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Kiyoko Kobayashi, Shikou Kubota, Naoya Iijima, Kiichirou Taguchi
1999 Volume 1999 Issue Supplement100 Pages
1-6
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Bone-conduction hearing aids are only indicated in cases of conductive loss, such as atresia auris congenita or light mixed type hearing loss (20 to 40 dB).
We examined a new high quality bone-conduction hearing aid (Sensor, WD2001) applicable in cases of sensori-neural hearing loss. Eighteen adult patients aged 18 to 79 years old and 7 pediatric patients aged 5 to 14 years old were studied. Their hearing threshold ranged between 53.3 and 95.9 dB,0.5-2.0 kHz. The speech intelligibility (for words) of patients with profound hearing loss (more than 90 dB of hearing loss) who were fitted with this bone-conduction hearing aid was 80% on average. Furthermore, a bilateral fitting with an air-conduction hearing aid on one side and a boneconduction hearing on the other side was more useful for patients with profound hearing loss. Their speech intelligibility was 10% greater than with a monoaural fitting. In conclusion: 1) this bone-conduction hearing aid can be applied to patients with profound sensorineural hearing loss.2) A bilateral fitting using both an air-conduction hearing aid and a boneconduction hearing aid proved to be effective in this study.
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Masanori Sakaguchi, Kiichiro Taguchi, Naoya Iijima, Tetsuya Ishiyama
1999 Volume 1999 Issue Supplement100 Pages
7-14
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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To clarify the characteristics of disequilibrium in patients with equilibrium disturbances, we investigated head movement (H. M. ) and movement of the body's center of gravity (M. C. G. ), using a cephalograph to record H. M., a strain-gauge platform to record M. C. G. and a technical computer. Patients were instructed to stand with feet close together on the platform with eyes open and then with eyes closed, for periods of 60 seconds each. The results were as follows:
1) In 4 patients with peripheral vestibular disorders, the area and total length of locus traced by H. M. and M. C. G. were greater than in normal controls, especially with eyes closed. The ratio of the total length of locus traced by H. M. to that of M. C. G. was also greater in the patients than in normal controls. The patients tended to sway laterally.
2) In 6 patients with spinocerebellar degeneration, the area and total length of locus traced by H. M. and M. C. G. were greater than in normal controls. The averaged divisional frequencies in an anteroposterior direction were also greater in the patients.
3) In 13 patients with Parkinson's disease, the total length of locus traced by M. C. G. with eyes open was larger than in normal controls, while the area of H. M. was smaller. The ratio of the total length of locus traced by H. M. and M. C. G. with eyes closed to those with eyes open was smaller in the patients than in normal controls.
4) In 4 patients with acoustic neurinoma, most parameters of H. M. and M. C. G. did not differ from those of normal controls.
These results suggest that patients with equilibrium disturbances have a pattern of body sway specific to the disease.
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Masanori Sakaguchi, Kiichiro Taguchi, Naoya Iijima, Tetsuya Ishiyama
1999 Volume 1999 Issue Supplement100 Pages
15-20
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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To evaluate quantitatively the chronological changes in equilibrium function in elderly persons, we investigated head movement (H. M. ) and movement of the body's center of gravity (M. C. G. ), using a cephalograph to record H. M., a strain-gauge platform to record M. C. G. and a technical computer. Seventy-five healthy subjects aged 30 to 91 years were instructed to stand with feet close together on the platform with eyes open and then with eyes closed for periods of 60 seconds each. The results were as follows:
1) The area and total length of locus traced by H. M. increased with age. Both were significantly greater in subjects older than 50 years of age than in younger adults under 40 years.
2) The area and total length of locus traced by M. C. G. also increased with age. Measurements were significantly greater in subjects older than 70 years of age than in younger adults under 40years.
3) The ratio of the anteroposterior component to the lateral component in H. M. did not differ between the age groups. This ratio for the M. C. G. with eyes open was however, significantly greater in subjects older than 70 years of age than in younger adults.
4) The ratio of the total length of locus traced by H. M. to that of M. C. G. did not differ among the age groups.
5) The ratio of the total length of locus traced by H. M. and M. C. G. with eyes closed to that with eyes open did not differ among the age groups. These results suggest that the body sway of the elderly is not only larger than that of younger adults, but is also fundamentally different in nature.
