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佐藤 勇
1995 年 1995 巻 Supplement83 号 p.
1-11
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
This study examined the topographical relationships of the loop of the anterior inferior cerebellar artery (AICA) to the cochleovestibular (VIII) nerve in the internal auditory canal (IAC) using histopathological methods involving three-dimensional reconstruction to clarify the cause and pathogenesis of neurovascular compression (NVC) of the VIInIe rve.
The AICA loop within the IAC was found in 50 of 356 autopsied human temporal bones examined histopathologically at the hospital of Fukushima Medical College. Thirty-three of the 50 temporal bones, which were well preserved, were observed by histopathological three-dimensional reconstruction. In addition, histological sections from 33 of the 50 temporal bones, which showed neither hemorrhage nor malignant tumor cell infiltration in the IAC, were stained with Kluver-Barrera's, Bodian's and Masson's methods and observed under light microscopy.
The temporal bones were grouped into two main classes by three-dimensional location of the AICA, VIIa nd VIII nerves in the IAC, the inter-nerve and the extra-nerve types. Twenty-four temporal bones with loops of the AICA located between the VII and VIII nerves were considered the internerve type, and 9 specimens with the loops of the AICA located outside the two nerves were considered the extra-nerve type.
In 23 of 33 temporal bones examined, the loop of the AICA was located at the Glia-Schwann sheath junction of the VIII nerve or more peripherally.
Demyelination of the VIII nerve and atherosclerosis of the AICA were found in 10 and 11 of 30temporal bones examined, respectively.
These morphological findings are discussed with special reference to NVC of the VIII nerve.
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ヒト側頭骨病理組織学的検討
鈴木 聡明, 相川 通, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
12-17
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Obstruction of the tympanic isthmus has been considered to play an important role in the development of cholesteatoma. However, it has recently been demonstrated by high resolution computed tomography that obstruction of the tympanic isthmus is not necessary for the etiology and progression of pars flaccida cholesteatoma. Therefore, histopathological changes in the epithelium and aeration of the middle ear was observed using seventeen human temporal bones obtained from cholesteatoma and retraction pocket cases. Inflammatory change occurs with high frequency in the lateral portion of incus and is less frequent in the tympanic isthmus. Obstruction of aeration in the lateral portion of the incus was very frequent, but in the tympanic isthmus, was rare. This study showed that the cause of retraction pocket and pars flaccida cholesteatoma is not only obstruction of the tympanic isthmus but also dysfunction of the Eustachian tube and local obstruction of aeration in the middle ear.
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ヒト側頭骨病理
鈴木 聡明, 大谷 巌, 相川 通, 佐藤 勇, 佐久間 仁, 小川 洋, 赤池 徹哉
1995 年 1995 巻 Supplement83 号 p.
18-21
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Cholesteatoma is classified as: primary acquired cholesteatoma, secondary acquired cholesteatoma and congenital cholesteatoma. Usually, the matrix of acquired cholesteatoma cornmunicates with the tympanic membrane. Recently, we encountered a case of acquired cholsteatoma not involving the tympanic membrane.
The case was a 64-year-old male who died of thyroid cancer on August 29,1991. After processing by conventional celloidin embedding, specimens were cut horizontally into 25 pm sections. Every 10th section was stained with hematoxylin-eosin and examined for histopathology under a light microscope. We also performed computer-aided three-dimensional reconstruction and immunohistochemical study.
Right temporal bone. Cholesteatoma without any connection to the tympanic membrane was found. Cholesteatoma with desquamated epithelial debris was seen in the antrum. The matrix of cholesteatoma showed autolytic change with infiltration by giant cells.
The tympanic membrane formed a dimeric membrane which was the result of a healed perforation. The three-dimensional reconstruction confirmed that the cholesteatoma was not connected with tympanic membrane. By immunohistochemistry, the matrix of cholesteatoma was positive for involucrin, but granulation in tympanic cavity was negative.
From these findings it was considered that this cholesteatoma was not congenital but acquired, and that the matrix of the cholesteatoma in the neighbourhood of tympanic membrane had disappeared.
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側頭骨病理組織学的検討
渡邉 睦, 相川 通, 鈴木 聡明, 菅野 秀貴, 山辺 習, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
22-27
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Temporal bone findings in a case of amyloidosis with hearing loss and vertigo are reported. The striking findings of the bilateral temporal bones were amyloid deposits observed in the facial nerve. To our knowledge, there are no cases with amyloid deposits in the temporal bones among amyloidosis cases reported in the literature. Dehiscence of the facial canal and the facial nerve protruding on to the stapes was observed bilaterally. Inflammation with ossification in the posterior semicircular canal and reduction in the number of spiral ganglion cells were observed in the left ear.
