issue Supplement73 Pages
120-125
Published: November 20, 1994
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Five hundred and forty five cases of epistaxis were treated at our hospital between January 1990 and December 1992. Of these 192 cases of idiopathic epistaxis were analyzed. Epistaxis occurred more frequently in January and February, but showed no correlation with weather conditions or phase of the moon.
Most cases were controlled after determining the site of bleeding and providing with suitable surgical treatment.
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Kiyoko Kimata, Kazutoshi Kato, Naoya Shiraki, Ichio Inuzuka, Shigeru I ...
1994 Volume 1994 Issue Supplement73 Pages
126-131
Published: November 20, 1994
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One hundred and one cases of laryngeal cancer treated at the Department of Otorhinolaryngology, Aichi Medical University between 1980 and 1992 were reviewed. Glottic cancer was the most common lesion. Surgery, radiotherapy and chemotherapy were performed singly or in combination. According to the 1987 UICC TNM classification system,4 patients were in stage 0,34 patients in stage I,31 patients in stage II,23 patients in stage III and 9 patients in stage IV. The five-year survival rates for stages I to IV were 100%,75.3%,61.2% and 0% respectively. The overall five-year survival rate was 71.9 %.
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Noboru Matsumoto, Tatsuyuki Banno, Mizuyo Hori, Ichio Inuzuka, Shigeru ...
1994 Volume 1994 Issue Supplement73 Pages
132-137
Published: November 20, 1994
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We present a rare case of post-trasfusion Graft Versus Host Disease (GVHD) that developed in a patient treated for laryngeal cancer. A 65-year-old man with laryngeal cancer (T
2N
1M
0) underwent total laryngectomy with right radical neck dissection after 30 Gy irradiation and chemotherapy with CBDCA and 5-FU. Blood loss volume during surgery was 890 ml and he was transfused with 3 U of packed red blood cells. On the fifth day after blood transfusion, high fever (39.0°C) developed. On the 7th day, erythema appeared over the whole body. Thereafter, liver dysfunction and pancytopenia developed. The patient died of heart failure on the 34th day. Prevention of transfusion-associated GVHD is very important because the mortality rate is more than 90%. Therefore, should be treated products with gamma radiation before transfusion or autologous blood should be used as a safety precaution.
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Yukihiko Hyo, Shigeru Inafuku, Hiromichi Ishigami, Isao Takimoto, Hiro ...
1994 Volume 1994 Issue Supplement73 Pages
138-141
Published: November 20, 1994
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A rare thyroglossal duct cyst in a 22-year-old male is reported. There were two cysts, one at the back of the right submandibular gland and the other above the right lobe of thyroid, which were connected through a single duct. The two cysts and duct were surgically resected. Histological examination showed a thyroglossal duct cyst.
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Kaneto Yoshikawa, Kazuhiro Izawa, Kazumi Yamada, Shigeru Inafuku
1994 Volume 1994 Issue Supplement73 Pages
142-148
Published: November 20, 1994
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Due to the advances in antibiotics, severe deep neck infection has recently become rare. We encountered two cases of deep neck infection, one with facial palsy and the other with vocal cord palsy. In this paper, two cases of deep neck infection treated with chemotherapy and surgical drainage are reported. The route of infection, cause of palsy, kinds of bacteria and methods of treatment are discussed.
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Tatsuaki Satoh, Meihou Nakayama, Hiroshi Iwasaki, Ichio Inuzuka, Shige ...
1994 Volume 1994 Issue Supplement73 Pages
149-157
Published: November 20, 1994
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Eighty-one cases of pharyngeal, esophageal, or tracheo-bronchial foreign bodies which required hospitalization during the past 10 years were statistically analyzed. The results were as follows:
1) Five cases of pharyngeal foreign bodies (male: 4, female: 1), fifty-one cases of esophageal foreign bodies (male: 37, female: 23), four cases of gastric foreign bodies and 21cases of tracheo-bronchial foreign bodies (male: 12, female: 9) were treated in our hospital.
2) Forty patients (52%) were under 9 years of age.
3) The foreign bodies included coins (19 cases ), P. T. P (press through pack) (15 cases), dentures (10 cases) and others.
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Tomoya Kohriyama, Hiroshi Iwasaki, Naoya Shiraki, Hiromichi Ishigami
1994 Volume 1994 Issue Supplement73 Pages
158-161
Published: November 20, 1994
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A case of chondrosarcoma in the cervical vertebrae is reported. The patient was a 70year-old woman who complained of pain during swallowing and sores from the nucha to the shoulders.
Fiberscopy revealed a protuberance of the posterior hypopharynx. MRI revealed a tumor in front of the cervical vertebrae.
The tumor was resected via a frontward-cervical approach, but the patient had not a relapse after surgery.
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