JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY
Online ISSN : 1884-474X
Print ISSN : 1349-581X
ISSN-L : 1349-581X
Volume 13, Issue 3
Displaying 1-14 of 14 articles from this issue
  • Yasukazu Mikami, Mamoru Tsukuda, Izumi Mochimatsu, Hideyuki Yamaoka, T ...
    2003 Volume 13 Issue 3 Pages 67-71
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    A 43-year-old female who had undergone a right thyroidectomy in 1988 suffered from swallowing sensation from 2000. The CT and MRI findings demonstrated large cystic masses in the right parapharyngeal space. The tumor was resected surgically using the mandibular swing method to get a wide view. Histological examinations showed that the tumor was metastatic retropharyngeal lymph node from papillary thyroid carcinoma. It is very rare that the metastatic lesion of thyroid carcinoma occurs in the retropharyngeal lymph node. For cases with extensive metastasis, careful attention to the retropharyngeal space should be paid.
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  • Yasushi Furuta, Akihiro Homma, Tatsumi Nagahashi, Dai Takagi, Fumiyuki ...
    2003 Volume 13 Issue 3 Pages 73-78
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    First bite syndrome (FBS) is one of the complications after surgery for parapharyngeal space tumor, which is characterized by pain in the parotid region after the first bite of each meal. The loss of the sympathetic nerve supply to the parotid gland by surgical procedures, causing a denervation supersensitivity of salivary gland myoepithelial cells, has been proposed as an etiologic factor in FBS. Here we report our experience of two typical FBS cases, in which FBS developed after surgery for a parapharyngeal sympathetic neuroma and a deep lobe parotid tumor. Since we were not aware of FBS at the time after surgery, it was very difficult to treat and counsel these patients. In our retrospective review of patients who underwent excision of parapharyngeal space tumors, including deep lobe parotid tumors, FBS was not a rare complication. Head and neck surgeons should be aware of FBS and be cautious at the time of preoperative informed consent.
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  • Yuko Sato, Masamichi Uzawa, Atsunobu Tunoda, Seiji Kishimoto
    2003 Volume 13 Issue 3 Pages 79-83
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    A rare case of paraganglioma arising in the vagus is reported. A 36-year-old woman complained of neck swelling. She underwent CT, MRI and angiography and was diagnosed as hypervascular tumor occupying the right parapharyngeal space. This tumor was totally removed using a mandibular swing approach. Prior to tumor removal, feeding artery was ligated, and relatively little bleeding (244 ml) was noted for such a case. After the surgery, she developed difficulty in swallowing, hoarseness and Homer's syndrome. She underwent additional surgeries: cricopharyngeal myotomy, laryngeal elevation and arytenoid roatation. Except these problems, the postoperative course was uneventful and she was free from disease for 12 months.
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  • Nobuhiro Hanai, Sotaro Kamei, Shinichiro Oyama, Shingo Murakami
    2003 Volume 13 Issue 3 Pages 85-90
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    We analyzed 7 cases of parapharyngeal space tumors and discussed our method of operation. In our department, we managed to resect the tumor without mandibular osteotomy. When this was possible, it meant the most minimally invasive surgery for the patient. This course has advantages in regards to post operation, duration of hospitalization and cosmetic results. In order to obtain operative fields, we dissected some structures from the cervical approach gradually. In the cases of neurogenic tumors, we resected the tumors after tumor reduction using CUSA. There was no recurrence after therapeutic resection, and there were fewer complications. From these results, we concluded that the decision regarding operative methods depends on the histology or the vascularity of the tumor rather than the size or the location.
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  • Katsunari Yane, Takehiko Hukuda, Tadashi Nishimura, Hideyuki Okamoto, ...
    2003 Volume 13 Issue 3 Pages 91-96
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    Parapharyngeal tumor is difficult to resect, as the parapharyngeal space is hard to view and cannot be operated on under direct visualization. Pleomorphic adenomas arising from the deep portion of the parotid gland in the parapharyngeal space were resected using a rigid nasal endoscope to avoid operating blind. Video-assisted endoscopic surgery allowed removal of the tumors under clear visualization with a slightly increased operation time, and no major difficulties were encountered. Video-assisted endoscopic surgery appears to be useful for parapharyngeal tumors.
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  • [in Japanese]
    2003 Volume 13 Issue 3 Pages 97-99
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
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  • Akira Kubota
    2003 Volume 13 Issue 3 Pages 101-106
    Published: March 30, 2004
    Released on J-STAGE: July 04, 2011
    JOURNAL FREE ACCESS
    The objective of chemotherapy for unresectable or recurrent advanced cancer is to improve the overall survival time rather than the overall response rate. Tumor dormancy therapy has reduced toxicity and can be administered for a long time, and results in an improvement in time to progression and survival time. Randomized studies have not proven a relationship between chemotherapy dose and therapeutic effects. Although a low dose of chemotherapy induced lower treatment toxicity than a high dose, we did not observe any improvement in terms of overall survival. The survival time was significantly longer in patients with progression-free survival (PFS) of more than 3 months than in patients with PFS of less than 3 months in the treatment of Nedaplatin and UFT for recurrent head and neck cancer in our study. Furthermore, there were no significant differences between the survival of NC patients with PFS of more than 3 months and CR+PR patients in the treatment of Nedaplatin and UFT. A future goal is to establish the tumor dormancy therapy to improve the survival rate for recurrent head and neck cancer without decreased QOL of the patient.
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  • Tatsumi Nagahashi, Akihiro Homma, Satoshi Fukuda
    2003 Volume 13 Issue 3 Pages 107-111
    Published: March 30, 2004
    Released on J-STAGE: February 25, 2011
    JOURNAL FREE ACCESS
    For the purpose of tumor dormancy therapy, UFT+Mitomycin C or TS-1 in patients with recurrent head and neck cancer was studied. Toxicity was not greater in the patients with a higher incidence of grade 2. One patient has survived for more than 4 years, having been given UFT+Mitomycin C at the beginning. For patients with lung metastasis, median survival time was 600 days, and time to progression was 4.5 months in the TS-1 group (n=4). TS-1 method was useful in terms of QOL. Based on these results, we believe that tumor dormancy therapy will be realized for the treatment of recurrent or lung metastastic head and neck cancer.
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  • [in Japanese]
    2003 Volume 13 Issue 3 Pages 113-123
    Published: March 30, 2004
    Released on J-STAGE: February 25, 2011
    JOURNAL FREE ACCESS
  • Yasuyuki Hinohiral, Naoaki Yanagihara, Kiyohumi Gyo
    2003 Volume 13 Issue 3 Pages 125-131
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    We have performed canal wall up tympanoplasty for middle ear cholesteatoma assisted with otoendoscope for the past six years. According to our results, one-stage operation with attic reconstruction using auricular cartilage and bone pate has been applied to patients with a small attic cholesteatoma not extending to the mastoid cavity. This paper describes the surgical indication, procedure, and outcome of the one-stage operation.A control hole for endoscopic exploration is made in the mastoid cavity. Reconstruction of the attic defect with a few pieces of thinly-sliced auricular cartilage and bone pate is done following transcanal removal of the cholesteatoma matrix in the case of aerated mastoid cavity without inflammation. The ossicular chain is also reconstructed if involved. The control hole is closed with bone pate. Second-look operation is not necessary if CT scan reveals no residual disease. We applied the one-stage operation to 30 patients between 1998 and 2003. Out of the 23 cases followed over two years, recurrence from the attic pocket was seen in only one case.
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  • Nin Fumiaki, Nobuhito Ioka, Kaheita Hirasugi, Susumu Nakae
    2003 Volume 13 Issue 3 Pages 133-139
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    We have experienced 7 cases of congenital aural atresia or stenosis in the past 10 years. They include 3 males and 4 females, and all of them are under 10 years old except for one case (47-year-old man). We performed both a canalplasty and a tympanoplasty at the same time in all cases. We have treated 3 cases as tympanoplasty type I, 2 cases as tympanoplasty type II -c, 1 case as tympanoplasty typeIV-c, and 1 case without reconstruction of ossicle, The major cause of hearing loss after the operation was lateralization of the tympanic membrane and fixation of a collumela. We performed re-operations in 2 cases by establishing a bony annulus or replacing the collumela with an artificial ossicle. If the handle of malleus is there, the interdigited method is effective to prevent lateralization of the tympanic membrane.