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相川 通, 鹿野 真人, 鈴木 聡明, 佐藤 勇, 佐久間 仁, 柏原 一成, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
28-33
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
The histopathological findings in the temporal bone of a 61-year-old male with Garcin syndrome due to nasopharyngeal cancer are reported. The patient complained of unilateral disturbance of the second to twelveth cranial nerves, except for the olfactory nerve. Approximately three months prior to death, the results of his audiogram demonstrated deafness.
The unilateral temporal bone was destroyed by extensive invasion at the petrous apex, tympanic cavity and mastoid air cells. In addition, the internal auditory canal showed tumor cell infiltration and hemorrhage. The facial and cochleovestibular nerves were also completely replaced by tumor cells and hemorrhage. Although the sensory organs of the cochlear, vestibule and semicircular canals were destroyed, tumor cells were not found in the membranous labyrinth.
It was thought that audiometric and vestibular dysfunctions, and facial nerve palsy were caused by severe infiltration of tumor cells into the internal auditory canal.
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側頭骨病理組織所見
馬場 陽子, 鈴木 聡明, 柏原 一成, 相川 通, 佐久間 仁, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
34-39
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
This report presents temporal bone findings from a 61-year-old woman who was diagnosed with Wegener's granulomatosis. She had facial palsy on the left side for 17 months prior to her death. Facial palsy improved with prednisone and endoxan, but she died of endoxan-induced pneumonitis. Histopathological examination of the left temporal bone revealed that the tympanic cavity was filled with granulation tissue and a fungus ball of Aspergillus. It was thought that the facial palsy resulted from the inflammation of the middle ear because of Wegener's granulomatosis through dehiscence of the facial canal.
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渡部 浩伸, 相川 通, 鈴木 聡明, 佐久間 仁, 堀 弘樹, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
40-44
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
We report the histopathological findings of a pair of temporal bones from a fetus with trisomy 13syndrome. To our knowledge, this is the eighteenth case of this syndrome with microscopic temporal bone findings reported in the literature. The temporal bones showed multiple anomalies in the middle and the inner ears. The striking finding was that the facial nerve passed through two separate canals from the internal auditory canal to the horizontal segment of the nerve. This is the second report describing a case of trisomy 13 syndrome in which the facial nerve bifurcated at the internal auditory canal.
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唯木 享, 相川 通, 鈴木 聡明, 佐藤 勇, 柏原 一成, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
45-48
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Histopathological findings in the temporal bone of a fetus with trisomy 18 syndrome are described. This study revealed many anomalies such as malformed auditory ossicles, residual mesenchyme in the middle ear, aberrant tensor tympanic muscle, absence of stapedial tendon, aberrant lateral ampullar nerve and wide endolymphatic sinus. Incus body especially was separated from the long process (right ear only).
Since Edwards first described trisomy 18 syndrome in 1960, findings in the temporal bones of twenty patients with this condition have been reported. They varied widely, ranging from a normal temporal bone to a severely malformed temporal bone.
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佐川 雄一, 鈴木 聡明, 柏原 一成, 相川 通, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
49-52
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
The histopathological findings in the temporal bone of a 79-year-old female with a huge high jugular bulb on the right side are reported. The patient died of renal failure. The high jugular bulb was in close contact with the stapedius muscle, facial nerve and vestibular aqueduct separated by thin connective tissues. It suggested that the jugular bulb might have caused tinnitus, hearing loss and facial palsy although they were not described in the clinical course.
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角田 保雄, 尾股 丈夫, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
53-67
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Correlations were made between audiometric pattern (especially flat and gradual high tone loss)and speech discrimination score (SDS) in 255 ears with sensorineural hearing loss that were tested at the Department of Otolaryngology of Shirakawa Kousei General Hospital during the past 6 years.