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Osamu Sasaki, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
21-27
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Stabilometry and oculomotor examination was used to study 17 patients with spinocerebellar degeneration. The patients with a peak of over 2 Hz in the power spectra in stabilometry were examined for characteristic abnormalities in eye movement.
The results of tests for pursuit eye movements, optokinetic nystagmus and visual suppression test were not related to the peak over 2 Hz in the power spectra of stabilometry. However, the occurrence of vertical saccadic eye movements was associated with the high frequency component over 2 Hz. The center of vertical saccade exists in the mesencephalic tegmentum.
The cause of postural tremor at over 2 Hz is atrophy of the anterior lobe of the cerebellum, to which the proprioceptive afferents project via the mesencephalic tegmentum. The relationship between postural tremor and abnormalities in the vertical saccade may be due to a common lesion in the mesencephalic tegmentum.
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Nagamasa Sakabe
1999 Volume 1999 Issue Supplement100 Pages
28-34
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Under the new system, the teaching staff submit the students' examination grades to the administration office through the university LAN. Every teaching staff member's room is equipped with a terminal connected to the LAN. To input the grades, a teacher downloads a password-protected folder containing student data files for the classes he or she is responsible for. The files are in Excel format and a macro is provided which guides the teacher through the process of inputting and submitting the grades. This makes it very simple so that even teachers who are not very skilled in computer use can do it with little difficulty. The completed files are submitted directly through the LAN to the administration office. This greatly simplifies the processing of examination grades for the administration staff and reduces their workload. It also reduces the possibility of error, as it is no longer necessary to use OCR to read the teachers' handwritten grades and resubmit the results to each teacher for double checking, as was the case under the former system.
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Masanori Sakaguchi, Kazuyuki Kainuma, Kiichiro Taguchi, Tetsuya Ishiya ...
1999 Volume 1999 Issue Supplement100 Pages
35-39
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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To clarify the clinical features of nasopharyngeal carcinoma in the Nagano Prefecture between 1986 and 1995, we analyzed questionnaires which were sent to all full-time otolaryngologists who work at the hospital in this prefecture. The results were as follows. The total number of patients amounted to 72. The incidence per 100,000 population was 0.33. The male to female ratio was 2.4to 1. The ages of the patients ranged from 10 to 78 years (mean age,53.6 years). Histologically,4% of the patients had keratinizing squamous cell carcinoma,51% non-keratinizing carcinoma and 44% undifferentiated carcinoma. A neck mass was present in 61% of the patients, ear symptoms due to eustachian tube involvement in 53%, nasal obstruction or epistaxis in 39% and cranial nerve dysfunction in 24%.
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Shiko Kubota, Akihiro Otsuka, Naoya Iijima, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
40-45
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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In the last 10 years,18 cases of schwannoma and 1 case of neurofibroma of the head and neck were seen in the Shinshu University Hospital. Patient age ranged from 17 to 78 years and the average was 48.5 years. The tumor was seen most often in the parapharyngeal space (33%). The nerve origin of the tumors was identified in 10 cases: 1 in the tenth cranial nerve,2 in the seventh,1in the fifth,1 in the ninth and 2 in the sympathetic trunk.2 additional cases were probably of anterior ethmoidal origin and great auricular nerve origin, respectively. One case showed recurrence 6 years later after the operation.
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Toshiya Suzuki, Yasushi Nomura, Akinobu Goto, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
46-51
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Thirty one cases of adenoid cystic carcinoma in the head and neck were treated in our clinic between 1982 and 1998. The patients included 17 men and 14 women, ranging in age from 32 to 77years. The main affected regions were the tongue to mouth floor, submandibular gland and maxillary sinus. The cumulative survival rates at 5 and 10 years were 86.1% and 68.5% respectively. Histologic findings were classified into three grades, Grade I: tumors with tubular and cribriform areas but without solid components, Grade II: cribriform tumors that were either pure or mixed with less than 30% solid areas, and Grade III: tumors with a predominantly solid pattern. There was no evidence that Grade III tumors were associated with a poorer prognosis in this study. The addition of postoperative radiation therapy was effective for prevention of recurrences.
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in Shinshu University Hospital over the Past 10 Years (1988-1997)
Eiko Kouda, Kiyoko Kobayashi, Yumi Mogami, Yuri Umegaki, Kiichiro Tagu ...
