巻号一覧
51 巻, 5 号
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カラーアトラス
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—血管性病変—西山 茂夫2008 年 51 巻 5 号 p. 276-277
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (3082K)
綜説
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久 育男, 板東 秀樹, 西尾 健志, 馬場 均2008 年 51 巻 5 号 p. 278-285
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリー多くの疾患の症状に日内変動が存在し, 治療上問題となることはよく知られている。我々耳鼻咽喉科医も日常臨床で夜間の咳などの症状増悪に苦しむ患者に接し対応に苦慮することも多い。近年概日リズム研究が飛躍的に進展し, 体内時計が遺伝子レベルで構築されており, またこの時計遺伝子が体内時計中枢である視交叉上核のみでなく全身の細胞に発現していることが明らかとなってきた。また, 臨床医学では症状発現の時間や細胞分裂の日内変動などを考慮に入れた投薬を行うクロノテラピーの重要性が認識されつつある。このような背景から我々は喉頭をはじめとする気道における時計遺伝子の発現を調べ, 機能を解明することが気道疾患治療の発展において今後重要となると考え, 気道時計の基礎研究に着手した。本稿では主にこれまでの我々の研究成果について紹介する。抄録全体を表示PDF形式でダウンロード (1642K)
臨床
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波多野 篤, 遠藤 朝則, 力武 正浩, 重田 泰史, 宇井 直也, 加藤 孝邦2008 年 51 巻 5 号 p. 286-293
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリー翼口蓋窩に発生する腫瘍性病変には原発例は少なく, 隣接臓器から浸潤した続発例が多い。翼口蓋窩近傍へ進展した腫瘍に対する手術治療では, これまで解剖学的位置を考慮して様々な皮膚切開および骨切りを組み合わせたアプローチ法が行われてきたが一定のものはみられない。今回, 当科で経験した翼口蓋窩近傍の悪性腫瘍7症例を対象として, 施行された種々のアプローチ法の有用性を検討し術式の選択に関して臨床的検討を行った。
7症例のうち咀嚼筋間隙原発の1例を除き他の6例は, 鼻副鼻腔, 口腔咽頭, 耳下腺などの周囲臓器から進展した続発例であった。病変の主座に応じて鼻副鼻腔領域から翼口蓋窩に進展したものに対しては前方から, 口腔咽頭領域からのものに対しては下方から, また耳下腺周囲からのものに対しては外側方からのアプローチ法が選択され有用であった。前, 下および外側の各方向から翼口蓋窩にいたるには, 顔面皮膚や顔面神経などの軟部組織の操作と共に上顎骨や下顎骨などの硬組織の操作が必要であり, またアプローチ方向と反対側の術野に制限がみられた。翼口蓋窩腫瘍の手術では, 各アプローチ法の特徴を理解した上で, それぞれの病変の占拠部位や進展範囲に応じて腫瘍の摘出操作が明視下に確実に行うことができるアプローチ法を選択することが有用と思われた。抄録全体を表示PDF形式でダウンロード (1342K) -
深見 雅也2008 年 51 巻 5 号 p. 294-301
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリー副鼻腔炎の診断あるいは治療効果判定の目的で, 上顎洞Bモード超音波検査 (ティッシュハーモニックイメージング) を行い, ウォータース法の結果と比較した。6歳以上では, 両検査は高い相関を示し, X線検査のかわりに超音波検査で副鼻腔炎の診断を行うことが十分可能であると考えられた。しかし, 5歳以下の上顎洞の発育が小さい例では, 偽陰性が避けられず, 超音波検査が陰性であっても副鼻腔炎を否定することはできないため, 症状と鼻内所見もあわせて, 総合的に判断することを忘れてはならない。小児副鼻腔炎の特徴として, 症状の変動が激しく消長を繰り返す例が多い。したがって, 小児副鼻腔炎の診断には, 頻回に侵襲なく行える検査が求められることから, 近年性能の向上した超音波検査は, 有用性を増していると考える。抄録全体を表示PDF形式でダウンロード (800K) -
志村 英二, 飯村 慈朗, 月舘 利治, 平林 秀樹, 春名 眞一2008 年 51 巻 5 号 p. 302-307
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリー症例は43歳女性で, 鼻閉, 咽頭違和感を主訴に受診した。内視鏡検査にて上咽頭に後鼻孔を閉塞する巨大な腫瘤性病変を認めた。画像診断上, 嚢胞性疾患が疑われ, 全身麻酔下に内視鏡下嚢胞摘出術を施行した。嚢胞は上咽頭のやや左側に基部を有し, 切開すると暗褐色の貯留液を認めた。病理組織学的検査にて嚢胞壁は線毛上皮に覆われていた。術後1年4ヵ月経過しているが, 嚢胞の再発は認めていない。上咽頭嚢胞疾患に関して, その診断と治療法につき, 文献的考察をまじえ報告する。抄録全体を表示PDF形式でダウンロード (1192K) -
高宮 優子, 飯村 慈朗, 今野 渉, 月舘 利治, 深美 悟, 平林 秀樹, 春名 眞一2008 年 51 巻 5 号 p. 308-313
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリー64歳男性に左視力障害・左眼痛が出現し, 原因不明の視神経炎と診断してステロイドパルス療法を施行したが改善せずに失明した。5ヵ月後には左外転神経麻痺・動眼神経麻痺が出現しCT, MRIで左眼窩尖端部に骨破壊を伴う腫瘤性病変を認めた。悪性腫瘍を疑い内視鏡下鼻内アプローチにて生検術を施行したところ, アスペルギルスによる浸潤型副鼻腔真菌症であった。抗真菌薬を投与するも真菌感染が頭蓋内まで波及し, さらに全身状態が悪化し死亡した。
本症例は画像上明らかな異常を認めるまで原因不明の視神経炎として加療された。視力障害の鑑別診断には浸潤型真菌症も念頭におき, 疑いがあれば内視鏡を用いて鼻内アプローチによる生検術を施行するべきである。抄録全体を表示PDF形式でダウンロード (989K)
境界領域
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勝沼 俊雄2008 年 51 巻 5 号 p. 314-316
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (277K)
画像診断
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尾尻 博也2008 年 51 巻 5 号 p. 317-318
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (390K)
薬剤の特徴と注意点
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—セロトニン5-HT3受容体拮抗薬—北村 正樹2008 年 51 巻 5 号 p. 319-321
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (325K)
学会関係【第９回 耳鼻咽喉科ナビゲーション研究会（手術支援システム研究会）】
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山下 裕司2008 年 51 巻 5 号 p. 325
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (204K) -
飯村 慈朗, 平林 秀樹, 春名 眞一2008 年 51 巻 5 号 p. 326-329
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーNavigation system was introduced into endoscopic sinus surgery, and the accuracy and safety of operation improved by leaps and bounds. The endoscopic sinus surgery using navigation system in our hospital is accepted as advanced medicine, and an indication disease serves as a intractableness sinusitis, a paranasal cyst, a circumference organ disease, and a paranasal tumor. While reporting our experience with navigation system, we examined the advantage of navigation surgery, the important matter, the indication.抄録全体を表示PDF形式でダウンロード (1014K) -
宮澤 徹, 村田 英之, 友田 幸一2008 年 51 巻 5 号 p. 329-331
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーNavigation system strongly supports endoscopic sinus surgery (ESS) in the case of postoperative maxillary cysts which has multiple cysts, bony cyst wall, and anatomical malformation. We presented a navigation guided ESS for multiple postoperative maxillary cysts.
The case was 52-year-old woman, who performed Caldwell-Luc sinus surgery over 30 years ago. Four cysts were existed in the right, and two in the left maxillary sinus. In the operation, navigation system helped to make a rout simple for reaching cyst wall even the cyst had distance from both inferior and middle nasal meatus. And another point of usefulness of navigation system was that we could find and punctured a cyst which was unclear by preoperative CT image.抄録全体を表示PDF形式でダウンロード (831K) -
中丸 裕爾, 古田 康, 佐伯 昌彦, 福田 諭2008 年 51 巻 5 号 p. 331-333
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーThere are two methods for the dacryocystorhinostomy one is an intranasaldacryocystorhinostomy and the other is a dacryocystorhinostomy from outside of the face. For the cosmetic reason, the intranasal operation is have an advantage. However, it is sometimes difficult to find outlacrimal sac from the nose.
