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Volume 1994, Issue Supplement75
Displaying 1-6 of 6 articles from this issue
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Ikuichiro Hiroto1994 Volume 1994 Issue Supplement75 Pages 1-8
Published: December 15, 1994
Released on J-STAGE: November 27, 2012
JOURNAL FREE ACCESSThe surgical management of the tracheal stenosis is classified into two techniques.1)The trachea is opened and a polyethylene tube is inserted into the trachea after removal of the cicatricial tissue. The tube is then fixed with a nylon thread and the tracheal cavity is primarily closed. The tube is removed 12 months later. The patient can respirate, phonate and swallow without disturbance from the tube in the trachea.2) The trachea is opened and the raw area is covered with advanced pedicle skin flaps. The tracheal cavity is secondarily closed 3 to 6 months after surgery.
In cases of subglottal stenosis, the c r icoid cartilage and the inferior part of thyroid cartilage are divided and the cicatricial tissue removed. A vinyl tube wrapped with a split free skin graft is inserted into the laryngeal cavity. A block of the thyroid ala is incised with the outer perichondrium connecting to the cricothyroid membrane and this block is rotated to fit between the cut edges of the cricoid cartilage. Then the subglottal space is closed and the tube is fixed in place with penetrating nylon threads through the skin. The tube is removed under microlaryngoscopy 5 weeks after surgery.
There are three techniques in the tre a tment of the glottal stenosis.1) The thyroid cartilage is divided. A core mold wrapped with a split free skin graft is inserted into the laryngeal cavity after the cicatricial tissue is removed and the laryngeal cavity is primarily closed.2) After removal of the cicatricial tissue, cervical skin flaps are advanced to cover the raw area. The laryngeal cavity is secondarily closed.3) As for the glottal reconstruction after hemilaryngectomy for carcinoma, bilateral pedicle island flaps are advanced into the laryngeal cavity to cover the raw area. The laryngeal cavity is primarily closed.View full abstractDownload PDF (3424K) -
Toshitaka Iinuma, Hidetake Shiga1994 Volume 1994 Issue Supplement75 Pages 9-15
Published: December 15, 1994
Released on J-STAGE: November 27, 2012
JOURNAL FREE ACCESSThe role played by the conventional X-ray projections in diagnosing fractures in the middle third of the face has declined since the advent of CT. Conventional projections, however, are chosen as t h e initial diagnostic modality in such uncomplicated cases as nasal bone, orbital wall, or zygomatic fractures. The lateral view of the nasal bone will show a true positive diagnosis depending upon the locations as follows: upper one third 36%, middle one third 80%, and lower one third 90%. Fractures of the orbital walls as evaluates by Caldwell's and Waters' p rojections will show true positive diagnosis in approximately 70-80% with a false positive diagnosis in 10-30% depending upon the location.View full abstractDownload PDF (6884K) -
Tsunemasa Satoh1994 Volume 1994 Issue Supplement75 Pages 16-22
Published: December 15, 1994
Released on J-STAGE: November 27, 2012
JOURNAL FREE ACCESSIn modern working environments, occupational noise exposure appears to be diminishing. However, there have been many cases of acute acoustic impairments resulting from leisure noise encountered in civic life. Especially, the possibility of sensorineural hearing loss in connection with rock-and-roll music has been reported. Many patients have long histories of listening to pop music in the past.
Audiograms showed various patterns. It is thought t h at the causes of hearing loss in patients with a dip pattern are mainly due to so-called “delayed recovery NITTS”, and that of low frequency disorder due to acute hearing loss from so-called “short term exposure to noise” (Shapiro).
It is most important that one's own hearing acuity is protected from such sound levels by wearing ear plugs.View full abstractDownload PDF (1168K) -
Yuji Sato, Kazumi Makishima1994 Volume 1994 Issue Supplement75 Pages 23-28
Published: December 15, 1994
Released on J-STAGE: November 27, 2012
JOURNAL FREE ACCESSIt has generally been recognized that noise-induced hearing loss (NIHL) often demonstrates a dip at 4000 Hz, the so-called C5dip, in its early stage. So far, hearing conservation in noisy plants has been needed to test for the C5dip. When hearing tests were made near frequencies of 4000 Hz, however, the so-called C5dip which was shown on the audiogram disappeared and correct locations of the dip occurred at other frequencies.
In this study, we investigated the actual state of noise in a certain plant using a noise badge, and demonstrated that testing for the C5dip alone passes over the early signs of NIHL. As the result, it is indispensable to measure hearing thresholds at high frequencies of 3000 Hz,4000 Hz and 6000 Hz for control of the NIHL, and to advise workers about the effects of protectors.View full abstractDownload PDF (976K) -
Kanemasa Mizukoshi, Yukio Watanabe, Hideo Shojaku, Akihiko Ohmura, Shi ...1994 Volume 1994 Issue Supplement75 Pages 29-42
Published: December 15, 1994
Released on J-STAGE: November 27, 2012
JOURNAL FREE ACCESSNeurotological studies of 132 patients with vertigo and dizziness following head and inner ear injuries were performed at the Department of Toyama Medical and Pharmaceutical University, between 1981 and 1993. These patients were classified as traumatic cervical syndrome (30 cases), simple head injuries (58 cases), head injuries with brain stem disorders (25 cases) and inner ear injuries (19 cases) based on the neurotological aspects.
In 25 patients with brain stem disorders, characteristic abnorma l dysequilibrium findings, such as gaze directional nystagmus (32%), failure of fixation suppression on caloric nystagmus (48%), bilateral diminution of OKN (44%), saccadic and/or ataxic smooth pursuit (64%) and abnormal visual-VOR gain (64%) were frequently observed. Provoked neck-torsional nystagmus was recorded in 20 patients with traumatic cervical syndrome (67%). In 19 cases with inner ear injuries including suspected traumatic perilymphatic fistula (15 cases), sensori-neural hearing loss (84%), fullness of the ear (47%) and dizziness or dysequilibrium (68%) were observed, and the reflected peripheral vestibular disorders, such as direction fixed positional nystagmus (63%) and abnormal findings on caloric nystagmus (CP and/or DP,87%) were recorded.
These neurotological findings corre l ated with the pathological conditions of the patients. Considering our clinical studies, it was concluded that multisensory equilibrium examinations, especially the oculomotor test, are able to easily detect central vestibular disorders, especially brain stem disorders. Moreover, pathological dysequilibrium findings in cases with concomitant brain stem lesions persist for a long period.View full abstractDownload PDF (2452K) -
Hiroyuki Zusho1994 Volume 1994 Issue Supplement75 Pages 43-48
Published: December 15, 1994
Released on J-STAGE: November 27, 2012
JOURNAL FREE ACCESSIn medical care, physicians start by listening to patients' complaints, making a comprehensive diagnosis based on the results of tests and then administer medical treatment. We have received education which attaches importance to methods of curing the disease concerned. However, we have reveived no training whatsoever on the judgement as to why that disease developed, particularly whether it was caused by an accident. In other words, we do not know much about the medical and legal issues as to the causal relationship of diseases and accidents.
Recently, awareness of human rights has expanded rapidly. Particularly, compensations for damage in traffic accidents resulting in injury and death are conspicuous. As for head and neck trauma in particular, there are many cases which involve compensations for damage. So physicians dealing with such cases are required to have some knowledge about this issue. In this paper, we discuss compensation medicine in head and neck trauma, particularly the necessity of compensation medicine, setup of compensation for damage, theory of cause-effect relationship, validity of medical certificates and neurosis arising from trauma.View full abstractDownload PDF (1299K)
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