1999 Volume 1999 Issue Supplement100 Pages
52-57
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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A clinic for young children with speech and hearing disorders was opened in 1960 at the otolaryngeal outpatient clinic Shinshu University Hospital. In 1980, Horiuchi and Imai reported the patient history and data obtained during the first 18years (1960-77).
In 1992 Aoki and Umegaki reported the data obtained in the subsequent 10 year period. (1978-87).
In this paper the clinical records of the most recent 10 year period (1988-97) are reviewed.
The number of diseased children decreased compared with 1978-87 reports, while the number of patients under 1 year of age has in a increased.
Review of the entire data set, there were 22.5% normal subjects, of which 47.5% were infants, under one year of age.
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Naoya Iijima, Tetsuya Ishiyama, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
58-61
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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We investigated 108 cases of radical surgery for chronic maxillary sinusitis from 1989 to 1997. The number of cases, sex, age, chief complaint, and clinical history were reviewed.
On average 12 cases of the operation was performed in a year. The male to female ratio was about 3: 2. The most important chief complaints were nasal obstruction and nasal discharge. The average suffering period was about 5 years, while 27% of the patients suffered for over 10 years. Our policy is to perform radical surgery only on patients suffering from sinusitis who were junior high school age (12 years old) and older.
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Akihiro Otsuka, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
62-69
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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We investigated ventilation tube therapy performed on 125 ears of otitis media with effusion (OME) in 69 children from 1988 to 1997. The recurrence of OME in children treated with adenoidectomy and ventilation tube therapy was less than those treated with ventilation tube therapy alone. The children in which the insertion period of the tube exceeded 6 months tended to experience better results. The recurrence of OME in children over 7 years of age was less frequent than in those under 6 years of age. A second ventilation tube insertion was less effective except in 2cases and the tube tends to be extruded for the same reason as the first insertion.
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Ren Guang, Osamu Sasaki, Toshizo Akahira, Koichi Miyashita, Kiichiro T ...
1999 Volume 1999 Issue Supplement100 Pages
70-74
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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A statistical analysis was carried out on 67 patients who visited our clinic complaining of vertigo and dizziness from January 1997 to March 1998. The ranged in patients age from eight to seventyseven years, and the average age was 50.1 years. The number of male patients totalled 31 and females totalled 36. Patients over 50 years of age accounted for 58.2%. A total of 61.2% of the patients were diagnosed with vertigo and dizziness of peripheral origin, while, those of central origin accounted for 20.9% and other causes for 17.9%. Equilibrium test results were as follows:
1. Spontaneous nystagmus: Spontaneous nystagmus of peripheral origin (PO) and central origin (CO) was found in about 41.5% and 42.9% of patients. Respectively, disturbed smooth pursuit in the ETT proved to occur in 10% of PO cases and in 63% of CO cases.
2. The results of the OKN were almost the same as ETT results, showing all cases of CO were abnormal and only 30% of PO cases were abnormal.
3. Caloric tests showed no significant differences between PO and CO cases.
4. Hearing tests revealed that CO patients showed a relatively higher incidence of abnormality as compared to other patients, partially explaining the presbyacoustic faction of CO patients.
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Tetsuya Ishiyama, Satoshi Katsuno, Masanori Sakaguchi, Akihiro Otsuka, ...
1999 Volume 1999 Issue Supplement100 Pages
75-79
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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In the surgical treatment of head and neck cancer, when tumors invade the carotid artery, there is a fear of cerebral ischemic complications during resection of these lesions with the involved carotid artery. Vascular reconstruction is useful in cases of radical neck dissection with the carotid artery resection. Numata et al. (1992) developed a surgical procedure for treating these cases, namely, the contralateral external carotid-middle cerebral artery bypass operation. We presented a case treated using this technique. The case was a 66 year-old male who underwent a total laryngectomy one year ago. He subsequently noted a painless right cervical node, and CT scanning revealed neck metastases involving the right internal carotid artery. Preoperative tests were performed to evaluate the carotid arterial system, including an evaluation of arterial stump pressure and temporary balloon occlusion of the right internal carotid artery. He underwent surgery using Numata's procedure, involving a left external carotid-right middle cerebral artery bypass with autologous great saphenous vein grafting. After three weeks, right neck dissection with the carotid artery resection was performed. He had no cerebral ischemic complications and has had no recurrence for 13 months.
