JIBI INKOKA TEMBO
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
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Volume 57, Issue 4
Displaying 1-24 of 24 articles from this issue
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FEATURE ARTICLE
  • OPEN SEPTORHINOPLASTY FOR DEVIATED NOSE AND CAUDAL DEVIATION: A JAPANESE RHINOLOGIC PERSPECTIVE
    Satoru Kodama
    2014 Volume 57 Issue 4 Pages 174-183
    Published: August 15, 2014
    Released on J-STAGE: August 15, 2015
    DOIhttps://doi.org/10.11453/orltokyo.57.174
    JOURNAL FREE ACCESS
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    　Deviated nose is one of the most difficult tasks in nasal and facial plastic surgeries even for the experienced surgeons. Correction of the deviated nose presents a challenge because frequently a functional as well as an aesthetic problem must be addressed. The anatomic basis of the deviation may be related to bony pyramid pathology and septal deformity. In patient with deviated nose, a proper correction of deviated septal cartilage is critically important factor for surgical success. For successful correction of deviated nose, the skill to precisely execute the surgical steps is required to alter and control the septum thorough understandings of nasal anatomy and physiology, accurate preoperative analysis and intraoperative diagnosis, an understanding of the physiology of cartilage and its healing.
    　External (open) septorhinoplasty approach provides a wide surgical filed that enable surgeon to implement various surgical procedures. The dorsal part of the L-strut is straightened by using spreader grafts, which are placed bilaterally in most cases. For correction of caudal septal strut, placement of batten graft on the concave side after scoring incisions can also be used, resulting successful correction of caudal deviation.
    　The deviated nose has multiple etiologies. Unrecognized trauma early in childhood can be an etiology. It often coexists with asymmetric face in which complete straightening is not entirely possible and may be in fact undesirable. Severely deviated noses are mostly post-traumatic and complicated with functional problems. In addition, aesthetic and ethical recognition may be different in countries. In Japan, a functional septorhinoplasty with ultimate purpose for the improvement of nasal obstruction is expected to develop from Japanese rhinologic perspective.
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ORIGINAL PAPERS
  • ENDOSCOPIC TUMOR RESECTION IN THE MANAGEMENT OF SELECTED SINONASAL MALIGNANT TUMORS
    Atsushi Hatano, Jiro Iimura, Yasushi Shigeta, Susumu Okano, Kensuke Ao ...
    2014 Volume 57 Issue 4 Pages 184-193
    Published: August 15, 2014
    Released on J-STAGE: August 15, 2015
    DOIhttps://doi.org/10.11453/orltokyo.57.184
    JOURNAL FREE ACCESS
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    　Background: Radical tumor resection is regarded as the treatment of choice for paranasal malignant tumors invading the adjacent structures. Tumors showing limited extension can be managed by less aggressive therapy.
    　Objective: To evaluate the usefulness of endoscopic endonasal surgery for malignant paranasal tumors by classifying the type of surgery according to the extent and site of origin of the tumor, and investigate the clinical course.
    　Materials and methods: Seven patients underwent endoscopic tumor resection for paranasal tumors, five patients received radiotherapy, and one patient received chemotherapy. Six of the seven patients treated by the endoscopic surgical approach were male and one patient was female, with an average age of 61 (range 45-76) years. The mean follow-up period was 41.1 (range 12-125) months.
    　Results: All tumors were resected with some safety margin in an en-bloc manner by the endoscopic endonasal approach. CSF leakage occurred in one patient and was repaired at the same time as the resection. One patient died of the disease at 12 months after the treatment, and one patient (neuroendocrine carcinoma) was alive with the disease at 36 months after the treatment; the remaining patients were alive without the disease. The type of surgery was classified into three types; the medial type, for tumors originating medially from the nasal septum; the superior type, for tumors originating superiorly from the medial nasal turbinate; the posterior type, for tumors originating posteriorly from the superior nasal meatus.
    　Conclusion: In very carefully selected cases where the tumor does not invade the adjacent structures and allows some safety margin be obtained, endoscopic endonasal tumor resection, without the need for a lateral skin incision, may be useful. Although the endoscopic approach is useful for treating sinonasal tumors, we should recognize its advantages and limitations, and choose an adequate approach considering the extent and site of origin of the tumor.
