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Volume 42, Issue 5
Displaying 1-15 of 15 articles from this issue
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[in Japanese]1999 Volume 42 Issue 5 Pages 472-473
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
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A STATISTICAL ANALYSIS OF 26-YEAR EXPERIENCE AT THE KITASATO UNIVERSITYMakito Okamoto, Hiroomi Takahashi, Kazuo Yao, Katsuhide Inagi, Meijin ...1999 Volume 42 Issue 5 Pages 474-482
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSA total of 1, 731 patients, who were registered as head and neck malignancies at the department of Otorhinolaryngology of the Kitasato University Hospital, were evaluated. Age-adjusted incidence was 21.2 in Japan standard population of 100, 000.
Involved local sites were found at larynx, pharynx, oral cavity, nasal and paranasal sinuses, thyroid gland, salivary gland, and neck region (listed in the order of the number of the patients). In the national statistics, cancer of the oral cavity was the most involved site. The fact that cancer of the oral cavity is also treated at the institute of oral surgeons might contribute to this discrepancy.
Squamous cell carcinoma was the most commonly made pathological diagnosis followed by malignant lymphoma, papillary carcinoma, adenocarcinoma and adenoid cystic carcinoma.
Five-year crude survival rate was 51% for the whole group and 10-year survival rate was 31%. Both the numbers of the new patients and the patients who died increased. Because of the high morbidity in the aged population, head and neck malignancy is presumed to increase as the life span prolonged.
To improve the mortality rate of head and neck malignancy, we must first improve the cure rate of the most encountered cancer of the oral cavity. Meanwhile, we need to demonstrate the importance of tobacco and alcohol cessation since these habits are known to increase the morbidity rate of the cancers of oral cavity, mesopharynx, and hypopharynx.
.Treatment was initiate without the definite diagnosis of pathology in 1.6% of the patients. These patients will exist in the future and we must continue to pursue the best solution for each patient based on the sufficient informed consent.View full abstractDownload PDF (1345K) -
Hiroaki Ohta1999 Volume 42 Issue 5 Pages 483-492
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSElectrocochleography (ECochG) was performed in 47 patients (47 ears) with sudden sensorineural hearing loss (SSNHL). The extratympanic ECochG procedure was carried out using a HN-5 electrode at the active site. Clicks, short tone bursts with a duration of 5 to 7 ms and long tone bursts with a duration of 52 ms were employed as acoustic stimuli.
The parameters investigated were detection thresholds of compound action potential (AP) and cochlear microphonics (CM), polarity of summation potential (SP) with long tone bursts, and click-elicited SP to AP amplitude ratio (SP/AP).
The patients were divided into a satisfactory group (patients with complete recovery and remarkable improvement) and an unsatisfactory group (patients with slight improvement and no change) in accordance with the Sudden Deafness Research Team of the Ministry of Health and Welfare of Japan.
A low-AP detection threshold and a high-advent rate of delayed CM were prominently observed in the satisfactory group. There was statistical significance in the ECochG findings between both groups (t-test), suggesting effective factors for prognostic criteria. We assumed a suitable AP detection threshold for prognostic criteria at 40-60 dBnHL. There were no significant differences in the CM detection threshold, SP/AP and SP polarity between the two groups (t-test).
The low-AP detection threshold and high-appearance rate seemed to suggest a cochlear pathophysiology with the nonlinearity and tip in the tuning curve of the basilar membrane. Extratympanic ECochG yielded useful electrophysiological information concerning the prognosis of SSNHL.View full abstractDownload PDF (1942K) -
Hiroya Utahashi, Yukie Mitani, Tomihiko Tsuji, Yukio Hamada, Kazuhiro ...1999 Volume 42 Issue 5 Pages 493-500
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSIt is thought that the pathogenesis of otitis media with effusion in children (OME) is related to eustachian tube dysfunction and upper respiratory inflammation. We previously studied the relationship between chronic middle ear inflammatory conditions and suppressed growth of mastoid pneumatized cellulae. We found that growth of the mastoid cellulae was suppressed by persistent inflammation in the middle ear. This suggests that the degree of suppression of mastoid pneumatization on X-ray films indicates in earlier inflammatory condition in the middle ear. We treated 727 children (1, 338 ears), ranging in age from 1 to 15 years in our outpatient department since 1981 April. We classified them with the degree of pneumatization seen on X-ray films. Forty-three percent (313 children) had a small number of mastoid air cell and were treated surgically (i.e. middle ear ventilation tube insertion, adenotomy and tonsillectomy). The remaining 57% (414 children) had a large mastoid air cells and were treated with conservatively. After initial conservative treatment proved ineffective, 84 children underwent surgery. The rate of hypertrophied adenoid tissue and severe sinusitis was significantly higher in the 84 cases than in the 330 conservatively treated cases (p <0.05).
The average duration of tube ventilation was 21.5 months. The OME recurrence rate was significant lower in the group intubated for 18 months or more compared with the group for less than 18 months.