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  • Nobuya Fujita, Toshiaki Yamanaka, Takayuki Murai, Hiroshi Hosoi
    2003 Volume 13 Issue 3 Pages 141-145
    Published: March 30, 2004
    Released on J-STAGE: February 25, 2011
    JOURNAL FREE ACCESS
    Ménierè's disease, which can be regarded as endolymphatic hydrops, and the cause and mechanism of the disease are not clear, although the pathophysiology of the disease involves endolymphatic hydrops. Though medication is the main therapy for symptoms, there is a surgical treatment for the endolymphatic hydrops as the cause. MEPP (middle ear positive pressure treatment) was performed by MeniettTM which is a pressure pulse generator for patients with intractable Maniere's disease. Though it is effective for vertigo, it is thought not to be effective for hearing loss or tinnitus. The disappearance of vertigo after MEPP and the mechanism of the hearing improvement are thought to involve a decrease in endolymphatic fluid. The usefulness of MEPP was between those of medication for Meniere's disease and surgical treatment. MEPP should be examined further as a treatment of the underlying cause of Meniere's disease.
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  • Takashi Matsuzuka, Makoto Kano, Masahiro Suzuki, Yukio Nomoto, Teruhis ...
    2003 Volume 13 Issue 3 Pages 147-152
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    In the submandibular region, lymphatics from the tongue drain mainly into deep nodes (preglandular and retroglangular nodes), and superficial nodes (prevascular and retrovascular nodes) rarely metastasize. The concept of avoiding the superficial nodes from the area of neck dissection to preserve the mandibular branch of the facial nerve was reported. We describe a case of prevascular node metastasis. The patient was a 67-year-old man, whose clinical stage of carcinoma of the tongue was T3N1M0, and preglandular node metastasis existed clinically. Left hemi-glossectomy and left neck dissection were performed, and at that time lymphatic mapping using sentinel node navigation was performed. 99m-Tc labeled rhenium sulfide colloid was injected around the primary tumor, and prevascular node was detected using NEO2000, but preglandular node was not detected. Pathologically, both preglandular and prevascular node were metastatic; the preglandular node was partly occupied by malignant cells. This phenomenon was supposed to be because conventional flow to the deep layer was blocked, and alternative flow to the superficial layer was formed. In this case, the sentinel node biopsy techiaue was feasible to find the prevascular lymph node metastasis from the carcinoma of tongue. In addition, although prevascular and retrovascular nodes exist by the mandibular branch of the facial nerve and these nodes might tend to be excluded from the area of neck dissection, we recommend inclusion of the superficial mandibular nodes for curative neck dissection for carcinoma of tongue.
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  • Seiichi Takekida, Kunihiko Makino, Mutuo Amatu
    2003 Volume 13 Issue 3 Pages 153-158
    Published: March 30, 2004
    Released on J-STAGE: July 27, 2010
    JOURNAL FREE ACCESS
    Angioma of the head and neck region accounts for about 40% of all cases of angioma and is encountered frequently. We recently encountered a case of cavernous angioma of the parathyroid gland, presenting with very rare angioma of the deep neck region. This paper describes this case. The patient was an 89-year-old woman. She consulted our department because of purpura appearing on the anterior neck to the chest. Neck ultrasonography revealed a tumor, accompanied by pulse waves, in the area posterior to the left lobe of the thyroid gland, suggesting angioma. We considered this angioma to have arisen from collapse of the blood vessels entering the thyroid gland. The angioma was resected together with the left lobe of the thyroid gland after a collar incision, using an operative procedure resembling that for thyroid surgery. The resected tissue was pathologically rated as cavernous angioma of parathyroid gland. Several days after surgery, purpura and congestive swelling of the left vocal cord subsided, allowing the patient to be discharged from the hospital 9 days after surgery. To date, the patient has been following an uneventful course.
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