We used the image-guided navigation system for dacryocystorhinostomy.
This system was very useful when we find lacrimal sac from nose.抄録全体を表示PDF形式でダウンロード (697K) -
長谷川 昌宏, 鈴木 幹男2008 年 51 巻 5 号 p. 333-336
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーEndoscopic orbital decompression has been used as a treatment of severe exophthalmos and/or optic nerve compression with visual loss in patient with thyroid eye disease. We reported one case of thyroid eye disease to be treated with endoscopic orbital decompression using navigation system. This method is very effective for preventing surgical complication during surgery.抄録全体を表示PDF形式でダウンロード (1151K) -
平海 晴一, 金丸 眞一, 三浦 誠, 伊藤 壽一, 小松崎 篤2008 年 51 巻 5 号 p. 336-338
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーThe translabyrinthine approach for vestibular schwannomas provides full access to the internal auditory canal, enabling total tumor removal. In the safe manipulation of tumor inside the internal auditory canal, removal of the bone between the internal auditory canal and jugular bulb is important. The anatomical variation of the jugular bulb is sometimes makes this challenging. We applied an image-guidance system in the detection of the jugular bulb in three patients. In two patients, the image-guidance system showed the jugular bulb correctly, and the other one, the system failed to point out correct location.抄録全体を表示PDF形式でダウンロード (778K) -
松本 希, 洪 在成, 大野 秀則, 杉山 久幸, 橋爪 誠, 小宗 静男2008 年 51 巻 5 号 p. 338-342
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーThe registration process determines the overall accuracy of image-guided surgery. Otologic surgery requires submillimetric accuracy, and it is known that invasive registration using bone-anchored fiducial markers acquire less error. We have developed a less-invasive strategy for attaching bone markers by transferring the markers to the patient's bone intraoperatively. The template of the bone surface (the “stamp”) was produced from the edited CT with virtual fiducial markers attached on the temporal bone. By matching the contour of the stamp with patient's bone surface after the bone was exposed, we could accurately and non-invasively transfer virtual markers on patient's bone for the registration. Our method would be a useful IGS method in the field of otology where both accuracy and non-invasiveness are required.抄録全体を表示PDF形式でダウンロード (870K) -
山本 功2008 年 51 巻 5 号 p. 342-344
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーThe StealthStation navigation system, which employed optical tracking technology, was introduced in 1995 and had been remodeled every few years. We have achieved the top market share of the navigation system in worldwide and Japan.
Currently, we deliver 2 types of navigation hardware for otolaryngology surgeries, “Treon” and “Tria”. The range of applications are “ENT application” for nose surgery, the “FrameLock” system for ear surgery.
We are preparing for the release of an electromagnetic navigation in Japan. Since this system se the small reference frame, it is the best for the nose surgery which does not usually apply a head fixation to a patient.
We introduce the method and technique to achieve high navigation accuracy in ear surgery.抄録全体を表示PDF形式でダウンロード (1000K) -
土屋 聡史2008 年 51 巻 5 号 p. 345-346
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリー“Kolibri ENT” has been developed using the cutting edge technology of BrainLAB (Germany), which is highly evaluated for its surgical navigation technology both domestically and internationally, with the concept of solving outstanding issues in conventional navigation systems-long setting time, complicated operation, bulky main unit, and so on. This is the navigation system that ENT practitioners can use in their daily surgeries, realizing its “SPEEDY, SIMPLE, and SMART” usage.抄録全体を表示PDF形式でダウンロード (800K) -
友田 幸一, 山下 裕司2008 年 51 巻 5 号 p. 347-348
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (968K) -
中丸 裕爾, 古田 康, 柏村 正明, 佐伯 昌彦, 福田 諭2008 年 51 巻 5 号 p. 348-350
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーThere are many reports which mentioned about the benefit of image-guided navigation system for the surgery of head and neck region. The wider the system become used, the more problems were raised ex; The indication of the system, or how accurate should it be. In this study, we report our experiments of the system, the estimates of the surgeon who used this system, the indication of the system, and the risk of the system. We found that the navigation system was very useful for the ENT surgery especially if the case was anatomically difficult.抄録全体を表示PDF形式でダウンロード (1058K) -
—その適応と基準づくりに向けて—工 穣, 浅村 賢二, 塚田 景大, 宇佐美 真一2008 年 51 巻 5 号 p. 351-355
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーThe Ministry of Health, Labour and Welfare, and the Ministry of Economy, Trade and Industry are working together to establish guidelines for medical equipment to be used in navigated surgery. A committee has also been formed to investigate the development and uses of medical navigation equipment.
Evidence attesting to the usefulness of navigation systems in surgery in the field of Otorhinolaryngology has been steadily accumulating, however, due to the still high costs of the equipment and the lack of certification for payment under health insurance schemes, implementation by individual departments remains difficult. The fact that within this meeting there have been many reports of the use of navigation, but there are still no clear guidelines as to indications, points up the difficulty of application procedures for leading medical technology.
In the fall of 2003, the Departments of Neurosurgery, Orthopedics and Otorhinolaryngology at our institution jointly purchased a StealthStation TREONTM manufactured by Medtronic Sofamor Danek, Co., Ltd., and began training and education in its use. The system is now being used in nearly all cases of endoscopic sinus surgery as well as being incorporated in some cases of ear, and head and neck surgery and the usefulness, accuracy, and preparation time in the clinical setting has been investigated.
Here, with an eye towards future application of this leading technology in the field of Otorhinolaryngology, we report our retrospective review of cases seen in our department as well as our investigation into the guidelines for use of navigation systems.抄録全体を表示PDF形式でダウンロード (1400K) -
杉本 太郎, 岸本 誠司2008 年 51 巻 5 号 p. 355-359
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーWe have used navigation system during surgery for head and neck region in 62 cases including 35 anterior skull base surgeries and 18 lateral skull base surgeries since September 2000 to August 2007. Navigation system was very useful in almost all anterior skull base surgeries and some of lateral skull base surgeries, especially when the lesion was adjacent to important organs (eye ball, optic nerve and internal carotid artery etc.) and liable to bleed. It was also very useful in case of volume reduction surgery for fibrous dysplasia of facial skull.
The necessity of navigation system didn't match the difficulty of surgery evaluated by Gaihoren in the report titled “Gaihoren's tentative plan concerning the remuneration for surgery (6th edition)” in otolaryngology, head and neck region.抄録全体を表示PDF形式でダウンロード (1102K) -
松脇 由典, 鴻 信義, 長岡 真人, 大櫛 哲史, 浅香 大也, 吉村 剛, 小島 純也, 吉川 衛, 森山 寛2008 年 51 巻 5 号 p. 359-362
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーWe present our experience of image-guided endoscopic sinus surgery (IG-ESS). We have experienced 444 cases of IG-ESS for 10 years at Jikei University Hospital. About 10% of all ESS cases were need for image-guide system. This system has been proven to facilitate complicated ESS and decrease the need for revision procedure. However, this system did not apply to the intraoperative anatomic changes that occur throughout the procedures. Nowadays, intraoperative CT scanning can be performed undergoing ESS in our hospital. We think that intraoperative update has the potential to improve the extent of surgery in patients with complicated anatomy and extensive diseases, such as skull-base diseases or orbital diseases.抄録全体を表示PDF形式でダウンロード (1168K) -
友田 幸一2008 年 51 巻 5 号 p. 362-366
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (1345K) -
綿貫 浩一2008 年 51 巻 5 号 p. 366-368
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーNavigation system for otolaryngological surgery has been a very useful and low invasive device. Endoscopic sinus surgery by using a navigation system was performed at forty-nine patients at our hospital for this four years. Our principle of adaptation for navigation surgery was reported at the present time.抄録全体を表示PDF形式でダウンロード (1125K) -
—2003年, 2007年全国アンケート調査結果報告—友田 幸一2008 年 51 巻 5 号 p. 368-374
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーPDF形式でダウンロード (1574K) -
—先進医療としての現状と問題点—鴻 信義2008 年 51 巻 5 号 p. 374-378
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーComputer assisted endoscopic sinus surgery was approved as advanced medical care as “the endoscopic nose and paranasal operations using navigation system” for from Ministry of Health, Labour and Welfare in August, last year. The patient bears expense for advanced medical care by oneself.
A subject of the advanced medical care is prescribed with “a chronic sinusitis, a paranasal cyst or a paranasal benign tumor”. However, the pathology of a patient is various even if we lump sinusitis and a paranasal cyst together. It is necessary to evaluate pathology of a patient thoroughly from preoperative endoscopic inspection and preoperative CT finding. Then a surgeon determines whether “navigation surgery as advanced medical care” is indicated or not. If navigation takes it as need or utility, we explain it to the patient enough and obtain consent. Aiming at improvement of postoperative outcomes, it is important that we perform navigation surgery more precisely.抄録全体を表示PDF形式でダウンロード (1064K) -
齊藤 俊2008 年 51 巻 5 号 p. 378-384
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーTo construct minimal invasive navigation in real time, we introduce optical measurement techniques with tumor sensitizer, which are 2-Color Photo-Dynamic Diagnosis (2C-PDD), Near Infrared Fluorescence Computed Tomography (NIR-FCT) and 2-Color Optical Coherence Dosigraphy (2C-OCD). Applying 2C-PDD to navigation system of brain tumor, one can obtain high contrast images between tumor lesion and normal tissue. To detect a tumor site deeply located, we employ NIR-FCT and construct fluorescence computed tomography images by convolution back projection method. To detect infinitesimal tumor, we develop a functional optical coherence tomography, namely 2C-OCD, which enables to visualize both the scatterer density and drug concentration.抄録全体を表示PDF形式でダウンロード (2448K) -
山下 樹里, 熊谷 徹, 森川 治, 小西 琢, 藤巻 慎一, 横山 和則, 石政 寛, 村田 英之, 友田 幸一2008 年 51 巻 5 号 p. 385-388
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリー[Objective]
To develop a distance education system that would allow novices to acquire manual skills in Endoscopic Paranasal Sinus Surgery (ESS).
[Method]
Subjects: Eleven medical students (5th year) at Kanazawa Medical University (KMU).
Equipment: Each KMU (Uchinada, Ishikawa) and AIST (Tsukuba, Ibaraki) site had a distance education system newly developed by AIST capable of communicating over a commercial Internet connection. Each system had two virtual mirrors in which video images of a trainee and a trainer are synthesized as if they are standing side-by-side and performing the same procedure on the same patient model. With the system, the trainee can easily note differences in equipment positions and mimic the motions of the trainer very quickly.
Procedure: A trainee at AIST remotely taught subjects at KMU two surgical tasks (A: Probing of the nasofrontal duct, B: Aspiration of the maxillary sinus) three times, for 10 minutes each. Data recorded were subjective evaluations of remote training and task performance by the trainer and the trainee, mental workload with NASA-TLX, and force applied to the patient model by the trainee during tasks using a force-torque sensor attached to the model.
[Results]
(1) After performing three remote training trials, the trainer's subjective evaluation of the trainee's task performance improved significantly (Wilcoxon Signed Ranks Test, p<0.05).
(2) Task completion time did not differ significantly.
(3) Size of the force vector (average and max. values during each trial) increased after remote training compared to that of the trainers (t-test, p<0.05).
[Discussion]
Surgical skills were acquired using a distance learning system. It was confirmed by the retention checking experiment conducted two months later. Time is not a good measure for the manual skills level of novices. Increase of the force applied to the patient model was actually observed in our previous experiment of gauze packing by subjects with different surgical experiences (less experienced surgeons applied greater force than either experts or novices).