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Haruki Yokoyama
1999 Volume 1999 Issue Supplement100 Pages
80-83
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Nasal and paranasal tuberculosis is a rare and virtually forgotten disease entity for ENT practitioners. The case of a 60 year-old female who complained of left nasal obstruction with tuberculosis of the nasal cavity and maxillary sinus is reported here. A clinical examination of the left nasal cavity revealed marked white exudation in the middle meatus and an erosive inferior turbinate. Plain Xray and CT-scans of the paranasal sinus showed an opacity in the left maxillary sinus. A biopsy was performed on the left inferior turbinate, and the pathological findings strongly suggested nasal tuberculosis. Mycobacterium tuberculosis was subsequently cultured from the nasal discharge. A chest X-ray and CT-scan showed active pulmonary tuberculosis, and the bacteriology also indicated the growth of Mycobacterium tuberculosis. Therefore, she was diagnosed with nasal and paranasal tuberculosis secondary to the pulmonary tuberculosis. She was treated with INH, RFP and EB, and obtained satisfactory results. Her prognosis has been good, without any complications or recurrences.
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Keiji Sato, Kazuko Oura, Shiro Asawa, Toshiya Suzuki, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
84-88
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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We report here the rare case of an occult medullary thyroid carcinoma which was found in a metastatic right maxillary sinus tumor.
A 47 year-old man had complained of a right maxillary tumor for 2 months. An open biopsy of the right maxillary sinus tumor was performed, and it was diagnosed histopathologically as a squamous cell carcinoma. Irradiation, chemotherapy, a right total maxillectomy and a neck dissection were then performed. Soon after the surgery, multiple systemic metastases were detected, and he died of a hepatic coma. An autopsy of the patient showed that the first diagnosis was actually a metastatic medullary thyroid carcinoma, and that the primary thyroid tumor had been overlooked. The occult type of thyroid carcinoma is also discussed.
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Satoshi Katsuno, Tetsuya Ishiyama, Masanori Sakaguchi, Kiichiro Taguch ...
1999 Volume 1999 Issue Supplement100 Pages
89-92
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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A 72 year-old male was referred to us complaining of respiratory distress. An endoscopic examination revealed a subglottic mass which occupied almost the whole subglottic space. The subglottic mass was totally removed using a laryngofissure technique, which gave us a wide operative field. The mass was pathologically confirmed as an inflammatory granuloma. A piece of the oral mucosa was successfully grafted to the excised portion. Although an intraluminal stent was not applied, the patient showed a satisfactory postoperative course with no signs of recurrence or any stenotic lesions. He had undergone cardiac surgery three months before his consultation, and had been intubated for 10 days. Therefore, the pathogenesis of the subglottic granuloma was believed to be inappropriate long-term intubation.
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Takao Ogiba, Shiro Asawa, Kazuyuki Kainuma
1999 Volume 1999 Issue Supplement100 Pages
93-98
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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The case of an extramedullary plasmacytoma of the bilateral paranasal sinuses is reported.
A 61 year-old male was referred to our clinic complaining of right nasal bleeding. A CT scan and MRI revealed a tumor in the right ethmoidal sinus. The histopathological diagnosis was an IgA-type plasmacytoma. Following VAD chemotherapy (a combination therapy consisting of vincristine, adriamycin and dexamethasone) and radiation, the tumor disappeared rapidly. Five months later, the tumor recurred in the left maxillary sinus. A M-2 chemotherapy protocol (a combination of vincristine, cyclophosphamide, ranimustine, melphalan, and prednisolone) and radiation reduced the tumor size significantly. Both the VAD chemotherapy and the M-2 chemotherapy protocol were effective against this tumor. No recurrence or progression to a multiple myeloma has been noted for the past five years.
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Koichi Miyashita, Toshizo Akahira, Tetsuya Ishiyama, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
99-102
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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We experienced the case of an 80 year-old female with a malignant lymphoma of the larynx. She had complained of hoarseness for the previous three months. A tumor was found in the right false cord, and its pathological diagnosis was a B cell lymphoma (diffuse mixed type). She was given a combined chemotherapy (CHOP) protocol. A hepatoma and lung tumor were then discovered by X-ray and MRI examinations. Therefore, radiation was added for the primary laryngeal and lung tumors, and the hepatoma was treated by transcatheter arterial embolization. The laryngeal and lung tumors were well controlled, but the hepatoma was still present at 6 months after her hospital discharge.
