Collagen sponge is made from a mixture of fibrillar and heat-denatured bovine atelocollagen stabilized by dehydrothermal cross linking. It shows a decreased foreign body reaction and has greater stability. I have obtained good results by applying this material in middle ear surgery. I report here my experience of its usefulness as a graft material for dermal, mucosal and connective tissue defects of the external and middle ear.

View full abstract

We report 3 cases of retropharyngeal abscess (RPA), extended by different routes.
We report these cases and review 13 years of the Japanese literature.
Computed tomography (CT), especially enhanced CT, was useful in diagnosing and determining abscess routes. The occurrence of primary RPA, common in infants, has decreased due to developments in antibiotic chemotherapy, but the incidence in adults has increased due to complications.
To understand the space of deep neck is available for detecting the anatomical site of abscess when a reasonable cervical incision is done.

View full abstract

We evaluated the treatment of frontal mucocele using a computer-aided endoscopic approach.
The 21 subjects involved 27 sides operated on. Using an electromagnetic tracking (InstaTrak^TM Visualization Technology) and an optical tracking (LandmarX Xomed), we accurately identified mucocele position, range, the site to be opened, and risk areas. Except of 1 case of cerebrospinal fluid leakage, no complications occurred, and surgery was safe, especially in the following situations : 1) previous surgery with anatomical distortion and no landmarks in the nasal cavity, 2) frontal sinus cyst with bony wall formation, 3) laterally located cysts, and 4) multiple cysts. The computer-aided system was useful and valuable. In follow-up from 5 months to 42 months, 18 (66.7%) sides had a large patency. Compared to previous studies, we consider results good. Bone exposure during surgery was, however, related to a poor postoperative result, as we observed in 9 (33%) sides with restenosis and obstruction of the opened ostium.

View full abstract

Earlobe keloids as a result of earlobe piercing may require clinical attention for obvious cosmetic deformity and a high rate of recurrence.
The treatment of earlobe keloids includes surgical excision in severe cases, local injections of triamcinolone acetonide, and/or pressure therapy to prevent recurrences. In less severe cases, local injections and/or pressure therapy are the treatments of choice.
The author describes two cases of earlobe keloids, one treated by surgery and the other by conservative measures.
The different treatment methods and their effects are discussed.

View full abstract

Ninety-one patients with Meniere's disease gave their informed consent and were randomly allocated to four treatment groups. The four treatment groups were then given the following drugs : group 1, a serotonergic antianxiety drug (tandospirone ; Sediel^®); group 2, a benzodiazepine tranquilizer (alprazolam ; Solanax^®); group 3, tandospirone and alprazolam in combination ; and group 4, a betahistine mesilate (Merislon^®). The State-Trait Anxiety Inventory (STAI) test and the Toho Medical Index (TMI) test were administered before and after drug ingestion ; these questionnaires surveyed the anxiety and autonomic nervous system function of the patients. The patients symptoms were then classified according to severity. All drugs were administered for at least 4 weeks.
The results showed that the combination of tandospirone and alprazolam produced the most significant reduction in the severity of the symptoms of Meniere's disease. Thus, antianxiety drugs appear to be effective for the treatment of Meniere's disease.

View full abstract

We report a case of eosinophilic granuloma of the soft tissue, i.e., Kimura's disease, involving the right cheek and submental region. A 52-year-old man reporting painless subcutaneuos swelling in the right cheek and submental region for 10 years was found from clinical data to have peripheral blood eosionophilia (36.5%) and increased serum IgE (over 16, 000 U/ml). Because of the clinical course and data, we diagnosed him as having Kimura's disease.
Such cases usually respond well to corticosteroid therapy, decreasing in size. After the mass volume decreases, antiallergic drugs and nonsteroidal antiinflammatory drugs (NSAIDS) should be successively given. Some cases may be resistant to corticosteroid hormons or become recurrent, in which case treatment other than chemotherapy, e.g., surgical resection and symptomatic radiation therapy, may be of value.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract