JIBI INKOKA TEMBO
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
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Volume 51, Issue 2
Displaying 1-10 of 10 articles from this issue
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FEATURE ARTICLE
ORIGINAL PAPERS
  • PREVALENCE OF ALLERGIC FUNGAL RHINOSINUSITIS
    Tsuguhisa Nakayama, Manabu Komori, Hirohisa Takayanagi, Tomoaki Yonemo ...
    2008 Volume 51 Issue 2 Pages 82-91
    Published: 2008
    Released on J-STAGE: September 17, 2009
    DOIhttps://doi.org/10.11453/orltokyo.51.82
    JOURNAL FREE ACCESS
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    Allergic fungal rhinosinusitis (AFRS) is estimated to account for 4% to 10% of all patients with chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery (ESS) in the United States. However, AFRS is regarded as a very rare disease in Japan. We retrospectively examined the prevalence of AFRS among the patients with CRS undergoing ESS at Fuji city general hospital between April 2006 and March 2007. Among the 50 consecutive patients with rhinosinusitis, 2 had acute rhinosinusitis with orbital complications and 48 had CRS. Among these latter cases, 12 had `allergic' mucin, 11 tested positive for fungi in mycology culture or microscopy of slides stained with Grocott's stain, and 4 patients had both `allergic' mucin and tested positive for fungi. All these last 4 patients showed type I hypersensitivity to fungal antigens and no tissue invasion by the fungi. Therefore, we diagnosed them as having AFRS. Three of the four patients experienced recurrent AFRS during a year's follow up. We conclude that 4 (8.3%) out of the 48 patients requiring ESS for CRS in our series were cases of AFRS, and that the prevalence of AFRS in Japan is as high as that in the United States.
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  • INITIALLY UNDIAGNOSED VERTIGO OF CENTRAL ORIGIN: A REPORT OF THREE CASES
    Kojiro Ishioka, Kenya Inukai, Sugata Takahashi
    2008 Volume 51 Issue 2 Pages 92-98
    Published: 2008
    Released on J-STAGE: September 17, 2009
    DOIhttps://doi.org/10.11453/orltokyo.51.92
    JOURNAL FREE ACCESS
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    Vertigo and dizziness are among the most common symptoms that prompt patient visits to a doctor. Most doctors recognize that vertigo is due to inner ear problems, whereas dizziness arises from disorder of the central nervous system. Central vertigo secondary to brainstem or cerebellar ischemia is often associated with other neurological signs. This is often true, however, there are exceptions. Anterior inferior cerebellar artery (AICA) syndrome is well known as a stroke syndrome whose presentation is similar in many respects to that of that often manifests with sudden deafness with vertigo. We recently encountered three patients with cerebrovascular disorder who presented with sensorineural hearing loss and vertigo. Case 1 was a 55-year-old woman with a week's history of vertigo of sudden onset. CT and MRI demonstrated intratumoral hemorrhage in a cavernous hemangioma of the cerebellar vermis. Case 2 was a 77-year-old woman with sudden-onset vertigo and hearing loss. MRI demonstrated infarction of the cerebellum. Case 3 was a 48-year-old man with sudden-onset vertigo and hearing loss. Initially, we treated him for sudden deafness with vertigo, and the MRI findings supported our approach at that time. However, he developed dysarthria just after discharge; MRI revealed pontine infarction and the patient was diagnosed as having the AICA syndrome.
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  • CHURG-STRAUSS SYNDROME DIAGNOSED DURING AN EPISODE OF EOSINOPHILIC SINUSITIS
    Manabu Komori, Tsuguhisa Nakayama, Hirohisa Takayanagi, Tomoaki Yonemo ...
