JIBI INKOKA TEMBO
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
Volume 52, Issue 1
Displaying 1-8 of 8 articles from this issue
FEATURE ARTICLE
  • Yoshitaka Okamoto
    2009 Volume 52 Issue 1 Pages 8-15
    Published: 2009
    Released on J-STAGE: February 18, 2010
    JOURNAL FREE ACCESS
    In recent years, many countries have experienced an increase in the prevalence of allergic rhinitis. In Japan, Japanese cedar and cypress pollens constitute a major, unique allergen that's spread is quite large, traveling more than 100 km and causing pollinosis that is severer than observed in other countries. In addition, cedar and cypress pollen spread season lasts for more than 12 weeks in and around Tokyo. To manage allergic rhinitis, the interventions at various stages are important. The recent progress in genetic analysis revealed the presence of genes regulating IgE producing abilities. For early prevention of allergic rhinitis, the allergen avoidance is important, however it is not easy to get effective results. Drug treatment is useful to improve the symptoms, however the role in early intervention in allergic rhinitis is not known and to keep taking medicine for a long term may not be acceptable. Allergen specific immunotherapy is effective in early intervention, and has possibilities of usefulness in primary or secondary intervention. Probiotics may play some role in preventions of allergic rhinitis. Futher studies to certify and to improve the clinical benefits of these early interventions are required.
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ORIGINAL PAPERS
  • Yasuhiro Tanaka, Hiromi Kojima, Ryuichi Yoshida, Hirotaka Uchimizu, [i ...
    2009 Volume 52 Issue 1 Pages 16-22
    Published: 2009
    Released on J-STAGE: February 18, 2010
    JOURNAL FREE ACCESS
    In cases with an adhesive tympanum, such as that associated with adhesive otitis media, pars tensa cholesteatoma or pars flaccida cholesteatoma with adhesion of the posterior part of the pars tensa, eardrum re-formation tends to be associated with postoperative re-adhesion, and therefore, poor postoperative hearing results. Until now, in treatment of such cases with pars tensa adhesion of the eardrum, we employed a surgical method in which an indwelling ventilation tube was placed through a fascia graft during tympanoplasty. Also, we employed a staged operation in which a silastic sheet was inserted in the tympanic cavity in some cases. Despite the use of the above surgical approaches, re-adhesion was still observed in some cases and the postoperative hearing results remained poor. Therefore, we attempted to perform cartilage tympanoplasty to prevent postoperative re-adhesion after eardrum re-formation. When the cases were analyzed at least half a year postoperatively, 94.4% of all cases showed no depression or adhesion of the reconstructed eardrum, with maintenance of a good morphology. The overall postoperative success rate was 62.5%. Successful hearing results were obtained in 77.8% of cases that underwent type III-c tympanoplasty and 42.9% of cases that underwent type IV-c tympanoplasty. These results were superior to our previous hearing results.
    These findings indicate that cartilage tympanoplasty is superior to the other surgical methods employed by us previously for an adhesive tympanum, for obtaining a good morphology of the reconstructed eardrum and hearing improvement. However, we observed the postoperative changes of the reconstructed eardrum only until five years after the surgery in this study. The long-term postoperative changes and hearing results must be evaluated in future studies.
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  • Atsushi Hatano, Naoya Ui, Yasushi Shigeta, Jiro Iimura, Masahiro Rikit ...
    2009 Volume 52 Issue 1 Pages 23-33
    Published: 2009
    Released on J-STAGE: February 18, 2010
    JOURNAL FREE ACCESS
    Deep neck space infections, which affect soft tissues and fascial compartments of the head and neck, can lead to lethal complications unless treated carefully and quickly, even with the advanced antibiotics available. We reviewed our seventeen patients with deep neck abscesses, analyzed their location by reviewing CT images, and discussed the treatment.
    Deep neck space infections were classified according to the degree of diffusion of infection diagnosed by CT images. Neck space infection in two cases was localized to the upper neck space above the hyoid bone (Stage I). Neck space infection in 12 cases extended to the lower neck space (Stage II), and further extended to the mediastinum in one case (Stage III). The two cases of Stage I and the four cases of Stage II were managed with incision and drainage through a submental approach. The seven cases of Stage II were managed with incision and drainage parallel to the anterior border of the sternocleidomastoid muscle, the “Dean” approach. The one case of Stage III received treatment through transcervicotomy and anterior mediastinal drainage through a subxiphodal incision.
    The parapharyngeal space played an important role in that the inflammatory change can spread to the neck space inferiorly. The anterior cervical space in the infrahyoid neck was important for mediastinal extension of parapharyngeal abscesses. It is important to diagnose deep neck space infections promptly and treat them adequately, and contrast-enhanced CT is useful and indispensable for diagnosis. The point is which kind of drainage has to be performed. If the surgical method of drainage is chosen according to the level of involvement in the neck space and mediastinum, excellent results may be obtained in terms of survival and morbidity.
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  • Kousuke Yoshifuku, Hiromi Nagano, Yuichi Kurono
    2009 Volume 52 Issue 1 Pages 34-42
    Published: 2009
    Released on J-STAGE: February 18, 2010
    JOURNAL FREE ACCESS
    Although hemangiomas are benign tumors which need surgical treatment, some form of preoperative treatment is often required since a good visual field is difficult to achieve in the case of hemangiomas in the nasal cavity or paranasal sinuses. Super-selective embolization is widely accepted as the treatment of choice to control hemorrhage during vascular tumor surgery. The subjects of the present study comprised two patients with nasal hemangiomas which underwent embolization prior to surgery and the usefulness of embolization is discussed with a review of previous reports.
    Case 1 was a 55-year-old male and case 2 was a 54-year-old male. They were both admitted to our hospital complaining of epistaxis, and in both cases ENT examination showed a hemorrhagic tumor in the nasal cavity. Enhanced-computed tomography (CT) indicated the presence of a nasal mass lesion which had a rich blood circulation. The finding indicated the necessity of super-selective embolization prior to surgery in order to minimize bleeding. Super-selective embolization was performed with a microcoil, which was introduced into the distal branch of the sphenopalatine artery. The tumors decreased in size after super-selective embolization of the feeding artery. After embolization, the tumors were resected with endoscopic sinus surgery without any remarkable bleeding. The two cases reported herein reconfirmed the usefulness and effectiveness of preoperative embolization in the treatment of nasal hemangiomas.
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