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Shiro Asawa, Michie Osawa
1999 Volume 1999 Issue Supplement100 Pages
103-108
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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The case of emphysema in the retropharyngeal and cervicomediastinal regions is reported. A nineteen year old male patient complained of neck pain and dyspnea, immediately after a sudden impact from his hand to the cervical region while sleeping in a moving car. A plain X-ray and CT scan revealed intermediastinal air, which suggested the possibility of tracheal trauma in the membranous wall. He was treated with rest and antibiotics, and recovered within several days. We believe that sudden and soft pressure can cause a mediastinal emphysema.
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Susumu Ezawa, Shikou Kubota, Akinobu Goto, Yasushi Nomura, Toshizou Ak ...
1999 Volume 1999 Issue Supplement100 Pages
109-114
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Two cases of rhinogenic spontaneous intracranial complications are reported. One case was a 10 year-old female, the other was a 53 year-old male. The primary lesion was located in either the frontal or sphenoidal sinus with respect to complications, brain and extradural abscesses were noted.
Intracranial complications arising from nasal infections are very serious, but these two cases were treated successfully with surgical drainage. A CT scan was useful for both the early detection and for facilitating the treatment of the intracranial lesions.
The intracranial complications arising from sinusitis continue to be present in different forms because antibiotic therapy can mask the real conditions.
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Ayako Onumata, Kiichiro Taguchi, Tetsuya Ishiyama, Yutaka Sakamoto, To ...
1999 Volume 1999 Issue Supplement100 Pages
115-118
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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A 36 year-old man developed an“abnormal sensation and cough”in his throat one year ago. A laryngoscopy revealed a large mass (10×10 mm) on the false vocal cord. Under general anesthesia, microlaryngo surgery was performed and the tumor was removed. After further histological examination, the tumor was diagnosed as a benign fibrohistiocytic tumor. The patient has shown no evidence of recurrence after more than 43 months.
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Kazuyuki Kainuma, Akinobu Goto, Toshiya Suzuki, Yasushi Nomura, Osamu ...
1999 Volume 1999 Issue Supplement100 Pages
119-124
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Adenoid cystic carcinomas of the larynx are very rare; only 26 cases have been reported in the Japanese literature. We have encountered two cases of laryngeal (subglottic) adenoid cystic carcinomas. Case 1 was a 46 year-old female, who was treated with combination of surgery and radiotherapy. Case 2 was a 46 year-old male, who was treated with combination of surgery, radiotherapy and chemotherapy. Case 2 died of lung metastasis, while case 1 is still alive without any evidence of recurrence.
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Koji Tsukamoto, Norio Takagi
1999 Volume 1999 Issue Supplement100 Pages
125-128
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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We report here a case of Hunt's syndrome with multiple cranial nerve symptoms. The patient was a 79 year-old man who had CN VII through CN XII cranial nerve palsies. The cranial nerve CN VII through CN XII palsies improved, but the hoarseness and right recurrent nerve paralysis remained without any swallowing disturbance. Recovery of the patient's voice was performed by a rehabilitation technique.
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Naoya Iijima, Shiko Kubota
1999 Volume 1999 Issue Supplement100 Pages
129-132
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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The auditory function was evaluated in 2 patients with mitochondrial diseases, including one case of MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes)and one unclassified case.
Bilateral sensorineural hearing loss was observed in both cases.
A young female with the mitochondrial disease at first suffered only from hearing loss, and about 10 years later she experienced renal disfunction. She was identified with a point mutation on the mitochondrial gene. An eldery male who had borderline uncomfortable sound and hearing loss was diagnosed as having a mitochondrial disease on the basis of a muscle biopsy.
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Kazuko Oura, Masanori Sakaguchi, Tetsuya Ishiyama, Kiichiro Taguchi
1999 Volume 1999 Issue Supplement100 Pages
133-140
Published: February 05, 1999
Released on J-STAGE: November 27, 2012
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Three cases of multiple Warthin's tumors with bilateral involvement of the parotid glands are described. Bilateral involvement or multiple involvement in a single parotid gland have been reported to be characteristic of Warthin's tumor. However, bilateral and multiple tumors are rare. The ages of the patients ranged from 64 to 68 years, and all of them were male. In all cases, a CTscan showed multiple lesions in both parotid glands. The cytological diagnosis made by needle biopsy was a Warthin's tumor. The masses were all removed surgically, and the subsequent histopathologic diagnosis was confirmed to be Warthin's tumor. We believe that it is necessary to observe the postoperative course very carefully.
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