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  • TWO CASES OF RENAL CELL CARCINOMA METASTASIS TO THE THYROID GLAND
    Tomotaka Miyamura, Kazuhiko Takeuchi
    2014 Volume 57 Issue 4 Pages 194-197
    Published: August 15, 2014
    Released on J-STAGE: August 15, 2015
    DOIhttps://doi.org/10.11453/orltokyo.57.194
    JOURNAL FREE ACCESS
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    　Metastasis of renal cell carcinoma to the thyroid gland is rare. We report two cases of metastatic renal carcinoma to the thyroid gland. The first case was that of a 68-year-old male patient who had undergone right nephrectomy for renal cell carcinoma 12 years earlier. He was referred to us for an enlarging mass in the right lobe of the thyroid gland. Fine needle aspiration cytology revealed suspected papillary carcinoma with intranuclear cytoplasmic inclusions. Therefore, right hemithyroidectomy was performed. Metastatic renal carcinoma was diagnosed because the histopathological findings were suggestive of a clear cell carcinoma. The second case was that of a 52-year-old female patient who had undergone left nephrectomy for renal cell carcinoma 6 years earlier. She was referred to our department because a follow-up CT scan had revealed a thyroid mass. Fine needle biopsy cytology of the thyroid mass showed a follicular lesion, therefore, the patient was observed for a while. However, as the thyroid mass had enlarged, isthmus excision was performed. The patient was diagnosed as having metastatic renal carcinoma because the histopathological findings were suggestive of a clear cell carcinoma. Since kidney cancers may cause distant metastasis after long periods of time, thyroid mass with a past history of renal cell carcinoma should be considered as a metastatic renal cell carcinoma. As for the treatment, excision of the metastatic lesion is the treatment of first choice. Since excision of a distant metastasis has been reported to prolong the survival in patients with renal cell carcinoma, aggressive excision is desirable in the case of distant metastasis to the head and neck region.
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  • ORAL-PHASE SWALLOWING APRAXIA: REPORT OF A RARE CASE ASSOCIATED WITH FRONTAL LOBE GLIOMA
    Kazutaka Goto, Yasuhiro Tsunemi, Chie Yoshida, Hiroaki Kanaya, Hideki ...
    2014 Volume 57 Issue 4 Pages 198-204
    Published: June 12, 2014
    Released on J-STAGE: August 15, 2015
    DOIhttps://doi.org/10.11453/orltokyo.57.198
    JOURNAL FREE ACCESS
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    　A 57-year-old male patient was emergently transferred to our institution after he lost consciousness in his vehicle. Careful neurological examinations led to the diagnosis of frontal lobe glioma. Chemoradiotherapy was administered with temozolomide and fractionated radiotherapy at 60 Gy. While his consciousness level gradually improved during the treatment, dysphagia and dysarthria became apparent. The patient was referred to our department for evaluation of the dysphagia. According to the first impression, he could not swallow, but nevertheless seemed desirous of oral intake. Video-assisted endoscopic and fluorographic examination revealed that he had no sensory or motor impairment of the lips, soft palate, tongue, pharynx or larynx. The pharyngeal phase of swallowing was considered normal, however, failure of the oral phase of swallowing was occasionally observed. Although he was able to swallow saliva unconsciously, he could not transport a bolus into the pharynx from the oral cavity if he felt something in his mouth. We made a final diagnosis, based on the clinical findings, of oral-phase swallowing apraxia complicating frontal lobe glioma. The site of involvement in this disorder was thought to be the neurotransmission pathway to the thalamus from the primary motor cortex in the cerebrum. In an attempt to restore the sensation for oral ingestion, the patient received rehabilitation with ingestion-mimicking therapy.
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  • THREE CASES OF CALCIFIC TENDINITIS OF THE LONGUS COLLI THAT NEEDED TO BE DIFFERENTIATED FROM RETROPHARYNGEAL ABSCESS
    Hijiriko Iwasaki, Fumio Miyashita, Satoshi Arai, Takao Saito
    2014 Volume 57 Issue 4 Pages 205-212
    Published: August 15, 2014
    Released on J-STAGE: August 15, 2015
    DOIhttps://doi.org/10.11453/orltokyo.57.205
    JOURNAL FREE ACCESS
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    　Calcific tendinitis of the longus colli is a disorder that manifests with acute-onset pain on swallowing and neck pain, as well as a limited range of motion of the neck as compensation for this pain, and is thought to be caused by inflammation resulting from hydroxyapatite deposition in the longus colli tendon. Due to its symptoms and the presence of prevertebral soft tissue swelling in the retropharyngeal region on diagnostic imaging, diagnosis of this disorder requires differentiation from retropharyngeal abscess and is often difficult. We encountered three cases of calcific tendinitis of the longus colli. In each case, a retropharyngeal abscess was initially suspected based on the symptoms, however, a definitive diagnosis of calcific tendinitis of the longus colli was made after characteristic calcifications were observed near the anterior tubercle of the atlas on lateral-view X-rays and contrast-enhanced computed tomographic images of the neck. The patients were treated with nonsteroidal anti-inflammatory drugs and antibiotics, and recovered with the conservative treatment. Calcific tendinitis of the longus colli differs from retropharyngeal abscess both in terms of the treatment strategy and the prognosis; therefore, it is necessary to differentiate between the two at an early stage.
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