First, the audiometric pattern was defined on all frequencies (0.125 k-8 kHz). SDS of each audiometric pattern resembled that in all similarly affected ears, but in younger ears (under 75 years old, the average value of pure tone hearing level subtracted from speech reception threshold was under 10 dB), SDS of patients with flat audiogram or abrupt high tone loss (mainly 8 kHz) maintained a good score (over 70%) at 10 dB intervals below 70 dB, then sharply decreased at 70 dB. However, SDS of patients with gradual high tone loss decreased in proportion to hearing loss. This fact supports Schuknecht's classification of hearing loss in presbycusis. Furthermore, this suggests that there is a boundary of good SDS at the 60 dB level, at which SDS was marked by deafness and a flat audiometric pattern caused by atrophy of the stria vascularis.
Second, the audiometric pattern was defined by the slope of the audiogram (value of 2 kHz loss subtracted from 0.5 kHz loss, and 4 kHz loss from 0.5 kHz loss). The gradual high tone loss group had a good SDS (over 70%) under 50 dB. In cases involving hearing loss reaching and exceeding 50 dB, SDS declined abruptly. Good SDS almost disappeared and poor SDS (under 50%) increased suddenly. This suggests that not only that the decrease in neurons reached the minimum necessary to maintain a good SDS, but also that the neurons which transfer information under 50 dB exerted great influence on SDS.
Differences were analyzed, between each audiometric pattern and between the group before abrupt deccrease in SDS and the group after the abrupt decrease in the flat audiogram or gradual high tone loss group.
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特に小腫瘍の診断について
佐久間 仁, 山辺 習, 松村 俊子, 安本 幸正, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
68-75
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Eight cases of small acoustic neurinoma were clinically analyzed along with a review of medical literature. The patients were 6 females and 2 males, ranging from 32 to 75 years old. Tinnitus was an initial symptom in 6 cases (75%) and was more frequent than hearing loss, although 2 cases had sudden onset hearing loss. Recognition of sudden onset hearing loss, tinnitus and vertigo as the initial symptoms is considered essential in detecting small acoustic neurinoma. Abnormal findings on pure tone audiogram were observed in 7 cases and abnormal findings on plain X-ray examination were observed in 6 cases. All cases showed abnormal findings on ABR while only 3 of 6 cases (50%)showed canal paresis in caloric test. MRI was most suitable for the demonstration of acoustic neurinoma in these cases. It is important for otolaryngologists to consider the possibility of acoustic neurinoma when patients complain of cochlear and vestibular symptoms. It is thought that patients in whom acoustic neurinoma is not excluded should be carefully observed and further examined until acoustic neurinoma is confirmed or definitely excluded.
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大谷 巌, 赤池 徹哉, 小川 洋, 相川 通, 鹿野 真人, 鈴木 聡明, 菅野 秀貴
1995 年 1995 巻 Supplement83 号 p.
76-81
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
We reviewed 18 patients with 20 involved ears who had undergone transmeatal atticotomy for attic cholesteatoma and then were followed for 1 to 7 years (mean =3.5 years) in our department. From the results analyzed with special reference to postoperative recurrence of cholesteatoma, the indications for atticotomy to treat attic cholesteatoma were evaluated.
Of 20 ears,14 ears (70%) have remained free of disease since surgery. Four ears (20%)developed attic retraction pocket and three of the ears finally developed recurrent cholesteatoma, and two ears (10%) have been wet with crust or granulation formation. Recurrent cholesteatoma can occur when an attic retraction pocket develops again after the procedure, because simple atticotomy has no influence on pathogenesis of attic cholesteatoma. Taking the age, hearing level and local findings of patients into consideration, therefore, we concluded that atticotomy is an appropriate indication for attic cholesteatoma under the following conditions: 1) when all the pathogenic processes of attic cholesteatoma have already disappeared, and 2) or when the mastoid is sclerotic, and the mastoid and antrum have no more space for retraction pocket even if the pathogenic processes of attic cholesteatoma have not yet disappeared.
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赤池 徹哉, 大谷 巌, 鈴木 聡明, 馬場 陽子, 小川 洋, 多田 靖宏
1995 年 1995 巻 Supplement83 号 p.
82-85
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Four cases of cholesteatoma with attic perforation closure during preoperative treatment are reported. Though the tympanic membrane findings after the closure of the perforation appeared similar to those during the healing process of cholesteatoma, we confirmed the presence of cholesteatoma behind the tympanic membrane because of findings before the closure. All cases were treated by intact canal wall tympanoplasty and the cholesteatoma was removed.
The conditions that allow the perforation to close easily are small perforation, difficultly in removing the polyp and localized inflammation in the perforation.
To avoid overlooking a cholesteatoma when the perforation has closed, careful observation and treatment under a microscope from the initial examination is most important.