The group underwent adenotomy showed better clinical progress after extubation than the group without adenotomy. This indicates that adenotomy is a useful approach in the treatment of OME in children.View full abstractDownload PDF (1167K) -
Toshikazu Shimane, Masako Terasaki, Mutsuo Naitou, Ken-ichi Kanai, Har ...1999 Volume 42 Issue 5 Pages 501-504
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSDespite the rare occurrence of tetanus in the field of otorhinolaryngology, otorhinolaryngologists successfully treated one patient with tetanus. There are few opportunities for otorhinolaryngologists to encounter the 1 st or 2 nd stage of tetanus. A successful outcome to save a patient's life is difficult, unless treatment has been provided in the early stage. The period between the first appearance of symptoms, such as difficulty in opening the mouth, or convulsion, and treatment is critical. If this period is less than 48 hours, an emergency tracheostomy must be performed. In this case, otorhinolaryngologists could save a patient's life because of immediate treatment using tetanus human immunoglobulin, tetanus toxoid, penicillin G injection and the early provision of a respirator pulmotor after tracheostomy. The diagnosis was made while observing the clinical symptoms and treatment was provided before the results of a bacteriological examination could determine that the cause was tetanus.View full abstractDownload PDF (631K) -
Mamoru Yoshikawa, Masanori Ishii, Shigeru Yoshida, Tomihiko Tsuji, Rik ...1999 Volume 42 Issue 5 Pages 505-509
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSWe report a giant mucocele of the frontal sinus that was accompanied by diplopia, left blepharoptosis, left exophtalmos, and slight swelling of the left frontal region. Preoperative computed tomography (CT) demonstrated a giant well-demarcated mucocele of the frontal sinus that was impacted into the orbit, as well as, a bone defect of the orbital roof. The mucocele was expanded in the area ranging from almost the whole of the left frontal region to the proximal side of the parietal region. Also the lamina interna cranii of the frontal region was revealed to have been eroded. The mucocele was found to have compressed the left frontal lobe extensively and part of the cerebral ventricle, but no evidence of local signs (psychogenic symptoms, abnormal reflex, and ataxia) indicating impairment of the frontal lobe was noted. We achieved safe, less-invasive treatment of the giant mucocele by selecting endoscopic sinus surgery.View full abstractDownload PDF (1631K) -
Akiko Ishihara, Hideki Muraoka, Yoshinobu Eishi1999 Volume 42 Issue 5 Pages 510-513
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSWe report a typical case of pilomatricoma in the right parotid region. The patient, an 18-year-old man, visited our hospital with a complaint of palpable and painless mass on the right side for two years. Clinical examination revealed a firm nodule that measured 2.0×1.5 cm. The skin was free of unusual pigmentation. CT scans demonstrated a well-demarcated and calcified mass in the subcutaneous tissue. Both clinical features and CT suggested pilomatricoma. Under local anesthesia, we removed the tumor together with a connective tissue capsule. Serum SCC antigen was elevated to 1.9 ng/ml on preoperative examination, but decreased to within the normal range (0.9 ng/ml) 1 month after surgery. Histological examination showed many islands of shadow cells including calcium deposits, and the specimen was diagnosed histologically as pilomatricoma.View full abstractDownload PDF (1792K) -
Naoya Ui, Shinichi Haruna, Nobuyoshi Ootori, Takakuni Katou, Hiroshi M ...1999 Volume 42 Issue 5 Pages 514-518
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSInferior turbinates of 28 patients whose chief complaint was nasal obstruction or hyposmia caused by nasal obstruction were treated with CO2 laser on an out-patient basis. Between 4 to 10 weeks after laser surgery, subjective symptoms which were nasal obstruction, nasal discharge, loss of sense of smell, postnasal discharge, headache, and nasal improvement as a whole were traced. Every symptom showed a tendency toward improvement, and more than 90% of patients showed either much improvement, or improvement of nasal obstruction and general improvement as a whole. We have comfirmed the effectiveness of CO2 laser surgery. There were no complications such as bleeding or infection after surgery among these patients.View full abstractDownload PDF (1667K) -
Choichi Horiuchi, Takafumi Yoshida, Toshiyuki Kokatsu, [in Japanese], ...1999 Volume 42 Issue 5 Pages 519-524
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSA case of nasopharyngeal tuberculosis in an immigrant is reported.
The patient was a 26-year-old woman from the Philippines. She complained of right cervical swelling. A white granular mass was observed in the nasopharynx and a biopsy of the lesion under a nasopharyngofiberscope, was conducted, which revealed tuberculous changes with acid fast bacilli. Chest X-ray showed pulmonary tuberculosis findings, and the tuberculin test was positive. There was no bacillus in the sputum and a culture of it was negative.
Treatment with antituberculous drugs (INH, RFP, EB) was continued for 12 months. The nasopharyngeal and cervical masses were reduced in size, but the chest lesion remained unchanged and appeared stable. The final diagnosis, based on a retrospective study, was nasopharyngeal tubrculosis, tuberculous cervical adenitis and prior pulmonary tuberculosis.View full abstractDownload PDF (2074K) -
[in Japanese]1999 Volume 42 Issue 5 Pages 525-530
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
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[in Japanese], [in Japanese]1999 Volume 42 Issue 5 Pages 531-534
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
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[in Japanese], [in Japanese]1999 Volume 42 Issue 5 Pages 535-537
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
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[in Japanese]1999 Volume 42 Issue 5 Pages 538-541
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
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[in Japanese], [in Japanese]1999 Volume 42 Issue 5 Pages 542-546
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
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[in Japanese]1999 Volume 42 Issue 5 Pages 547-556
Published: October 15, 1999
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSDownload PDF (1842K)
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