JIBI INKOKA TEMBO
Online ISSN : 1883-6429
Print ISSN : 0386-9687
ISSN-L : 0386-9687
Volume 59, Issue 1
Displaying 1-20 of 20 articles from this issue
FEATURE ARTICLE
  • Hitome Kobayashi
    2016 Volume 59 Issue 1 Pages 12-18
    Published: February 15, 2016
    Released on J-STAGE: February 15, 2017
    JOURNAL FREE ACCESS

     Children with cleft palate (CP) often develop the complication of intractable otitis media with effusion. The increased risk of this complication in children with CP is attributable to Eustachian tube dysfunction. We previously reported that children with CP had a smaller mastoid air cell area than those without CP, and showed that the mastoid air cell area increased as the age advanced, although there was no significant increase in the area in response to ventilation tube (VT) placement. Of the CP patients treated by VT placement, approximately 30% were very intractable cases requiring such surgical measures as VT re-placement or tympanoplasty even at 6 years of age or later.

     It is recommended undergo a neonatal hearing screening test. Eardrum status should be evaluated before palatoplasty. When referred for a neonatal hearing screening test, hearing tests should be performed. When otitis media with effusion has been found to persist for 3 months or more, when the eardrum findings are poor, when there is clear bilateral hearing loss, and when there is language delay, VT placement should be performed. If at that time, the pathological changes in the eardrum are not prominent, prescribing a hearing aid may be considered. When eardrum status is very poor, an imaging examination should be considered. It is necessary to give a consideration to minimizing the impact of radiation exposure. Long-term follow-up is necessary.

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ORIGINAL PAPERS
  • Yuko Sasaki, Hideo Edamatsu
    2016 Volume 59 Issue 1 Pages 19-25
    Published: February 15, 2016
    Released on J-STAGE: February 15, 2017
    JOURNAL FREE ACCESS

     Introduction: Minimally invasive tympanoplasty (MIT) is defined in this study as an endoscopic endaural tympanoplasty, involving only a small skin incision for procuring graft and no large incision of the posterior external auditory canal. MIT has several advantages as compared to conventional tympanoplasty (CT) carried out using a surgical microscope.

     Material & Methods: We have performed type I tympanoplasty in 80 patients with chronic otitis media from January 2008 through December 2011. The patients' backgrounds and postoperative results were compared between 28 ears treated by MIT and 52 ears operated by CT. The number of MITs gradually increased to surpass the number of CTs from the year 2010. The width of the external auditory canal was measured by preoperative CT to determine whether the 2.7-mm-wide endoscope could be used for the endaural tympanoplasty.
     Results: The postoperative results in terms of the perforation closure rate, re-perforation rate, hearing improvement and operation time were similar between the cases treated by MIT and those treated by CT. The 2.7-mm-wide endoscope could be used in all cases, including all adults and all children. The endoscopic operative view was wider and clearer in MIT than in CT.
     Conclusion: MIT represents an endoaural approach for the treatment of tympanic perforation, involving only a small skin incision for fascial graft procurement and is applicable even to pediatric patients. MIT is less traumatic and provides a clearer operative view, and is therefore very useful and expected to be used increasingly widely in ear surgery.

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  • Kosuke Takabayashi, Masayoshi Nagamine, Taketoshi Fujita
    2016 Volume 59 Issue 1 Pages 26-30
    Published: February 15, 2016
    Released on J-STAGE: February 15, 2017
    JOURNAL FREE ACCESS

     Surgical repair for blow-out fractures aims to improve enophthalmos and eye movement.

     We examined the postoperative outcomes of 83 patients who had undergone surgery for blow-out fracture of the orbit at our department from April 2000 to April 2014. We examined the features of postoperative enophthalmos in the 47 cases for which both pre- and postoperative data were available. Except in cases with inferior-wall linear type fractures, we performed surgery using an endoscope to remove all the isolated splinters of bone. We used silicon plates and the balloon as needed.
     Among the cases of medial wall fracture in which surgery was performed, none of the patients felt their own enophthalmos. In cases of inferior-wall fractures, a correlation was observed between the fracture extent and the presence of postoperative enophthalmos. Among cases with both types of fracture, 25% felt their own enophthalmos, although no significant correlation was observed between the fracture area and the occurrence of postoperative enophthalmos.

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  • Taku Atsumi, Kosuke Saito, Motoki Sekine, Atsushi Harimaya, Satoshi Ki ...
    2016 Volume 59 Issue 1 Pages 31-35
    Published: February 15, 2016
    Released on J-STAGE: February 15, 2017
    JOURNAL FREE ACCESS

     We investigated the tissue penetration of garenoxacin mesilate hydrate (GRNX) into the site of infection in patients undergoing endoscopic sinus surgery for chronic rhinosinusitis. The subjects comprised nine chronic rhinosinusitis patients who were hospitalized to undergo endoscopic sinus surgery between June 2011 and January 2012. GRNX was administered orally for 7 days prior to the surgery. On the day of surgery, we measured the concentrations of GRNX in the blood (sample collected within 3 h of the drug administration) and in tissue samples collected intraoperatively. The mean blood concentration in the nine cases was 8.06±4.41 μg/mL and the mean tissue concentration was 6.98±2.82 μg/mL. Thus, the concentration exceeded the minimum inhibitory concentrations for the main pathogenic bacteria. These results suggest that GRNX offers high tissue permeation even in the sinus mucosa, which often tends to show poor tissue permeation. Thus, GRNX is expected to have effective antimicrobial activity, making it a useful antibiotic for cases of rhinosinusitis.

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