JIBI INKOKA TEMBO
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
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Volume 58, Issue 3
Displaying 1-9 of 9 articles from this issue
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FEATURE ARTICLE
ORIGINAL PAPERS
  • EVALUATION FOR CLASSIFICATION AND STAGING OF CONGENITAL CHOLESTEATOMA AT OUR DEPARTMENT
    Yuichiro Yaguchi, Kota Wada, Manabu Komori, Masaomi Motegi, Kazuhisa Y ...
    2015 Volume 58 Issue 3 Pages 145-152
    Published: June 15, 2015
    Released on J-STAGE: June 15, 2016
    DOIhttps://doi.org/10.11453/orltokyo.58.3_145
    JOURNAL FREE ACCESS
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    　The pathogenesis of congenital cholesteatoma is still unclear. Therefore, it is desirable to discover the disease at an early stage and administer appropriate treatment according to the disease stage. It would be important to classify and examine cases based on a unified standard among institutions. Although the Potsic classification has often been used, no unified progression-level classification of congenital cholesteatoma has been established in Japan. In addition to the classification of Potsic et al, we thought that the classification and staging of cholesteatoma proposed in 2010 is applicable to the progression-level classification of congenital cholesteatoma. We examined each patient using this classification and report some considerations for the staging of the disease. A total of 70 ears were treated surgically for congenital cholesteatoma from 1984 to 2010 at the Jikei University Hospital. Although the Potsic classification reflects better clinical outcomes, and is therefore convenient to use, it seems necessary to consider a feature of congenital cholesteatoma in this country, namely, that the posterior superior part is predominantly affected and the anterior superior part is less commonly involved. Moreover, the classification and staging of cholesteatoma proposed in 2010 is applicable to acquired cholesteatoma, whereas the pars tensa cholesteatoma classification and PTAM classification are considered to be applicable to the classification of congenital cholesteatoma. It would be desirable to consider progression-level classification in combination with the Potsic classification in the future.
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  • STRESS TEST IN OTORHINOLARYNGOLOGY
    Tomihiko Tsuji
    2015 Volume 58 Issue 3 Pages 153-157
    Published: June 15, 2015
    Released on J-STAGE: June 15, 2016
    DOIhttps://doi.org/10.11453/orltokyo.58.3_153
    JOURNAL FREE ACCESS
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    　We compiled the results of stress testing (using STAI: State-Trait-Anxiety-Inventory) in patients with ENT diseases admitted to our clinic in 2013. We categorized cases with STAI scores of IV and V into the high score group. High STAI scores were observed at high rates in several ENT disease groups: 47.1% (A-Trait: Trait anxiety) and 80.8% (A-State: State anxiety) in the “vertigo group,” comprising patients with peripheral vertigo and Meniere' disease; 50.0% (A-Trait) and 69.7% (A-State) in the “hearing-loss group,” comprising patients with sudden deafness, low-tone sudden deafness, etc.; 42.9% (A-Trait) and 57.1% (A-State) in the “abnormal sensation group,” comprising patients with laryngopharyngeal abnormal sensation and reflux esopagitis. These rates are much higher than the reported rate of 30～40% for healthy adults showing with STAI scores of IV or V. Our data show that stress is involved in these ENT diseases and also that the STAI is a useful tool for objectively quantifying the stress.
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  • A CASE OF IGG4-RELATED DISEASE MANIFESTED CEREBRAL NERVE DYSFUNCTION ASSOCIATED WITH ESOPHAGEAL CANCER
    Ryosuke Ueyama, Hiroaki Kanaya, Kazutaka Goto, Hideki Hirabayashi, Shi ...
    2015 Volume 58 Issue 3 Pages 158-163
    Published: June 15, 2015
    Released on J-STAGE: June 15, 2016
    DOIhttps://doi.org/10.11453/orltokyo.58.3_158
    JOURNAL FREE ACCESS
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    　We encountered a complicated case of a patient with IgG4-related disease who presented with left-sided recurrent laryngeal nerve paralysis associated with esophageal cancer and hypertrophic pachymeningitis. A 75-years-old male patient was referred to our department due to progressive hoarseness and swallowing disorder. A general check-up was planned to clarify the cause of those symptoms, and hypertrophic pachymeningitis and retroperitoneal fibrosis were detected by imaging examinations. An upper gastrointestinal endoscopic examination incidentally revealed a superficial esophageal tumor. The diagnosis of IgG4-related disease was made on the basis of the increased serum IgG4 level. We concluded that the recurrent laryngeal nerve paralysis was caused by the pachymeningitis. Histopathological examination of the resected esophageal tumor revealed findings consistent with squamous cell carcinoma associated with focal plasmacytic infiltration in the stroma. These plasmacytes were predominantly positive for IgG4. Since the recurrent laryngeal nerve paralysis remitted gradually, no corticosteroid treatment was administered. Otolaryngologists should bear in mind that recurrent laryngeal nerve paralysis can manifest as the primary symptom accompanied with pachymeningitis due to a partial lesion of IgG4-related disease.
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  • A CASE OF PAPILLARY CARCINOMA ARISING FROM A THYROGLOSSAL DUCT CYST
    Yuki Yoshida, Sachiko Omae, Masanori Shiwa, Hidetaka Akita, Shikofumi ...
    2015 Volume 58 Issue 3 Pages 164-168
    Published: June 15, 2015
    Released on J-STAGE: June 15, 2016
    DOIhttps://doi.org/10.11453/orltokyo.58.3_164
    JOURNAL FREE ACCESS
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    　A case of papillary carcinoma arising from a thyroglossal duct cyst is reported. A 26-year-old woman with IgA nephropathy was referred to our clinic for tonsillectomy. Although she did not have any symptoms, we felt a mass in her anterior neck. MRI showed a cystic tumor with a solid lesion. Fine-needle aspiration biopsy of the mass did not reveal any malignant cells. We resected the mass and performed tonsillectomy at the same time. Histopathological examination of the surgical specimen showed that the solid lesion contained a papillary carcinoma arising from a thyroglossal duct cyst. The postoperative examinations (CT scan, neck ultrasonography and PET-CT) revealed no thyroid cancer or metastatic lymph nodes. As the malignant lesion was limited to the cystic tumor, we followed the patient up without any additional treatment. Until now, one year since the surgery, she has shown no sign of recurrence.
    　Thyroglossal duct cyst has been reported to be infrequently (with a probability of 1-2%) associated with malignancy. We suggest that it is important to consider malignancy, especially when the cyst contains a solid component, and to take a careful aim at the lesion during fine-needle aspiration biopsy. Measurement of the serum thyroglobulin may also contribute to an accurate diagnosis.
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