[Conclusions]
Distance surgical skill training is possible using our training system that presents synthesized virtual mirror images of the trainer and the trainee.抄録全体を表示PDF形式でダウンロード (1373K) -
山本 清二, 渡邉 高弘, 細川 誠二, 竹下 有, 峯田 周幸, 中谷 広正, 寺川 進2008 年 51 巻 5 号 p. 389-392
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーWe have newly developed a navigator for endoscopic paranasal sinus surgery. In this system, the optical 3D scanner captures the positions of patient and endoscope simultaneously. The software calculates the positions in the center observed with an endoscope, and presents them on the preoperative CT images. This system requires no specific endoscope and surgical instrument without any markers such as spheres.抄録全体を表示PDF形式でダウンロード (1411K) -
福岡 久邦, 工 穣, 塚田 景大, 宇佐美 真一2008 年 51 巻 5 号 p. 392-395
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーA virtual reality temporal bone (VR TB) simulator has become a valuable tool to resident education in otolaryngology. The simulator must provide a realistic representation of tissue in three dimensions, with haptic feedback (the operator must feel the sensation of different drill speeds, pressures, and directions). We present our experience with the simulator for temporal bone practical training. Five residents drilled both a cadaveric TB and a simulated VR TB. We suggest that the ability of a simulator to provide objective assessment of residents as they transition from laboratory-based learning to operative otology provides a useful measurement.抄録全体を表示PDF形式でダウンロード (1274K) -
角田 篤信, 岩崎 朱見, 角 卓郎, 白倉 聡, 岸本 誠司2008 年 51 巻 5 号 p. 395-397
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーVarious kinds of nasal and paranasal lesions may involve the skull base, however, surgical approaches to lesions in this area are difficult because of the anatomical complexity. In order to facilitate both surgical planning and actual surgery, we had introduced several devices such as navigation system and/or endoscope. In addition to these, a three-dimensional model was made from images of actual patients.
These devices had facilitated not only surgical planning but also actual surgical procedure. In this paper, we report our experiences of applications of these supporting systems for skull base surgery.抄録全体を表示PDF形式でダウンロード (1133K) -
大野 秀則, 杉山 久幸2008 年 51 巻 5 号 p. 398-401
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーOur 3D model, OMeR (JP Pat. 3927487, US Pat. 6932610) precisely replicates the inner structure of human bones. It can be shaved using a surgical drill, burr and suction irrigator the same way as human bones. Thus, it has been proven useful for surgical planning, simulation, training, and education.
Applying the manufacturing method of OMeR, we have now created a registration plate for image guided surgery, OMeR-Navi. With Axis, you can accurately and non-invasively transfer virtual markers on a patient's bone for registration.
We hope our OMeR-Navi, together with OMeR, will further facilitate the complex surgery in the field of Otology and related fields.抄録全体を表示PDF形式でダウンロード (1286K) -
大野 伸晃, 村上 信五2008 年 51 巻 5 号 p. 401-404
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーWe use the new surgical instrument, HOT biopsy forceps that cut and coagulate the target tissue. This instrument is useful of open surgery of the epiglottic cyst. We opened the glottic cysts of 7 cases using this instrument with local anesthesia. All cases presented in this paper were successful and lost any complications.抄録全体を表示PDF形式でダウンロード (1349K) -
夜陣 真司, 長谷川 賢作, 河本 勝之, 北野 博也2008 年 51 巻 5 号 p. 404-407
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーWe present our experience using Nerve Integrity Monitor (NIM) for parotid grand surgery. We evaluated the meaning of using NIM and found it useful to avoid iatrogenic facial nerve injury. One of the greatest meanings of using NIM is that it can observe the damage to nerves during operation and predict the possibility of recovering from palsy after operation.抄録全体を表示PDF形式でダウンロード (982K) -
原 浩貴, 宮内 裕爾, 山下 裕司2008 年 51 巻 5 号 p. 407-411
発行日: 2008年
公開日: 2009/12/17
ジャーナル フリーWe have performed nine cases of coblation-assisted adenoidectomy in children suffering from sleep disturbed breathing. Compared with cold instruments like curettage, coblation offered better visualization of the surgical field due to minimal intraoperative bleeding throughout the procedure. To avoid damage to adjacent tissue, the volume of adenoid should be measured with wands before coblation. To avoid the incomplete tissue removal, especially close to the nasal septum, wands was needed to be flexed.
How to use a coblation in tonsillectomy is also reported.抄録全体を表示PDF形式でダウンロード (1352K)
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