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小川 洋, 大谷 巌, 赤池 徹哉, 菅野 秀貴
1995 年 1995 巻 Supplement83 号 p.
86-89
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
We treated 187 primary cases of cholesteatoma by mastoid surgery between 1985 and 1990. Of 187 cases,137 cases underwent tympanoplasty. Although we performed radical surgery on cases which had the matrix tightly adhering to the foot plate, we have recently carried out planned staged tympanoplasty with an intact canal wall technique. In 4 cases, we have intentionally left a tiny part of the matrix during the initial surgery to avoid surgical damage to the inner ear. Each remnant of the matrix had formed a keratin-containing cyst resembling a pearl by the time of the second surgery and in all the cases, these cysts could be easily removed without causing any inner ear damage.
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堀 弘樹, 相川 通, 小川 洋, 山辺 習, 鈴木 聡明, 安田 秀男, 大谷 巌, 渡辺 一男
1995 年 1995 巻 Supplement83 号 p.
90-94
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Squamous cell carcinoma-related antigen (SCC antigen), which was purified from the tissue of liver metastasis from uterine cervical squamous cell carcinoma, is clinically available as a tumor marker for squamous cell carcinoma.
This is a case report of inverted papilloma of the nasal cavity diagnosed in a 56-year-old male with high serum SCC antigen level. CT-scan revealed a well circumscribed mass in the left nasal cavity. The tumor was difficult to detach at surgery because of synechia with the left middle turbinate, so it was completely resected including the left middle turbinate. The high serum SCC antigen level quickly declined to the normal level after surgery. Histopathological examination of the resected tumor showed typical features of inverted papilloma without malignancy. Immunohistological distribution of SCC antigen in the tissue of the resected tumor was observed by the strepto avidin-biotin peroxidase complex-method (SABC-method). SCC antigen immunoreactivity was diffusely present in the cytoplasm of tumor cells.
The findings suggest that SCC antigen is available as a tumor marker for inverted papilloma.
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宗田 由美, 大槻 好正
1995 年 1995 巻 Supplement83 号 p.
95-98
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
We reported a case of facial trauma caused by a metal wire. A 40-year-old man who had been under treatment for alchoholism stumbled and fell. At that time, he injured the left side of his face on a metal object. A foreign body thrust into his lower left eye lid, through the left maxillary sinus and reached the left parotid gland. There was no disturbance of vision or eye movement but there was the left facial paralysis in the lower jaw area. X-rays revealed that the end of the wire was bent back like a fish hook and pressed into the left lower branch of the facial nerve at the parotid gland. At surgery, the facial nerve was exposed and the wire was removed from the wound. Facial paralysis recovered after surgery.
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鈴木 知子
1995 年 1995 巻 Supplement83 号 p.
99-102
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
A rare case of acquired nasolacrimal duct cyst in a 79-year-old male is reported. He complained of nasal obstruction and the protrusion of the right inferior turbinate was observed. CT-scan showed the mass in the right nasolacrymal duct, right inferior turbinate and right inferior nasal meatus.
He had previous history of right dacryocystectomy and facial trauma. The diagnosis of acquired nasolacrimal duct cyst was made from the CT-scan findings and the previous history. Using a nasal endoscope, marsupialization of the cyst was performed under local anesthesia. At his 3month postoperative evaluation, the patient was asymptomatic.
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鈴木 茂憲, 赤池 徹哉, 菅野 秀貴, 柏原 一成, 大谷 巌, 大河内 幸男
1995 年 1995 巻 Supplement83 号 p.
103-107
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
This paper describes a very rare case of basal cell adenoma in the bilateral parotid glands. The patient was a 65-year-old woman with a painless mass in the left parotid gland since she was approximately 20 years old, but she had not sought treatment. Recently, she had also noticed a painless mass in the right parotid gland, and underwent bilateral partial superficial parotidectomies. Histological examination revealed tubular and trabecular type basal cell adenoma of the bilateral tumors. Bilateral parotid gland tumors are rare. Among them, Warthin's tumor is the most common, it is extremely rare for basal cell adenoma to occur in the bilateral parotid glands.
