JIBI INKOKA TEMBO
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
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Volume 53, Issue 2
Displaying 1-11 of 11 articles from this issue
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FEATURE ARTICLE
  • GAIT ABNORMALITY AND VESTIBULAR SYSTEM DISORDERS
    Kazuo Ishikawa, Nakarin Angunsri, Koji Kudo, Eigou Oumi
    2010 Volume 53 Issue 2 Pages 92-102
    Published: 2010
    Released on J-STAGE: April 15, 2011
    DOIhttps://doi.org/10.11453/orltokyo.53.92
    JOURNAL FREE ACCESS
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    Human gait is an acquired motor function which plays one of important roles for quality of life. An overview regarding control mechanism of this motor function was presented based upon important research results. This motor function is closely related with vestibular system. Accordingly various vestibular system disorders could result in some form of gait abnormality. Our recent study on gait analysis by the use of tactile sensor in patients with vertigo such as vestibular neuronitis, acoustic neuroma and spinocerebellar degeneration were shown. Gait abnormality could be reflected by increment of coefficient of variation of especially stance and swing, and its greatness was mostly parallel to severity of disorder of gait control system. Those abnormalities caused by vestibular lesion might clearly be shown under gait with eyes closed. Visual input plays important role for sensory substitution in those vestibular disease patients toward better gait performance. This instability was also shown in patients with small acoustic neuroma who has seemingly normal gait, and those who had abnormal caloric response showed greater instability than those who had not. Gait abnormality could also be shown by figuring out stability of foot pressure progression and trajectories of center of force during stance and their analytical results were shown.
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ORIGINAL PAPERS
  • CLINICAL INVESTIGATION OF OTOSCLEROSIS
    Kazuhisa Yamamoto, Hirotaka Uchimizu, Yasuhiro Tanaka, Masanori Shiwa, ...
    2010 Volume 53 Issue 2 Pages 103-111
    Published: 2010
    Released on J-STAGE: April 15, 2011
    DOIhttps://doi.org/10.11453/orltokyo.53.103
    JOURNAL FREE ACCESS
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    We studied 192 ears with clinical otosclerosis operated on from 1984 to 2006, focusing on the clinical features and hearing improvement, causes of treatment failure, and the relationship between the computed tomographic (CT) and audiometric findings.
    The patients ranged in age from 14 to 73 years old (mean: 45.7 years). Small-fenestra stapedectomy was performed on 177 ears, partial stapedectomy on 11 ears, and total stapedectomy on 4 ears. The prosthesis used was the Shuknecht-type Teflon wire piston in all cases; the 4.25mm teflon wire piston was used for 101 (52.6%) ears.
    The hearing outcomes were satisfactory in 188 (97.9%) ears, based on the criteria proposed by the Otological Society of Japan (2000). No hearing improvement was achieved in 4 ears. Long-term hearing failure was noted in 3 ears; the suspected causes were displacement of the prosthesis and the presence of fibrotic tissue around the prosthesis.
    We found otospongiotic lesions in 62% of the cases. No significant differences were observed in the bone conduction thresholds between the ears with lesions around the cochlea and those with lesions anterior to the vestibule.
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  • A CASE OF IATROGENIC FOREIGN BODY IN THE INNER RIGHT PTERYGOID MUSCLE
    Shunya Egawa, Toshikazu Shimane, Tomohiro Ono, Tomoaki Mori, Takeyuki ...
    2010 Volume 53 Issue 2 Pages 112-116
    Published: 2010
    Released on J-STAGE: April 15, 2011
    DOIhttps://doi.org/10.11453/orltokyo.53.112
    JOURNAL FREE ACCESS
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    We encountered a case in whom a needle had pierced the mouth during dental treatment while the patient was under the effect of a local anesthetic. The foreign body could not be visually confirmed, however, the object lodged in the pterygoid muscle could be extracted from the mouth with the use of radioscopy during surgery.
    The presence of the foreign object was confirmed on a simple X-ray, but its location could not be accurately confirmed. A 20-mm needle-shaped shadow was recognized on CT, lodged partially in the levator veli palatini muscle from the inner right pterygoid muscle. It was judged that removal of the object would be difficult using an external cervical incision, therefore, the oral approach was employed in conjunction with radioscopy during surgery to extricate the foreign object.
    Although there are many kinds of pharyngeal and laryngeal foreign objects, during diagnosis, physicians should be mindful of the possibility that a foreign object might exist even if it cannot be confirmed on visual inspection by endoscopy.
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  • A CASE OF MASSIVE CONCHA BULLOSA WITH SECONDARY SEPTAL DEVIATION AND SINUSITIS
    Rika Sawai, Daiya Asaka, Nobuyoshi Otori
    2010 Volume 53 Issue 2 Pages 117-120
    Published: 2010
    Released on J-STAGE: April 15, 2011
    DOIhttps://doi.org/10.11453/orltokyo.53.117
    JOURNAL FREE ACCESS
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    An 18-year-old man presented with the complaint of radical nasal obstruction. Physical and nasal endoscopic examination revealed a large lesion completely occupying the right nasal cavity. Computed tomographic examination of the nasal cavity revealed septal deviation to the left side, and a massive concha bullosa mucocele and maxillary sinusitis on the right side. When a concha bullosa becomes obstructed, a mucocele can form and rapidly increase in size, and cause septal deviation and sinusitis as secondary complications. Therefore, we consider it necessary to undertake immediate surgery via the endoscopic approach in patients with concha bullosa mucocele.
    We report here a patient with a massive concha bullosa mucocele with secondary septal deviation and maxillary sinusitis.
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  • TUMOR OF THE SUBMANDIBULAR GLAND SEEN IN OUR DEPARTMENT
    Tomohiro Ono, Toshikazu Shimane, Shunya Egawa, Tomoaki Mori, Takeyuki ...
    2010 Volume 53 Issue 2 Pages 121-125
    Published: 2010
    Released on J-STAGE: April 15, 2011
    DOIhttps://doi.org/10.11453/orltokyo.53.121
    JOURNAL FREE ACCESS
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    We performed a study of 33 patients with tumors of the submandibular glands who underwent surgical treatment during the 4-year period between September 2005 and August 2009, in order to examine the age distribution, tumor size, histopathological classification, disease duration and the usefulness of fine-needle aspiration cytology in these patients.
    Among the 26 patients with benign tumors, most (20 patients) had pleomorphic adenoma. Malignant tumor, adenocarcinoma, adenoid cystic carcinoma, cancer in pleomorphic adenoma, salivary duct cancer, mucoepidermoid tumor, squamous cancer, and other types of cancer were confirmed in one each of 7 patients. Among these patients, malignant tumors accounted for 21.2% of all tumors. In regard to the age distribution, the incidence of malignant tumors was higher in elderly female patients, while no difference in the tumor size or the disease duration was observed among the patients with either benign or malignant tumors. The accuracy, sensitivity and specificity of perioperative fine-needle aspiration cytology were 92.3%, 66.7%, and 100%, respectively.
    Although the usefulness of fine-needle aspiration cytology was confirmed, the false-negative rate was 33.3%. Thus, careful consideration must be given during consultation, to obtain informed consent for this examination.
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  • ENDOSCOPIC ENDONASAL SKULL BASE RECONSTRUCTION USING A NASAL SEPTAL FLAP
    Naokatsu Saeki, Kentaro Horiguchi, Hisayuki Murai, Yuzo Hasegawa, Toyo ...
    2010 Volume 53 Issue 2 Pages 126-131
    Published: 2010
    Released on J-STAGE: April 15, 2011
    DOIhttps://doi.org/10.11453/orltokyo.53.126
    JOURNAL FREE ACCESS
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    This is a report to describe the procedure of the endoscopic endonasal skull base reconstruction using a vascularized nasoseptal flap. Between November 2008 and October 2009, 22 patients underwent reconstructions using a nasal septal flap combined with a balloon catheter (flap group) for closure of large dural defects after the endoscopic endonasal skull base approaches. The method is as follows; We start to harvest the nasal septal flap as a mucoperichondrial flap based on the posterior septal branch of sphenopalatine artery. The middle nasal turbinate is usually dissected. The first incision is the anterior vertical incision made with unipolar electrocautery at the intercutaneomucous point of the nasal vestibule. The second incision is made the along the floor of the nasal cavity from the choana to the location of the initial anterior incision. Thereafter, the superior incision to the sphenoid ostium is made 1.0∼1.5cm below the most superior aspect of the nasal septum. The pedicle of the flap formed in the width from the sphenoid ostium to the choana is extended laterally to the level of the sphenopalatine foramen. The nasal septal flap is usually placed in the nasopharynx until using in later reconstruction. On the reconstruction phase, the nasal septal flap is laid directly on the large dural and bony defect and fat grafts are applied outside with fibrin tissue glue. A Sinus balloon catheter is finally placed as support for 7∼10 days. Otorhinolaryngological endoscopic assessments are regularly performed at outpatient clinics.
    Postoperative CSF leaks occurred in two patients (9.1%) Conclusions: Our endoscopic endonasal skull base reconstructions using a nasal septal flap combined with a balloon catheter are useful and reliable for ventral skull base defects after endoscopic endonasal approaches.
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