    2008 Volume 51 Issue 2 Pages 99-103
    Published: 2008
    Released on J-STAGE: September 17, 2009
    DOIhttps://doi.org/10.11453/orltokyo.51.99
    JOURNAL FREE ACCESS
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    We report one patient of Churg-Strauss syndrome who was diagnosed during follow-up for an episode of eosinophilic sinusitis. A 67-year-old man came to our hospital with complaints of chronic cough and postnasal discharge. We tried conservative therapy, however, the symptoms did not improve. Therefore, we performed endoscopic endonasal sinus surgery, which produced symptomatic improvement, nonetheless, the symptoms relapsed 1 month later. Therefore, we diagnosed the patient as a case of eosinophilic sinusitis. One year later, the patient presented with sudden loss of vision and numbress of the back. Based on the neurological and hematological findings, we made the diagnosis of Churg-Strauss syndrome and initiated the patient on steroid pulse therapy. This treatment was followed by marked improvement of the sinusitis.
    In recent years, the concept of including Churg-Strauss syndrome as a cause of eosinophilic sinusitis has been proposed. It is thought that close examination should be conducted in any patient of eosinophilic sinusitis who develops symptoms of angiitis during follow-up.
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  • A CASE OF ARNOLD-CHIARI MALFORMATION MAINLY MANIFESTING AS VERTIGO
    Koji Yamamoto, Yoshinori Tomiya, Kazuhiro Soeda, Toshiharu Tsukidate, ...
    2008 Volume 51 Issue 2 Pages 104-109
    Published: 2008
    Released on J-STAGE: September 17, 2009
    DOIhttps://doi.org/10.11453/orltokyo.51.104
    JOURNAL FREE ACCESS
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    This report presents a case of Arnold-Chiari malformation mainly manifesting as vertigo that was seen recently at our department. The patient was a 23-year-old man presenting with the chief complaint of vertigo. Around December 2006, the patient began experiencing a sensation of spinning when he looked to the right, and similar symptoms were occasionally and transiently noted thereafter when looking to the right. The patient visited a nearby clinic, where a head MRI revealed no abnormal findings. However, since the symptoms persisted, the patient visited our department on February 22, 2007. On initial examination, vertical downbeat nystagmus was detected. Then, the findings on electronystagmography and head MRI led to the diagnosis of Arnold-Chiari malformation. The present case report highlights the need for further detailed examination in patients with spontaneous vertical downbeat nystagmus, bearing in mind the possibility of Arnold-Chiari malformation.
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  • THORACIC AORTIC ANEURYSM WITH RECURRENT LARYNGEAL NERVE PALSY: A CASE REPORT
    Hiromi Nagano, Kousuke Yoshifuku, Yuichi Kurono
    2008 Volume 51 Issue 2 Pages 110-114
    Published: 2008
    Released on J-STAGE: September 17, 2009
    DOIhttps://doi.org/10.11453/orltokyo.51.110
    JOURNAL FREE ACCESS
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    Recurrent laryngeal nerve paralysis has been classified as postoperative and non-postoperative. The condition caused by thoracic aortic aneurysm is classified as non-postoperative, and patients may present with only hoarseness of the voice. Since the prognosis after rupture of a thoracic aortic aneurysmis extremely poor, precise early diagnosis and timely treatment are essential.
    This case report describes a 59-year-old man who was referred to our clinic with the chief complaint of a one-month's history of hoarseness of the voice, with no other remarkable respiratory symptoms. Fiberoptic laryngoscopy showed fixation of the left vocal cord and redness of the left epiglottic fold and false cord. Computed tomography (CT) scans of the neck demonstrated a heterogeneous lesion in the left larynx and a thoracic aortic aneurysm. Because we could not rule out cancer on the basis of the laryngoscopic and CT findings, especially on account of a history of heavy tobacco use in the patient, we performed microscopic laryngeal surgery, and malignancy was ruled out.
    Then, based on the CT and MRI findings, the patient was diagnosed as having a thoracic aortic aneurysm.
    Although artificial vessel replacement grafting was successfully performed, no resolution of the recurrent laryngeal nerve paralysis was obtained.
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