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松塚 崇, 鹿野 真人, 佐藤 和則, 佐久間 仁, 渡部 浩伸, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
108-112
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Basal cell adenocarcinoma is a low grade malignant tumor of the salivary glands. There are only a few reports of this tumor in the literature. We report a 76-year-old man with basal cell adenocarcinoma derived from the minor salivary gland. The tumor was located in the right retromolar region with infiltration to the mandible. The patient underwent preoperative radiotherapy and surgical excision. Histopathologically, the tumor was characterized by multiple variably-sized nodules. Two forms of infiltrative epithelial cells were seen and radiotherapy was not effective. There has been no sign of local recurrence or metastasis during 10 months follow-up.
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多田 靖宏, 小川 洋, 赤池 徹哉, 佐藤 勇, 鹿野 真人, 佐藤 和則, 佐川 雄一, 松塚 崇, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
113-118
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Hemangiopericytoma is an uncommon tumor derived from pericytes surrounding the vessels. It is a rare tumor in the head and neck, especially in the submandibular region. In general, it is very difficult to diagnose such a tumor before surgical excision. We reported a case of hemangiopericytoma in the left submandibular region. The patient was a 48-year-old man who complained of swelling in the left submandibular region and oral floor. The tumor was removed surgically and proved to be a low-grade-malignancy on histopathological examination. Local recurrence developed 14 months after surgery. We would like to stress that close observation is needed after treatment because of the high rate of local recurrence.
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石川 浩男, 鈴木 聡明, 鹿野 真人, 馬場 陽子, 柏原 一成, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
119-123
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
A rare case of diffuse neurofibroma located in the cervical region is presented along with a review of the medical literature. A 43-year-old female noted a swelling in the left side of the cervical region. She was admitted to our hospital, and the tumor was surgically removed. Histological examination of the resected tumor revealed diffuse neurofibroma immunohistochemically. There has been no recurrence for one year and 10 months following surgery.
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猪本 雄一郎, 赤池 徹哉, 佐藤 勇, 馬場 陽子, 柏原 一成, 相川 通, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
124-131
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
We encountered a case of Castleman's lymphoma in the right side of the neck of an 18-year-old male patient.
The present case involved a mixed-type lymphoma which comprises only a few percent of Castleman's lymphoma in the head and neck region in Japan.
Although Castleman's lymphoma occurs most frequently in the mediastinum, it can occur in the head and neck. The usual treatment is excision and the prognosis is usually good. We must take Castleman's lymphoma into consideration when we diagnose head and neck masses.
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大石 剛資, 鹿野 真人, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
132-137
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Between 1985 and 1993,86 cases of major salivary gland tumors treated in the department of otolaryngology, Fukushima Medical College Hospital were reviewed according to the classification of the World Health Organization (WHO) and investigated the incidence, location, treatment and prognoses.
There were 62 parotid gland tumors and 24 submandibular gland tumors. Malignancy was detected in 33.3% of the parotid gland tumors and 29% of the submandibular gland tumors.
The most common benign tumor in both the parotid and submandibular glands involved pleomorphic adenoma. Mucoepidermoid carcinoma and adenoid cystic carcinoma were the most frequently encountered malignancies.
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安田 秀男, 相川 通, 桑畑 直史, 鹿野 真人, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
138-144
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Between 1982 and 1994,54 cases of maxillary cancer were treated in the Department of Otorhinolaryngology of Fukushima Medical College. There were 41 males and 13 females (male to female ratio,3: 1). The peak incidence was in the fifth decade, with patient ages ranging from 50 to 70 years old accounting for 75.9% of those treatend.
Squamous cell carcinoma was the most frequent histopathologic type, accounting for 79.6% of all cases. The most common chief complaints were nasal obstruction and pain in the cheek. The cancers were stage III or 1V in 90.7% of all cases. Thus, most of the carcinomas were already advanced at the time of the initial examination.
The five-year survival rates by stage were: Stage II 80%, Stage III 78.6%, and Stage IV 57.4%. The most successful treatment was intra-arterial infusion combined with radiotherapy and surgery. The five-year survival rate in this group was 87.4%.
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佐藤 和則, 桑畑 直史, 渡邉 睦, 鹿野 真人, 菅野 秀貴, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
145-149
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
We reviewed the records of 63 primary cases with tongue cancer treated between January 1985and December 1994 in our department. The male to female ratio was 1.4 to 1. The incidence of tongue cancer peaked in the sixth decade of life. The five-year survival rate was 52.1% overall. In the recent five years, however, extended surgery with reconstructive procedures markedly improved the three-year survival rate as compared to that in the previous five-year. It is expected that survival rate will further improve in the future.
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当科10年間の集計
渡部 浩伸, 相川 通, 渡邉 睦, 鹿野 真人, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
150-154
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Between 1984 and 1993,29 cases of epipharyngeal carcinoma were treated in our clinic.
The male to femal ratio was 1.6: 1. The highest incidence accurred in the sixth decade. The most frequent symptoms were ear symptoms and the next was swelling of the cervical lymph nodes. The primary sites were the posterosuperior wall in 15 cases and the lateral wall in 14 cases. According to TNM classification, the carcinoma was classified as Ti in 2 cases, T2 in 4 cases, T3 in 3 cases and T4 in 20 cases. Most patients were treated with chemotherapy and radiotherapy. The overall 5-year survival rate was 56.6% (Kaplan-Meier method). The most frequent cause of death was untreatable local recurrence, and the next was distant metastasis.
Early diagnosis is important. In addition, the prevention of local recurrence and distant metastasis is also important.
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鹿野 真人, 佐藤 和則, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
155-159
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Forty-one patients with oropharyngeal carcinoma were treated in our department between 1976and 1993. The mean age of patients was 62.1 years, and the male-female ratio was 4.8: 1.0. Twentyone patients developed the lateral wall type,9 had the superior wall type,9 had the anterior wall type, and 2 had the posterior wall type. According to the UICC system (1987),2 patients were stage I,9 were II,8 were III, 22 were IV. The rate of advanced stage (stage III, IV) was 73%. From 1976 to 1988, radiation therapy was mainly selected as the initial treatment. After 1989, surgery, irradiation and chemotherapy were combined for many cases. The overall five-year survival rate was 41.4%. The three-year survival rate was 41.7% between 1976 and 1988, and 70.6% after 1989. Due to these results, we expect the survival rate to improve.
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渡邉 睦, 鹿野 真人, 渡部 浩伸, 佐藤 和則, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
160-164
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Since 1987,29 patients with carcinoma of the hypopharynx were treated with various combined therapies, including radical resection of the tumor. Reconstruction using free flaps has also been available for the resected site since 1987. Of 29 cases, the primary sites of the carcinoma were the piriform sinus in 23 cases, postcricoid in five cases and posterior pharyngeal wall in one case. Overall,93.1% were in stage III or IV. The rate of cervical lymph node metastasis was 79.3%overall.
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桑畑 直史, 鹿野 真人, 大谷 巌
1995 年 1995 巻 Supplement83 号 p.
165-169
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
We reviewed 143 patients with laryngeal cancer, who had undergone primary treatment in our hospital between 1983 to 1993. These patients consisted of 45 cases of supraglottic carcinoma,94cases of glottic carcinoma and 4 subglottic carcinoma. The respective five-year survival rates were 55.4%,80.1%,100% and 72.9% for supraglottic carcinoma, glottic carcinoma, subglottic carcinoma and that over all. Successful radiation control rates for primary glottic carcinoma in stage I and stage II were 89.4% and 76.9%, respectively. Laryngectomy was performed on 65 patients, but the larynx could be preserved in 54.5% of all cases.
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菅野 秀貴, 山辺 習, 大谷 巌, Leonard P. Rybak
1995 年 1995 巻 Supplement83 号 p.
170-175
発行日: 1995/08/01
公開日: 2012/11/27
ジャーナル
フリー
Deferoxamine mesylate (DFO) has been used as an iron-chelating agent since the 1960s. In the 1980s, it was demonstrated that intensive high-dose chelation therapy can induce cochlear impairment or aural symptoms, although adverse effects from initial mild therapy were unclear. This article reviewed reports regarding DFO-associated hearing loss and the ototoxicity of DFO, and those written to alert the otolaryngologist.
The incidence of DFO ototoxicity varied from 3.8 to 57%. The majority of the sensorineural hearing loss (SNHL) occurred at high frequencies similar to that of other ototoxic drugs. The audiometric threshold in some patients with severe SNHL exceeded 50 dB at all frequencies, indicating a ‘flat’ type of loss. The DFO-induced SNHL is, in most cases, accompanied by positive recruitment, and does not show any abnormality on ABR tests. However, the site of DFO activity in the auditory pathway remains controversial.
There are only a few experimental studies regarding DFO ototoxicity available. The generation mechanism of DFO ototoxicity remains unclear because an animal model for ototoxicity has not yet been established. It is expected that an animal model of DFO ototoxicity will be established soon, allowing the mechanism to be elucidated.
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